Accuracy and reproducibility of dental caries risk classification in São Paulo, Brazil

Abstract

Aim: To evaluate the accuracy and reproducibility of the dental caries risk classification applied in the state of São Paulo, Brazil, in an attempt to organize the demand for primary care in oral health. Materials andMethods: Eleven dentists independently examined 120 individuals (75 from 12 to 19 years of age and 45 from 35 to 44 years of age) by visual inspection, and classified them into six codes ranging from A to F, in whichcode A indicated the healthiest individual (low-risk) and F indicated the sickest individual (high-risk). The agreement between the intraexaminer and the gold standard examiner was evaluated by Kappa. The percentageof agreement, sensitivity, specificity, positive predictive value, and negative predictive value regarding the gold standard examiner was also calculated. Results: It could be observed that 60.0% of the individuals examinedwere considered sick, while 40.0% were considered healthy. Values for intra and inter-examiner agreement were k=0.66 and k=0.72, respectively. The percentage of agreement, sensitivity, specificity, positive predictivevalue, and negative predictive values were 83.8%, 82.5%, 85.8%, 90.2%, and 76.9%, respectively. Conclusion: This study suggests that the dental caries risk classification, with its various levels of standardization, presentedgood accuracy and reasonable reproducibility, as well as a low cost and a relatively low demand for resources. As such, this risk classification is recommended for large-scale use.Uniterms: Dental caries. Epidemiology. Oral health. Primary health care.