Advances in Dental Research, Vol 7, 80-86, Copyright © 1993 by International & American Associations for Dental Research
Diagnosis and prediction of root caries
D. W. Banting
Faculty of Dentistry, The University of Western Ontario, London, Canada.
Diagnosis is the process of recognizing diseases by their characteristic
clinical signs and symptoms. Diagnostic ability varies considerably between
and among examiners, and, consequently, the accuracy of the diagnosis can
be questioned. Root caries is a disease for which there are several
clinical signs (location, color, surface texture, and surface cavitation).
Unfortunately, these signs are open to broad clinical interpretation. As a
result, estimates of disease occurrence (incidence rate) have ranged from
0.87 to 8.20/100 surfaces at risk/year or 0.15 to 0.43 lesions/person/year
for adults living independently in the community. When multiple examiners
are utilized, interexaminer agreement has been reported to be relatively
good but could be further improved by minimizing the effects of several
sources of examiner disagreement, including the absence of a global
consensus on the signs which indicate the presence of root caries. The use
of a diagnostic test can enhance the diagnosis and prediction of root
caries, but the development of useful tests is hindered by the lack of an
accurate clinical standard of diagnosis. At this time, diagnostic tests for
root caries are quite limited and of questionable value. A powerful
predictive tool for root caries would result from the combination of risk
assessment measures and a valid diagnostic test developed with use of
standardized and accurate methods of clinical diagnosis.
