Assessment of caries diagnostic thresholds of DMFT, ICDAS II and CAST in the estimation of caries prevalence rate in first permanent molars in early permanent dentition—a cross-sectional study

Abstract

Background The actual burden of dental caries prevalence varies with the caries assessment tool used. Therefore, the present study evaluated the caries diagnostic potentials of Decayed, Missing and Filled Teeth (DMFT); International Caries Detection and Assessment System (ICDAS) II and Caries Assessment Spectrum and Treatment (CAST) indices in estimating the caries prevalence rate of first permanent molar (FPM) in Saudi male children aged 7–9 years. Methods This descriptive, cross-sectional study included 390 children by multistage stratified cluster sampling method in Al-Jouf Province, Saudi Arabia. The prevalence rates of FPM caries were determined by DMFT, ICDAS II and CAST indices at various diagnostic cut-off points. Intra- and inter-examiner reliability was determined. Results The prevalence rates of FPM caries determined by DMFT (decayed), ICDAS II (codes 1–6) and CAST (codes 3–7) were 64.4% (61.6–67.2), 71.5% (69.2–73.2) and 71.0% (68.7–73.3), respectively. The prevalence rates of FPM caries determined by ICDAS II at various diagnostic cut-offs were as follows: ‘sound’ (code ‘0’), 28.5% (26.3–30.8); ‘enamel caries’ (codes 1–3), 57.2% (54.7–59.7) and ‘dentinal caries’ (codes 4–6), 14.3% (12.6–16.1). Similarly, the prevalence rates estimated by CAST at different diagnostic cut-off points were: ‘healthy’ (scores 0–2), 28.1% (25.9–30.4); ‘premorbid’ (score 3, enamel carious), 56.5% (54.0–59.0); ‘morbid’ (scores 4–5, cavitated carious dentin), 7.9% (6.6–9.3); ‘severe morbidity’ (scores 6–7, pulp exposure/fistula/abscess), 6.6% (5.4–8.1) and ‘mortality’ (score 8, lost), 0.8% (0.4–1.4). Conclusion Enamel caries lesions were found in more than half of the FPMs investigated in the current study. CAST index is preferable because it detects the complete spectrum of caries. ICDAS II at codes 1–6 and CAST at codes 3–7 projected similar caries prevalence rates in FPMs.

Assessment of dental caries based on ICDAS and WHO criteria: A comparative study

“…The current study showed a highly significant difference ( p < 0.001) in caries prevalence between WHO and ICDAS II. This finding is supported by many other studies 2,3,5,17,19–21 . The discrepancy between the two systems might be due to the failure of the WHO system to include noncavitated lesions.…”

“…A tooth that had been crowned because of previous decay was also recorded studies. 2,3,5,17,[19][20][21] The discrepancy between the two systems might be due to the failure of the WHO system to include noncavitated lesions.…”

Food insecurity and dental caries prevalence in children and adolescents: A systematic review and meta‐analysis

“…Given the growing interest in minimally invasive dentistry, detecting precavitated lesions seems to be considered. Nonetheless, adopting such an approach might not be viable for epidemiological surveys, especially in low‐income settings where resources are scarce 51 . Besides, most studies included in this meta‐analysis reported data from children aged 5 years and older; of those, all but one reported data on both primary and permanent tooth caries.…”

“…Nonetheless, adopting such an approach might not be viable for epidemiological surveys, especially in low-income settings where resources are scarce. 51 Besides, most studies included in this metaanalysis reported data from children aged 5 years and older; of those, all but one reported data on both primary and permanent tooth caries. This allowed us consider the nonage-dependent approach and further avoided the common caries-free pattern seen in permanent teeth of individuals in their early mixed dentition.…”

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010–2021)

“…For cavitated carious lesions, both indices tend to report similar prevalence rates. Nevertheless, dmft index is unable to detect non-cavitated lesions cases, unlike the ICDAS which has the advantage of distinguishing between the stages of caries progression in early enamel, enamel, and dentin [91,92]. Hence the variation between the two indices needs to be taken into consideration while interpreting the results of this review.…”