Nursing caries in Head Start children, St. Thomas U.S. Virgin Islands: assessed by examiners with different dental...

The purposes of this study were to determine the prevalence of nursing caries in 3- to 5-year-old Head Start (HS) children on St. Thomas, U.S. Virgin Islands and to assess the reliability of examiners with different dental backgrounds. A dentist, hygienist, and nondental HS personnel participated in a 1/2 day training session (lecture and workshop) and then independently conducted visual examinations for caries of the maxillary anterior teeth including nursing caries. Twenty-three HS personnel examined a total of 375 children; the dentist and hygienist examined a random sample of 74 and 73 children, respectively. Seventy-one children received all three independent examinations. Reliability was assessed by percent agreement, sensitivity, specificity, and kappa value. The dentist found 41% of the children had caries of the maxillary incisors, which included nursing caries. The percentage of children with nursing caries was 12%. There was strong-to-good diagnostic agreement between the dentist and hygienist. The HS personnel also found that 12% of the children had nursing caries, but the diagnostic agreement between the dentist and HS personnel was only good-to-fair.