LAUSR

BACKGROUND Early childhood caries (ECC) requires systematically collected and standardized data. AIM To describe a novel multilevel calibration procedure in primary dentition. DESIGN Calibration method involved two calibration levels: the first (L1 ) involved inter-examiner agreement between three main investigators, the group leaders (GLs) in the following level; the second level (L2 ) involved three groups of 11 pediatric dentists and inter-examiner agreement assessment according to the GLs in each group. The study sample consisted of 650 primary teeth surfaces in eight children (mean age 6.56±2.22 years). Surface-by-surface percent agreement, tooth-by-tooth percentage agreement, Cohen's kappa and Fleiss Kappa statistics were used to calculate inter-examiner reliability. Statistical analysis was performed with SPSS 27.0. RESULTS Surface-by-surface agreement regarding ICDASepi -merged revealed almost perfect agreement (>90.00%) both on L1 and L2 . Kappa values and ranges showed good agreement both at L1 (Overall Kappa=0.95) and L2 (Overall Kappa=0.98) and almost perfect consistency was detected between GLs at L1 (>91.30%) and substantial agreement at L2 (>85.00%). All examiner at L2 showed almost perfect positive agreement (sensitivity=96.77-100%) when detecting presence of dental plaque. CONCLUSIONS The calibration procedure appeared feasible prior to organizing multicenter epidemiological oral health survey in large population groups of preschool children, with higher number of examiners.