Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil.
Departments of Periodontics and Oral Biology, Dental College of Georgia, Augusta University, Augusta, GA, USA.
Int Dent J. 2018 Jun;68(3):144-151. doi: 10.1111/idj.12352. Epub 2018 Jan 5.
This study aimed to compare the prevalence and extent of dental caries according to the standard World Health Organization (WHO), modified WHO and International Caries Detection and Assessment System (ICDAS) criteria among 12-year-old Brazilian schoolchildren and to assess the impact of these detection criteria on the assessment of sociodemographic risk indicators for dental caries.
This cross-sectional survey used a multistage probability sampling strategy to select a representative sample of 12-year-old schoolchildren. After tooth cleaning and drying, a single examiner recorded the presence of non-cavitated and cavitated caries lesions. A questionnaire gathered demographic and socio-economic information. Three proposed thresholds for caries detection were used: standard WHO criteria (only cavitated lesions); modified WHO criteria (active non-cavitated lesions and cavitated lesions); and ICDAS (all non-cavitated and cavitated lesions). Prevalence ratios (PR), rate ratios (RR) and 95% confidence intervals (95% CI) were estimated using survey Poisson regression analysis.
In total, 1,528 of 1,837 eligible schoolchildren participated. Caries prevalence (standard WHO, 55.23%; modified WHO, 63.33%; ICDAS, 79.82%) and decayed, missing and filled teeth (DMFT) index (standard WHO, 1.39; modified WHO, 1.95; ICDAS, 3.78) increased as the detection criteria became more sensitive. Compared with the standard WHO criteria, ICDAS had a greater impact on caries estimates, mainly in schoolchildren of higher socio-economic background. All socio-economic variables were significantly associated with dental caries, irrespective of the detection criteria.
The inclusion of non-cavitated lesions impacted estimates of prevalence and extent of dental caries, mainly when ICDAS was used. No impact was observed on the association between caries and socio-economic variables.
本研究旨在比较根据世界卫生组织（WHO）标准、改良 WHO 标准和国际龋病检测和评估系统（ICDAS）标准，巴西 12 岁儿童的龋齿患病率和严重程度，并评估这些检测标准对龋齿社会经济风险指标评估的影响。
本横断面研究采用多阶段概率抽样策略，选择具有代表性的 12 岁儿童样本。牙齿清洁和干燥后，由一名检查者记录非龋性和龋性病变的存在情况。问卷调查收集了人口统计学和社会经济信息。使用了三种龋齿检测的建议阈值：WHO 标准（仅龋性病变）；改良 WHO 标准（活跃的非龋性病变和龋性病变）；和 ICDAS（所有非龋性和龋性病变）。使用调查泊松回归分析估计患病率比（PR）、发病率比（RR）和 95%置信区间（95%CI）。
共有 1837 名符合条件的儿童中，有 1528 名参加了研究。龋齿患病率（WHO 标准为 55.23%；改良 WHO 标准为 63.33%；ICDAS 为 79.82%）和龋失补（DMFT）指数（WHO 标准为 1.39；改良 WHO 标准为 1.95；ICDAS 为 3.78）随着检测标准的敏感性增加而增加。与 WHO 标准相比，ICDAS 对龋齿的估计影响更大，主要是在社会经济背景较高的儿童中。所有社会经济变量与龋齿均有显著相关性，无论检测标准如何。
纳入非龋性病变会影响龋齿的患病率和严重程度的估计，特别是使用 ICDAS 时。龋齿与社会经济变量之间的关联未受影响。
