Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements

Community Dent Oral Epidemiol. 2008 Dec;36(6):475-84. doi: 10.1111/j.1600-0528.2008.00436.x. Epub 2008 Apr 14.


This epidemiological study aimed to compare the diagnostic outcome of the WHO criteria, ICDAS II criteria, laser fluorescence measurements, presence of plaque and roughness as activity scores on occlusal fissures and buccal/palatal pits of the first permanent molars. The study involved 311 children between 8 and 12 years of age from the Ennepe-Ruhr District in North Rhine-Westphalia, Germany. The surface-related caries status was registered according to the WHO basic method criteria (1997). Additionally, pit and fissure sealants, the ICDAS II visual criteria, the DIAGNOdent reading, plaque retention and surface roughness were documented. Caries experience was 1.0 (+/-2.5) DMFS. About 70% of the examined students had no obvious dentin caries in the permanent dentition (DMFS = 0). Sealants were registered on 1.4 (+/-1.7) occlusal fissures and 0.4 (+/-0.9) palatal/buccal pits. Noncavitated caries lesions were recorded as ICDAS II score 1-4 on 1.8 (+/-1.6) fissures and 1.5 (+/-1.4) pits. The comparison of the diagnostic methods suggests a relationship between higher ICDAS II scores/DIAGNOdent values and a proportional increase in the occurrence of plaque as well as in the number of rough surfaces. In conclusion, this study showed the diagnostic potential of the ICDAS II criteria in comparison to the traditional WHO criteria by means of the noncavitated caries lesions additionally detected. The DIAGNOdent use in field studies that already apply detailed visual criteria seems to bring limited additional information. While the presence of plaque provides information for the caries activity assessment more work is required to provide information about the contribution of surface roughness.

MeSH terms

  • Child
  • DMF Index
  • Dental Caries / diagnosis*
  • Dental Caries / epidemiology
  • Dental Caries Activity Tests*
  • Dental Plaque Index
  • Epidemiologic Methods
  • Female
  • Fluorescence
  • Germany / epidemiology
  • Humans
  • Lasers
  • Male
  • Molar