DECISIONS ON DIAGNOSIS AND MANAGEMENT OF APPROXIMAL CARIES BY FINAL-YEAR DENTAL STUDENTS

Objectives: To investigate the decision-making processes for dental ca ries from bitewing radiographs of final-year dental students in Mexico City. Methods: Five sets of radiographs were converted to slides and projected on a screen under standardized conditions. 143 students were asked to determine separately the presence of all proximal caries, of proximal lesions to be restored in the present course of treatment, a nd of unreadable surfaces due to technical deficiencies. A gold standa rd was obtained from two expert clinicians who examined the radiograph s under similar conditions. Results: Misdiagnoses were common. Overdia gnoses became evident at the treatment planning stage where many surfa ces were incorrectly planned for restoration. Subjective appraisals of presence of lesions, unreadable surfaces, and surfaces planned for re storation showed substantial variation. Conclusions: Students' overall assessment of lesions detected did not differ between restored and un restored surfaces. However, when compared with the gold standard, thei r decisionmaking was found to be better on surfaces which had not been restored previously as opposed to those already restored, both in ter ms of identification of lesions and in terms of treatment planned for deeper lesions.