Clinical Versus Radiographic Caries Diagnosis in Primary Tooth Approximal Surfaces.

Area of Science:

• Dentistry
• Pediatric Dentistry
• Dental Public Health

Background:

• Accurate diagnosis of dental caries is essential for effective treatment and public health assessments.
• Clinical examination alone may not detect all carious lesions, potentially leading to underestimation of disease prevalence.

Purpose of the Study:

• To compare the diagnostic accuracy of clinical examination versus radiographic examination for approximal carious lesions in dentin.
• To quantify the underdiagnosis of caries by clinical examination alone in high-caries-risk children.

Main Methods:

• Eighty-four high-caries-risk Amish children (2-11 years) were examined clinically and radiographically.
• Approximal carious lesions were identified using standard epidemiological and radiographic criteria.
• McNemar's test was used to compare lesion detection rates between clinical and radiographic methods.

Main Results:

• For anterior approximal surfaces, clinical exam missed 9% of lesions detected by radiographs.
• For posterior approximal surfaces, clinical exam missed 31.1% of lesions detected by radiographs.
• Overall, clinical examination significantly underestimated caries prevalence compared to radiographic examination.

Conclusions:

• Clinical examinations without radiographs significantly underestimate the prevalence of approximal carious lesions in children.
• Radiographic examination is essential for accurate caries diagnosis in epidemiological studies and clinical trials involving children.
• Integrating radiographic assessments can improve the reliability of dental caries data in pediatric populations.