Assessment of caries experience in epidemiological surveys: a review

To review aspects of methods for assessing caries experience (CE) in epidemiological surveys.

A search of English language literature published between January 2000 and December 2008 was undertaken using 'epidemiology', 'dental caries' and 'assessment' as search terms. Information on criteria for CE assessment, materials and settings, diagnostic threshold, training of examiners and validation of the screening results was extracted from the reports.

Eighty-nine reports met the inclusion criteria. In 9 of the reports (10%) no reference was made to existing standardisation criteria for assessment of CE. Light condition applied (60 reports, 67%) and the use of a probe (60 reports, 67%) were frequently reported. Most reports mentioned that training and calibration of examiners took place, but the outcome of reliability checks were often not presented (48 reports, 54%). Only 28 of the reports (32%) specified that cleaning took place before the examination. Journals with Impact Factor (IF) provided specific information on methods more frequently than journals without. The WHO Basic Methods for Oral Health Surveys were most often applied (52 surveys, 58%). However, deviations from the original description were found especially for measurement and reporting of reliability measurement (24, 46% and 29, 56% respectively), type of probe used (27, 52%) and light condition (16, 31%). All of these hamper the (external) validity of the obtained results.

There is a clear need for improvement of the reporting and application of methods for assessing CE in epidemiological surveys. A check-list of aspects of methods to be included in reports of surveys assessing CE is proposed by the authors.