Background and Objectives: Dental caries is a preventable, reversible disease in its early stages. This study evaluated the intra-rater agreement of International Caries Assessment and Detection System (ICDAS) scores with Medit i500^® and Omnicam^® scanners versus traditional clinical examinations and the inter-rater agreement using the Omnicam^® among senior dentists and dental students and between these two groups. Materials and Methods: A total of 24 patients aged between 21 and 34 years, randomly selected from dental students and interns, underwent four examinations (three intraoral scans and one clinical examination), and the corresponding ICDAS scores were recorded by a randomly selected rater out of the 31 available examiners. The examination team consisted of dental students, dentists with less than 3 years, and dentists with more than 5 years of clinical experience. The following inter- and intra-rater agreement tests for the ordinal data were chosen: Fleiss’ kappa coefficient, Cohen’s weighted kappa, and inter-class correlations. Results: For all examination techniques, there was statistically significant agreement for the experienced raters (p < 0.05). The highest positive interclass correlation was obtained for inter-rater agreement tests of 288 observations recorded by senior dentists: ICC = 0.969 (95% CI 0.949–0.981). Conclusions: Intra-rater reliability was excellent for Omnicam compared to clinical exams conducted by senior dentists but moderate for Medit i500. Although inter-rater agreement using Omnicam was poor between students and between senior dentists and students, it was excellent among senior dentists.

Background and Objectives: In recent decades the prevalence of dental caries has continued to increase despite widespread access to modern dental care. This study aimed to evaluate the diagnostic relevance of differentiating healthy, carious, and restored dental structures using intraoral scans—a non-irradiating imaging technique. Materials and Methods: A cross-sectional reliability (diagnostic agreement) study was carried out. All 36 examiners underwent pre-calibration on the ICDAS scores recordings. They filled in ICDAS files for each randomly assigned patient through three different methods: clinical examinations and three-dimensional digital models obtained with two different intraoral scanners. Cohen’s weighted kappa test and Prevalence and Biased Adjusted Kappa (PABAK) were utilized to evaluate agreements. A corresponding p-value for agreement was computed for each agreement coefficient. Results: When ICDAS values recorded using intraoral scanners were compared for examiners with different experience levels, there was an inter-rater substantial agreement for all teeth (PABAK = 0.688; CI 95% = 0.344–0.894), but also for anterior teeth only, as well as for smooth surfaces only. Regardless of the examiner’s clinical experience, PABAK inter- and intra-rater agreement on fillings identification on three-dimensional digital models obtained by intraoral scanning were at least moderate in most cases. Conclusions: Three-dimensional digital models offer reliable diagnostic information, especially for experienced clinicians, supporting their use as a standardized tool in routine practice to obtain an accurate, dynamic view of patients’ caries status, although limitations such as controlled study conditions and variability in scanning algorithms across systems must also be acknowledged in daily dental diagnostics.