ABSTRACT
The aim of the present study was to correlate clinical and radiographic diagnoses of the occlusal surfaces of the first permanent molars. A total of 56 first permanent molars with no macroscopic evidence of caries were selected from 40 children. A research worker performed the visual examination (VE) and an expert performed the radiographic analysis employing bitewing radiographs. Each professional performed diagnosis independently. The statistical analysis revealed: 1) Low correlation between both methods; Kappa: 0.03, p = 0.34; 2) Correlation between past history of caries and VE: taub Kendall 0.333, p = 0.003; no correlation between past history of caries and radiographic diagnosis: 0.002, p = 0.984; 3) No correlation between each of the methods of diagnosis and the age of the patients. The radiographic analysis showed a high revalence of radiolucid images, interpreted as caries, that failed to be detected by VE. To improve VE as a diagnostic method for pits and fissures we should combine various procedures and consider other clinical predictors.