According to the outcomes of the present appraisal, it was concluded that the numerical score provided by the CAST severity scores allows an overview of the severity of caries disease and the classification of individuals into mild, moderate or severe levels of dental caries when the new formula (F1) is used.
Resumo O CAST (Caries Assessment Spectrum and Treatment) é um instrumento desenvolvido para a detecção de cárie a ser utilizado em levantamentos epidemiológicos. Foi validado e tem se mostrado efetivo, fornecendo um diagnóstico mais preciso do estado de saúde bucal do que o critério OMS, recomendado pela Organização Mundial da Saúde. O objetivo deste artigo é comparar a apresentação dos resultados de cárie dentária utilizando o instrumento CAST e o critério OMS, numa mesma população. Foram avaliados por dois examinadores treinados na utilização do instrumento CAST 680 escolares de 6 a 8 anos do Distrito Federal, Brasil. A avaliação constou do índice de placa visível (IPV) e do índice de sangramento gengival (ISG). Os escores CAST dente foram convertidos em componentes ceo/CPO e calculados os ceod/CPOD. Os pais responderam a um questionário sociodemográfico. A idade média foi 7,45 anos (± 0,91). A prevalência de cárie na dentição decídua foi de 65,44% e 61,61%, considerando o CAST e o critério da OMS, respectivamente; na dentição permanente: 38,19% e 10,2%, respectivamente. A média do ceod foi de 2.4 (± 2.7) e a média do CPOD 0.16 (± 0.53). o IPV foi associado a maiores CAST máximos p < 0,005. O instrumento CAST demonstrou maior sensibilidade em identificar a presença e gravidade de lesões cariosas quando comparado ao critério OMS.
Aim: to evaluate changes in the frequency of use of minimum interventions (MI) techniques for caries management during the COVID-19 pandemic. Materials and Methods: a questionnaire was applied through the SurveyMonkey™ platform to evaluate changes in the dentist’s frequency of use of non-invasive, micro-invasive, minimally invasive, and mixed interventions, non-aerosol, or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test and the effect size (ES) was calculated. An α = 0.05 was adopted. Results: a total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30’s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the non-invasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p<0.01; ES=0.11). The frequency of sealants to repair defective restorations were the only micro invasive technique that increased during the pandemic (p<0.01; ES=0.03). Among the minimally invasive techniques the use of atraumatic restorative treatment (ART) increased significantly (p<0.01; ES=0.06), while the use of air abrasion decreased (p=0.02; ES=0.04) during COVID-19 pandemic. Moreover, non-restorative cavity control (mixed intervention) increased during pandemic period (p<0.001; ES=0.11). Conclusion: Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.
Background:The intriguing failure in eradicating tooth decay is an inexhaustible topic for research and has resulted in numerous epidemiological surveys, and, in the development of different tools for recording the data collect ed in relation to the disease. Aim: To describe the caries prevalence in a group of students among 6 to 8 years of age at Estrutural City -DF through the CAST instrument (Caries Assessment Spectrum and Treatment); to correlate the disease and the visible plaque (VPI), gingival bleeding (GBI) indexes and the toothache; to assess the CAST severity score according to the formula (F) proposed by the CAST Manual and to propose other formulae (F1 and F2) for presenting epidemiological data. Material and Methods: The study was carried out in 680 schoolchildren in a low income region of the Federal District, among 6 to 8 years old. The dental exam was performed by two trained and calibrated examiners in using the CAST instrument (k1 intra = 0.79, k2 intra = 0.82; k inter = 0.90) and the calculation of caries prevalence based on the CAST Manual. The clinical outcomes and gender were compared using the chi-square or Fisher test. With the aim of assessing the correlation between pain and the maximum CAST score per subject, Pearson corelation test was used, with a level of significance of 0.05. CAST maximum score per tooth and the CAST severity score per subject was calculated using three different formulae. Results: Overall caries prevalence (enamel and dentine lesions) was 69.12%; 65.44% for the primary dentition and 38.19% for the permanent dentition; the mean score for VPI and GBI were 0.52 (±0.27) and 0.034 (±0.07), respectively; the prevalence of pain was 21.76%. The correlation between pain and the maximum CAST score per subject was statistically significant (p < 0.001). The F (weights: CAST 3=1; 4=2; 5=3; 6=4; 7=5 e 8=6) was applied stratifying the population into quartiles (bellow 25; 25-75; higher 75), with 28.7% of the subjects being classified as having a mild CAST severe score, 46.9% moderate and 24.4% severe. The weights of the scores were changed for F1 CAST 3-5 (3=0.25; 4=1; 5=2) but the way of stratifying the sample was maintained: 27.8% of the subjects were classified as mild, 47.5% mild and 24.7% severe. The F2 changed the way the sample was stratified (tertiles): 34.1% of the subjects were mild, 29.5% moderate and 36.4% severe. Conclusion: The caries prevalence was considered high, as well as the report of pain. Pain and visible plaque index were correlated with higher CAST scores. In regard to the CAST score gravity, it was concluded that it can provide important additional information about the analysis of dental caries in epidemiological surveys. The modified formulae, F1 and F2, resulted in better grouping according to the severity of the assigned scores. In the age group of the subjects included in this study, F2 exhibited greater accuracy than F1.
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