Fissure caries diagnosis and resulting treatment decisions by clinical community dental officers and general dental practitioners.

In this in vitro study, 12 General Dental Practitioners and 13 Clinical Community Dental Officers examined the occlusal, buccal and palatal pits and fissures of 35 extracted molar teeth. They were asked to make a management/treatment decision, on the basis of their diagnosis of caries, whether each tooth should be left untreated, fissure sealed or investigated. After all the management/treatment decisions had been made, the teeth were serially sectioned perpendicular to the occlusal surface and examined for the presence of caries in dentine. It was impossible to demonstrate differences in the management/treatment decisions and the diagnosis of caries made by the two groups. No significant difference in sensitivity or specificity could be detected between operators diagnosing by visual inspection alone and those using visual inspection in combination with a tactile method. The use of radiographs did not significantly improve the validity of the diagnosis or management of fissure caries.