The occlusal bite-wing radiograph evaluations of 13114-year-old and of 12317-and 20-year-old Dutch persons were compared with the clinically collected observations. The clinical observations and the bite-wing radiographs were collected as part of a longitudinal epidemiological survey conducted in 1987 and 1990. Comparison of the evaluations of the first and second molar teeth showed significantly more radiolucencies in all three age groups than expected clinically. Of the clinically judged ‘sound’ surfaces, 26% in the 14-, 37.5% in the 17- and 50% in the 20-year-old group showed a radiolucency on the bite-wing radiograph. In the 14-, 17- and 20-year-old age group a radiolucency was noticed on the bite-wing radiograph in 32,44 and 58% of the sealed teeth, respectively. The radiolucencies below the occlusal enamel of sealed teeth were most likely due to the problems in diagnosing occlusal dentine lesions correctly with the clinical diagnostic methods. Therefore not only approximal but also occlusal bite-wing radiograph judgement before sealant application seems to be advisable now. Because of the numbers of clinically undetected lesions it may be advisable to reconsider the criteria for occlusal diagnosis in epidemiological surveys and to judge not only the approximal but also the occlusal surfaces in epidemiological surveys when bite-wing radiographs are available.
The aim of this study was to determine, for different age groups, the additional value of bite–wing radiographs compared to the clinical information, and to calculate the subsequent effect on the DMFS index. Subjects were 14, 17, 20, 23 years old, or in the age groups 25–34 and 35–54, who participated in a clinical epidemiological survey. After obtaining consent, bite–wings were taken of approximately 25% of the participants (n = 663). The extra diagnostic yield of the bite–wings varied between 163 and 700% for approximal dentine caries diagnosis of untreated surfaces, and between 233 and 593% for inadequate restoration judgement for filled surfaces. The DS score went up by about 20–98%, whereas the DMFS index increased between 1 and 12%, resulting in a radiographic correction factor of 1.01–1.12. In conclusion, the considerable increase in the prevalence of approximal dentinal lesions and inadequate restorations for all age groups results in higher numbers of surfaces in need of treatment, but is not accompanied by a significant increase in DMFS scores.
In 1987, an epidemiological study was started with the aim to evaluate the development of dental health in young people insured by ‘Health Insurance Funds’. In The Netherlands, insurance by such funds is compulsory for individuals earning less than some income criterion (in 1995 59,000 Dutch florins) and their families, together approximately 60% of the Dutch population. Dental health care is included in the insurance. Caries data were obtained in subjects aged 5–23 years in 1987, 1990 and 1993. Mean DMFS scores of groups aged 11,17 or 23 years in 1993 were about 40% lower than in 1987. No significant differences in mean number of dmfs of 5-year-olds in 1987 and 1993 could be observed. A breakdown by country of birth of the mother showed that the difference between indigenous Dutch juveniles and juveniles of Turkish or Moroccan origin depended on year of birth. Caries prevalence of Turkish or Moroccan children born in 1982 or later was higher than that of Dutch children of equal age; no significant difference in DMFS could be demonstrated between ethnic categories in juveniles born in 1976. In cohorts born before 1976, DMFS scores of Turkish/Moroccan juveniles were much lower than those of Dutch juveniles. It is suggested that these opposite trends were caused by the fact that subjects in the youngest cohorts had been born in The Netherlands, while the oldest cohorts spent the first years of their life in those parts of Turkey or Morocco where caries prevalence of children is low. Between 1987 and 1993 caries prevalence in 5-year-old children of Turkish or Moroccan origin decreased significantly.
The bitewing radiographs showed a considerable number of enamel lesions for these age groups. This seems to justify its use on a routine base as a diagnostic tool at the age of 14-16 years.
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