Do tooth gaps matter? Evaluation of self-assessments: a pilot study

This study aimed to test the hypothesis stating no difference in number of teeth or tooth gaps counted by the dentist or the patient. The sample consisted of 49 randomly selected regular patients and their dentists (response rate 10%, 53% males). Mean age of the patients was 53.6 +/- 11.9 years. The mean number of teeth was 26.5, 20/49 reported tooth gaps (excluding second and third molars) and 12/20 had visible gaps. The calculation of patients' detection of gaps showed a sensitivity = 79%, specificity = 96% and a positive predictive value of 95%. The patients reported more teeth in the maxilla and fewer teeth in the mandible compared with their dentists. More teeth were misdiagnosed as the number of teeth increased in the mandible. Patients reported more gaps than dentists in both jaws (NS); an average of 0.04, 0.18 and 0.22 misdiagnosed gaps in the maxilla, mandible and for both jaws respectively. Agreement on tooth present/missing in the maxilla was 91.3% (+/-9.82) and in the mandible 88.2% (+/-10.44). Correlation between self-report and dentist's report of the number of teeth present and the number of gaps in the maxilla was (Pearson's r) 0.94 and 0.83. One person with self-perceived visible gaps and five persons with non-visible gaps were recommended treatment; two persons agreed about a treatment need. Self-assessments of tooth gaps show limited but acceptable sensitivity and excellent specificity. No significant differences in tooth counting were found when comparing self-reports and dentists' reports. The study should be tried on a larger scale.