THE ACCURACY OF CLINICAL AND ROENTGENOLOGIC DIAGNOSIS OF DENTAL CARIES AS DETERMINED BY MICROSCOPIC STUDIES

¹ University of Pennsylvania Dental School, Philadelphia, Pa.

Comparative gross, microscopic and roentgenologic examinations for dental caries were made on 460 teeth of which 347 interproximal and 221 occlusal surfaces were judged carious by one or more methods of examination. The highest incidence of positive diagnoses by all three methods was observed for interproximal caries. The roentgenray was a greater aid in determining interproximal than occlusal caries.

While the roentgenogram may be of superior accuracy in the diagnosis of interproximal caries our histologic studies show that both clinical and roentgenologic examination fail to detect many carious lesions. One hundred forty-three (24 per cent) of the cavities were demonstrated only in the microscopic preparations. In the group studied, caries was more often detected by a careful clinical examination than by the use of the roentgenogram.

The foregoing study has conclusively shown that it is a physical impossibility to diagnose all carious lesions of the teeth. Therefore, it is essential that a complete roentgenologic examination for caries be made in addition to a thorough physical examination since it is impossible to utilize the microscope clinically for the detection of early lesions.