Detection of Early Smooth Surface Caries in Primary Molars using Conventional Methods in a Low-Resource Setting: A Cross-sectional Study

Abstract

Introduction: Dental caries is a widespread chronic disease that affects nearly 100% of adults in developing countries. Detecting caries early is crucial for effective remineralisation and improved prognosis. However, identifying smooth surface caries in its early stages remains challenging for many healthcare professionals globally due to the subjective nature of visual inspection. Aim: To determine the most effective method for detecting early smooth surface caries in limited resource settings. Materials and Methods:The present cross-sectional study was conducted in the Department of Pedodontics, Dr. R. Ahmed Dental College and Hospital (tertiary care centre), Kolkata, West Bengal, India, from March 2021 to August 2022. Study was conducted involving 120 primary molars from Bengali children aged 5 years and above. The teeth were randomly selected while adhering to specific inclusion and exclusion criteria. The occlusal and proximal surfaces of the teeth were assessed using three methods: unaided Visual Examination (VE), Magnifying Loupe (ML)-assisted VE, and the fluorescence-based DIAGNOdent pen (considered the gold standard). Two assessments were performed for each method, one before air-drying and another after air-drying. Caries detection followed the International Caries Detection and Assessment System (ICDAS) II clinical scoring system, and data analysis was conducted using the Chi-square test for proportions. Results: In the present study, there were 76 male children and 44 female children and the mean age of the children was 7±2.5 years. Unaided VE exhibited a diagnostic accuracy of 87.5% and 77.5% for air-dried and non air-dried tooth surfaces, respectively. ML-aided VE yielded a diagnostic accuracy of 88.34% and 85% for air-dried and non air-dried tooth surfaces, respectively. Conclusion: The present study concluded that even without the assistance of an ML, drying the tooth surface can achieve a level of caries detection accuracy comparable to that of MLaided VE.