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.
Research
In order to use the ICDAS criteria in clinical research the following conditions are essential to enable examiners to assess each of the caries codes accurately: overhead operating light; cleaned teeth and compressed air.
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 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 column 2. +=active lesion;- =arrested lesion |
| 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: | Scores for ECM; classification of lesion severity: Only occlusal |
| 0= -0.45-1.0 | |
| 1= 1.1-3.0 | |
| 2= 3.1-9.0 | |
| 3= 9.1-12.0, clinically ±microcavitated | |
| 4= 9.1-12.0 Clinically shadowed | |
| 5= >12 Clinically cavitated but < ½ the surface | |
| 6= > 12 Clinically cavitated but > ½ the surface | |
| Column 8: | Yet to be established |
| Column 9: | Risk assessment:h=high, m=medium, l=low |
| Column 10: | Yet to be established |
| Column 11: | PTO = Preventive treatment option; OTO = Operative treatment option |
| Column 12: | p = progressing; a = arrested; r = regressing |
| Table | |
