scholarly journals A Hands-On Exercise on Caries Diagnostics among Dental Students—A Qualitative Study

2021 ◽  
Vol 9 (10) ◽  
pp. 113
Author(s):  
Heidi Kangas ◽  
Saujanya Karki ◽  
Tarja Tanner ◽  
Anne Laajala ◽  
Helvi Kyngäs ◽  
...  
Keyword(s):  
Content Analysis ◽  
Qualitative Study ◽  
Learning Experience ◽  
Dental Students ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Caries Diagnostics ◽  
Hands On ◽  
Caries Lesions

According to current care practices, the aim is to prevent the onset of caries lesions and to stop the progression of incipient lesions. A visual lesion assessment system, International Caries Detection and Assessment System (ICDAS), has been developed to promote reliability and repeatability of assessment of different stage caries lesions. The aims of this study were to evaluate the experiences of a hands-on exercise with authentic teeth as an adjunct to lecturing among third-year dental students and to evaluate the learning process during the hands-on exercise measured by qualitative (inductive content) analysis of the given feedback. In 2018, 51 third-year dental students at the University of Oulu, Finland, participated in a hands-on exercise on caries detection, where they assessed the depth and activity of lesions in extracted teeth using the ICDAS classification. After the lecture, students evaluated the exercise, giving feedback according to five given topics, three of which were analyzed using inductive content analysis. The exercise was considered useful and necessary but, overall, also challenging. The diverse activities and materials, as well as observational methods, promoted learning. The classification of lesions, the diagnostic methods, and the fact that there was not enough time to adopt things during the exercise were found to be challenging. For developing the exercise, the students suggested that more time should be scheduled for it and there should be more individual teaching. This qualitative study showed that, despite the challenge in caries diagnostics, dental students perceive the hands-on exercise as both a communal and individual learning experience.

scholarly journals Influence of Examiner Experience on Clinical Performance of Visual Inspection in Detecting and Assessing the Activity Status of Caries Lesions

2013 ◽  
Vol 38 (6) ◽  
pp. 583-590 ◽  
Author(s):  
T Gimenez ◽  
DG Bittar ◽  
C Piovesan ◽  
CAB Guglielmi ◽  
KY Fujimoto ◽  
...  
Keyword(s):  
Clinical Features ◽  
Visual Inspection ◽  
Dental Treatment ◽  
Pediatric Dentistry ◽  
Dental Students ◽  
Assessment System ◽  
Caries Detection ◽  
Caries Activity ◽  
Caries Lesions ◽  
Different Levels

SUMMARYOur hypothesis was that a method of caries activity evaluation based on the clinical features of the lesions would be less time consuming but more influenced by the examiner's experience than the scoring system used in association with the International Caries Detection and Assessment System (ICDAS). Thus, the aim of this study was to evaluate the performance of three groups of examiners with different levels of experience using two different methods to assess the activity status of caries lesions by visual inspection. A cross-sectional study in a dental office setting was performed selecting 18 children, aged three to eight years, who had sought dental treatment at a dental school. Examinations to detect caries lesions were performed using visual inspection by six examiners with different levels of experience: two undergraduate dental students, two specialists in pediatric dentistry, and two graduate students. The examiners used ICDAS and two different methods to assess caries activity: using an additional score system or considering the examination of clinical features. Two benchmark examiners examined the children in a joint session, and their consensus was considered to be the reference standard. The sensitivity, specificity, and reproducibility were calculated for different thresholds: all, cavitated, and active caries lesions. Multilevel analyses were performed to compare the different methods and examiners. No differences were observed among the examiners, either in detecting all lesions and cavitated lesions or regarding the activity assessment. The methods of assessing activity status performed similarly, but the time spent on examinations was shorter for the method evaluating clinical features. In conclusion, the experience of examiners does not significantly influence the performance of visual inspection, and both methods of assessing activity status result in similar diagnostic accuracy.

scholarly journals Comparison of Laser Fluorescence and Digital Radiograph with International Caries Detection and Assessment System in Primary Teeth (In-vivo study)

2021 ◽  
Vol 17 (14) ◽  
Author(s):  
Rana Kassab ◽  
Nayer Abo Elsaad ◽  
Shiern Badr
Keyword(s):  
Primary Teeth ◽  
Clinical Performance ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Bitewing Radiography ◽  
Diagnodent Pen ◽  
Icdas Ii ◽  
Caries Lesions

Background: There has been an increased incidence of dental caries in children due to recent changes in lifestyle. More sensitive and reproducible diagnostic tools for precise caries detection in children are needed because of the complex occlusal anatomy. Aim: To compare the clinical performance and accuracy of international caries detection and assessment system-II (ICDAS II) versus DIAGNOdent pen and digital bitewing radiograph in the detection of occlusal caries in the primary teeth. Materials and Methods: Fifty children aged 6-11 years were assessed of both gender (29 girls and 21 boys) and 377 occlusal surface of primary teeth were examined by visual ICDAS II, DIAGNOdent pen and digital bitewing radiographic examination at D0 (non caries lesions), D1 (lesions limited to enamel) and D2 (lesions limited to dentin) thresholds. Results: Sensitivity at D0 for ICADS II was 14.23% and 95.95% for DIAGNOdent pen and 87.85% for digital bitewing, radiographs while specificity for both ICADS II and bitewing radiographs were 99.23% but 73.85% for DIAGNOdent pen. At D1, threshold sensitivity of ICADS II and digital bitewing radiographs were higher than DIAGNOdent pen but specificity for bitewing radiographs and DIAGNOdent pen 90.69% - 87.99%. were highly significant than ICADS II At D2, threshold specificity for all diagnostic methods was almost similar with better sensitivity for ICADS II and digital bitewing radiographs. Conclusion: This study showed that ICDAS II, Diagnodent pen, and bitewing radiography are effective for the detection of occlusal caries for primary molars. Digital bitewing radiography correlated stronger with ICDASII than Diagnodent pen and proved to be the best method to detect occlusal lesions within the dentin in primary molars while Diagnodent pen and bitewing radiography are better for detecting enamel caries lesion. In addition, the clinical performance of three diagnostic methods was insufficient to detect occlusal caries lesions separately. Consequently, it is advisable to use a combination of diagnostic methods, especially in unclear cases, as well as in cases of initial lesions and their monitoring.

scholarly journals Metabolic Profile of Supragingival Plaque Exposed to Arginine and Fluoride

2019 ◽  
Vol 98 (11) ◽  
pp. 1245-1252 ◽  
Author(s):  
M.M. Nascimento ◽  
A.J. Alvarez ◽  
X. Huang ◽  
C. Browngardt ◽  
R. Jenkins ◽  
...  
Keyword(s):  
Acid Production ◽  
Metabolic Profile ◽  
Assessment System ◽  
Caries Detection ◽  
Metabolic Profiles ◽  
Ph Homeostasis ◽  
Supragingival Plaque ◽  
Plaque Ph ◽  
Oral Biofilms ◽  
Caries Lesions

Caries lesions develop when acid production from bacterial metabolism of dietary carbohydrates outweighs the various mechanisms that promote pH homeostasis, including bacterial alkali production. Therapies that provide arginine as a substrate for alkali production in supragingival oral biofilms have strong anticaries potential. The objective of this study was to investigate the metabolic profile of site-specific supragingival plaque in response to the use of arginine (Arg: 1.5% arginine, fluoride-free) or fluoride (F: 1,100 ppm F/NaF) toothpastes. Eighty-three adults of different caries status were recruited and assigned to treatment with Arg or F for 12 wk. Caries lesions were diagnosed using International Caries Detection and Assessment System II, and plaque samples were collected from caries-free and carious tooth surfaces. Taxonomic profiles were obtained by HOMINGS (Human Oral Microbe Identification using Next Generation Sequencing), and plaque metabolism was assessed by the levels of arginine catabolism via the arginine deiminase pathway (ADS), acidogenicity, and global metabolomics. Principal component analysis (PCA), partial least squares–discriminant analysis, analysis of variance, and random forest tests were used to distinguish metabolic profiles. Of the 509 active lesions diagnosed at baseline, 70 (14%) were inactive after 12 wk. Generalized linear model showed that enamel lesions were significantly more likely to become inactive compared to dentin lesions ( P < 0.0001), but no difference was found when treatment with Arg was compared to F ( P = 0.46). Arg significantly increased plaque ADS activity ( P = 0.031) and plaque pH values after incubation with glucose ( P = 0.001). F reduced plaque lactate production from endogenous sources ( P = 0.02). PCA revealed differences between the metabolic profiles of plaque treated with Arg or F. Arg significantly affected the concentrations of 16 metabolites, including phenethylamine, agmatine, and glucosamine-6-phosphate ( P < 0.05), while F affected the concentrations of 9 metabolites, including phenethylamine, N-methyl-glutamate, and agmatine ( P < 0.05). The anticaries mechanisms of action of arginine and fluoride are distinct. Arginine metabolism promotes biofilm pH homeostasis, whereas fluoride is thought to enhance resistance of tooth minerals to low pH and reduce acid production by supragingival oral biofilms.

scholarly journals Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

2014 ◽  
Vol 93 (11) ◽  
pp. 1070-1075 ◽  
Author(s):  
M. Fontana ◽  
J.A. Platt ◽  
G.J. Eckert ◽  
C. González-Cabezas ◽  
K. Yoder ◽  
...  
Keyword(s):  
Assessment System ◽  
Retention Rates ◽  
Caries Detection ◽  
Major Barrier ◽  
Occlusal Surfaces ◽  
Before And After ◽  
Permanent Molars ◽  
Caries Lesions ◽  
Sealant Retention ◽  
Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

scholarly journals SOPROLIFE System: An Accurate Diagnostic Enhancer

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mona Zeitouny ◽  
Mireille Feghali ◽  
Assaad Nasr ◽  
Philippe Abou-Samra ◽  
Nadine Saleh ◽  
...  
Keyword(s):  
Assessment Tool ◽  
High Reliability ◽  
Intraclass Correlation ◽  
High Sensitivity ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Icdas Ii

Objectives.The aim of this study was to evaluate a light-emitting diode fluorescence tool, the SOPROLIFE light-induced fluorescence evaluator, and compare it to the international caries detection and assessment system-II (ICDAS-II) in the detection of occlusal caries. Methods. A total of 219 permanent posterior teeth in 21 subjects, with age ranging from 15 to 65 years, were examined. An intraclass correlation coefficient (ICC) was computed to assess the reliability between the two diagnostic methods.Results.The results showed a high reliability between the two methods (ICC = 0.92; IC = 0.901–0.940;P<0.001). The SOPROLIFE blue fluorescence mode had a high sensitivity (87%) and a high specificity (99%) when compared to ICDAS-II.Conclusion.Compared to the most used visual method in the diagnosis of occlusal caries lesions, the finding from this study suggests that SOPROLIFE can be used as a reproducible and reliable assessment tool. At a cut-off point, categorizing noncarious lesions and visual change in enamel, SOPROLIFE shows a high sensitivity and specificity. We can conclude that financially ICDAS is better than SOPROLIFE. However SOPROLIFE is easier for clinicians since it is a simple evaluation of images. Finally in terms of efficiency SOPROLIFE is not superior to ICDAS but tends to be equivalent with the same advantages.

scholarly journals Improving interprofessional team simulation learning. One more step towards the humanization of health care in emergency situations

2021 ◽  
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Qualitative Study ◽  
Interprofessional Education ◽  
Positive Emotions ◽  
Learning Experience ◽  
Learning Tools ◽  
Descriptive Content ◽  
Interprofessional Team ◽  
Emergency Situations

Interprofessional education refers to the collaboration of students from different disciplines towards the resolution of a series of clinical situations. The general objective of this study was to analyze the perspective of the participants in interprofessional simulations (doctors and nurses) in emergency situations. Qualitative study with an inductive approach for the identification of categories derived from the opinions provided by the participants in interprofessional simulations was conducted (n = 58). Individual open-ended questions were provided through a self-completed qualitative questionnaire. The answers were subjected to a descriptive content analysis. Three emergent themes, 13 categories and 21 sub-categories were obtained. Emotions-related aspects, strengths, and areas to be improved were identified with respect to the interprofessional simulations. The participants highlighted the great closeness to reality, they felt comfortable and confident, and their positive emotions had a greater weight than the negative ones (uncomfortableness, frustration, and insecurity). The most prominent positive aspects were teamwork, the realism of the training, and the empowerment of the nurses. The areas that could be improved were those related to aspects associated with carrying out the simulations, the demand for joint planning, and the improvements in the development of the sessions by the facilitators (co-debriefers). This work demonstrates the good reception of the learning experience by the participants. Interprofessional simulations are great learning tools, although weaknesses were found that could be improved with adequate planning by the educators.

The International Caries Detection and Assessment System – ICDAS: A Systematic Review

2018 ◽  
Vol 52 (5) ◽  
pp. 406-419 ◽  
Author(s):  
Kim Rud Ekstrand ◽  
Thais Gimenez ◽  
Fernanda R. Ferreira ◽  
Fausto M. Mendes ◽  
Mariana M. Braga
Keyword(s):  
Roc Curves ◽  
Diagnostic Odds Ratio ◽  
Assessment System ◽  
Caries Detection ◽  
Activity Assessment ◽  
Caries Progression ◽  
Overall Performance ◽  
Meta Analyses ◽  
Caries Lesions ◽  
Specific Search

The aims of this study were: (1) to evaluate the overall reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) for assessing coronal caries lesions, and (2) to investigate the use of systems associated with the ICDAS for activity assessment of coronal caries lesions. Specific search strategies were adopted to identify studies published up to 2016. For the first objective, we selected studies that assessed primary coronal caries lesions using the ICDAS as a reference standard. A total of 54 studies were included. Meta-analyses summarized the results concerning reproducibility and accuracy (correlation with histology, summary ROC curves [SROC], and diagnostic odds ratio [DOR]). The latter 2 were expressed at D1/D3 levels. The heterogeneity of the studies was also assessed. Reproducibility values (pooled) were > 0.65. The ICDAS mostly presented a good overall performance as most areas under SROC were > 0.75 at D1 and > 0.90 at D3; DOR ≥6. For the second objective, we selected studies investigating activity assessment associated with the ICDAS. The meta-analyses pooled results based on the same methodology and parameters as above. Longitudinal findings regarding caries progression were described to estimate the validity of these systems. On average, the systems for activity assessment of caries lesions showed moderate values concerning reproducibility and overall performance. Active caries lesions were more prone to progress than inactive ones after 2 years. In conclusion, the ICDAS presented a substantial level of reproducibility and accuracy for assessing primary coronal caries lesions. Additional systems associated with the ICDAS that classify caries lesion activity can be useful as they are moderately reproducible and accurate.

scholarly journals Knowledge and Use of Caries Detection Methods among Dental Students and Dental Practitioners in Riyadh, Saudi Arabia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Waseem Radwan ◽  
Abeer A. AlNasser ◽  
Hesah Aloqab ◽  
Khalid Al-Saggaf ◽  
Nora A. Almuhtab ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Saudi Arabia ◽  
Linear Regression Analysis ◽  
Dental Students ◽  
Diagnostic Methods ◽  
Detection Methods ◽  
Health Concern ◽  
Caries Detection ◽  
Assessment Practices ◽  
Dental Practitioners

Aim. Accurate detection and diagnosis of dental caries is an integral part of achieving adequate comprehensive dental care. Furthermore, the high prevalence of caries and generally poor oral health in Saudi Arabia is a public health concern. In addition to necessary preventive programs and awareness initiatives, understanding diagnostic practices plays an important role in garnering broad background knowledge regarding the routine diagnostic means utilized by our targeted respondents. Therefore, this study aimed to assess the methods of caries detection among dental students and dental practitioners in Riyadh using a cross-sectional observational study design. Methods. The sample comprised 496 dental students, interns, postgraduate residents, general dental practitioners, specialists, and consultants from the Riyadh region of Saudi Arabia. A survey was designed to assess caries detection methods, risk assessment practices, and knowledge of advanced diagnostic methods. The responses were correlated with demographic and educational variables. Regression models were used to predict associations. Results. 42.3% and 32.7% use sharp explorers in diagnosing caries always and most of the time, respectively. When conducting caries risk assessment practices, 64.4% was very likely to review the patient’s medical history and lifestyle. In terms of knowledge of advanced diagnostic methods, 47.8% know “much” to “very much” about FOTI. The knowledge of advanced caries diagnostic methods and practices of advanced diagnostic methods were significantly positively correlated (r = 0.388, P < 0.001 ). Linear regression analysis indicated that higher experience (10+ years) was associated with higher knowledge regarding advanced caries diagnostic methods ( β  = 0.27, P = 0.009 ). The mean rank for risk assessment practices was significantly lower in GPs compared to consultants P < 0.05 . Conclusions. The use of traditional and invasive methods of caries detection is prevalent among our respondents, while the usage of advanced diagnostic methods is for the most part low. Therefore, we advocate for more minimally invasive approaches and as such encourage the practice and availability of advanced diagnostic methods.

scholarly journals Clinical Trial of the Canary System for Proximal Caries Detection: A Comparative Study

2021 ◽  
pp. 38-50
Author(s):  
Janja Jan ◽  
Wan Zaripah Wan Bakar ◽  
Sapna M. Mathews ◽  
E. Uzamere ◽  
Linda O. Okoye ◽  
...  
Keyword(s):  
Assessment System ◽  
Receiver Operating Curve ◽  
Caries Detection ◽  
Proximal Caries ◽  
Bitewing Radiography ◽  
Initial Caries ◽  
High Caries Risk ◽  
Icdas Ii ◽  
Risk Patients ◽  
Caries Lesions

Background: Detecting initial caries on the proximal surfaces of teeth in an intact dentition is a problem in dental practice since radiograph has been shown to have poor sensitivity with this stage of caries lesions. Hence there is need for an alternative technology. Objectives: The aim of this study was to investigate the efficacy of the Canary System (CS) to detect proximal caries in a clinical setting, comparing it with bitewing radiography (BWR).  Methodology: 33 subjects, age 18 years and above, were recruited from a mixed population of low, moderate, and high caries risk patients. BWR and the CS were used to detect proximal caries lesions in these subjects. Teeth were separated by 48 hours insertion of rubber rings, and the proximal surfaces were examined by direct visual examination using the International Caries Detection and Assessment System II (ICDAS-II) scoring system. The Sensitivity (se), specificity (sp), positive (ppv) and negative predictive (npv) values of the CS and BWR in detecting caries on proximal surfaces were calculated by evaluating each method alone against ICDAS-II system (used as bronze standard). The two methods were compared statistically using their Area Under the Receiver Operating Curve (AUC). The sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong’s method of nonparametric testing of AUC values.  Results: The se, sp, ppv and npv for the CS are 0.92, 0.78, 0.89, 0.84 respectively, and for BWR are 0.67, 0.54, 0.78, and 0.40 respectively. The AUC of the Canary System (0.77) was statistically significantly higher than the AUC of the radiography (0.53, P < .001).  Conclusions: This study demonstrated the efficacy of the Canary System in detecting proximal caries lesions to be greater than that of bitewing radiography.  Clinical Significance: The Canary System can be a valuable clinical device for detecting and monitoring proximal caries lesions in clinical practice.

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