Errors, Reversals, and Questionable Dental Caries Diagnoses Based on a Longitudinal Study in Children

¹ University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania

During a 3-year period, multiple dental examinations for the same population of 588 North American Indian boarding school children were evaluated for errors in diagnosis, reversals, and questionable dental caries diagnoses.

Questionable dental caries diagnoses, reversals, and errors did not occur in a random or uniform fashion or with any predictable distribution and frequency between and within groups. There were significant differences in the distribution of these variables when compared in relation to the numbers of children, numbers of teeth, and DMFT. Inclusion of these data in the results, and also separate reporting, would be necessary for a more accurate evaluation of dental caries determinations.

In addition, questionable caries diagnoses should be considered individually and be included in dental caries evaluation, provided that the examiners apply standardized criteria. As the clinical examinations progressed, questionable caries diagnoses decreased in frequency. It appeared that more of these borderline conditions were recognized early in the study, thus reflecting a decrease in the reservoir for future examinations.