| In order to use the ICDAS criteria 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. Those teaching ICDAS should at least be familiar with the ICDAS e-learning material which is available for free use from here ICDAS.org website |
International Caries Assessment and Detection System (ICDAS)
ICDAS shared vision
- ICDAS is a clinical scoring system for use in dental education, clinical practice, research, and epidemiology.
- ICDAS is designed to: lead to better quality information to inform decisions about appropriate diagnosis, prognosis, and clinical management at both the indivdual and public health levels.
- and ICDAS provides a framework to support and enable personalised total caries management for improved long term health outcomes.
Education
Explanation to the table
| Column 1: | Relationship between scores 0-6 in the table and histological depth |
| Scores | Histological depth |
| 0 | No enamel demineralization or a narrow surface zone of opacity (edge phenomenon) |
| 1 | Enamel demineralization limited to the outer 50% of the enamel layer |
| 2 | Demineralization involving between 50% of the enamel and 1/3 of the dentine |
| 3 | Demineralization involving the middle 1/3 of the dentine, clinically microcavitated |
| 4 (3) | Demineralization involving the middle 1/3 of the dentine, clinically shadowed |
| 5 (4) | Demineralization involving the inner 1/3 of dentine± into the pulp, clinically cavitated but the cavitation < ½ the surface |
| 6 (4) | Demineralization involving the inner 1/3 of dentine± into the pulp, clinically cavitated but the cavitation > ½ the surface |
See table at the end of this page Modified from Ekstrand et al., 1997 |
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| Column 2: | Terms of increasing severity stages of caries for lay persons |
| Column 3: | Terms for the visual apperance for increasing severity stages of caries for professionals |
| Column 4 | Related scores to coulmn 3 |
| Column 5: | Activity assessment posibilities for the scores in column 4 and thus also columns 3 and 2. +=active lesion;- =arrested lesion |
| Column 6: | 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 7: | 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 8: | Risk assessment:h=high, m=medium, l=low |
| Column 9: | PTO = Preventive treatment option; OTO = Operative treatment option |
| Column 10: | p = progressing; a = arrested; r = regressing |