Validity of oral health screening in field conditions: pilot study

This small pilot study examined the validity of visual dental hygiene screenings (VDHS) in conditions found in local communities.

A sample of 126 children in kindergarten through second grade was screened by 2 dental hygienists and inspected by a dentist. None of the assessors had more than minimal experience and training in epidemiological methodologies. Two dental hygienists noted teeth as decayed or not decayed using only a tongue blade and a goose-neck lamp (VDHS). The dentist noted decay by tooth and surface using a mirror, explorer, portable dental chair, as well as a goose-neck lamp; this examination is referred to as a mirror, tactile dental inspection (MTDI). The dentist's assessment (MTDI) was the "gold standard." Data were analyzed using frequency distributions, sensitivity, specificity, and kappa coefficient statistics, as well as other statistics to test the significance of differences and to investigate explanations for discrepancies between the VDHS and MTDI.

Sensitivity and specificity for the VDHS for all teeth were 61% and 96%, with a kappa coefficient of 0.6. Analysis of the discrepancies between the VDHS and the MTDI suggest that, for primary teeth, the sensitivity of the VDHS is greater when: (1) lesions are large (i.e. multi surface) and (2) single surface lesions are located anteriorly. No statistically significant explanations were found for differences in permanent teeth.

In this study, VDHS demonstrated high specificity and moderate sensitivity for caries identification.