Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta‐analysis

Turchiello, Ronairo Zaiosc; Pedrotti, Djessica; Braga, Mariana Minatel; Rocha, Rachel de Oliveira; Rodrigues, Jonas Almeida; Lenzi, Tathiane Larissa

doi:10.1111/ipd.12463

Cited by 5 publications

(13 citation statements)

References 41 publications

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“…The need for dental students to receive a systematic and profound education in cariology has long been recognised [ 14 ]. While caries detection and diagnosis are now established among undergraduate students with standardised systems such as ICDAS [ 15 ], the assessment of caries risk and caries management is still not the subject of a systematic approach, at least not in the centres where the present study was conducted.…”

Section: Discussionmentioning

confidence: 99%

“…These students had typically more clinical experience than the participants in centre 1 who attended the sixth semester and did not work with patients yet. It was reported that the clinical experience of the examiners had no influence on the performance of caries assessment with a visual inspection [ 15 , 21 ]. Jablonski-Momeni et al [ 11 ] reported in another study that an additional theory lesson improved the reproducibility of responses by students who had just started learning the ICDAS method.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge of undergraduate dental students regarding management of caries lesions

et al. 2022

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Objectives Understanding of lifelong control of disease processes associated with caries and its management is an essential part of dental education. This study evaluated the dental students’ knowledge of caries diagnosis and management using the International Caries Classification and Management System (ICCMS). Methods A survey was conducted among undergraduate dental students at two dental schools, attending the sixth (centre 1) and seventh semester (centre 2), respectively. Medical histories, clinical images and radiographs of 12 patients were compiled as anonymous cases. For each case, a specific lesion was to be assessed. In addition, the students should determine the patient’s caries risk and select a treatment option. An expert report (consensus decision) was used as the reference standard. For statistical analysis, kappa statistics and binomial tests were used. Results A total of 46 students participated in this study. The percentage of agreement of responses to the reference was: centre 1: 40.7–51.3%, centre 2: 57.9–67.9%. The corresponding Kappa values were: centre 1: 0.073–0.175, centre 2: 0.315–0.432. Overall, students tended to underestimate the codes compared to the reference standard (p < 0.001). Conclusion Introducing systematic content about caries diagnosis and management such as ICDAS and ICCMS in the learning objectives of undergraduate dental students can be proposed. However, in order to improve diagnosis and enable a more reliable choice of treatment options, attention should also be given to the way they are didactically taught.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Knowledge of undergraduate dental students regarding management of caries lesions

et al. 2022

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“…After this first assessment, the students were then randomized through an online randomization tool (http://www.random.org) into two experimental groups -ICDAS or Nyvad (experimental units: 6 students/group) criteria -and received the original article that described each criterion 8,9 . After reading the article, each group attended an expository lesson about the etiology, pathogenesis, and diagnosis of dental caries based on the assigned criteria (either ICDAS or Nyvad) and treatment decisions.…”

Section: Methodsmentioning

confidence: 99%

“…Visual inspection is a method commonly taught at dental schools for caries detection and allows having a good performance even if it is not associated with other methods 8,9 . In order to facilitate the detection of carious lesions, reduce subjective decision-making, and improve the standardization of studies and epidemiological surveys, different indices with well-defined criteria have been developed 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…Theoretical knowledge and expertise seem to have some importance for the application of criteria for the detection of signs that indicate the presence or absence of carious lesions and, consequently, for the decisions about the treatment to be offered to the patient [14][15][16] . According to a recent systematic review 8 , undergraduate students demonstrate good performance in caries detection and staging using visual inspection, but their performance in the assessment of caries activity still needs improvement. Bussaneli et al 16 pointed out poor clinical experience as a possible influence on the choices of undergraduate students for more invasive dental caries treatments.…”

Section: Introductionmentioning

confidence: 99%

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Impact of the undergraduate clinical teaching-learning process on caries detection and treatment decision-making

et al. 2021

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Aim: The aim of this study was to evaluate caries diagnosis and treatment decisions made by undergraduate dental students based on ICDAS or Nyvad criteria. Methods: Twelve students analyzed 90 digital photographs of permanent teeth at different clinical stages of carious lesion development and chose among different treatments in three different assessments: when there was no knowledge of the criteria (described as “No knowledge (N)”; when there was theoretical knowledge of the criteria (described as “Theoretical knowledge (T)” and when there was theoretical knowledge, clinical experience about dental caries and the criteria (described as “Theoretical and clinical knowledge (TC)”. For “T” and “TC” the students were randomized into two experimental groups – ICDAS or Nyvad (experimental units: 6 students/group). The reference standard was established cooperatively by two experienced researchers. Criteria performance was evaluated by sensitivity, specificity, AUC, and Kappa statistics. Treatment decision was described in percentage by contingency tables and Spearman’s correlation with the reference standard. Results: The first assessment demonstrated a high percentage of operative treatment even for initial enamel lesions based on ICDAS criteria and treatment was proposed for both active and inactive lesions, according to the Nyvad criteria. In the second assessment, the students continued recommending treatments for initial or inactive lesions, but less frequently. In the third assessment, treatment decisions presented greater cohesion in relation to the assigned classification criterion. The criteria presented no differences between them in terms of diagnostic in the third assessment. Conclusion: Clinical experience may improve caries detection and treatment decisions with the use of ICDAS and Nyvad criteria.

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Developing diagnostic skills from preclinical dental education: Caries detection and assessment using e‐learning assisted practice

Escobar

Rojas‐Gualdrón

Vélez

et al. 2022

Journal of Dental Education

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To evaluate the feasibility of developing visual diagnostic skills for detecting and assessing dental caries using e-learning assisted practice in preclinical dental education. Methods: A one-group before and after the study was conducted. After a theoretical lesson on cariology, 53 inexperienced second-year preclinical students assessed 78 clinical photographs using the Nyvad criteria; they received automated feedback upon completion of the test. After a week, all students reassessed the same set of photographs, which were randomly reordered. Differential diagnostic accuracy was analyzed category-pairwise, and overall accuracy measures were based on the receiver operator curve. Diagnostic accuracy in both attempts was evaluated and compared through estimation and pooling of individual student accuracies. Results: Pooled category-pairwise accuracy was lower for discriminating Sound surface from Non-cavitated-active caries, and for discriminating inactive caries (surface discontinuity) from intact surface inactive caries and Cavitated-active caries. Pooled overall accuracy, after the theoretical lesson, was 0.79 (95% confidence interval [CI] 0.77-0.81), and it increased to 0.99 (95% CI 0.98-0.99) after feedback. Between-student variability in accuracy was reduced from I 2 = 0.66 to 0.55. Conclusion: E-learning assisted practice is a feasible alternative to start developing visual diagnostic skills for detecting and assessing dental caries using the Nyvad criteria from preclinical dental education in cariology. However, further studies are required to evaluate its effectiveness in improving real-world practice knowledge and skills.

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Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta‐analysis

Cited by 5 publications

References 41 publications

Knowledge of undergraduate dental students regarding management of caries lesions

Knowledge of undergraduate dental students regarding management of caries lesions

Impact of the undergraduate clinical teaching-learning process on caries detection and treatment decision-making

Developing diagnostic skills from preclinical dental education: Caries detection and assessment using e‐learning assisted practice

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