In order to use the ICDAS criteria in clinical practice the following conditions are essential to enable examiners to assess each of the caries codes accurately: overhead operating light; cleaned teeth and compressed air.  Since caries forms in areas of plaque stagnation it is essential that the teeth are cleaned with at least a toothbrush and floss before conducting an examination using the ICDAS criteria.

Explanation to the table

Column 1: Terms of increasing severity stages of caries for lay persons

Column 2: Terms for the visual apperance for increasing severity stages of caries for professionals

Column 3 Related scores to coulmn 2

Column 4: Activity assessment posibilities for the scores in column 3 and thus also columns 2 and 1

Column 5: Scores for radiographical classification of lesion severity:

  0=no radiolucency 

  1= radiolucency in outer ½ of the enamel

  2= radiolucency in inner ½ of the enamel± EDJ 

  3= radiolucency limited to the outer 1/3 of dentine

  4= radiolucency reaching the middle 1/3 of dentine

  5= radiolucency reaching the inner 1/3 of dentine, clinically cavitated

  6= radiolucency into the pulp, clinically cavitated

Column 6: Scores for Fibre-optic translumination (FOTI); classification of lesion severity: Proximal and occlusal

  0= no shadow or stained area

  1= Lesion stays the same width when transilluminated/Thin grey shadow into enamel when transilluminated

  2= Wide grey shadow into enamel when transilluminated 

  3= Wide grey shadow into enamel with no evidence of dentine shadow

  4= Orange/brown or bluish/black shadow < 2mm in width

  5= Shadow as described above and/or transillumination light is blocked > 2mm in width

  6= Large area of frank cavitation with likely pulpal involvement

Column 7: Risk assessment:h=high, m=medium, l=low

Column 8: PTO = Preventive treatment option; OTO = Operative treatment option

Column 9: p = progressing; a = arrested; r = regressing