Reliability Assessment of a Plaque Scoring Index Using Photographs

Abstract

Summary Objectives: The need to evaluate the reliability of a clinical index before using it as a research tool is clearly recognized. Therefore the aim of this study was to evaluate whether a new calibration method by means of photographs would be useful for assessing the examiners’ reliability in the interpretation of a plaque index. Methods: Nine children were randomly recruited from a public school in Rio de Janeiro, Brazil. Two trained examiners evaluated these children for dental plaque, in a classroom environment, in order to record plaque scores. The children’s teeth were dyed and colored photographs were taken of all tooth surfaces using a camera, mouth mirrors and lip retractors. The photographs were evaluated to select and identify the best visible tooth surfaces, and the final sample consisted of 343 tooth surfaces. One week after the clinical examination, both examiners scored the tooth surfaces from the photographs according to the index used. The intra and inter-examiner agreements were measured by intra-class correlation coefficient (ICC) for individual mean scores and for tooth surfaces scores. Results: The data showed an excellent agreement (ICC > 0.80) between clinical and photographic examinations, for both examiners, both for tooth surface and patient analysis. The statistics also demonstrated excellent (ICC > 0.80) inter-examiner agreement on clinical and photographic examinations. Conclusion: The method seems to be an effective technique to evaluate the reliability of the plaque index, improving the reproducibility of epidemiological studies.

Could a national oral health promotion program improve the oral hygiene of persons attending special care establishments in France? Evaluation of a pilot program

“…This was not possible for reasons of timing of the data collection, lack of resources to bring the dentists together from around the country, and population limitations . Other studies have shown that the use of photographs may replace clinical examination for the purposes of training and calibration when in vivo calibration is not practical, without adversely affecting data quality . However, caregivers were informed in advance of the evaluation dates, which was likely to have led to an improvement in oral hygiene at these times.…”

Pilot Testing of Intervention Protocols to Prevent Pneumonia in Nursing Home Residents

“…Residents who met one of these screening criteria were examined by a dentist consultant and were eligible if their oral plaque score was > 1.0. The oral plaque scoring method was adapted from published and validated plaque scoring tools (19, 20). For dentate patients (i.e., > 6 teeth), plaque was scored as follows: 0= no plaque noted, 1= plaque seen only when the tip of a probe was passed over tooth (or tissue bearing side of denture surface), 2= plaque obvious with naked eye (or visible on <50% of denture surface), 3= gross deposits of plaque over entire tooth (or on >50% of denture surface).…”

“…Initial eligibility screening for impaired oral hygiene required no documented dental examination for more than 12 months or assessment by nursing staff that oral hygiene was poor. A dentist consultant examined residents who met one of these screening criteria, and they were eligible if their oral plaque score using a scoring method adapted from published and validated plaque scoring tools 19,20 was greater than 1.0. For dentate patients (46 teeth), plaque was scored as follows: 0 5 no plaque noted, 1 5 plaque seen only when the tip of a probe was passed over tooth (or tissue-bearing side of denture surface), 2 5 plaque obvious with naked eye (or visible on o50% of denture surface), 3 5 gross deposits of plaque over entire tooth (or on 450% of denture surface).…”

A novel approach for classifying protruding ears is easy to calculate and implement in daily clinical practice

“…Leonardo da Vinci appraised the ratio of different facial elements, applying what he called the golden ratio . Clinical Photography, already frequently used for medical teaching purposes , is also more recently being applied as an important diagnostic and follow‐up tool in clinical medicine . Driessen et al.…”