Diagnosis of occlusal caries in primary teeth

Much research has been published over the last few years looking at alternative diagnostic systems for the diagnosis of occlusal caries in permanent teeth, but there has been little research on primary teeth. The aim of this study was to compare the accuracy of one alternative system (the Electronic Caries Monitor [ECM]) against visual diagnosis for the detection of occlusal dentine caries in primary teeth. Fifty-eight apparently noncavitated extracted first and second primary molars were selected. They were examined visually and with the ECM for dentine caries. Presence or absence of caries was validated by hemisecting the teeth and examining them under a stereomicroscope--37 teeth had occlusal dentine caries, 21 were sound or had enamel caries. Sensitivities and specificities of the ECM diagnoses were 0.81 and 0.90, respectively, and for the visual diagnosis were 0.73 and 1. In conclusion, the ECM did not provide increased accuracy over visual diagnosis when detecting occlusal caries in primary teeth.