Examination Time Using the ICDAS Criteria in Epidemiological Setting in Infants from 1 to 5 Years of Age

Objectives: The aim of the present study was to determine the evaluation time that the ICDAS criteria entail in epidemiological settings, examining children from 1 to 5 years of age.
Methods: Six examiners, previously trained and calibrated by a trainee (RV), participated in the study (Kappa inter and intra-examiner ranges: 0.70-0.81 and 0.74-0.87, respectively). All the examiners are dentists with a pediatric dentistry background. 311 children where included in the study (1-year-olds: n = 35; 2-year-olds: n = 55; 3-year-olds: n = 58; 4-year-olds: n = 66; 5-year-olds: n = 97) from two public schools in the periphery of Lima - Peru. Once the parents had signed the informed consent, the children were assisted by one member of the research team (DZ) to brush their teeth and floss. The examinations were performed using biosecurity items, front-lights, examination instruments, WHO probes, gauzes and the knee-to-knee technique with children from 1 to 3 years of age. The examination time was recorded with a chronometer by one of the researchers.
Results: The mean caries prevalence in the examined children was 85,2% and the mean of cavitated surfaces (c_3-6) was 9.4±7,3. When the codes c_1-2 were included in the results the caries prevalence increased 11%. The mean evaluation time was 3,10 ± 1,3 min, range from 40 seconds to 4 minutes 23 seconds, which varied depending on the number teeth to evaluate, number of lesions detected by patient and the cooperation of the patient, showing a linear correlation (ANOVA test; p < 0.001).
Conclusions: The ICDAS criteria protocol demands a teeth cleaning (tooth brushing and flossing) before the examination, action that demands time and additional human resources. However, the time consumption during the clinical evaluation makes it very feasible, considering the fact of the pediatric population. Number of teeth, number of lesions and the behavioral aspects were directly related to the time raise in clinical evaluations.