Abstract
AimTo evaluate the ability to recognise different types of developmental defects of enamel (DDE) by a group of general dental staff, trained prior to the comprehensive prevalence study (the BITA study), and to compare their skills to that of an untrained group. To evaluate the validity and reliability of the DDE registrations and MIH diagnoses, 3 years after the BITA study ended. To evaluate the reliability of an MIH diagnose, 3 years after the study ended.Materials and methodsThe dental staff from five clinics (n = 43) was given instructions in identifying different types of DDE, according to the mDDE index (FDI in Int Dent J 42:411–426 1992). A test protocol with 24 digital photos of teeth with different DDE was filled out. The dental staff from five other clinics (n = 60), without preceding instructions, also filled out the protocol. Ninety-one patients with reported DDE were clinically re-examined 3 years later by two dentists with certified experience of DDE.ResultsWhen untrained dental staff filled out the test protocol, only 42% of the affected surfaces were correctly assessed, whereas 85% of the dental staff instructed in recognizing DDE made a correct assessment (p < 0.000). The specialists confirmed 73% of the teeth diagnosed with DDE in the BITA study as affected. The agreement in judging the opacities as diffuse or demarcated was 76%. One-fourth of those being judged to be affected by MIH in the BITA-study also showed to be affected by other enamel disturbances.ConclusionsThe ability of the untrained dental staff to recognize DDE was insufficient. Instructions, using digital photos, raised the ability considerably. To ensure a correct MIH diagnosis, the patients should be followed until all the permanent teeth have erupted.
Highlights
Developmental defects of the enamel (DDE) are common in many child populations (King 1989; Dummer et al 1990; Elley and Charlton 1992)
As preparation for a 5-year longitudinal study in Sweden [the BITA study concerning different aspects in the oral health of children (Oldin et al 2015)], the staff in five Public Dental Service clinics in the Region Västra Götaland were given a 2-h lecture on how to recognise developmental defects of the enamel (DDE). They were trained in discerning between demarcated opacities (DEO), diffuse opacities (DIO), and hypoplasia (Hypo), according to the mDDEindex (FDI 1992)
When untrained dental staff filled out the test protocol, only 42% of the affected surfaces were correctly assessed, while 85% of the dental staff instructed in recognizing developmental defects of the enamel (DDE) made a correct assessment (p < 0.000) (Table 1)
Summary
Developmental defects of the enamel (DDE) are common in many child populations (King 1989; Dummer et al 1990; Elley and Charlton 1992). They may occur as pits or grooves, denominated hypoplasia, and are defined as a quantitative defect of enamel or as a white or discoloured area, denominated opacities, and are defined as a qualitative defect, i.e., an enamel hypomineralisation. There are DDE affects individuals to varying degrees. All teeth or just single teeth can be affected. The enamel can be soft and disintegrating, or with just a few discreet opacities. The patients can be exposed to great suffering with pain, difficulties in eating or tooth brushing, and with great aesthetical problems (Jälevik and Klingberg 2002), or have hardly noticed the defects at all
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