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Cited by 1,535Dental Health and Care UtilizationDental materials and restorationsOral microbiology and periodontitis research

The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries

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Ismail, A. I., Sohn, W., Tellez, M., Amaya, A., Sen, A., Hasson, H., Pitts, N. B.·2007·Community Dentistry and Oral Epidemiology
DOI 10.1111/j.1600-0528.2007.00347.x
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Abstract

Abstract – This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR‐OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR‐OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven‐point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.

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  • The inter-rater Kappa scores in this study were similar to those from a previous study (0.69-0.81) conducted in a university pediatric dental and endodontic clinic.

    “The inter-reliability kappa scores reported in this study were similar to a previous study (0.69–0.81) that conducted ICDAS training in a pediatric dental and endodontic clinic in a university institution,10 a finding similar to prior studies.14”

    From Training Protocol and Calibration of the International Caries Detection and Assessment System in a School-Based Clinical Trial of Elementary School-Age Children (2025) · cites this paper as [14]

    The Reliability of ICDAS section (page unavailable) reports inter-examiner kappa scores from examiners trained and calibrated with ICDAS, including values that overlap the claimed range. It does not report a 0.69–0.81 range or identify the study setting as a university pediatric dental and endodontic clinic. (LLM, conf=0.82)

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Research works printed but not linked: 4

  1. [10]10. International Caries Detection and Assessment System (ICDAS) Coordinating Committee. Rationale and Evidence for the International Caries Detection and Assessment System (ICDAS II). In: Stookey GK, editor. Early detection of dental caries: proceedings of the 2005 Indiana conference, Indianapolis: Indiana University; 2007. in press.
  2. [18]18. Finlayson TL, Siefert K, Ismail AI, Sohn W. Psycho- logical factors and oral health among low-income African American children in Detroit. Community Dent Oral Epidemiol 2006;340:460-6.
  3. [19]19. Drury TF, Horowitz AM, Ismail AI, Maertens MP, Rozier RG, Selwitz RH. Diagnosing and reporting Early Childhood Caries for research purposes. J Public Health Dent 1999;59:192-7.
  4. [25]25. Black GV. A peal for the greater earnestness in the study of caries of the enamel and its relation to the practice of dentistry. Dent Brief 1910;15:161-78.

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Authors
Ismail, A. I., Sohn, W., Tellez, M., Amaya, A., Sen, A., Hasson, H., & Pitts, N. B.
Affiliations
  • University of Michigan (US)
  • University of Dundee (GB)
Corresponding author
Ismail, A. I.
ORCID
Venue
Community Dentistry and Oral Epidemiology
Publisher
Wiley
Published
2007-05-21
Volume
35
Issue
3
Pages
170-178
ISSN
  • 0301-5661 (ISSN-L)
  • 1600-0528
DOI
10.1111/j.1600-0528.2007.00347.x
OpenAlex
W2128019757
Semantic Scholar
24b85f2d66c610ad889eff38985ddffe434cc04f
Cited by
1,535
References
23
Citations by year
2026: 99 · 2025: 113 · 2024: 120 · 2023: 103 · 2022: 118 · 2021: 135 · 2020: 106 · 2019: 93 · 2018: 82 · 2017: 85 · 2016: 88 · 2015: 74 · 2014: 62 · 2013: 69 · 2012: 61
FWCI
33.05
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Community Dentistry And Oral Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • University of Michigan
  • National Institutes of Health (1r13de016786-01)
  • National Institute of Dental and Craniofacial Research (U54DE014261, R13 DE016786-01, #U-54 DE 14261-01)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
Keywords
dental caries, caries assessment, dentin demineralization, histopathological confirmation, examiner reliability, caries activity, oral health disparities, extracted teeth
MeSH terms
Adult, Child, Child, Preschool, Crowns, Dental Caries, Dental Restoration, Permanent, Dentin, Feeding Behavior, Humans, Pit and Fissure Sealants, Socioeconomic Factors, Tooth, Reproducibility of Results, Cohort Studies, Health Behavior, Tooth Loss, Tooth Demineralization, Outcome Assessment, Health Care, Needs Assessment

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