DMF from WHO basic methods to ICDAS II advanced methods: a systematic review of literature

Odontostomatol Trop. 2012 Sep;35(139):5-11.


Background: Evaluation of caries status has changed with emergence of modified ways of managing the condition. There is a need to assess the relationship between the old and new methods of registering caries.

Objective: To identify the ICDAS II codes to be used to record the D-component of the DMF index as defined in the WHO Basic Methods, 1997 publication.

Method: A review of literature published between January 2002 and January 2012 was undertaken using "ICDAS" as keyword in an electronic search. Only epidemiological studies that used ICDAS II as an evaluation criterion calculated the DMF indices and gave the ICDAS II codes for the diagnosis of caries lesions, were included.

Results: Fourteen studies met the inclusion criteria. The DMF designations that corresponded with the WHO definition were D(3-6)MF (10 studies), D(4-6)MF (4 studies) or D(5-6)MF (3 studies). The D-component referred to cavitated carious lesions (7 studies) or dentine caries (7 studies), but there was no consensus on the ICDAS II codes that are used to define them. Only the ICDAS II codes 5 and 6 had unanimous support; they were always counted as "Caries", but there was less certainty for codes 3 and 4. The only study on fields that compared both methods showed D(3-6) to be the always associated with the D-component of the DMF index as defined in the WHO Basic Methods.

Conclusion: There was disagreement of the ICDAS II codes to be used for the DMF calculation; and when there was a need to compare DMF values between studies, the diagnosis threshold should be verified to be the same.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • DMF Index*
  • Dental Caries / classification
  • Dental Caries / diagnosis
  • Dental Enamel / pathology
  • Dentin / pathology
  • Humans
  • Risk Assessment
  • World Health Organization