title: Influence of examiner's clinical experience in detecting occlusal caries lesions in primary teeth.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effect of examiner's clinical experience in detecting occlusal caries lesions in primary teeth using visual inspection and the diode laser fluorescence (LF) method.
  
  
  METHODS
  Eighty-seven suspected occlusal sites in 50 exfoliated or extracted primary molars were evaluated via the visual inspection and LF (DIAGNOdent) by 3 last-year dental students, 3 recent graduate dentists, and 3 pediatric dentistry specialists. After the examination, the teeth were cut and evaluated in stereomicroscope. Sensitivity, specificity, and accuracy were calculated, and the values were compared using the McNemar change test at the enamel and dentin caries lesion thresholds. The means of Cohen's kappa values among the different groups of examiners were compared with the ANOVA and Student-Newman-Keuls test.
  
  
  RESULTS
  At the enamel caries lesions threshold, there was no difference in accuracy among the different groups of examiners using both the methods. At the dentin caries threshold, however, the students achieved the worst results using visual inspection. Nevertheless, regarding visual inspection, the dental students presented higher sensitivity and lower specificity than the other examiner groups at both thresholds. When using the LF method, there was no significant difference among the parameters, and the interexaminer agreement was higher.
  
  
  CONCLUSIONS
  Detecting caries lesions with the laser fluorescence device presents lower variation with respect to the examiner's experience.
authors.affiliation: Department of Pediatric Dentistry, Faculty of Dentistry, Metropolitan University of Santos, Santos, Brazil.
authors.forename: Antonio Lucindo
authors.initials: AL
authors.lastname: Bengtson
authors.forename: Ana Catarina
authors.initials: AC
authors.lastname: Gomes
authors.forename: Fausto Medeiros
authors.initials: FM
authors.lastname: Mendes
authors.forename: Loty Rosana Damy
authors.initials: LR
authors.lastname: Cichello
authors.forename: Nadya Galvão
authors.initials: NG
authors.lastname: Bengtson
authors.forename: Sérgio Luiz
authors.initials: SL
authors.lastname: Pinheiro
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002675:Child, Preschool; D002983:Clinical Competence; D003731:Dental Caries / Q000175:diagnosis*; D003732:Dental Caries Activity Tests; D003815:Dentists; D005453:Fluorescence; D006801:Humans; D007834:Lasers; D008963:Molar / Q000473:pathology; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013335:Students, Dental; D014094:Tooth, Deciduous / Q000473:pathology