The aim of this in vitro study was to determine if experience and country of training influenced the accuracy of detecting occlusal caries from radiographs. Standardised 'bitewing' radiographs were recorded of 166 third permanent molar teeth. The radiographs were examined by four different groups with 5 subjects in each group. These groups comprised dentists and dental students from Switzerland or Brazil. Their observations were compared to the histological gold standard. Dentists had the highest values for specificity (teeth identified from radiographs as not having caries) and the lowest levels of sensitivity (true cases of disease). An explanation for this is that 'they (dentists) are willing to not detect some caries lesions in order not to overtreat the disease'. Swiss dental students had the 'highest value of sensitivity (0.75) and the lowest value of specificity (0.24)'.
