RESUMO
OBJECTIVE: The aim of this pilot study was to address the reliability, internal validity and viability of oral health methods used in the South American Youth/Child cARdiovascular and Environmental study. METHODS: South American Youth/Child cARdiovascular and Environmental study was a multicentre feasibility observational study and conducted in seven South American cities. The training sessions were performed in two steps before data collection: the first verified the inter-rater reproducibility between the examiners of the six centres in relation to the gold standard, and the second one verified the inter-rater reproducibility between the examiners at each centre in relation to the main rater. The diagnostic methods used were International Caries Detection and Assessment System II and Pulpal Involvement, Ulceration, Fistula and Abscess for dental caries and Periodontal Screening and Recording and Index Plaque for periodontal disease. Anthropometric variables were measured and used to calculate the body mass index and were classified according to the cut-off points defined by the International Obesity Task Force. Cohen's kappa coefficient and proportions of agreement were calculated to report inter-rater and intra-rater reliability in the calibration process and pilot study. RESULTS: The inter-rater weight kappa ranged from 0.78 to 0.88 and proportion of agreement from 96.07% to 98.10% for the International Caries Detection and Assessment System II and for the Periodontal Screening and Recording, 0.68 to 0.95 and 94.40% to 98.33%, respectively, in the calibration process. At the pilot study, a total of 490 children (40.8% overweight and 12.9% obese) and 364 adolescents (23.4% overweight and 4.3% obese) were examined. The prevalence of dental caries was 66% in children and 78% in adolescents, and gingival bleeding was 49% and 58.20%, respectively. CONCLUSION: The results demonstrated good reliability and internal validity after the examiners were trained, as well as the feasibility of using the methods chosen for this multicentre study.
RESUMO
OBJECTIVE: The aim of this study was to evaluate the use of the DIAGNOdent system in epidemiological studies to detect noncavitated occlusal caries lesions, and compare the results with those found in radiographic examinations. METHODS: The sample consisted of 1,290 occlusal surfaces of permanent molars, examined in 179 schoolchildren aged 12-15 years. The methods used were: visual inspection, radiographic examination and DIAGNOdent exam, with radiographic examination being considered the gold standard, and noncavitated caries lesions identified in dentin under sound enamel. The inclusion criterion of this study was to have sound occlusal surfaces on visual inspection. The sensitivity and specificity, positive and negative predictive values were used for statistical analysis. RESULTS: Of the 1,290 surfaces examined during visual inspection, 918 were scored as clinically sound. Of these, 789 were examined by radiographic examination and DIAGNOdent, considering that in more than half of them (410) there were coincident results in the absence of noncavitated lesion in both methods (radiographic examination by DIAGNOdent), with specificity of 74% and negative predictive values of 82% and 155 coincident surfaces with presence of caries, with sensitivity of 64% and positive predictor values of 53% for DIAGNOdent. CONCLUSION: These results suggest that although DIAGNOdent is not a substitute method for the radiographic examination in surveys, it may be an alternative as an auxiliary to visual inspection.
