Effect of Different Lighting Conditions on Proximal Caries Detection in Dental School Settings
Mohammed Alsaati, Thomas Deahl, Marcel Noujeim
Journal of Clinical and Diagnostic Research
Environmental factors, including ambient light, play an important role in caries detection. Dental private practices and dental school clinics are exposed to extraneous light from fluorescent fixtures, operative unit lights and/or windows. In previous studies, visual fatigue and impaired diagnostic accuracy are found to be associated with the viewing conditions. Aim: The study aims to evaluate and compare dental students' performance at detecting proximal caries on intraoral digital
... under different ambient light conditions. Materials and Methods: Eight randomly chosen senior dental students and a dentist evaluated intraoral digital images of 32 extracted teeth mounted in 12 quadrants. Almost half of the teeth were carious as confirmed by histology. The illuminance measuring unit (Lux) was used to measure the light conditions at luminous flux per unit area. Raters viewed the images in ambient light conditions i.e., dim light settings (Less than 50 Lux) and in bright light settings (more than 800 Lux). Images were viewed with the same calibrated monitor. All other viewing conditions were controlled. Raters stated their certainty of caries presence on a 5-point scale. Sensitivity, specificity and Receiver Operating Characteristic (ROC) curve was calculated for all observations and for both light settings. Results : Raters performed at a higher specificity under dim light conditions (p<0.05). ROC analysis showed that the overall performance under dim light environment was better than the bright light environment (0.745 vs. 0.710), which was statistically significant (p<0.05). Conclusion: The results support reducing ambient light levels to rule out caries, as there is a significantly higher specificity and performance in a dim light environment compared to bright one. Recent studies have focused on experienced dentists in caries detection. However, little attention has been given to students. To our knowledge, only one study, done by Kutcher MJ et al., compared clinicians' performance with students' on caries detection. This study showed comparable results between clinicians and students, but also showed high inconsistency in students' abilities to detect caries compared to experienced clinicians . The study suggested that the diagnostic ability could be improved by hooding laptops in bright clinical environments. Objective of present study is to measure the effect of ambient light settings on the students' ability to interpret digital radiographs, in order to enhance their educational experience.