[Clinical assessment of oral health between physician and dentist--a pilot study on inter-examiner reliability].
OBJECTIVE
Very little is known about the ability of physicians to assess oral health of geriatric patients. The aim of this pilot study was to assess the in ter-examiner reliability in assessment of oral health for a dentist and a physician, and to evaluate the influence of training in dental findings for the physician on inter- examiner reliability.


METHODS
Inter-examiner reliability between a physician and a dentist was tested in a primary geriatric hospital with 126 participants 60 years old or more (mean 77 years; 32% men) using the Revised Oral Assessment Guide (ROAG) and additional items relating to caries and dentures (14 items). Calculated were kappa-coefficients, and percentage agreement between the examiners before (n = 50) and after (n = 51) training for the physician in dentistry (n = 25 for the common training session).


RESULTS
Before the training both kappa-values and percentage agreement were not acceptable in the different categories. After the training, with the exception of the categories swallow and tongue, the reliability of all items was moderate or good. The number of occasions on which the physician underestimated the clinical finding compared to the dentist - indicating a clinical finding was overlooked - decreased for every item; for retention of denture and decayed teeth this decrease was significant.


CONCLUSIONS
Screening for oral health performed by a physician was insufficient regarding the different clinical aspects. Training in the use of an oral health assessment tool improved the reliability of the screening. Because of the low number of examiners the results should be interpreted as a pilot investigation on this new topic.
Hassel
Alexander J
AJ
Poliklinik für Zahnärztliche Prothetik, Universität Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. alexander.hassel@med.uni-heidelberg.de
Leisen
Joachim
J
Rolko
Claudia
C
Rexroth
Walter
W
Ohlmann
Brigitte
B
Rammelsberg
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D004245:DMF Index; D016321:Dental Care for Aged; D003778:Dentures; D005260:Female; D005853:Geriatrics; D005858:Germany; D006782:Hospitals, Special; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009911:Oral Hygiene Index; D010348:Patient Care Team