Abstract This study aimed to make a longitudinal analysis of interexaminer calibration reproducibility in diagnosing dental caries in posterior teeth, by examiners without previous experience in epidemiological studies. A group of 11 inexperienced examiners underwent theoretical-practical training and calibration assessments, assisted by a standard examiner. An examiner who did not participate directly in the research selected 5-year-old children with and without caries. The D3 diagnostic threshold was used to evaluate dental caries, based on the World Health Organization (WHO) criteria. The initial calibration (baseline) was performed after the theoretical-practical training session, and consisted of examining 20 children; the second calibration occurred three months later, and involved evaluating another 18 children. The interexaminer agreement was obtained by kappa statistics, and by overall percentage agreement. The paired t-test was applied to compare the values for kappa means and overall percentage agreement between the time points studied. At baseline, the values for kappa (> 0.81) and overall percentage agreement (> 95.63%) were considered high. At the 3-month calibration assessment, all the examiners showed some decrease in both kappa (p < 0.0001) and overall percentage agreement (p = 0.0102). The calibration process currently proposed by the WHO is effective. However, reproducibility was not maintained over time for inexperienced examiners evaluating the posterior teeth of 5-year-old children, under epidemiological conditions. studies 1 theoreticalpractical theoretical practical assessments 5yearold yearold 5 year old D (WHO criteria baseline (baseline session 2 later statistics ttest t test studied > ( 0.81 081 0 81 95.63% 9563 95 63 high 3month month 3 assessment p 0.0001 00001 0001 0.0102. 00102 0.0102 . 0102 0.0102) effective However conditions 0.8 08 8 95.63 956 9 6 0.000 0000 000 0010 0.010 010 0. 95.6 0.00 00 001 0.01 01 95. 0.0

Resumo Introdução A tendência de redução da cárie dentária tem sido constatada, apesar de maiores investigações sobre seu padrão e desenvolvimento serem ainda necessárias. Objetivo investigar a influência de variáveis clínicas, sociais e ambientais sobre a cárie em adolescentes de um município brasileiro com água fluoretada, no ano de 2018. Método Empregou-se uma amostra não probabilística de 277 adolescentes de 12 anos, de escolas públicas de Nova Friburgo, Rio de Janeiro, Brasil. Exames clínicos foram realizados por examinadores calibrados, para avaliação de cárie, doença periodontal e fluorose, sob critérios da Organização Mundial da Saúde (OMS). Questionários semiestruturados foram aplicados para coletar informações socioambientais. Resultados Indivíduos residentes em regiões com flúor na água em subdoses (OR=3,60, p=0,0006), e aqueles com baixa renda (OR =1,90, p=0,0444), com presença de gengivite (OR = 3,36; p = 0,0016) e cuja razão para a visita ao dentista foi para tratamento dentário (OR=2,41; 0,0203), apresentaram mais chances de terem cárie. Uma redução significativa (p<0,0001) nos índices de cárie foi observada entre 2012 (primeiro levantamento epidemiológico) e 2018. Conclusão A fluoretação das águas de abastecimento público, quando em níveis não adequados, assim como outras variáveis sociais e clínicas, podem influenciar o padrão de cárie nos adolescentes.

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

ABSTRACT Objective: To evaluate the association of oral health indicators and social variables on the frequency of visit to the dentist by persons with intellectual disability (ID). Material and Methods: The study comprised a sample consisting of 149 participants with ID, aged from 11 to 29 years, from non-governmental institutions. Semi-structured interviews were held to collect sociodemographic and psychosocial information with their parents/guardians, followed by oral health evaluations in accordance with World Health Organization criteria. Crude analyses and multiple analysis were conducted to test whether oral health indicators and social data were predictors of the visit to dental care services. Results: In the multiple logistic regression model, individuals with lower DMF-t (OR=3.13; 95% CI=1.40-6.97) and those with less crowded housing (OR=2.33; 95% CI=1.06-5.12) presented less frequency of visits to oral health services. Conclusion: DMFT and crowded housing are associated to the frequency of persons with intellectual disability to dental care as well as this outcome measure affects the oral health of persons with ID. Therefore, identifying limiting factors to dental care of persons with intellectual disability is needed so that this group can receive adequate attention.

Abstract The aim of this study was to evaluate the influence of the Brazilian School Health Program (SHP) on dental clinical disorders such as caries, gingivitis, and dental trauma as well as on the oral-health-related quality of life (OHRQoL) of adolescents in Nova Friburgo, RJ, Brazil. The study consisted of a non-probabilistic (convenience) sample comprising 319 12-year-old adolescents, both participants and non-participants of the SHP, for at least two years. Socio-demographic and OHRQoL questionnaires (CPQ11-14, the Child Perceptions Questionnaire) were applied as well as clinical examinations for caries, periodontal disease, and dental trauma following the World Health Organization (WHO) criteria by calibrated researchers. Mann-Whitney, chi-square tests, and multiple logistic regression models were used for the data analysis. Statistically significant differences were observed between the groups covered and not covered by the SHP for gingivitis (p = 0.0373) and OHRQoL on the social welfare subscale (p = 0.0265) and total scale (p = 0.0449) of CPQ11-14. Multivariate analysis showed that female adolescents were 1.74 times more likely to present a lower OHRQoL (OR = 1.74, 95%IC = 1.10–2.77, p = 0.0183) than males. In addition, non-SHP subjects were 1.56 times more likely to have poor OHRQoL (OR = 1.56, 95%IC = 0.94–2.59, p = 0.0873) than program participants. In conclusion, SHP positively influenced the OHRQoL of adolescents. However, follow-up studies are needed to verify the continued effectiveness of this Brazilian SHP in improving the oral health levels and quality of life of adolescents.

Os Centros de Especialidades Odontológicas (CEOs) foram criados dentro do contexto da Política Nacional de Saúde Bucal e a principal função desses estabelecimentos é servir como unidades de referência em atenção secundária à saúde bucal no SUS, devendo oferecer pelo menos os serviços de estomatologia, periodontia especializada, cirurgia oral menor, endodontia e atendimento a pacientes com necessidades especiais. O objetivo deste estudo foi avaliar a qualidade dos Centros de Especialidades Odontológicas da região serrana do Estado do Rio de Janeiro, Brasil, por meio da satisfação dos pacientes com necessidades especiais ou de seus acompanhantes. Os dados foram coletados de 159 usuários utilizando um questionário semiestruturado individual auto-aplicado padronizado. Os resultados indicaram uma avaliação positiva na maioria das dimensões, exceto na acessibilidade. Diferenças significativas (p < 0.05) foram observadas entre os serviços nas seguintes dimensões de qualidade: acessibilidade, resolutividade, qualidade técnico-científica, eficiência, eficácia e aceitabilidade. A análise dos dados qualitativos, por meio da técnica do Discurso do Sujeito Coletivo (DSC) e das representações sociais, apresentou cinco ideias centrais sobre a satisfação e insatisfação dos usuários com os serviços dos CEOs (cuidado humanizado, resolutividade do serviço, competência profissional, infraestrutura e organização do serviço, acesso aos serviços). Em conclusão, a maioria dos pacientes com necessidades especiais e seus acompanhantes estavam satisfeitos com os serviços dos CEOs, embora houvesse diferenças significativas entre os serviços dos CEOs em relação à satisfação dos indivíduos.

The Dental Specialties Centers (CEOs) were created within the context of the National Oral Health Policy, and the main function of these establishments is to serve as units of reference in secondary oral health care in the Brazilian national health system (SUS), and they must offer at least the services of stomatology, specialized periodontology, minor oral surgery, endodontics, and attendance to patients with special needs. The aim of this study was to evaluate the quality of the CEOs in the mountain region of the Rio de Janeiro State, Brazil, in the perspective of the patients with special needs care or their companion’s satisfaction. Data were collected from 159 users by using a standardized self-applied individual semi-structured questionnaire. The results indicated a positive evaluation in most of the dimensions, except the accessibility dimension. Significant differences ( p < 0.05) were observed between the services of the following dimensions of quality: accessibility, resoluteness, technical-scientific quality, efficiency, efficacy, and acceptability. The analysis of qualitative data, through the discourse of the collective subject technique (DCS) and social representations, showed five central ideas about users’ satisfaction and dissatisfaction with CEOs services (humanized health care, resoluteness of the service, professional competence, infrastructure and organization of the service, access to the services). In conclusion, most patients with special needs care and their companions were satisfied with specialized dental centers (SDC) services, although there were significant differences among SDCs services in relation to individuals’ satisfaction.

RESUMO JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi identificar a prevalência de suspeita de disfunção temporomandibular em funcionários e estudantes em uma universidade no Brasil e analisar a influência das variáveis sócio-demográficas e clínicas sobre essa disfunção. MÉTODOS: Este estudo teve uma amostra não probabilística compreendendo 575 voluntários que foram avaliadas por um questionário, proposto pela Academia Americana de Dor Orofacial. RESULTADOS: A suspeita de disfunção temporomandibular estava presente em 60,87% da população. Por meio da análise de regressão logística múltipla, apenas variáveis clínicas foram associadas com a presença de suspeita de disfunção temporomandibular, como: apresentar cefaleia, dores no pescoço ou nos dentes (OR=47,60), maxilares rígidos, apertados ou cansados com regularidade (OR=13,37), dificuldade na abertura da boca (OR=13,55) e dor ao redor das orelhas, têmporas ou bochecha (OR=4,61). CONCLUSÃO: O questionário foi eficaz como um instrumento de pré-triagem no levantamento dos sintomas; e os resultados suportam o ponto forte dos sintomas clínicos na identificação e acompanhamento de indivíduos com tais lesões.

ABSTRACT BACKGROUND AND OBJECTIVES: This study aimed at identifying the prevalence of suspected temporomandibular disorders in employees and students of a Brazilian university and at evaluating the influence of socio-demographic and clinical variables on this disorder. METHODS: This study had a non-probabilistic sample of 575 volunteers who were evaluated by a questionnaire proposed by the American Academy of Orofacial Pain. RESULTS: Suspected temporomandibular disorder was present in 60.87% of the population. By means of multiple logistic regression analysis, just clinical variables were associated to the presence of suspected temporomandibular disorder, such as: headache, neck pain or teethache (OR=47.60), stiff, tight or regularly tired jaws (OR=13.37), mouth opening difficulty (OR=13.55) and pain around the ears, temples or cheeks (OR=4.61). CONCLUSION: The questionnaire was effective as a pre-screening tool to identify symptoms, and results support the importance of clinical symptoms for the identification and follow up of patients with such disorders.

RESUMO O presente estudo pedagógico objetivou investigar o processo de formação em Odontologia com base na visão dos gestores, docentes e discentes de um curso de Odontologia em uma instituição de ensino superior (IES) – Faculdade de Odontologia do Instituto de Saúde de Nova Friburgo da Universidade Federal Fluminense (FO/ISNF/UFF). A amostra não probabilística foi composta por 98 sujeitos (8 gestores, 28 docentes e 62 alunos), que foram entrevistados ou responderam a questionários semiestruturados. A análise dos resultados foi realizada por meio da técnica do Discurso do Sujeito Coletivo (DSC) e representações sociais. Os resultados apontaram que 49,0% e 76,5% do corpo docente e discente da IES não têm conhecimento sobre as Diretrizes Curriculares Nacionais (DCN). As sugestões de melhoria incluíram a oferta de cursos de formação continuada em docência, inclusive a respeito das DCN, melhorias na infraestrutura do campus universitário e uma relação professor/aluno mais compatível. O estudo permitiu verificar algumas deficiências nas práticas e posturas, percebidas pelos sujeitos entrevistados. Entretanto, parece haver uma relevante preocupação de alguns sobre um alinhamento do Projeto Político Pedagógico (PPP) com as DCN.

ABSTRACT This pedagogical study aimed to investigate the training process in dentistry, from the perspective of managers, teachers and students of a dentistry course at a Higher Education Institution (HEI) – the Fluminense Federal University (CNF-UFF) Dental School – Nova Friburgo Campus. A non-probabilistic sample was comprised of 98 subjects (8 managers, 28 teachers and 62 students) who completed questionnaires. The analysis was performed using the Collective Subject Discourse technique (DCS) and social representations. The results showed that 49% and 76.5% of the professors and students of HEI, respectively, do not know about the NCGs (National Curricular Guidelines). The suggestions for improvement included the provision of teacher training courses, including subjects for discussions such as NCGs, improvements in campus infrastructure and a more compatible student-teacher ratio. Therefore, the study showed some shortcomings in the practices and attitudes perceived by managers, teachers and students. However, some people seem to be duly concerned about the alignment of the Pedagogical Political Project (PPP) with the NCGs.

Resumo: Objetivo: Identificar características desejáveis, considerando diferentes tamanhos de amostra e prevalências de cárie em amostras virtuais que possibilitem, simultaneamente, altos valores de porcentagem geral de concordância (PGC) e do coeficiente Kappa (κ), sob baixo intervalo de confiança (IC), em estudos de reprodutibilidade. Método: Ao total, 384 simulações estatísticas de calibração interexaminador, variando o tamanho da amostra (12, 15, 20, 60, 200 e 500 indivíduos), a prevalência de cárie (30, 50, 60 e 90%) e as taxas de concordâncias positiva (CP) e negativa (CN) (30, 50, 60 e 90%) foram realizadas. Os valores de PGC e κ foram utilizados para mensurar a reprodutibilidade e o desvio entre as respectivas medidas PGC/Kappa. Resultados: A amostra de 60 indivíduos, com prevalência de cárie de 50% e taxas de concordância positiva e negativa de 90%, apresentou um valor de PGC = 90%, Kappa = 80%, um intervalo de confiança (IC95% 0,65 - 0,95) relativamente pequeno e um desvio PGC/Kappa de 10,00. Conclusão: A amostra virtual de 60 indivíduos parece ser viável, em condições epidemiológicas, para produzir uma concordância interexaminadores satisfatória. Contudo, estudos epidemiológicos para corroborar ou refutar esta conclusão são necessários.

Abstract: Objective: To identify desirable characteristics, including different sample sizes and dental caries prevalences, in virtual samples that allow, at the same time, higher values of general agreement percentage (GPA) and Kappa coefficient (κ), under a low confidence interval (CI), in reproducibility studies. Method: A total of 384 statistical simulations of inter-examiner calibration, varying sample size (12, 15, 20, 60, 200 and 500 individuals), caries prevalence (30, 50, 60 and 90%) and percentages of positive (PA) and negative (NA) agreement (30, 50, 60 and 90%) were undertaken. GPA and κ were used to measure reproducibility and define deviation between them. Results: The sample of 60 individuals, under caries prevalence of 50%, PA and NA of 90%, presented a GPA and Kappa values of 90 and 80%, respectively, a relative small confidence interval (95%CI 0.65 - 0.95) and a GPA/Kappa deviation of 10.00. Conclusion: A virtual sample of 60 individuals, under caries prevalence of 50%, seems feasible to produce a satisfactory interexaminer agreement at epidemiological conditions. However, epidemiological studies to corroborate or refute this assertion are necessary.

Resumo: Objetivo: Identificar características desejáveis, considerando diferentes tamanhos de amostra e prevalências de cárie em amostras virtuais que possibilitem, simultaneamente, altos valores de porcentagem geral de concordância (PGC) e do coeficiente Kappa (κ), sob baixo intervalo de confiança (IC), em estudos de reprodutibilidade. Método: Ao total, 384 simulações estatísticas de calibração interexaminador, variando o tamanho da amostra (12, 15, 20, 60, 200 e 500 indivíduos), a prevalência de cárie (30, 50, 60 e 90%) e as taxas de concordâncias positiva (CP) e negativa (CN) (30, 50, 60 e 90%) foram realizadas. Os valores de PGC e κ foram utilizados para mensurar a reprodutibilidade e o desvio entre as respectivas medidas PGC/Kappa. Resultados: A amostra de 60 indivíduos, com prevalência de cárie de 50% e taxas de concordância positiva e negativa de 90%, apresentou um valor de PGC = 90%, Kappa = 80%, um intervalo de confiança (IC95% 0,65 - 0,95) relativamente pequeno e um desvio PGC/Kappa de 10,00. Conclusão: A amostra virtual de 60 indivíduos parece ser viável, em condições epidemiológicas, para produzir uma concordância interexaminadores satisfatória. Contudo, estudos epidemiológicos para corroborar ou refutar esta conclusão são necessários.

Abstract: Objective: To identify desirable characteristics, including different sample sizes and dental caries prevalences, in virtual samples that allow, at the same time, higher values of general agreement percentage (GPA) and Kappa coefficient (κ), under a low confidence interval (CI), in reproducibility studies. Method: A total of 384 statistical simulations of inter-examiner calibration, varying sample size (12, 15, 20, 60, 200 and 500 individuals), caries prevalence (30, 50, 60 and 90%) and percentages of positive (PA) and negative (NA) agreement (30, 50, 60 and 90%) were undertaken. GPA and κ were used to measure reproducibility and define deviation between them. Results: The sample of 60 individuals, under caries prevalence of 50%, PA and NA of 90%, presented a GPA and Kappa values of 90 and 80%, respectively, a relative small confidence interval (95%CI 0.65 - 0.95) and a GPA/Kappa deviation of 10.00. Conclusion: A virtual sample of 60 individuals, under caries prevalence of 50%, seems feasible to produce a satisfactory interexaminer agreement at epidemiological conditions. However, epidemiological studies to corroborate or refute this assertion are necessary.

A pentassomia do cromossomo x é uma síndrome rara, de incidência desconhecida e com poucos relatos na literatura científica, especialmente no que diz respeito à atenção odontológica para pacientes portadores da mesma. O objetivo deste estudo foi relatar um caso de atenção odontológica a uma jovem com pentassomia do cromossomo x, que apresentava fenda palatina, dentes inclusos, má-oclusão, alta atividade de cárie, gengivite e múltiplas perdas dentárias devido à cárie. Apesar das dificuldades de se realizar o tratamento dentário devido aos movimentos involuntários e a não colaboração inicial da paciente, houve total viabilidade da atenção odontológica em âmbito ambulatorial, observando-se significativa cooperação, formação de vínculo e adesão ao tratamento pela mesma e seus responsáveis, o que gerou sucesso terapêutico.

Pentasomy of the x chromosome is a rare syndrome of unknown incidence and there are few reports in the scientific literature, especially in terms of dental care for patients with this syndrome. The aim of this study was to report the dental care given to an adolescent with pentasomy of the X chromosome. The patient presented a cleft palate, impacted teeth, malocclusion, high caries activity, gingivitis and multiple tooth loss due to caries. Despite the difficulties of carrying out the dental work due to involuntary movements and the initial lack of collaboration from the patient the overall dental care was completed on an outpatient basis. The therapeutic success of the treatment was strongly supported by the significant cooperation and relationship that grew up along the period of the treatment, as well as the desire to have the treatment done by both the patient and her parents.

AIM: To evaluate the performance of dental caries detection when adjunct methods are associated and their applicability in epidemiological survey of dental caries, at D3 cavitated carious lesions at dentin layer and D1+D3 non cavitated and cavitated carious lesions at enamel/dentin layer diagnostic thresholds. METHODS: A total of 2189 posterior teeth from 165 12-year-old schoolchildren underwent visual examination without CL1 and with artificial lighting CL2, radiographic bitewing BW, fiber-optic transillumination/FOTI FT, DIAGNOdentTM DD and associations of these methods. Reproducibility was calculated by Kappa statistics and validity was calculated by sensitivity, specificity and accuracy tests. ANOVA Scott-Knott test was performed in order to compare the average values of DMF-S obtained by the diagnostic methods. RESULTS: The CL2FTDDBW D3 and CL2BW D1+D3 exams presented the highest values for accuracy at epidemiological setting. The DMF-S index obtained for those exams was statistically different at D3 and D1+D3 thresholds. CONCLUSIONS: The association of adjunct methods increased the validity of dental caries examination in an epidemiological setting. However, the potential of CL2BW traditional caries detection methods or visual exam performed under a more refined diagnostic criteria must be considered in dental caries epidemiological surveys.

AIM: To identify the prevalence of dental caries in inland Brazilian adolescents, and to analyze the influence of socio-demographic and clinical variables, and access to dental service on caries experience.METHODS: This study had a non-probabilistic sample comprising 504 adolescents aged 12 years, attending public schools in the city of Nova Friburgo, mountain region of Rio de Janeiro, Brazil. The World Health Organization (WHO, 1997) criterion was used by previously calibrated examiners to report dental caries. Variables were obtained by means of a semi-structured questionnaire applied to the adolescents' parents.RESULTS: The D3MFT mean was 1.90 and the Significant Caries (SIC) Index was 4.54, mainly represented by the carious component. Multiple logistic regression analysis revealed that parents with over 8 years of schooling (OR=0.579), absence of pain (OR=0.396) and not visiting the dentist (OR=0.270) might suggest protective factors against the disease; the possible risk factors were male gender (OR=1.982) and pain, extraction and others were reasons for consultation (OR=2.435).CONCLUSIONS: Although the prevalence of caries was slightly below the national mean, polarization of the disease was clearly observed. Education and no access to the dentist led to protection against the disease. These results may contribute to planning of oral health actions directed towards this target population for the control of caries.

OBJECTIVE: The aim of this 2-year cohort study (2003 to 2005) was to investigate how caries experience, at initial lesions (early or non-cavited lesions) and cavited stages, predicts caries increment in permanent teeth in 7-10- year-olds. MATERIAL AND METHODS: The random sample of 765 children attending public schools in the city of Piracicaba, SP, Brazil, was divided into two groups: 423 children aged 7-8 years and 342 children aged 9-10 years. All subjects were examined by a calibrated examiner, using dental mirror and ball-ended probes, after tooth brushing and air-drying in an outdoor setting, based on the World Health Organization criteria. Active caries with intact surfaces were also recorded as initial lesion (IL). Univariate analysis was used for statistical analysis (Odds Ratios and Chi-square). RESULTS: The association between the DMFT (decayed, missing and filled teeth) increment and the presence of IL was significant only for 9-10-year-old children. The children with DMFT>0 at baseline were more prone to have DMFT increment, with the highest risk for caries increment occurring in children aged 7-8 years. CONCLUSIONS: The predictors of caries increment were the presence (at baseline) of caries experience in permanent teeth for both age groups (7-8; 9-10-year-olds) and the presence of the IL (at baseline) for 9-10-year-olds.

Objectives: a) to evaluate the interexaminer reliability in caries detection considering different diagnostic thresholds and b) to indicate, by using Kappa statistics, the best way of measuring interexaminer agreement during the calibration process in dental caries surveys. Methods: Eleven dentists participated in the initial training, which was divided into theoretical discussions and practical activities, and calibration exercises, performed at baseline, 3 and 6 months after the initial training. For the examinations of 6-7-year-old schoolchildren, the World Health Organization (WHO) recommendations were followed and different diagnostic thresholds were used: WHO (decayed/missing/filled teeth - DMFT index) and WHO + IL (initial lesion) diagnostic thresholds. The interexaminer reliability was calculated by Kappa statistics, according to WHO and WHO+IL thresholds considering: a) the entire dentition; b) upper/lower jaws; c) sextants; d) each tooth individually. Results: Interexaminer reliability was high for both diagnostic thresholds; nevertheless, it decreased in all calibration sections when considering teeth individually. Conclusion: The interexaminer reliability was possible during the period of 6 months, under both caries diagnosis thresholds. However, great disagreement was observed for posterior teeth, especially using the WHO+IL criteria. Analysis considering dental elements individually was the best way of detecting interexaminer disagreement during the calibration sections.

Comparar três medidas (kappa, porcentagem geral de concordância e índice dice) utilizadas para se determinar a reprodutibilidade do diagnóstico da cárie em levantamentos epidemiológicos, sob diferentes níveis de detecção da doença. Onze examinadores com experiência prévia em levantamentos epidemiológicos foram submetidos a um processo teórico-clínico de calibração. Dois níveis de detecção da cárie foram adotados: Organização Mundial da Saúde (OMS) e OMS com inclusão de lesões iniciais em esmalte (OMS + LI). Os exames foram realizados em 23 crianças de 6-7 anos de idade com e sem atividade da doença. A análise dos dados foi realizada mediante dois limiares: OMS e OMS + LI. Valores médios dos índices kappa, porcentagem geral de concordância e dice foram considerados altos (>0,90), à exceção do índice dice para o limiar OMS + LI (0,69). O kappa, por ser um índice de concordância ajustado, pode ser considerado como instrumento de escolha para a calibração dos examinadores. Entretanto, na impossibilidade de seu uso, recomenda-se a utilização da porcentagem geral de concordância associada ao índice dice, a fim de direcionar e aprimorar os examinadores no exame das lesões cariosas.

This study compares three measurements (Kappa, general agreement percentage, or GAP, and dice index) used to determine the reproducibility of caries diagnosis in epidemiological surveys under different clinical diagnostic thresholds. Eleven examiners with previous experience in epidemiological surveys were submitted to a theoretical and clinical calibration process. Data analysis used two caries detection thresholds: World Health Organization (WHO) and WHO with the inclusion of initial enamel lesions (WHO + IL). Twenty-three children 6-7 years of age were examined, with and without caries. Mean values for Kappa index, GAP, and Dice were considered high (> 0.90), except for the dice index for the WHO + IL threshold (0.69). Since Kappa is an adjusted agreement index, it can be considered the instrument of choice for calibration of examiners. However, when it is impossible to use, the GAP is recommended together with the dice index in order to orient and improve examiners when examining caries lesions.