Evaluation of a Preventive Program Aiming at Children With Increased Caries Risk Using ICDAS II Criteria

Clin Oral Investig. 2013 Dec;17(9):2049-55. doi: 10.1007/s00784-012-0907-x. Epub 2012 Dec 16.


Objectives: A selective intensified prevention (SIP) was introduced at individual schools in deprived areas in Marburg County (Germany) in 1995. The outcome of the program was evaluated in sixth graders (mean age: 12.06 years) in comparison to a control region.

Materials and methods: Caries experience was recorded by applying International Caries Detection and Assessment System (ICDAS) II criteria. Tooth brushing habits and other independent variables were examined psychometrically. To compare the mean caries scores, non parametric tests were applied. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. The matching criteria age, gender, ethnicity and maternal education were used to parallelize the samples.

Results: ICDAS scores of 2-6 were detected uniformly more often in the control region than in the test group. Combining ICDAS scores 3-6, children from the control region (mean D(3-6)MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D(3-6)MFT: 0.88, p < 0.005). The D(5,6)MFT score of the test group amounted to 0.50, and the corresponding value of the reference group was 0.77 (p = 0.043). Multivariate analysis disclosed fissure sealants, early start of tooth brushing and topical fluoride application to be associated with the prevention of dental caries. High frequency of sugar intake was associated with the presence of dentine lesions.

Conclusions: The results of our study confirm the positive effect of SIP on the dental health of 12-year-old pupils living in deprived areas.

Clinical relevance: On the basis of ICDAS II, targeted preventive measures can be applied in children with increased caries risk. Frequent applications of fluoride varnish inhibit the progression of initial lesions in this group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Dental Caries / prevention & control*
  • Germany
  • Humans
  • Preventive Health Services / standards*
  • Program Evaluation
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires