Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial.

OBJECTIVE

This 3-year multicentre randomised controlled trial compared, in 6-7-year-old Colombian children, the effectiveness of the ICCMS (International Caries Classification and Management System) with a conventional caries-management system (CCMS) in terms of individual caries-risk, caries lesions, and secondarily, oral-health-related knowledge/attitudes/practices, and number of appointments.

MATERIAL AND METHODS

With ethical approval, 240 6-7-year olds from six Colombian clinics were recruited. Trained examiners conducted the following baseline/follow-up assessments: Caries risk (Cariogram-ICCMS); caries severity/activity staging (ICDAS-merged combined radiographic/visual); sealants/fillings/missing teeth, and oral-health-related knowledge, attitudes and practices. Children received their randomly allocated (ICCMS/CCMS) care from dental practitioners. Outcomes: caries-risk control (children); caries-progression control (tooth surfaces); oral-health-related knowledge/attitudes/practices improvement (parents/children), and appointments' number (children). Descriptive and non-parametric/parametric bivariate analyses were performed.

RESULTS

Three-year-follow-up:  = 187 (77.9%; ICCMS:  = 92; CCMS:  = 95) disclosed a baseline-to-3-year overall high-caries-risk children decrease (ICCMS: 60.9-0%,  < .001; CCMS: 54.7-5.3%,  < .001) ( > .05). ICCMS versus CCMS showed: fewer tooth-surface caries progression (6.2% vs 7.1%,  = .010) and fewer active-caries lesions (49.8% vs. 59.1%,  < .05); higher proportion of children with ≥2/day fluoride-toothpaste tooth-brushing practice ( < .05); similar mean number of appointments (10.9 ± 5.9 vs. 10.0 ± 3.8,  = .15).

CONCLUSION

Both caries-management systems showed similar effectiveness in caries-risk control, with ICCMS more effectively controlling tooth-surface caries progression and improving toothbrushing practices.