Sociodemographic, behavioral, and clinical indicators for added value of radiography in caries diagnosis in adolescents: A cross-sectional study

Abstract

The aim was to assess the value of sociodemographic, behavioral, and clinical characteristics in identifying adolescents who would benefit from radiographs for dental caries detection in a high-caries experience population. In total, 356 adolescents answered a validated questionnaire on sociodemographic characteristics and oral health behavior and were clinically and radiographically examined for caries. The outcome was the benefit arising from radiographs for caries detection at the patient level, defined as the number of surfaces clinically classified as sound but presenting radiolucency. A total of 169 participants (47.5%) benefited from radiographs. One-third of approximal lesions were detected clinically, whereas two-thirds, mostly initial lesions, were detected radiographically only. Adolescents who reported frequent consumption of soft drinks and sugary food, those with D1MFS (noncavitated and cavitated caries experience) ≥12, D5MFS (cavitated caries experience) ≥1, clinically detected approximal lesions, and active caries were significantly more likely to benefit from radiographs (P ≤ .002). Although some indicators showed moderate-to-good sensitivity (consumption of sugary food, caries activity) or specificity (absence of clinically diagnosed approximal lesions), the accuracy of indicators evaluated (isolated or combined) never reached 0.60. The possibility of correctly identifying which adolescents would benefit from radiographs for caries detection purposes was limited in a population with high-caries experience.