A new equine peripheral caries grading system: Are the caries likely active or inactive?
Abstract: Equine peripheral caries can be a significant welfare issue in affected horses. Recent work has shown that complete reversal of the condition may be possible if the primary risk factor can be identified and corrected. Determining whether caries are active (deteriorating) or inactive (improving) is of vital importance when formulating a management and treatment plan. A new grading system is proposed that looks at whether caries are likely active or inactive to assist clinicians deciding whether intervention is required. Objective: To examine the reliability of an alternative grading method for equine peripheral caries. Methods: Online survey of veterinary surgeons. Methods: Reviewers (n = 22) graded images of peripheral caries using three methods: the traditional grading system, a new research grading system and a new clinical grading system. Percentage agreement and Fleiss' kappa were used to examine the participant's agreement of the severity of caries. Results: All percentage agreements and Fleiss' kappa values were significantly greater than zero (P < .001). The Fleiss' kappa for the new methods were higher (ranging from 0.48 to 0.58), but not significantly different from the traditional method (0.40). There was a high level of consistency in the assessment of caries as either active or inactive with both grading systems reporting over 80% agreement. Feedback on the grading systems was positive with over 90% of reviewers saying they were likely to use the system. Conclusions: The use of photographs provided some difficulties with image quality and judging whether the dentin was affected without an occlusal image. Conclusions: The new grading system produced a consistent estimate of caries severity and provided high levels of agreement on whether the caries were likely 'active' or 'inactive'. This is likely to be very useful clinically to assist practitioners to determine whether intervention is required.
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Publication Date: 2020-10-29 PubMed ID: 33007110DOI: 10.1111/evj.13359Google Scholar: Lookup
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Summary
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This research article presents a proposed grading system for assessing equine peripheral caries to assist clinicians in evaluating the condition, categorizing it as likely active or inactive and determining the need for intervention.
Objective of the Research
- The main goal of this study was to test the reliability of a new alternative grading method for equine peripheral caries composed of three systems: the traditional grading system, a new research grading system, and a new clinical grading system.
Research Methodology
- An online survey was carried out among veterinary surgeons who then graded images of peripheral caries using the three grading systems.
- The consistency in grading and agreement among the participants on the severity of caries was analyzed using a statistical measure known as Fleiss’ kappa and the percentage agreement.
Results of the Study
- All percentage agreements and Fleiss’ kappa values were significantly greater than zero, indicating a high level of agreement among graders.
- The Fleiss’ kappa for the new methods ranged from 0.48 to 0.58, which was higher than the traditional method (0.40), but the difference was not significant.
- There was a high level of consistency in the assessment of caries as either active or inactive, with both grading systems showing over 80% agreement.
- Over 90% of reviewers stated that they were likely to use the new grading system, indicative of a positive feedback.
Conclusions Drawn
- There were some difficulties in using photographs due to image quality and the challenge in judging if the dentin had been affected without an occlusal image of the teeth.
- Despite these, the new grading system still provided a consistent estimate of caries severity and offered high levels of agreement as to whether the caries were likely active or inactive. This makes it a promising tool to aid practitioners in deciding whether intervention is necessary.
In conclusion, this research proposes an alternative method to the traditional grading system for equine peripheral caries that not only estimates the severity of the caries but also provides valuable information on their current state as either active or inactive. This could assist clinicians in formulating better-informed management and treatment plans for affected horses.
Cite This Article
APA
Jackson K, Kelty E, Tennant M.
(2020).
A new equine peripheral caries grading system: Are the caries likely active or inactive?
Equine Vet J, 53(4), 780-786.
https://doi.org/10.1111/evj.13359 Publication
Researcher Affiliations
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The University of Western Australia, Nedlands, WA, Australia.
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia.
- International Research Collaborative - Oral Health and Equity, Department of Anatomy, Physiology and Human Biology, The University of Western Australia, Nedlands, WA, Australia.
MeSH Terms
- Animals
- Dental Caries Susceptibility
- Horses
- Observer Variation
- Reproducibility of Results
- Risk Factors
- Surveys and Questionnaires
References
This article includes 12 references
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Citations
This article has been cited 1 times.- Nitzsche AM, Fey K, Büttner K, Gröf M, Staszyk C. The Gingiva of Horses With Pituitary Pars Intermedia Dysfunction: A Macroscopic Anatomical Evaluation. Front Vet Sci 2021;8:786971.
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