Radiographic detection of approximal caries: a comparison between senior dental students and senior dental hygiene students.
OBJECTIVE
Dental hygienists do not legally (or definitively) diagnose caries, but they often are responsible for preliminary interpretation of bitewing (BW) radiographs taken during prophylaxis appointments. Given this custom of practice, it is important to understand whether there is a difference between the capabilities of dental hygienists and dentists in interpreting BWs based on education and clinical experience. This study compared proximal carious lesion classification from BWs by senior dental students and senior dental hygiene students.


METHODS
Volunteers (40 dental [D] and 54 dental hygiene [DH] students) classified proximal carious lesions from BWs of 96 extracted teeth, which were mounted in wax to simulate quadrants of the mouth. A soft tissue equivalent was placed in front of the mounted teeth before x-ray exposure. Films were developed automatically and mounted into six sets point scale. The teeth were sectioned vertically and evaluated clinically at 5x magnification with an explorer. The "gold standard" of carious lesion classification was then compared to the students' classifications.


RESULTS
All students detected 54% of the carious lesions and correctly identified lack of caries 80.5% of the time. There were no differences between the two groups of students in terms of sensitivity, but dental students showed higher specificity (p = 0.0006).


CONCLUSIONS
Permitting dental hygienists to make preliminary interpretations of caries from BWs in the dental office appears to be an acceptable practice.
Wojtowicz
Patricia A
PA
Department of Oral Medicine, Pathology and Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Brooks
Sharon L
SL
Hasson
Hana
H
Kerschbaum
Wendy E
WE
Eklund
Stephen A
SA
D001641:Bicuspid / Q000000981:diagnostic imaging / Q000473:pathology; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003731:Dental Caries / Q000145:classification / Q000000981:diagnostic imaging*; D003756:Dental Hygienists / Q000193:education* / Q000706:statistics & numerical data*; D004497:Education, Dental / Q000592:standards; D006801:Humans; D008824:Michigan; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013335:Students, Dental / Q000706:statistics & numerical data*