title: Comparison of epidemiological evaluations under different caries diagnostic thresholds.
abstract: OBJECTIVE
  To investigate the influence of different settings, epidemiological and clinical, and different diagnostic thresholds on caries detection in a group of 7-10-year-old children in Brazil.
  
  
  METHODS
  In total, 983 children aged 7-10 years old and enrolled in four public schools were randomly selected. Three examiners performed epidemiological examinations followed by an examination of the same children in a clinical setting. The examinations of cleaned and dried teeth in both settings were carried out using a dental mirror and ball-ended probe, under natural light in the epidemiological setting examinations and under artificial light during the clinical setting examinations. For the analysis of results, comparisons were focused on WHO (World Health Organization) diagnostic thresholds versus WHO+IL (initial lesions) diagnostic thresholds, both under epidemiological conditions, in order to demonstrate the influence of the inclusion of IL in the study; and WHO+IL in the epidemiological setting versus WHO+IL in the clinical setting, aiming to demonstrate the importance of examination setting. Outcome measures were dmfs, DMFS, ds, Ds, sealants and number of children 'free' of caries. Paired t-test and McNemar's test were used to test the difference between means and proportions for each age group.
  
  
  RESULTS
  Epidemiological examinations, under the WHO diagnostic threshold, showed significant differences for all outcome measures when compared with the WHO +IL threshold. Statistical differences were also detected when comparingthe WHO+IL threshold under different settings.
  
  
  CONCLUSIONS
  The choice of a diagnostic threshold (WHO or WHO+IL) and the conditions of examination (epidemiological or clinical) were important for caries detection.
authors.affiliation: School of Dentistry of Piracicaba - State University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, SP 13414-900, Brazil.
authors.forename: Ariana Bellotto Correa
authors.initials: AB
authors.lastname: Kassawara
authors.forename: Andréa Videira
authors.initials: AV
authors.lastname: Assaf
authors.forename: Marcelo de Castro
authors.initials: Mde C
authors.lastname: Meneghim
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Pereira
authors.forename: Gail
authors.initials: G
authors.lastname: Topping
authors.forename: Katy
authors.initials: K
authors.lastname: Levin
authors.forename: Gláucia Maria Bovi
authors.initials: GM
authors.lastname: Ambrosano
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D004245:DMF Index; D003731:Dental Caries / Q000175:diagnosis* / Q000453:epidemiology; D003753:Dental Health Surveys; D019229:Dentition, Permanent; D006801:Humans; D008029:Lighting; D015588:Observer Variation; D010895:Pit and Fissure Sealants; D014094:Tooth, Deciduous; D014944:World Health Organization
chemical_list: D010895:Pit and Fissure Sealants