ICDAS Flashcards
When Do Patients Become Concerned About Caries?
- When it hurts (pulpal involvement)
- Need for endodontic treatment or extraction
- When fillings are required
- When it affects appearance
- When it affects their own or their child’s teeth
When Do Dental Professionals Become Concerned About Caries?
- In the dental surgery
- When operative intervention is needed
- Presence in areas of plaque stagnation
- When a probe sticks in a fissure
- When a cavity is present
- Detection on radiographs
- When it affects aesthetics
What Is ICDAS (International Caries Detection & Assessment System)?
- Standardized system for:
o Detecting caries presence
o Staging severity (similar to cancer staging)
o Assessing lesion activity - Covers primary, secondary, and root caries
Objective method to determine disease presence
Characterizing or monitoring a lesion post-detection
What Is the Rationale Behind ICDAS Development?
- Reflects modern scientific understanding of caries
- Uses visual criteria to classify caries in a standardized way
- Enables valid comparisons across time, examiners, and locations
- Recognizes that waiting for cavitation is “too late” in preventive dentistry
- Clinical visual assessment is a key reference standard (validated histologically)
- Teeth should be cleaned before caries is recorded to avoid missing lesions
How should we be probing?
o Ball-ended probes are used gently
o Sharp explorers are not recommended
may produce traumatic defects
Describe ICDAS 0
no evidence of enamel translucency due to cars after plaque removal and air drying
Describe ICDAS 1-2
carious enamel opacity or visible discolouration (brown/white)
no evidence of enamel breakdown
no underlying dentine shadowing or cavitation
Describe ICDAS 3
enamel breakdown
white/brown spot lesion with localised micro-cavity
without visible dentine exposure
seen after air-drying
Describe ICDAS 4
seen easiest when tooth is wet
not cavitated into dentine
dentinal shadow
Describe ICDAS 5
distinct cavity with visible dentine
Describe ICDAS 6
extensive distinct cavity with visible dentine
What are the restoration and sealant codes?
0 = not sealed/restored
1 = partial sealant
2 = full sealant
3 = tooth coloured restoration
4 = amalgam restoration
5 = stainless steel crown
6 = porcelain, gold, PFM crown or veneer
7 = lost/broken restoration
8 = temporary restoration
What Is ICCMS (International Caries Classification and Management System)?
- Merged with ICDAS
- Uses a structured 4D approach:
What is the 4D’s?
- Determine the patient’s caries risk
- Detect and assess caries severity
- Decide on a treatment plan
- Do preventive and restorative care
What Are the Caries Risk Factors at the Patient Level?
head and neck radiation
dry mouth
poor OHI
insufficient fluoride exposure
poor diet
irregular attender
socioeconomic status
for children : high caries experience of mothers/caregivers
