Has occlusal caries become more difficult to diagnose? A study comparing clinically undetected lesions in molar teeth of 14-16-year old children in 1974 and 1982

Sawle, R F; Andlaw, R J

doi:10.1038/sj.bdj.4806403

Cited by 72 publications

(41 citation statements)

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“…Thus, endodontic treatment due to caries in young permanent teeth mostly concerned molars with deep occlusal restorations [Ridell et al, 2006]. Surfaces that could not be examined because they were not included in the radiographic image (3% of all surfaces) deserve attention since the radiograph is a particularly important aid for diagnosing occlusal dentin caries [Creanor et al, 1990;Sawle and Andlaw, 1988]. The impact of such potentially missed diagnoses is uncertain but may well have contributed to the development of deep restorations.…”

Section: Discussionmentioning

confidence: 99%

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

2008

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The objectives of this longitudinal study were to assess: (a) the prevalence of unrestored dentin caries among 15-year-olds, (b) the proportion of these lesions that had progressed to deep dentin lesions (inner half of dentin) since the immediately preceding examination at the age of 14 and (c) the frequency of deep restorations (extending into the inner half of the dentin). The sample consisted of all 15-year-olds (n = 2,487) born in 1990 and included in the Public Dental Service in Malmö, Sweden. Bitewing radiographs taken during 2005–2007 and the immediately preceding radiographs were analysed and scored by two examiners. The main radiographic scores were: sound; radiolucency in the outer or inner half of dentin; restored surface. The results showed that 22% of the individuals had 1 or more dentin lesions left unrestored from the time of the examination at the age of 14 until the next recall examination at the age of 15. During the observation period (median time 1.2 years), 9% of the unrestored outer dentin lesions progressed to deep dentin lesions. The majority of these (93%) were in molars. One or more deep restorations were found in 22% of the 15-year-olds; the majority involved occlusal surfaces of first molars. In conclusion, unrestored dentin lesions were common in 15-year-olds. Progression to deep dentin lesions occurred in 9% of these lesions and was most common in first molars. Occlusal surfaces of first molars had the highest frequency of deep restorations.

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Section: Discussionmentioning

confidence: 99%

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

2008

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“…These lesions have come to be called hidden [Ball, 1986;Weerheijm et al, 1990], occult [Ball, 1986;Page, 1986;Pitts, 1991;Liebenberg, 1993] or fluoride [Millman, 1984;Lewin, 1985] caries. There is now some scientific evidence that occlusal caries was more difficult to diagnose clinically in 1982 than in 1974 [Sawle and Andlaw, 1988]. A number of authors [Millman, 1984;Lewin, 1985;Sawle and Andlavv, 1988;Lussi, 1993] have suggested fluo ride may be responsible for the change in presentation of the disease.…”

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confidence: 99%

The Effect of Fluoridation on the Occurrence of Hidden Caries in Clinically Sound Occlusal Surfaces

Weerheijm¹,

Kidd²,

Groen

1997

Caries Res

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It has been suggested that the diagnosis of occlusal dentine carious lesions has become more difficult due to the influence of fluoride on the character of pit and fissure surfaces. The issue pertains to the occurrence of hidden caries exemplified by occlusal surfaces judged as clinically sound but showing a radiolucency on the bite-wing radiograph. The aim of this study was to investigate the influence of water fluoridation on the occurrence of hidden caries in clinically sound occlusal surfaces in young people. The data of 515 persons (15 years of age) collected in 1968/1969 as part of the Dutch longitudinal epidemiological Tiel/ Culemborg study were used. The participants in Tiel (F) were exposed to artificially fluoridated drinking water (F^- concentration 1.1 ppm F) from birth until the end of the data collection. The participants in Culemborg (NF) were not exposed to extra fluoride (F^- concentration 0.1 ppm F). In 1994 the status of occlusal surfaces of the first and second molars, as read from bite-wings made in 1968/1969, were judged by 2 investigators (Cohen’s Kappa intra- and inter-examiner agreement 0.90, 0.83 and 0.85, respectively). The original clinical data of 270 inhabitants of Tiel (F) and 245 of Culemborg (NF) were compared with the radiographic judgements. The children examined in Tiel (F) had a mean of 2.54 clinically sound occlusal surfaces in first and second molars (including surfaces with an enamel demineralization only) of which bite-wing radiographs detected 0.43 surfaces (16.9%) with a radiolucency into dentine. In Culemborg (NF) the children had a mean 0.65 clinically sound judged surfaces of which 0.16 (24.6%) showed a radiolucency on the bite-wing films. The results of the investigation show a proportional reduction of surfaces with hidden caries among clinically sound surfaces in the fluoridated area compared to the control.

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“…In populations with decreasing caries prevalence, the proportion of occlusal caries has increased [Lussi, 1991;Mejàre et al, 1998], but many workers have been concerned that even advanced lesions, with extensive dentinal involvement but minimal surface change, may be difficult to detect [Sawle and Andlaw, 1988;Weerheijm et al, 1989;Creanor et al, 1990;Wenzel and Fejerskov, 1992;Kidd et al, 1993;Ie et al, 1995]. The bitewing radiograph is a valuable diagnostic tool for practitioners, but the radiograph detects demineralisation in dentine, and not the enamel lesion .…”

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confidence: 99%

Comparison between Visual Examination and a Laser Fluorescence System for in vivo Diagnosis of Occlusal Caries

et al. 2001

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This study compared a laser fluorescence (LF) system (DIAGNOdent) with a visual caries scoring system for in vivo detection and diagnosis of occlusal caries under the conditions of an epidemiological study, in 132 mandibular and 38 maxillary first permanent molars in 170 children (mean age: 6.85 ± 0.58 years). The teeth were cleaned and occlusal caries status in a selected investigation site recorded using both visual and LF systems. The LF readings were interpreted both according to the cut–off points recommended by the manufacturers and those based on laboratory research with histological validation. The percentage agreement of the LF and visual scoring system was better using the cut–off limits recommended by the manufacturer. Histological validation was not possible in this clinical study, but it appeared that either the LF method was overscoring some lesions or the visual method was underscoring them. Since the LF instrument cannot be expected to differentiate caries from hypomineralisation, it should probably be used as an adjunct to a clinical examination.

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Has occlusal caries become more difficult to diagnose? A study comparing clinically undetected lesions in molar teeth of 14-16-year old children in 1974 and 1982

Cited by 72 publications

References 0 publications

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

The Effect of Fluoridation on the Occurrence of Hidden Caries in Clinically Sound Occlusal Surfaces

Comparison between Visual Examination and a Laser Fluorescence System for in vivo Diagnosis of Occlusal Caries

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