title: Caries-based treatment need assessment by clinical dental nurses in Anguilla, British West Indies.
abstract: OBJECTIVE
  To determine the ability of dental nurses in Anguilla to assess treatment need following training in WHO criteria.
  
  
  METHODS
  Sixty-six randomly selected schoolchildren aged 6, 9, 12, 14, 15 and 17 years.
  
  
  METHODS
  Point prevalence study involving three different groups of schoolchildren [n = 20 (C0), 23 (D1), 23 (D2)] and four plaster casts comprising 52 extracted teeth (T0).
  
  
  METHODS
  Tooth- and person-based inter and intra-examiner agreement.
  
  
  METHODS
  The only three government dental nurses in Anguilla were trained and calibrated by a benchmark dentist in June 2000 using WHO criteria. Tooth-based Treatment Need and person-based Treatment Urgency were assessed during 466 evaluations involving 1,733 teeth. Examiner agreement levels were compared during two calibration exercises (T0, C0) and two duplicate examinations (D1 and D2). The treatment components were classified as preventive (diet modification, prophylaxis, OHI, sealants); restorative (restorations, pulp care and crowns); and rehabilitative (tooth removal).
  
  
  RESULTS
  All scores presented are Kappa scores. Substantial agreement was obtained at T0 (0.614-0.764), and almost perfect agreement at C0(0.832-0.872), D1(0.917-0.954) and D2(0.966-0.977). Almost perfect reliability occurred at C0(0.963-0.991) and D1(0.971-0.992) while perfect reliability was attained by all examiners at D2(1.0). Substantial and almost perfect agreement was obtained for all treatment modalities irrespective of caries prevalence and severity. Agreement levels increased as the survey progressed. Perfect agreement was obtained for all categories of treatment urgency.
  
  
  CONCLUSIONS
  Dental nurses in Anguilla can validly and reliably assess treatment need provided training is adequate, of realistic duration and they are involved in all aspects of the exercise.
authors.affiliation: Oral Healthcare Solutions, Tunapuna, Trinidad, West Indies.
authors.forename: Adenike Adejoke
authors.initials: AA
authors.lastname: Adewakun
authors.forename: Bennett Tochukwu
authors.initials: BT
authors.lastname: Amaechi
mesh_terms: D000293:Adolescent; D002648:Child; D002983:Clinical Competence; D004245:DMF Index; D003727:Dental Auxiliaries; D003731:Dental Caries / Q000175:diagnosis*; D006801:Humans; D020380:Needs Assessment; D015588:Observer Variation; D015203:Reproducibility of Results; D014900:West Indies