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Caries Diagnosis and Management by Dentists and Dental Hygienists: A Pilot Study
M Bozia1, E Berkhout1, D E Slot1,2
1Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Background:
Dutch dental hygienists are trained to indicate, take, and interpret intraoral radiographs to diagnose and treat primary caries. Therefore, the aim of this pilot study was to explore whether the profession (dentists or dental hygienists) influences caries detection based on intraoral radiographs and the subsequent treatment plan.
Methods:
A total of 60 oral health care professionals participated, comprising 39 dentists and 21 dental hygienists. They were recruited in their clinical practice to assess a selection of 28 radiographs for caries depth diagnosis and treatment option selection. Analyses included subanalyses based on gender and clinical experience. Statistical analyses were performed using linear mixed models, Bland-Altman plot, and intraclass correlation coefficient (ICC) analysis to test interexaminer reproducibility.
Results:
No significant differences were observed between dentists and dental hygienists in diagnostic ability or treatment decisions. Clinical experience had a significant effect on the caries depth score (P = 0.004). Gender had a significant effect on the treatment decision (P = 0.018). The ICC score for dentists assessing caries depth using the International Caries Detection and Assessment System was 0.782, and for dental hygienists, it was 0.758. For agreement on treatment options, dentists had an ICC of 0.708, while dental hygienists had 0.651.
Conclusion And Clinical Relevance:
In the relatively small group studied, no significant differences were observed between dentists and dental hygienists in diagnostic ability or treatment decisions. However, the study was not powered to demonstrate equivalence. The method proved feasible, and clinical experience and gender emerged as factors to include in future studies.Knowledge Transfer Statement:In this pilot study, dentists and dental hygienists showed comparable radiographic caries detection and treatment decisions in a relatively small group of practitioners. The findings demonstrate the feasibility of the assessment method and identify clinical experience and gender as factors that future research should take into account. For policymakers and researchers, the results provide preliminary evidence and a basis for the design of future studies on the redistribution of diagnostic tasks within oral health care.