Are Dentists Required to Perform Screenings?

The University of Manitoba Variety Children's Dental Outreach Program utilizes general dentists (GP) to screen children in inner-city schools to identify children in need of treatment in order to generate a patient pool for the Faculty. This study investigated whether non-dentists could conduct these screenings.

Objective: The objectives of this ethically approved study are to determine the reliability of screening results when compared to two different gold-standards (G): (a) screening results obtained by a GP, and, (b) treatment needs as determined by subsequent treatment-plan.

Methods: 90 children were screened twice in the school environment, once by a non-dentist and once by a GP. The results were used to categorize the children into one of three groups; group 1 requiring urgent treatment, group 2 requiring less urgent treatment, and group 3 not requiring treatment. Groups 1 and 2 were seen at the Faculty and had a treatment-plan completed.

Results: Results for objective (a) are: sensitivity= 0.9259, specificity= 0.5556 and Ks= 0.4382. For objective (b), 17 of the original 90 children presented for comprehensive treatment plans at the Faculty with results for the non-dentist group as follows: sensitivity=0.8000, specificity=0.8571, Ks=0.5556; with 1 false positive and 3 false negatives. For the GP, results are: sensitivity=0.9000, specificity=0.8571, Ks=0.4767; there were no false positives and four false negatives. For the comparison of the results of brief screenings, Kappa value indicated only moderate agreement above chance.

Conclusion: These results give early indication that non-dentists may be able to reliably screen children according to criteria set out by the Faculty. However, further calibration of non-dentists may be necessary. It is important to note that these results should be interpreted with caution, as further investigation is necessary.