title: General dental practitioners diagnostic and treatment decisions related to fissure sealed surfaces.
abstract: OBJECTIVE
  The purpose of this in-vitro study was to assess the validity and reproducibility of the diagnosis and treatment planned for occlusal surfaces prior to and following the placement of a clear sealant by a sample of general dental practitioners (GDPs).
  
  
  METHODS
  160 permanent posterior teeth were examined by 25 GDPs. The GDPs were not given any criteria and were therefore free to diagnose and plan care, as they felt appropriate. Each GDP conducted four examinations, two prior to and two after sealing. The teeth were serially sectioned to provide the validating criterion.
  
  
  RESULTS
  After sealant placement, there was a statistically significant increase in specificity and decrease in sensitivity of both diagnostic and treatment decisions. The reproducibility expressed by the kappa-statistic was of the order of 0.5 prior to and after sealing with regard to diagnostic decisions. There was a general tendency to diagnose less disease after placement of a sealant (P<0. 001). There was also significantly less care (preventive or restorative) planned after sealant placement (P<0.001).
  
  
  CONCLUSIONS
  The placement of a sealant resulted in the diagnosis of less disease and less restorative treatment. This may be appropriate as evidence exists to support the use of sealants as caries therapeutic agents.
authors.affiliation: Dental Health Services Research Unit, Dental Hospital and School, University of Dundee, Park Place, Dundee, UK. c.h.deery@dundee.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Deery
authors.forename: H E
authors.initials: HE
authors.lastname: Fyffe
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Nugent
authors.forename: N M
authors.initials: NM
authors.lastname: Nuttall
authors.forename: N B
authors.initials: NB
authors.lastname: Pitts
mesh_terms: D001641:Bicuspid; D002648:Child; D003657:Decision Making; D003750:Dental Fissures / Q000175:diagnosis* / Q000628:therapy; D003793:Dental Restoration, Permanent; D005792:General Practice, Dental; D006801:Humans; D008963:Molar; D015588:Observer Variation; D010347:Patient Care Planning; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D019239:Practice Patterns, Dentists'; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D010895:Pit and Fissure Sealants