Validity of caries data in the Swedish Quality Register (SKaPa) in a cohort of 19-year-olds in Region Värmland, Sweden

OBJECTIVE: The Swedish Quality Register for Caries and Periodontal Disease (SKaPa) is a national registry providing oral health data for children and adolescents. Since no validation has been performed on adolescents with permanent dentitions, the aim of this study was to evaluate SKaPa data for dental caries in 19-year-olds. MATERIAL AND METHODS: This diagnostic accuracy study included a random sample of 19-year-olds (N = 250) examined in 2014 in the Public Dental Service, Region Värmland. Clinical records served as the reference standard and SKaPa variables as the index test. Number of decayed and filled teeth (DFT), number of decayed, missing, and filled teeth (DMFT), missing teeth due to caries (MTC), missing teeth due to any reason (MTA), number of decayed teeth (DT), and number of filled teeth (FT) were evaluated. Agreement was evaluated using exact agreement, Cohen's kappa, and intraclass correlation coefficients. RESULTS: Data showed high agreement for DFT, DMFT, MTA, DT, and FT (kappa between 0.82 and 0.90; ICC 0.93-0.96). SKaPa underestimated caries by 6-7%. Among 155 participants with DFT/DMFT ≥1, only three had MTC, limiting evaluation. CONCLUSIONS: SKaPa caries data demonstrate high accuracy. However, as MTC could not be evaluated, DMFT should be used with caution in research at this point. Researchers should instead use DFT but be observant of the risk of an underdiagnosis of dental caries in SKaPa for 19-year-olds.