Role of bitewing in enhancing the assessment of DMFS index in a group of Indian adolescents

Context: Caries epidemiological studies based on clinical examination alone tend to underestimate proximal caries. Aims: This study aims to determine the additional value of radiographic examination (bitewings) compared to clinical examination in assessing posterior proximal caries. It also aims to determine the radiographic multiplication /adjusting / correction factors by which a clinical decayed surface (D-S) and decayed-missing-filled surfaces (DMFS) score could be multiplied, to obtain an actual D-S and DMFS score Materials and Methods: Two groups of 100 subjects each, in the age range of 16-20 years, were examined clinically for caries and their DMFS index recorded. Both groups were subjected to bitewing radiographs to detect the clinically undiagnosed posterior proximal caries. The radiographic adjusting factors were determined for group A. To check its repeatability and thus its usefulness, radiographic correction factor was determined for Group B. Statistical Analysis: The results were statistically analyzed with the use of means, standard deviations, regression equation and "Z" test. Level of significance was determined at P > 0.05. Results: A significant number of clinically undetected proximal caries was diagnosed with the help of bitewing radiographs. The difference between the radiographic adjusting/correction factor for D-S and DMFS score for the two groups was statistically not significant (P > 0.05) thus verifying the repeatability of the radiographic correction factors. Conclusion: The radiographic correction factors can be used to obtain a more precise estimate of true caries prevalence in a particular study population without having to subject all individuals to radiographic examination