Can dental students be taught to use dental radiographs for osteoporosis screening?

This study investigated the possibility of teaching dental students to detect radiographic changes suggestive of osteoporosis. Twenty-five panoramic radiographs from dental school patients with a history of osteoporosis and radiographic changes suggestive of the disease and twenty-five normal panoramic radiographs were selected by a clinician from the database of the College of Dentistry, University of Tennessee Health Science Center. Twenty students were taught to use the mandibular cortical index (MCI) and detect changes suggestive of osteoporosis. Students also used a five-point scale to determine the diagnostic accuracy of panoramic images for osteoporosis. Intraclass Correlation Coefficient (ICCC) and Cronbach's alpha internal coefficiency statistical tests were used to evaluate interrater reliability among the twenty students and between the students and the radiologist. To test for differences in diagnosis between the gold standard (dental clinician) and the oral radiologist, we performed a McNemar's chi-square test for matched data. The interrater consistency was excellent for both the students (α=0.902) and between the students and the radiologist (α=0.909). The diagnostic accuracy of panoramic images was moderate (Az=0.81). No statistically significant difference between radiographic and clinical evaluations (McNemar's chi-square=3.063; p=0.0801) was observed. Teaching dental students to recognize radiographic changes suggestive of osteoporosis in routine panoramic radiographs should be emphasized to improve their awareness and identification of this disease.