The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries

Abstract

This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.

Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries

“…Although several detection methods have been described in the literature [7][8][9]17 , choosing the ideal method it is not an easy task.…”

“…The first stage involves classifying each tooth surface according to its condition (sound, sealed, restored, with or without a dental crown, or missing). The second stage involves the classification of the extent of the lesion on an ordinal scale 17 .…”

“…The International Caries Detection & Assessment System (ICDAS) 17 is an accessible set of criteria for dentists, researchers and professors and presents acceptable sensitivity and specificity to the detection of occlusal caries 4,5,10,18,19 . According to this system, caries detection on coronal teeth surfaces is a process that comprises two stages.…”

Parental influence on children’s answers to an oral-health-related quality of life questionnaire

“…Code 2 was used for white spots, and codes ≥ 3 determined different degrees of cavitation. 16 This variable was categorized by considering the most serious lesion suffered by the child.…”

Risk Factors of Caries Progression in a Hispanic School-aged Population

“…We examined a convenience sample of 408 children at baseline and 12 and 24 mos to monitor caries development/progression in primary and permanent teeth, using the International Caries Detection and Assessment System (ICDAS) applied by a single calibrated dentist (Ismail et al, 2007). Ten percent of the children were re-examined after each visit to determine intra-and inter-examiner (examiner and back-up examiner) reliability.…”