INTERNATIONAL

CARIES
DETECTION AND
ASSESSMENT
SYSTEM (ICDAS)
DSR 411 DGB
Rondilla, Jayson
Ruiz, Lorenz Mariae
San Pedro, Bianca
Sebanes, Valerie
Shahbeigi, Shaghayegh
Shahrohki, Mina

INTRODUCTION
International Caries Detection and Assessment System (ICDAS)
A clinical scoring system used in dental education, clinical practice, research
and epidemiology.
Provides a framework to support and facilitate personalized management of
caries process and dental decay for improved long term health outcomes.
ICCMS linked with IDCAS- a health outcomes focused system that aims to
maintain health and preserve tooth structure. Staging of the caries process
and activity assessment is followed by risk-adjusted preventive care, control
of initial non-cavitated lesions, and conservative restorative treatment of
deep dentinal and cavitated caries lesions.
PURPOSE
Lead to better quality information to inform decisions about appropriate
diagnosis, prognosis, and clinical management
OVERVIEW OF THE DEVELOPMENT OF ICDAS
Core ICDAS Criteria 2004
For use on coronal and root surfaces, as well as caries adjacent to
restorations and sealants
ICDAS Criteria 2009
For coronal primary caries
ICDAS detection codes for coronal caries range from 0-6 depending on the
severity of the lesion
Core ICDAS Criteria 2010
For use on coronal and root surfaces, as well as caries adjacent to
restorations and sealants
Criteria code that presents a range of characteristics of clean, dry teeth in a
consistent way that promotes the valid comparison of results between
studies, settings and location
Record both enamel and dentin caries and explore the measurement of caries
activity in all domains
A two- number coding system will be used to identify restorations. This system is as
follows.
TOOTH STATUS: FIRST NUMBER
Restoration and Sealant Codes
0
Not restored or sealed
1
Partial sealant
2
Full sealant
3
Tooth colored restoration
4
Amalgam restoration
5
Stainless Steel Crown
6
Porcelain or Gold or PFM crown or Veneer

7
8

Lost or Broken Restoration

Temporary Restoration

Missing Teeth
97
Tooth extracted due to caries
98
Tooth extracted for other reason
99
Unerupted
STAGING CORONAL CARIES LESIONS CLINICALLY
Staging of coronal caries will include primary caries and caries associated
with restorations/sealants (CARS) as one classification system.
CARIES STATUS: SECOND NUMBER
Caries Codes
0
Sound tooth surface
1
First visual change in enamel
2
Distinct visual change in enamel
3
Enamel breakdown, no dentin visible
4
Underlying dentinal shadow (not
cavitated dentin)
5
Distinct cavity with visible dentin
6
Extensive distinct cavity with visible
dentin
STAGING CORONAL CARIES LESIONS RADIOGRAPHICALLY
Radiographic information adds significantly to clinical findings in terms of
finding lesions at different stages of progression
It helps estimate the depth of caries demineralization into enamel and dentin.

LESION ACTIVITY ASSESSMENT

Currently it is clear that caries lesions can be detected and assessed at an
early stage as initial lesions. These, and also lesions at a further stage of
severity, can be progressing at the moment of the clinical examination.
Therefore, the next step after the severity assessment of the caries lesions is
to judge if these, irrespective of stage, are inactive or active.

Active Lesion

Considered to have a greater likelihood of transition (progress, arrest

or regress) than an inactive lesion (there is an increase in dynamic
activity in terms of mineral movement).

Inactive (arrested) Lesion

Considered to have a lesser likelihood of transition than an active

lesion (there is less movement of mineral and the lesion stays at the
same stage of severity.)

ROOT CARIES
The
the base of
on the root
used to
the root
active or not.
These
include
(shiny/glossy
glossy),
plaquearea/not,
texture on

(NEW IN ICDAS)
characteristics of
the discolored area
surface can be
determine whether
caries lesion is

characteristics
appearance
or matte/nonlocation in a
stagnation
and perception of
gentle probing
(soft/leathery, or
hard/ rough/smooth). Active root caries lesions are usually located within 1
mm of the crest of the gingival margin

ICDAS PROTOCOL
1 Ask patient to remove any removable
appliances
2 Clean
3 Place cotton roll in buccal vestibules
4 Remove excess/frothy saliva
5 Visual examination of the wet surface
6 Dry the surface
7 Visual inspection of the dry surface

EXAMINATION PROTOCOL