The effect of lighting conditions on caries interpretation with a laptop computer in a clinical setting

Objective: To test the null hypothesis of no difference in caries detection in dim, bright, and hooded environments for laptop viewing of intraoral radiographs. Study design: Extracted posterior teeth were imaged with posterior bite wing geometry by using storage phosphor plates. Images were displayed on a laptop computer placed in 3 lighting environments. Six dental students and 6 faculty observers scored the caries status of proximal surfaces. Responses were compared to histologic ground truth by using receiver operating characteristic (ROC) analysis and other measures of accuracy. Performance was also compared to photometer-measured light levels and time spent in observation. Results: ROC A_Z was significantly higher for faculty using hooded displays (0.87) than in a bright clinical environment (0.79; P = .04). Student performance was highly variable and not significantly different in any of the lighting environments. Conclusion: The ability to detect caries by experienced clinicians may be improved by hooding laptop displays in bright clinical environments.