Introduction: The diagnosis of dental fluorosis in primary teeth is complicated by the color and anatomical characteristics of the teeth. Currently available methods to diagnose dental fluorosis rely on subjective measurements and have not been modified to address primary teeth diagnosis. Preliminary studies using photographs suggest it is potentially useful to diagnose and quantify dental fluorosis objectively. Objective: To compare visual examination to photographic detection of dental fluorosis on in-vitro primary teeth. Methods: 120 extracted or exfoliated temporary teeth were selected, 60 with fluorosis 30 with white spot lesion and 30 sound. An initial calibration session was performed using the TSIF Index. Three examiners conducted visual examinations and diagnosed teeth as sound, flurorosed (TSIF 1, 2) or carious. A fourth examiner scored a subset of photographs of the same teeth taken using a SUNI digital imaging system. Results obtained through the visual exam were compared to the scores given to the photographic images and kappa values were calculated. Results: When results of examinations were compared, percent agreements for the three visual examiners ranged from 92.0% (weighted Kappa of 0.83) to 95% (weighted Kappa of 0.87) showing a strong agreement. Repeatability was also assessed and repeat Kappas ranged from of 0.71 to 0.75. All Kappas showed that there was substantial agreement between original fluorosis calls and those from repeated examinations. Comparison of visual examinations to photographs obtained in a subset of patients (n= 64) showed and agreement of 76% when diagnosing clinically vs. later diagnosis using the photographs. Conclusion: The calibration exercise of in-vitro primary teeth was performed successfully; a moderately strong agreement was achieved. Photographs were a useful tool for calibration purposes.

Supported by NIH 1 R21 DE16034-01A

Back to the Cariology Research Program
Back to the IADR/AADR/CADR 85th General Session and Exhibition (March 21-24, 2007)

Top Level Search