Sensitivity and specifity of methods of caries detection amongst students

OBJECTIVE: Detection of initial caries in pits and fissures is a problem during clinical examination of teeth. Traditional diagnostic methods (radiographic, tactile and visual) exhibit low sensitivity, but high specificity. Sensitivity refers to the correct recognition of carious teeth, whereas specificity refers to the correct recognition of sound teeth. The low sensitivity of traditional methods may result in under treatment of initial carious lesions, thereby allowing the caries disease process to progress and making treatment more complex. The more accurately the carious lesion can be diagnosed the sooner the correct treatment can be performed. Laser technology (Diagnodent pen) is available to detect and quantify caries. This in vitro study compared the sensitivity and specificity between the traditional diagnostic methods and laser. Histological diagnosis was used as the control/gold standard.

METHODS: In 2008, eight BDS V dental students assessed 29 extracted molars for pit and fissure caries using traditional methods and a laser device (Diagnodent pen). These results were compared with histological analysis which acted as the control/gold standard. RESULTS: With radiographic examination the mean sensitivity value was 41.48% and mean specificity value was 69.64%. With visuotactile examination the mean sensitivity value was 38.07% and mean specificity value was 98.15%. With the Diagnodent pen device the sensitivity was 59.09% and specificity was 100%.

CONCLUSION: The results show that the Diagnodent pen as the better tool for the diagnosis of occlusal pit and fissure caries compared to the traditional diagnostic methods.