Influence of examiner's clinical experience in detecting occlusal caries lesions in primary teeth

The purpose of this study was to evaluate the effect of examiner's clinical experience in detecting occlusal caries lesions in primary teeth using visual inspection and the diode laser fluorescence (LF) method.

Eighty-seven suspected occlusal sites in 50 exfoliated or extracted primary molars were evaluated via the visual inspection and LF (DIAGNOdent) by 3 last-year dental students, 3 recent graduate dentists, and 3 pediatric dentistry specialists. After the examination, the teeth were cut and evaluated in stereomicroscope. Sensitivity, specificity, and accuracy were calculated, and the values were compared using the McNemar change test at the enamel and dentin caries lesion thresholds. The means of Cohen's kappa values among the different groups of examiners were compared with the ANOVA and Student-Newman-Keuls test.

At the enamel caries lesions threshold, there was no difference in accuracy among the different groups of examiners using both the methods. At the dentin caries threshold, however, the students achieved the worst results using visual inspection. Nevertheless, regarding visual inspection, the dental students presented higher sensitivity and lower specificity than the other examiner groups at both thresholds. When using the LF method, there was no significant difference among the parameters, and the interexaminer agreement was higher.

Detecting caries lesions with the laser fluorescence device presents lower variation with respect to the examiner's experience.