DENTISTS RELIABILITY SCORING THE PLAQUE INDEX USING A FLUORESCENT COLOURING AGENT

Abstract

Aim: Plaque level is one of the risk factors for assessing individual caries risk. While disclosing agents are effective for the detection of dental plaque, patients do not like having their teeth and soft tissue dyed. Fluorescein is an alternative plaque detection agent which fluoresces yellow-green when activated with blue light. The aim of the present study was to evaluate the level of agreement of Silness-Löe Plaque Index measurements using a fluorescent colouring agent among eight dentists.

Methods: Eight practice owning general dental practitioners (volunteers) in Cork, Ireland, were recruited as examiners for a randomised clinical study investigating the impact of a personalised caries prevention approach. Prior to the commencement of the study a training and calibration programme was delivered. The Clinical Research Ethics Committee of the Cork Teaching Hospitals approved the calibration exercise, subjects provided informed consent prior to being examined. The dentists were trained in the use of the Silness-Löe Plaque Index (1964) in the Oral Health Services Research Centre (OHSRC), Cork, in February 2015; Plaque Test® (Ivoclar Vivadent, Liechtenstein) was used to highlight plaque. The gold standard examiner (the Professor of Restorative Dentistry (Periodontology) in University College Cork) and the eight dentists examined 12 subjects (a convenience sample) aged between 19 and 75 years (mean age±SD: 40.9±23.9 years) who were recruited from patients attending the restorative clinic in the University Dental Hospital, applying. Plaque Test® before each clinical examination. We calculated weighted Kappa statistics to evaluate the inter-examiner and intra-examiner reproducibility.

Results: The weighted Kappa statistics varied from 0.3 to 0.5 for inter-examiner reproducibility and from 0.4 to 0.7 for intra-examiner reproducibility. A problem reported by the examiners indicated that Plaque Test® did not stay on tooth surfaces and that it was difficult to detect plaque consistently.

Conclusions: The agreements of Plaque Index using Plaque Test® were fair to good in this calibration session. Although patients would prefer invisible agents to ordinal disclosing agents due to the advantage of not dyeing teeth and soft tissue, clinicians should note viscosity of Plaque Test® in use.