Impact of different detection criteria on caries estimates and risk assessment

Luana Severo Alves, Cristiano Susin, Nailê Damé-Teixeira, Marisa Maltz

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Aim: This study aimed to compare the prevalence and extent of dental caries according to the standard World Health Organization (WHO), modified WHO and International Caries Detection and Assessment System (ICDAS) criteria among 12-year-old Brazilian schoolchildren and to assess the impact of these detection criteria on the assessment of sociodemographic risk indicators for dental caries. Methods: This cross-sectional survey used a multistage probability sampling strategy to select a representative sample of 12-year-old schoolchildren. After tooth cleaning and drying, a single examiner recorded the presence of non-cavitated and cavitated caries lesions. A questionnaire gathered demographic and socio-economic information. Three proposed thresholds for caries detection were used: standard WHO criteria (only cavitated lesions); modified WHO criteria (active non-cavitated lesions and cavitated lesions); and ICDAS (all non-cavitated and cavitated lesions). Prevalence ratios (PR), rate ratios (RR) and 95% confidence intervals (95% CI) were estimated using survey Poisson regression analysis. Results: In total, 1,528 of 1,837 eligible schoolchildren participated. Caries prevalence (standard WHO, 55.23%; modified WHO, 63.33%; ICDAS, 79.82%) and decayed, missing and filled teeth (DMFT) index (standard WHO, 1.39; modified WHO, 1.95; ICDAS, 3.78) increased as the detection criteria became more sensitive. Compared with the standard WHO criteria, ICDAS had a greater impact on caries estimates, mainly in schoolchildren of higher socio-economic background. All socio-economic variables were significantly associated with dental caries, irrespective of the detection criteria. Conclusion: The inclusion of non-cavitated lesions impacted estimates of prevalence and extent of dental caries, mainly when ICDAS was used. No impact was observed on the association between caries and socio-economic variables.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalInternational Dental Journal
Issue number3
StatePublished - Jun 2018
Externally publishedYes


  • Dental caries
  • diagnosis
  • epidemiology
  • prevalence
  • risk indicators

ASJC Scopus subject areas

  • Dentistry(all)


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