DENTAL CARIES EVALUATION USING ICDAS FOR CHILDREN FROM A DEPRIVED ROMANIAN REGION

Abstract

The aim of the study was to evaluate dental caries in children aged 7-10 coming from deprived area in Romania using the ICDAS criteria.

Methods: 485 children from the South- East region of Romania were selected from all primary schools according to the geographical area (county) and the size of the school (small, average, and large). Ethical approval was obtained from the Ethical Committee of the University of Medicine and Pharmacy Timisoara, Romania and the written informed consent forms were signed by the parent/carer. All the examinations were conducted in standard dental chairs by two trained and calibrated examiners. Before the study, a 90 minutes e-learning program of the ICDAS system was sent to the examiners and calibration sessions were arranged at the examination site before starting the study. ICDAS caries codes 1, 2, and 3 were counted together as a measure of enamel caries (D1−3) and 4, 5, and 6 as dentine caries (D4−6). The data was analysed by IBMSPSS Statistics 20.0. The association between first permanent and the second primary molars was analysed by Spearman correlation coefficient (r) and the mean caries indices according to the age by Kruskal-Wallis test.

Results: The inter- and intra- examiner correlation was high, all the weighted kappa values being >0.9. Altogether 450 children (92.7%) participated in the clinical examinations, 45.5% (n=205) boys and 54.4% (n=245) girls. The mean age was 8.8 years (0.38). There was a clear prevalence of lower ICDAS scores (1-3) for permanent molars and higher ICDAS scores (4-6) for temporary molars. The most prevalent score was 2 on the occlusal surfaces of permanent upper and lower molars. The highest ICDAS scores (4-6) were recorded on the occlusal surfaces of lower temporary molars. All the mean caries indices were not statistically different according to age. However, the mean number of dentine caries (d/D4−6T, d/D4−6S) seemed to decrease according to the increasing age. When analysing the association of the distributions of ICDAS codes on the different surfaces of the first permanent and second primary molars, the strongest correlations were on the occlusal surfaces of the maxillary and mandibular molars and on the lingual surfaces of the mandibular molars.

Conclusion: A high prevalence of dental caries in both primary and permanent teeth was found. It can be concluded that the ICDAS method gives relevant information about caries status for children coming from a deprived community in Romania.