The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 19 , ISSUE 5 ( 2018 ) > List of Articles


Caries Assessment Spectrum and Treatment: Would It direct Future Epidemiological Surveys?

Abhishek Jahagirdar, Praveen H Bhoopathi, Sreenivas Voruganti, Nukala S Suma, Tejaswini Samudrala, B Vinayak Kamath

Keywords : Caries Assessment Spectrum and Treatment, Caries epidemiology, Dental caries, Disease progression

Citation Information : Jahagirdar A, Bhoopathi PH, Voruganti S, Suma NS, Samudrala T, Kamath BV. Caries Assessment Spectrum and Treatment: Would It direct Future Epidemiological Surveys?. J Contemp Dent Pract 2018; 19 (5):546-553.

DOI: 10.5005/jp-journals-10024-2297

License: CC BY-NC 3.0

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: To evaluate caries spectrum among 12- and 15-year-old Indian children using the Caries Assessment Spectrum and Treatment (CAST) index. Materials and methods: An epidemiological survey of the schoolchildren was carried out in a district in India. A stratified cluster random sampling method was used to select the sample. The caries prevalence of the surveyed population was obtained by using this CAST tool. Chi-square test was used to verify the association between dental fluorosis, socioeconomic status, and age and caries experience. Mann–Whitney U-test was used to compare the caries experience between the two age groups Results: A total of 2,610 children were examined. The majority of the schoolchildren (12 years: 74.2%, 15 years: 75.5%) were healthy concerning their caries experience and the prevalence of the other codes was minimal. The prevalence of dentin carious lesions and the percent of restorable teeth was greater among the 15-year-olds. The mean decayed, missing, and filled teeth (DMFT) of 12- and 15-year-old subjects was calculated to be 0.22 and 0.29 respectively. Conclusion: The currently surveyed population showed a low caries prevalence and the use of the tool highlighted the caries spectrum in an impressive way. Clinical significance: A well-designed tool to assess the carious spectrum of an individual or a community, thus enabling the responsible stakeholders to plan an appropriate care that is necessary.

PDF Share
  1. Peterson PE, Bourgeois D, Ogawa H, Estupinian-Day S, Ndiaye C. The global burden of oral diseases and the risks to oral health. Bull World Health Organ 2005 Sep;83(9):661-669.
  2. Peterson PE, Lennon MA. Effective use of the fluorides for the prevention of dental caries in the 21st century: the WHO approach. Community Dent Oral Epidemiol 2004;32(5): 319-321.
  3. Marthalar TM. Changes in dental caries 1953-2003. Caries Res 2004 May-Jun;38(3):173-181.
  4. World Health Organization. Educational imperatives for oral health personnel: change or decay? Geneva: WHO; 1990.
  5. Kulkarni SS, Deshpande SS. Caries prevalence and treatment needs in 11-15 year old children of Belgaum city. J Indian Soc Pedod Prev Dent 2002 Mar;20(1):12-15.
  6. National Oral Health Survey and Fluoride Mapping. An epidemiological study of the oral health problems and estimation of fluoride levels in drinking water. New Delhi: Dental Council of India; 2004.
  7. Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. Am J Dent 2009 Feb;22(1):3-8.
  8. World Health Organization: Oral Health survey, Basic methods, 4th ed. Geneva: World Health Organization; 1997.
  9. Klein H, Palmer CE, Knutson JW. Studies on dental caries 1. Dental status and dental needs of elementary children. Public Health Rep 1938 May;53:751-765.
  10. Burt BA. How useful are cross sectional data from surveys of dental caries. Community Dent Oral Epidemiol 1997 Feb;25(1):36-41.
  11. Frencken JE, Amorin RG, Faber J, Leal SC. The caries assessment spectrum and treatment (CAST) index: rationale and development. Int Dent J 2011 Jun;61(3):117-123.
  12. Pitts N. ICDAS—an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community Dent Health 2004 Sep;21(3):193-198.
  13. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol 2007 Jun;35(3): 170-178.
  14. Monse B, Heinrich-Weltzein R, Benzian H, Holmgren C, van Palenstein Helderman W. PUFA—an index of clinical consequences of untreated dental caries. Community Dent Oral Epidemiol 2010 Feb;38(1):77-82.
  15. De Amorim RG, Figueiredo MJ, Leal SC, Mulder J, Frencken JE. Caries experience in a child population in a deprived area of Brazil, using ICDAS II. Clin Oral Invest 2012 Apr;16(2): 513-520.
  16. Braga MM, Oliverira LB, Bonini GAVC, Bonecker M, Mendes FM. Feasibility of the International Caries Detection and Assessment system (ICDAS-II) in epidemiological surveys and comparability with the standard World Health Organization criteria. Caries Res 2009; 43(4): 245-249.
  17. Frencken JE, de Souza AL, van der Sander WJM, Bronkhorst EM, Leal SC. The Caries Assessment Spectrum and Treatment (CAST) instrument. Community Dent Oral Epidemiol 2013;61:117-123.
  18. de Souza AL, van der Sander WJM, Leal S, Frencken JO. The caries assessment spectrum and treatment (CAST) index: face and content validation. Int Dent J 2012 Oct;62(5):270-276.
  19. de Souza AL, Leal SC, Bronkhorst EM, Frencken JE, Creugers NH. The caries assessment spectrum and treatment (CAST) instrument: construct validation. Eur J Oral Sci 2014 Apr;122(2): 149-153.
  20. de Souza AL, Bronkhorst EM, Creugers NH, Leal SC, Frencken JE. The caries assessment spectrum and treatment (CAST) instrument: its reproducibility in clinical studies. Int Dent J 2014 Aug;64(4):187-194.
  21. Brindha K, Rajesh R, Murugan R, Elango L. Fluoride contamination in groundwater in parts of Nalgonda District, Andhra Pradesh, India. Environ Monit Assess 2011 Jan;172(1):481-492.
  22. Shekar C, Cheluvaiah MB, Namile D. Prevalence of dental caries and dental fluorosis among the 12 and 15-year-old school children in relation to the fluoride concentration in drinking water in an endemic fluoride belt of Andhra Pradesh. Indian J Public Health 2012 Apr-Jun;56(2):122-128.
  23. Dean HT. Classification of mottled enamel diagnosis. J Am Dent Assoc (1922) 1934 Aug;21(8):1421-1426.
  24. World Health Organization. Oral health surveys: basic methods. Geneva: World Health Organization; 2013.
  25. Sukhabogi JR, Parthasarthi P, Anjum S, Shekar BR, Padma CM, Rani AS. Dental caries and dental caries prevalence among 12 and 15 year old school children in Nalgonda district, Andhra Pradesh, India. Ann Med Health Sci Res 2014 Sep;4(Suppl 3): S245-S252.
  26. Fejerskov O, Manji F. Reaction paper: risk assessment in dental caries. In: Bader JD, editor. Risk assessment in dentistry. Chapel Hill (NC): University of North Carolina Dental Ecology; 1990. pp. 215-217.
  27. Christensen LB, Twetman S, Sundby A. Oral health in children and adolescents with different socio cultural and socio economic backgrounds. Acta Odontol Scand 2010 Jan;68(1): 34-42.
  28. Brathall D, Hansel-Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci 1996 Aug;104(4):416-422.
  29. de Souza AL, Leal SC, Bronkhorst EM, Frencken JE. Assessing caries status according to the CAST instrument and the WHO criterion in epidemiological studies. BMC Oral Health 2014 Sep;14(1):119.
  30. Baginska J, Rodakowska E, Kierklo A. Status of the occlusal surfaces of the first permanent molars in 6-8-year-old children evaluated by the CAST and the DMF indices. Eur J Paediatr Dent 2014 Jun;15(2):107-112.
  31. Baginska J, Rodakowska E, Milewski R, Kierklo A. Dental caries in primary and permanent molars in 7-8 year old school children evaluated with the caries assessment spectrum and treatment (CAST) index. BMC Oral Health 2014;14(1):1.
  32. Baginska J, Rodakowska E, Wilczko M, Kierklo A. Caries assessment spectrum and treatment (CAST) index in the primary molars of 6 to 7 year old Polish children. Oral Health Prev Dent 2016;14(1):85-92.
  33. Simensen RJ. Pit and fissure sealant: review of the literature. Pediatr Dent 2002 Sep-Oct;24(5):393-414.
  34. Sudhir KM, Prashant GM, Reddy VS, Mohandas U, Chander GN. Prevalence and severity of dental fluorosis among 13 to 15 year old school children of an area known for endemic fluorosis: Nalgonda district of Andhra Pradesh. J Ind Soc Pedod Prev Dent 2009 Oct-Dec;27(4):190-196.
  35. Manji F, Fejerskov O. Dental caries in developing countries in relation to the appropriate use of fluoride. J Dent Res 1990 Feb;69(2):733-741.
  36. Dean HT. Endemic fluorosis and its relation to dental caries. Pub Health Rep 1938 Aug;53:1443-1452.
  37. Horowitz HS, Heifetz SB, Meyers RJ, Driscoll WS, Korts DC. Evaluation of a combination of a self-administered fluoride procedures for control of dental caries in a non-fluoride area: findings after 2 years. Caries Res 1977;11(3):178-185.
  38. Yoder KM, Mabelya L, Robison VA, Dunipace AJ, Brizindine EJ, Stookey GK. Severe dental fluorosis in a Tanzanian population consuming water with negligible fluoride concentration. Community Dent Oral Epidemiol 1998 Dec;26:382-393.
  39. Driscoll WS, Horowitz HS, Meyers RJ, Heifetz SB, Kingman A, Zimmerman ER. Prevalence of dental caries and dental fluorosis in areas with negligible optimal and above optimal fluoride concentrations in drinking water. J Am Dent Assoc 1986 Jul;113(1):29-33.
  40. Grobler SR, Louw AJ, van Kotze TJ. Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa. Int J Paediatr Dent 2001 Sep;11(5):372-379.
  41. Cortes DF, Ellwood RP, O'Mullane DM, Mangalhaes Bastos JR. Drinking water fluoride levels, dental fluorosis and caries experience in Brazil. J Pub Health Dent 1996;56(4): 226-228.
  42. Wondwossen F, Astrom AN, Bjorvatn K, Bardsen A. The relationship between dental caries and dental fluorosis in areas with moderate and high fluoride drinking water in Ethiopia. Community Dent Oral Epidemiol 2004 Oct;32(5):337-344.
  43. Kumar JV, Green EL, Wallace W, Carnahan TA. Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY. Am J Public Health 1989 May;79(5):565-569.
  44. Eklund S, Moller IJ, Leclercq MH. Calibration of the examiners for oral epidemiological surveys. Geneva: World Health Organization; 1993 (ORH/EIS/EPID.93.1).
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.