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. 2019 Mar 7;19(1):41.
doi: 10.1186/s12903-019-0730-8.

The impact of ICDAS on occlusal caries treatment recommendations for high caries risk patients: an in vitro study

Muawia A Qudeimat  1 , Yacoub Altarakemah  2 , Qasem Alomari  2 , Nour Alshawaf  3 , Eino Honkala  4
Affiliations

The impact of ICDAS on occlusal caries treatment recommendations for high caries risk patients: an in vitro study

Muawia A Qudeimat et al. BMC Oral Health. .

Abstract

Background: The diagnostic criteria and tools used in caries lesion detection have been shown to affect the decision-making for caries treatment. Compared to other diagnostic criteria/classifications, ICDAS has been shown to provide a more accurate method for the detection of occlusal caries lesions. The influence of using ICDAS on caries treatment recommendations has received increasing attention in recent years. Therefore, the aim of this study was to assess the impact of ICDAS on dentists' occlusal caries lesions' treatment decisions for patients at high risk for caries.

Methods: Five dentists examined the occlusal surfaces of 270 extracted premolars and permanent molars. For a predetermined clinical scenario, the examiners were asked to indicate their treatment recommendations for each tooth. Four weeks later, all the examiners were trained and calibrated for the use of ICDAS. Then the investigators examined the same 270 teeth independently and indicated their treatment recommendations using the same clinical scenario. Histological validation was used to determine the caries lesions detection performance of the examiners using ICDAS and to assess the relationship between the presence of dentin caries and treatment recommendations for each examiner before and after ICDAS training. Specificity, sensitivity, area under the receiver operating characteristic curve (AUC), and Spearman's correlation coefficients were calculated. The Wilcoxon two-related sample rank test was used to test for differences between treatment recommendations.

Results: The strongest correlation for inter-examiner reproducibility was found between the ICDAS D2 cut-off point (ICDAS codes 3-6 as dentin caries) and histologic dentin caries. Treatment recommendations among different examiners before and after ICDAS training demonstrated a statistically significant increase in operative intervention and an increase in the percentage of overtreatment recommendations for two examiners.

Conclusions: The impact of ICDAS on the examiners' caries lesion treatment recommendations varied among the dentists in this study. Treatment decision-making can be influenced by the caries lesion's detection and classification system used.

Keywords: Caries lesion treatment; Clinical decision making; Dental caries; High risk; ICDAS.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were approved by the Health Sciences Centre Ethical Committee at Kuwait University and are in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. A written consent to use extracted teeth was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Competing interests

All authors declare they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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