Comparison of a full arch digital photographic assessment of caries prevalence in 5-year-old children to an established visual assessment method: a cross-sectional study

INTRODUCTION: Digital epidemiology in dental disease screening has a number of advantages which warrant further exploration. AIM: This study aimed to test the examination accuracy of digital images to evaluate child oral health by comparing the new method to a gold standard method. It also investigated the levels of diagnostic accuracy between different examiners, including dental care professionals and a lay examiner, when quantifying dental disease using images. METHODS: A calibrated dental examiner inspected forty 5-year-olds. In addition, three sets of digital images were taken per child. These images were assessed by six examiners. Sensitivity and specificity of caries diagnosis and inter-examiner reliability were calculated to compare the caries scores derived from examination of the images to those of the gold standard examinations. RESULTS: The mean values for sensitivity and specificity scores were 48.0% and 99.1%, respectively. The mean value for kappa showed moderate agreement between 0.43 and 0.73 (0.57). Mean values for agreement using intra-class coefficients were excellent (0.78) and good (0.73) for dt and dmft, respectively. No statistical difference in the validity of the caries scores was shown between the different image assessors. CONCLUSIONS: These data demonstrate the feasibility of using digital images to screen child oral health and for nondental professionals to be recruited to carry out digital epidemiology for the oral health surveillance of children.