Observer's Confidence in Occlusal Caries Detection

Objectives: To examine how observer's background and different caries detection methods influenced the observer's confidence in placing their diagnosis. Material and methods: The material comprised 80 extracted molars and premolars, presenting as occlusal surfaces, both sound and with a variety of carious lesions. Ten dentists examined the material, five of them had work experience of more than 10 (average 19 years) and five had less than 10 years (average 5 years). They examined radiographic images, DIFOTI images and teeth visually, on separate appointments. Occlusal surfaces were graded on a 5 point scale: 0= definitely not caries, 1=probably not caries, 2=questionable, 3=probably caries and 4=definitely caries. They were also asked to grade the surfaces on a 5point scale with respect to the extent of the caries lesion Results: The more experienced dentists showed greater confidence in placing their diagnoses for all three detection methods. On average, the more experienced group was confident in their diagnosis for 76.5% of surfaces when using DIFOTI, 72% when using radiographs and 64.5% for visual inspection. The results for the less experienced group were 42.8% for DIFOTI, 56.8% for radiographs and 53.8% for visual inspection. The difference was though non-significant between groups or methods. Non-significant difference was observed between groups in the accuracy of their diagnosis concerning the extent of the lesions. Conclusions: Increased work experience results in more confidence in placing occlusal caries diagnosis but does not necessarily increase the accuracy of the diagnosis.