How Long does it Take to Examine Young Children with the Caries ICDAS System and how do they Respond?

Abstract

A caries-epidemiological study using the ICDASepi-merged system was conducted in Colombian young children. This study aimed at associating the time needed for the clinical examination of caries and caries risk in 1 to 5-year-old children according to age and caries risk, and to assess behavior and child pain self-perception during examination according to age. After IRB approval and given parents/caregivers’ informed consent, seven trained examiners assessed 1 to 5-year olds in kindergartens under local field conditions. ICDASepi-merged caries experience (depiMEmf) was assessed as follows: Initial-depi (ICDAS 1/2 without air-drying); Moderate-dM (ICDAS 3,4); Extensive-dE (ICDAS 5,6) lesions; due-to-caries fillings-f and missing-m surfaces/teeth. Caries risk was assessed with Cariogram®. Child’s behavior (Frankl-Behavior-Rating-Scale) and self-perceived pain (Visual-Analogue-Scale-of-Faces) during examination were evaluated. Clinical examination time was recorded with a stopwatch. A total of 592 children participated (1-yr.: n=31; 2-yrs.: n=96; 3-yrs.: n=155; 4-yrs.: n=209, 5-yrs.: n=101). The depiMEmfs prevalence was of 79.9% and the mean 8.4±10.4. Most were high-caries-risk children (68.9%). The majority (58.9%) showed ≥ positive-behavior and ≤ light-pain self-perception (88.4%). Mean clinical examination time was around 3.5 minutes (216.9±133.9 seconds). For 5-yr. olds it corresponded to 4 minutes (240.4±145.0 seconds) vs. 2 minutes (122.8±80.1 seconds) for 1-yr. olds (Kruskal-Wallis; p=0.00). For high- and low-caries risk children it was around 4.3 minutes (255.7±118.5 seconds) and 3.3 minutes (201.3±129.4 seconds), respectively (ANOVA; p=0.01). This study demonstrates using the ICDAS system in young children is feasible, taking less than 4 minutes for the clinical examination without children behavior/pain self-perception issues.

Inclusion of initial caries lesions in a population-based sample of Brazilian preschool children: Impact on estimates and treatment needs

“…On the other hand, additional time may be necessary for the examination and less reliable detection of non-cavitated thresholds may be observed [5]. The merged ICDAS codes could be used in epidemiological surveys [7,8]. This methodological approach could simplify the calibration process for epidemiological purposes while guaranteeing the mapping of caries lesions in all severity stages.…”

Visual and radiographic merged‐ICDAS caries progression pattern in 2‐6 years old Colombian children: Two‐year follow‐up

“…The use of the ICDAS criteria has shown to require initial training of examiners and understanding of the system, which involves more study preparation time. On the other hand, it has been shown that the examination time during the study does not take over 4 minutes per child, which is adequate.…”

Multilevel calibration procedure for the oral health national multicenter survey in primary teeth

“…12 Caries experience including missing and filled primary teeth surfaces was registered using the standard method-dmfs, while "d" part included ICDASepi-merged system (d epiME mf). 12,15 In order to analyze the agreement between examiners, we transformed ICDASepi-merged into binomial variable: agreement…”

“…12,14 Caries experience including missing and filled primary teeth surfaces was registered using the standard methoddmfs, while "d" part included ICDASepi-merged system (d epiME mf). 12,15 According to the literature, the inspection and visual evaluation of lesion size and extent showed good overall performance, especially when a validated and recognized scoring system was used. 17 Moreover, visual assessment of the tooth surface by observing lesion location, plaque accumulation, roughness, or radiance might be used to develop decisions regarding lesion activity.…”