title: Validation of the digital photographic assessment to diagnose traumatic dental injuries.
abstract: BACKGROUND
  Alternatives for monitoring dental trauma in epidemiological surveys may be useful, as data collection of epidemiological investigation can be jeopardized due to several conditions.
  
  
  OBJECTIVE
  To investigate the validity of standard digital photographs to determine the occurrence of anterior dental trauma compared to the clinical examination in an epidemiological survey.
  
  
  METHODS
  Participants were children aged 8-12 years old attending both private and public schools; children were clinically evaluated for the assessment of dental trauma, and standard photographs were taken from maxillary and mandibular permanent incisors of each child. Validity was determined by calculating the percentages and respective 95% confidence interval of sensitivity, specificity, positive predictive value, and negative predictive value. Cohen's kappa statistic was also used.
  
  
  RESULTS
  A total of 412 children were included, totaling 3296 teeth assessed for dental trauma presence. The prevalence of dental trauma was 11.2% (95% CI 8.29-14.61) and 10.2% (95% CI 7.45-13.53), respectively, for the clinical examination and the photographic method. Agreement between the gold standard and the photographic diagnosis was good: 0.64 for the prevalence of dental trauma and 0.66 for diagnosis of dental trauma on a tooth basis. The diagnosis through the photographic method had higher specificity (96.7%) than sensitivity (65.2%). High positive likelihood ratio and low negative likelihood ratio were also observed.
  
  
  CONCLUSIONS
  The photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination.
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Gabriela dos Santos
authors.initials: Gdos S
authors.lastname: Pinto
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.|Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
authors.forename: Marília Leão
authors.initials: ML
authors.lastname: Goettems
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Letícia Coutinho
authors.initials: LC
authors.lastname: Brancher
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Fernando Barcellos da
authors.initials: FB
authors.lastname: Silva
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Gregori Franco
authors.initials: GF
authors.lastname: Boeira
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.|Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Marcos Britto
authors.initials: MB
authors.lastname: Correa
authors.affiliation: Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Iná da Silva dos
authors.initials: Ida S
authors.lastname: Santos
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Dione Dias
authors.initials: DD
authors.lastname: Torriani
authors.affiliation: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.|Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
authors.forename: Flávio Fernando
authors.initials: FF
authors.lastname: Demarco
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D023861:Photography, Dental / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018677:Tooth Injuries / Q000000981:diagnostic imaging*
keywords: dental photography; dental trauma; sensitivity; specificity