Clinical and radiographic judgement of occlusal caries in adolescents

In this study, the clinical and radiographic material of two groups of 17- and 20-yr-old adolescents, born either in 1970 or in 1976, was compared to study changes in the prevalence of occlusal dentine caries and to determine the additional value of the bitewing radiographs. The first and second mol ars of 478 participants were included. Clinical data were derived from an e pidemiological project. Two examiners judged the bitewing radiographs, of w hich about 10% was examined by both. The overall Cohen's kappa for interexa miner agreement was 0.87. The prevalence of occlusal caries had not changed for the two age groups; after clinical and radiographic examination, aroun d 33% of the occlusal surfaces of the 17 yr olds and around 25% of the 20 y r olds exhibited dentine caries. The clinical prevalence of occlusal caries in first and second molars was highly underestimated when compared with th e radiographs. In the 1976 group, more sealants were recorded during the cl inical examination. On the bitewing radiographs, radiolucencies were found underneath one-half of the sealants of the 17 yr olds and underneath one qu arter of the sealants present in the 20 yr olds.