A new equine peripheral caries grading system: Are the caries likely active or inactive?

Area of Science:

• Veterinary Dentistry
• Equine Health
• Diagnostic Imaging

Background:

• Equine peripheral caries presents a significant welfare concern for horses.
• Accurate assessment of caries activity (active vs. inactive) is crucial for effective management.
• A novel grading system aims to improve the determination of caries status.

Purpose of the Study:

• To evaluate the reliability of an alternative grading method for equine peripheral caries.
• To compare the new grading system with traditional methods.

Main Methods:

• An online survey was distributed to veterinary surgeons.
• Twenty-two reviewers assessed peripheral caries images using traditional, research, and clinical grading systems.
• Agreement was measured using percentage agreement and Fleiss' kappa.

Main Results:

• Both new grading systems demonstrated higher Fleiss' kappa values (0.48-0.58) compared to the traditional method (0.40).
• Over 80% agreement was achieved in classifying caries as active or inactive using both systems.
• Reviewer feedback was positive, with over 90% indicating likely adoption of the new system.

Conclusions:

• The new grading system provides consistent estimates of caries severity.
• High agreement on active/inactive status assists practitioners in determining necessary interventions.
• Image quality and assessment of dentin without occlusal views posed minor challenges.