Radiographic prevalence of approximal enamel lesions and relationship with dentine lesions and restorations in Dutch adolescents

Aim: The aim of this study was to assess the prevalence of approximal enamel lesions from radiographs in groups of 14, 17, 20 and 23 years old, and to determine the relation with dentine lesions and restorations present. Method: Per age group, the bitewings of 120 persons were randomly selected and assessed for enamel lesions from the distal surface of the first premolar to the mesial surface of the second molar. A second examiner assessed 20% of the material for enamel lesions to determine the interexaminer agreement (Cohen's kappa = 0.63). Results: An enamel lesion was found in 12-15% of the unfilled surfaces. The mean number of surfaces with enamel lesions was almost three per person. For all age groups it was found that about 20% of the persons had at least four enamel lesions and the number of enamel lesions was significantly correlated with the number of dentine lesions. Of all enamel lesions 20% were found in persons without any dentinal lesions or restorations. Conclusion: The bitewing radiographs showed a considerable number of enamel lesions for these age groups. This seems to justify its use on a routine base as a diagnostic tool at the age of 14-16 years.