Discriminant validity of the International Caries Detection and Assessment System (ICDAS) and comparability with World Health Organization criteria in a cross-sectional study

Community Dent Oral Epidemiol. 2010 Oct;38(5):398-407. doi: 10.1111/j.1600-0528.2010.00557.x.


Objectives: The aim of this cross-sectional study in preschool children was to assess the ability of International Caries Detection and Assessment System (ICDAS) in discriminating socioeconomic factors associated with the presence of caries lesions at both noncavitated and cavitated thresholds and to compare with the standard World Health Organization (WHO) criteria.

Methods: The study was carried out in Amparo, Brazil, during the National Day of Children's Vaccination including 252 children aged 36-59 months. The same child was independently examined by two calibrated examiners, one using the ICDAS and the other using WHO criteria. Socioeconomic information was also recorded. Associations between socioeconomic factors and presence of caries assessed as binary (caries prevalence) and count outcome (actual dmfs values) obtained by WHO criteria and by ICDAS at noncavitated and cavitated thresholds were evaluated by Poisson regression analysis with robust variance.

Results: Some covariates were significantly associated with the presence of caries evaluated by the WHO criteria and by ICDAS (using score 3 as cut-off point). When noncavitated scores of ICDAS were used to calculate the presence of caries, the discriminant power decreased. When dmfs values were used as outcome, no differences in the associations were observed between two systems or using noncavitated caries lesions.

Conclusion: Cavitated scores of ICDAS present similar discriminant validity compared with WHO criteria when presence of caries is used as outcome; however, when actual dmfs values are used, no differences are observed in using noncavitated or cavitated caries lesions.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Brazil / epidemiology
  • Child, Preschool
  • Cross-Sectional Studies
  • DMF Index
  • Dental Caries / diagnosis*
  • Dental Caries / epidemiology
  • Dental Caries / etiology
  • Dental Caries Activity Tests / standards
  • Female
  • Humans
  • Male
  • Poisson Distribution
  • Reproducibility of Results
  • Sex Factors
  • Socioeconomic Factors
  • World Health Organization