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Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
1
Methods for staging of the caries process to enable dentists to manage caries
International Caries Detection and Assessment System (ICDAS)
Professor Nigel PittsDental Health Services Research Unit& Centre for Clinical Innovations
University of Dundee
Professor Kim EkstrandCariology and Endodontics
School of Dentistry
University of Copenhagen
On behalf of the ICDAS Foundationwww.icdas.org
University of Copenhagen
International Caries Detection& Assessment System ICDAS:
Who has been involved since 2002?The ICDAS Core Group comprises:
• University of Dundee (Nigel Pitts + team)
• Temple University (was Michigan) (Amid Ismail + team)
• Indiana University (Dom Zero + team)
• University of Copenhagen (Kim Ekstrand)
• FDI [when able to contribute] (Elmar Reich> Martin Tyas> Michel Glick)
• NIH / NIDCR: (was Rob Selwitz>) (Al Kingman)
All working with Gail Douglas and the wider ICDAS Coordinating Committee, with wide involvement from many Countries, for over a decade
www.icdas.org
• Introduction and Historical Development
• Evidence to support validity of staging and adoption to date
• ICDAS Domains
• Next steps in use of ICDAS for Clinicians and Educators
• Summary
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
OutlineInternational Caries Detection and Assessment System (ICDAS)
• Introduction and Historical Development
• Background
• What is ICDAS in 2012?
• Developments in recent years
• “ICDAS” to “ICCMS™”
• Evidence to support validity of staging and adoption to date
• ICDAS Domains
• Next steps in use of ICDAS for Clinicians and Educators
• Summary
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
OutlineInternational Caries Detection and Assessment System (ICDAS)
ICDAS International Caries Detection &
Assessment System: Concept
To lead to:
Better quality information to inform decisions about appropriate diagnosis, prognosis and clinical management at both the individual and public health levels
• Pitts N B, Community Dental Health 2004 21:193-198 • http://www.icdas.org
For more on ICDAS see:-
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
2
+ clinically detectable "cavities" limited to enamel
+ clinically detectable enamel lesions with “intact” surfaces
+ lesions detectable only with traditional diagnostic aids
+ sub-clinical initial lesions in a dynamic state of progression/regression
Mis-labelled "caries free" at the D threshold
3
+ clinically detectable
lesions in dentine
lesions into pulp
D 4
D3 + enamel=
D3
D1
N B Pitts © 2006
Diagnostic threshold
determines what is recorded as “diseased” or
“sound” D 3
D 2
D 1
The “iceberg of dental caries”Diagnostic thresholds in surveys, research & practice
ICDAS Caries Severity Codes in summary – thanks to Indiana University
“Staging” the caries process – compare to oncology decision making
www.icdas.org www.icdas.org
www.icdas.org
Ismail AI. Visual and visuo‐tactile detection of dental caries. J Dent Res 2004; 83: C56–66.
This review compiled details of the (many) previously published systems for classifying caries, in which the variable diagnostic criteria in many cases lacked construct validity and also made comparison of evidence from different studies impossible
International Consensus Workshop on Caries Clinical Trials ‐ Agreeing Where the Evidence Leads ‐
ICW CCT Systematic Review of previousCARIES CLASSIFICATION SYTEMS
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
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Terminology:ICW-CCT Consensus Statements
The consensus was to separate out three key terms:
lesion detection (which implies an objective method of determining whether or not disease is present)
lesion assessment (which aims to characterise or monitor a lesion, once it has been detected)
caries diagnosis (which should imply a human professional summation of all available data)
Pitts N B and Stamm J. ICW-CCT Statements. J Dent Research 2004 83C: 125-128.
The Evidence Base in Caries Detection and Assessment
• Backer Dirks 1951 >
• Marthaler 1966 >
• WHO 1979
• Pitts & Fyffe 1988
• Ismail 1992
• Ekstrand, Ricketts & Kidd 98
• Fyffe et al 2000
• Nyvad 2001
• And many, many more (see Systematic Reviews NIH CDC and ICW‐CCT)
ICDAS
Reliable inclusion of clinical visual enamel & dentine caries detection is not new
www.icdas.org
Merging of systems to create ICDAS after the “ICW – CCT”
Pitts and Fyffe 1988 Ismail et al 1992 BASCD 1992 ERK 1998 (Ekstrand, Ricketts and Kidd) Indiana (various) DSTM 2000a and 2000b (Dundee Selectable Threshold)
+ others over time ……
The ICDAS Committee recognised the urgent need for valid comparability and a histological basis, both for Systematic Reviews and getting “evidence” into practice
Some of the Key References:
Pitts NB. “ICDAS” – an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community Dental Health 2004 21: 193-198
Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet 2007 369: 51-59.
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 Dentistry and Oral Epidemiology 2007 35: 170-178
http://www.icdas.orgFor ICDAS references see
ICDASWardrobe
Epidemiology / Public Health
ICDAS
Clinical ResearchICDAS
Clinical PracticeICDAS
EducationICDAS
ICDASWardrobe
Clinical PracticeICDAS
Lesion Detection Tool
Activity Assessment Tool
CVA
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
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ICDAS in the literature
e-learning programme
Two following documents [Microsoft Word] may be downloaded.The Rationale and Evidence for the International Caries Detection and
Assessment System (ICDAS II)Criteria Manual for the International Caries Detection and Assessment
System (ICDAS II)
For further information please contact:Prof. Gail Douglas - ICDAS Co-ordinator [email protected]
http://www.icdas.orgHow should we best Control
dental caries in 2012?
We need a validated method to STAGE the disease process to plan, deliver and monitor appropriate care
Is restorative intervention the best way to manage a preventable disease process?
At the present time we have no substitutes which are the equal of original tooth tissues!
Courtesy of Dr Domenick T. Zero – Indiana University
The shared Vision for the InternationalCaries Detection and Assessment System – ICDAS is:
ICDAS: employs an evidence based and preventively oriented approach
ICDAS is: a detection & assessment system classifying stages of the caries process
ICDAS is for: use in dental education, clinical practice, research and public health
ICDAS provides: all stakeholders with a common caries language
ICDAS has evolved: to comprise a number of approved, compatible “formats”
ICDAS supports decision‐making: at both individual & public health levels
ICDAS has generated ICCMS™ to enable: improved long‐term caries outcomes
Following the July 2011 ICDAS Review in Kaunas, Lithuania
A Registered Charity
• http://www.icdas.org
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
5
www.icdas.org www.icdas.org
www.icdas.org www.icdas.org
Population and Clinical Research on caries and
caries management
Standardized and EBD Cariology Education
Prevention-focussed Clinical Care for
individual patients
Population focussed Health Promotion, Prevention and
Needs Assessment
ICCMS™ Practice
ICCMS™ Education
ICDAS & ICCMS™
Research
ICDAS & ICCMS™
Public Health
ICDAS and the International Caries Classification and Management System™ ICCMS™
www.icdas.org
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
6
FDI World Dental Federation
• Introduction and Historical Development
• Evidence to support validity of staging and adoption to date• Histological validation• ICDAS in the literature • Staging disease linking to planning and monitoring treatment
• ICDAS Domains
• Next steps in use of ICDAS for Clinicians and Educators
• Summary
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
OutlineInternational Caries Detection and Assessment System (ICDAS)
a) Sound b) Visible after airdrying c) visible without airdrying
d) Visible without airdrying e) Microcavitation or shadowed f ) dentine cavitation
1.1
Fig. 1
a) Sound b) Visible after airdrying c) visible without airdrying
d) visible without airdrying e) Microcavitation or shadowed f ) dentine cavitation
Lesion open for assessment (extracted)Fig. 2
Fig. 3
2012 122011 232010 192009 122008 102007 62006 52004 1
Peer Reviewed Papers using ICDAS
Total to date 88+ Books/Chapters 6+ Abstracts/others 45
ICDAS in the literature
World‐wide adoption (as of May 2012)Country of study or first author
Australia• Bailey et al. (2009) Journal of Dental Research
Brazil• Arruda et al. (2012) Community Dentistry and Oral Epidemiology• Braga et al. (2010) Community Dentistry and Oral Epidemiology• Braga et al. (2010) Journal of Biomedical Optics• Braga et al. (2010) Dental Clinics of North America • Braga et al. (2010) Caries Research• Braga et al. (2009) Caries Research• Braga et al. (2009) Caries Research• Braga et al. (2009) Oral Surg Oral Med Oral Pathol Oral Radiol Endod.• Cadavid et al. (2010) Brazilian Oral Research • de Amorim et al. (2011) Clinical Oral Investigation• Diniz et al. (2012) Journal of the American Dental Association [Brazil]• Diniz et al. (2011) Operative Dentistry• Diniz et al. (2010) Journal of Dental Education• Diniz et al. (2009) Community Dentistry and Oral Epidemiology
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
7
• Frencken et al. (2011) International Dental Journal• Leal et al. (2012) Caries Research• Mendes et al. (2010) Community Dentistry and Oral Epidemiology• Matos et al. (2011) Caries Research• Novaes et al. (2012) International Journal of Paediatric Dentistry• Novaes et al. (2010) Caries Research• Vidmar et al. (2012) NMR Biomed• Soviero et al. (2011) Journal of Dentistry
Colombia• Díaz‐Cárdenas and González‐Martínez (2010) Revista de Salud Pública• Martignon et al. (2010) Community Dental Health
Denmark• Bakhshandeh et al. (2011) Caries Research• Ekstrand et al. (2010) Caries Research• Ekstrand et al. (2011) Caries Research• Ekstrand et al. (2007) Operative Dentistry
France• Aidara et al. (2011) International Dental Journal• Joseph et al. (2011) European Archives of Paediatric Dentistry
Germany• Berger et al. (2009) Clinical Oral Investigation• Jablonske‐Momeni (2012) Lasers in Medical Science• Jablonski‐Momeni et al. (2011) Caries Research• Jablonski‐Momeni et al. (2010) Lasers in Medical Research• Jablonski‐Momeni et al. (2009) Journal of Dentistry• Jablonski‐Momeni et al. (2009) International Journal of Dentistry • Jablonski‐Momeni et al. (2008) Caries Research• Kühnisch et al. (2008) Community Dentistry and Oral Epidemiology• Paris et al. (2011) European Journal of Oral Science
Greece• Michalaki et al. (2010) European Archives of Paediatric Dentistry• Mitropoulis et al. (2012) Caries Research• Mitropoulis et al. (2010) Journal of Dentistry • Parapanisiou et al. (2009) European Archives of Paediatric Dentistry
Hungary• Pinke et al. (2011) Fogorvosi Szemle
Iceland• Agustsdottir et al. (2010) Community Dentistry and Oral Epidemiology
India• Shivakumar et al. (2009) Journal of Conservative Dentistry
Kuwait• Al‐Khatrash et al. (2011) Operative Dentistry• Honkala et al. (2011) International Dental Journal
Malaysia• Shoaib et al. (2009) Caries Research
Mexico• Cook et al. (2008) International Journal of Paediatric Dentistry• Guido et al. (2011) International Journal of Paediatric Dentistry• Soto‐Rojas et al. (2012) International Journal of Paediatric Dentistry
Puerto Rico
• Fontana et al. (2011) Journal of Dental Research
Romania• Maxim DC, Dănila I, Dascălu CG, Balcos C. (2010) Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din
Iaş̧i
Sweden• Baeshen et al. (2011) American Journal of Orthodontics and Dentofacial Orthopedics
Switzerland• Neuhaus et al. (2010) Clinical Oral Investigation • Rodriques et al. (2008) Caries Research
UK• Banerjee et al. (2011) Journal of Dentistry• Bonner et al. (2011) Primary Dental Care• Ormond et al. (2010) Primary Dental Care• Nazir et al. (2011) Journal of Orthodontics • Pretty, I.A. (2006) Journal of Dentistry
• Pitts et al. (2011) European Journal of Dental Education• Pitts, N.B. (2004) Community Dental Health • Pitts, N.B. (2011) Journal of Dentistry• Varma et al. (2008) Journal of Dentistry
USA• Burt et al. (2006) Caries Research• Graye et al. (2012) Journal of Clinical Dentistry • Ferreira Zandoná et al. (2010) Caries Research• Ferreira Zandoná and Zero (2006) Journal of American Dental Ass. • Finlayson et al. (2007) Community Dentistry and Oral Epidemiology• Ismail et al. (2011) Community Dentistry and Oral Epidemiology• Ismail et al. (2008) Community Dentistry and Oral Epidemiology• Ismail et al. (2008) Pediatric Dentistry• Ismail et al. (2007) Community Dentistry and Oral Epidemiology• Kolker et al. (2007) Pediatric Dentistry• Lim et al. (2008) Journal of the American Dental Association• Nriagu et al. (2006) International Journal of Hygiene and Environmental Health• Nelson et al. (2011) Community Dental Health• Rechmann et al. (2012) Journal of Biomedical Optics• Reisine et al. (2008) Community Dentistry and Oral Epidemiology• Sohn et al. (2008) Journal of the American Dental Association• Sohn et al. (2007) Journal of the American Dental Association• Stahl and Ferreira Zandoná (2007) General Dentistry• Tellez et al. (2012) Community Dental Health• Tellez et al. (2006) Journal of Public Health Dentistry• Zandona et al. (2009) Operative Dentistry
ICDAS codes and histological extent of cariesImages provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana
Traditionally a binary choice: sound vs end stage disease
www.icdas.org
ICDAS codes and histological extent of cariesImages provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana
Some conventions allow small cavities in enamel and dentine shadows: variability high!
www.icdas.org
ICDAS codes and histological extent of cariesImages provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana
ICDAS codes stage the continuum of carieswww.icdas.org
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
8
• Introduction and Historical Development
• Evidence to support validity of staging and adoption to date
• ICDAS Domains • Clinicians • Educators • Researchers • Dental Public Health and Epidemiology*
• Next steps in use of ICDAS for Clinicians and Educators
• Summary
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
OutlineInternational Caries Detection and Assessment System (ICDAS)
Population and Clinical Research on caries and
caries management
Standardized and EBD Cariology Education
Prevention-focussed Clinical Care for
individual patients
Population focussed Health Promotion, Prevention and
Needs Assessment
ICCMS™ Practice
ICCMS™ Education
ICDAS & ICCMS™
Research
ICDAS & ICCMS™
Public Health
ICDAS and the International Caries Classification and Management System™ ICCMS™
for Clinicians
www.icdas.org
ICDAS and the International Caries Classification and Management System™ ICCMS™
ICDAS-enabled, patient-centred, Caries Management
Clinical Visual Lesion
Detection
RRMRecall, Reassessment
& Monitoring
Lesion Detection
Aids
Assessmentof Patient
Lesion Activity
Assessment
Lesion Diagnosis
PTOPreventive
Treatment Options:
OTOOperative
Treatment Options
Lesion Prognosis
Patient: Dentition / Lesion History
Patient: Caries Risk Assessment
Patient: Behavioural Assessment
Tooth/Surface Patient
BLCBackgroundLevel Care
Prognosis for Patient
synthesis
integrated, personalised
Treatment Planning
How the CarieScan PRO works
• The product platform is based on the application of a technique called ac impedance spectroscopy (ACIST).
• The measurement relies on the application of small electrical signals through the tooth while monitoring the response to the sensor.
• Analysis of the impedance response relates to the physical structure of the tooth and any subsurface loss of mineral within it
www.Cariescan.com
2010-2: Development of ICDAS’s International Caries Management System (ICCMS™)
ICDAS Workshop at Temple University, USA – April 2010
ICDAS Symposium at Montpellier, France – July 2010
(FDI Science Committee in Salvador, Brazil – Sept 2010)
EADPH Special Interest Working Group - Sept 2010
ICDAS Workshop re ORCA Kaunas - July 2011
Working-up ICDAS Book - Currently“Clinical Management of Dental Caries:
How to plan and deliver rational, evidence-based caries care”
www.icdas.org
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
9
Caries Classification & Management System
including e-Learning, software and data aspects
Initial Patient
Caries Risk Assessment
Synthesis and
Decision -Making
Detection, Activity and Enhanced
Risk Assessment
Clinical Treatments (Non-surgical & Surgical)
with prevention
Monitoring & Review
Monitoring & Review
The International Caries Classification and Management System (ICDAS-ICCMS™)
With parallel “Upstream”
Common Risk Factor
Approach Activities
In concert with other
improvements in Oral and
GeneralHealth
Goal: to improve oral health through the implementation of a new paradigm for managing dental caries and its consequences, one that is based
on our current knowledge of the disease process and its prevention, so as to deliver optimal oral and thus
general health and well being to all peoples (FDI Global Caries Initiative)
©
ICDAS stages
0 1 2 3 4 5 6 PUFAWellness Initial Caries Moderate Caries Extensive Caries Pain / Sepsis
Caries Prevention & Control
Conventional Dental Caries Classifications
Health Disease
Traditional “cavitated” d3mft“Non-cavitated”
D1 Lesions(can derive
D1MFT (or S)
Pain. Pulp &Sepsis
How to stay healthy?
www.icdas.org
Dental Caries: The ICDAS* Caries Continuum (using ICDAS stages and assessment with PUFA)
0 1 2 3 4 5 6 PUFAWellness Initial Caries Moderate Caries Extensive Caries Pain / Sepsis
* ICDAS is a Charitable Foundation committed to open access
Caries Prevention & Control
A holistic view of the The International Caries Classification and Management System™
Health Disease
Traditional “cavitated” d3mft“Non-cavitated”
d1 lesions(can derive d3mft
or d3mfs)
Pain, Pulp &Sepsis
How to stay healthy?
www.icdas.org
The ICDAS Framework develops into the ICCMS™ICDAS–based personalised care in Japan
唾液量
唾液緩衝能
SM
LB
飲食の回数
プラーク
フッ素
dmft
DMFT
即青
ゆっくり青
緑
黄
0
10 万
50 万
100 万1,000
1 万10 万100 万
0
1
2
3
4
5
63
0
0
1
2
3
1
2 4 6
0
2
3
唾液量
唾液緩衝能
SM
LB
飲食の回数
プラーク
フッ素
dmft
DMFT
即青
ゆっくり青
緑
黄
0
10 万
50 万
100 万1,000
1 万10 万100 万
0
1
2
3
4
5
63
0
0
1
2
3
1
2 4 6
0
2
3
情報の共有化
共通理解
Common Information
Caries Risk
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
10
Population and Clinical Research on caries and
caries management
Standardized and EBD Cariology Education
Prevention-focussed Clinical Care for
individual patients
Population focussed Health Promotion, Prevention and
Needs Assessment
ICCMS™ Practice
ICCMS™ Education
ICDAS & ICCMS™
Research
ICDAS & ICCMS™
Public Health
ICDAS and the International Caries Classification and Management System™ ICCMS™
www.icdas.org
for Educators
ORCA and ADEE / ADEA
Monitoring & Review
Domains comprising the European Core Curriculum in Cariology
Domain IVCaries Management
Decision Making & Surgical Therapy
Domain IIICaries Management Decision Making & Preventive Non-Surgical Therapy
Domain VEvidence-based Cariology in Clinical & Public Health Practice
Domain IIRisk Assessment, Diagnosis and
Synthesis
Clinical Decision Making
Domain IThe Knowledge Base
Schulte A G, Pitts N B, Huysmans M C D N J M, Splieth C, Buchalla W. European Core Curriculum in Cariology for undergraduate dental students. European Journal of Dental Education 2011, 15, Supplement 1
Monitoring and Review
Domain IVCaries Management
Decision Making & Surgical Therapy
Domain IIICaries Management Decision Making & Preventive Non-Surgical Therapy
Domain VEvidence-based Cariology in Clinical & Public Health Practice
Domain IIRisk Assessment, Diagnosis and
Synthesis
Clinical Decision Making
Domain IThe Knowledge Base
0 1 2 3 4 5 6 PUFAWellness Initial Caries Moderate Caries Extensive Caries Pain /
SepsisThe ICDAS Caries Continuum
Pitts N, Melo P, Martignon S, Ekstrand K, Ismail A. Caries risk assessment, diagnosis and synthesis in the context of a European Core Curriculum in Cariology. European Journal of Dental Education 2011, 15, Supplement 1
Clinical Decision Making - most challenging for Moderate Caries
Population and Clinical Research on caries and
caries management
Standardized and EBD Cariology Education
Prevention-focussed Clinical Care for
individual patients
Population focussed Health Promotion, Prevention and
Needs Assessment
ICCMS™ Practice
ICCMS™ Education
ICDAS & ICCMS™
Research
ICDAS & ICCMS™
Public Health
ICDAS and the International Caries Classification and Management System™ ICCMS™
for Researchers
www.icdas.org
ICDAS and the International Caries Classification and Management System™ ICCMS™
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
11
Research
BRASIL
ECUADOR
PERU
CHILE
ARGENTINA
COLOMBIA
URUGUAY
VENEZUELA
Population and Clinical Research on caries and
caries management
Standardized and EBD Cariology Education
Prevention-focussed Clinical Care for
individual patients
Population focussed Health Promotion, Prevention and
Needs Assessment
ICCMS™ Practice
ICCMS™ Education
ICDAS & ICCMS™
Research
ICDAS & ICCMS™
Public Health
ICDAS and the International Caries Classification and Management System™ ICCMS™
for Public Health
www.icdas.org
ICDAS and the International Caries Classification and Management System™ ICCMS™
Percentage “no detectable caries” at 12 years was 48%, or 34%, or 22% or 15%!
Percentage with “no detectable caries” at 15 yrs was 35%, or 20%, or 16% or 6%!
First digit = Restoration/Sealant code
Second digit = Caries code
Restoration and Sealant Codes
0 = Not sealed or restored1 = Sealant, partial2 = Sealant, full3 = Tooth coloured restoration4 = Amalgam restoration5 = Stainless steel crown6 = Porcelain, gold, PFM crown or veneer7 = Lost or broken restoration8 = Temporary restoration8 = Temporary restoration
Caries Severity Codes
0 = Sound tooth surface1 = First visual change in enamel2 = Distinct visual change in enamel3 = Enamel breakdown, no dentine visible4 = Dentinal shadow (not cavitated into dentine)5 = Distinct cavity with visible dentine6 = Extensive distinct cavity with visible dentine
ICDAS Code: 1 4
ICDAS coding for restoration status and caries severity
www.icdas.org
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
12
Acknowledgements to:Smile‐on for partnering with development and to
Colgate / GABA for an Educational Grant to support the Project
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
13
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
14
• Introduction and Historical Development
• Evidence to support validity of staging and adoption to date
• ICDAS Domains
• Next steps in use of ICDAS for Clinicians and EducatorsWorking with partners:‐• Web developments• Updated eLearning and case studies• ICDAS Book • More software tools….
• Summary
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
OutlineInternational Caries Detection and Assessment System (ICDAS)
ICDAS e‐learning training Programme developed with Smile‐on.com, supported by Educational Grant from Colgate Palmolive
CASE STUDIES
Methods for Staging of the Caries Process to Enable Dentists to Manage Caries | Professor Nigel Pitts, Professor Kim Ekstrand
05/29/2012
15
• Introduction and Historical Developmento For more than a decade an International Group, constitutesd as a Charitable
Foundation, has been synthesising best evidence to stage the caries process to obtain better quality information to inform decisions about appropriate clinical management at both the individual and public health levels
• Evidence to support validity of staging and adoption to dateo There is now a wealth of published international evidence to support the
validity and utility of this method of staging caries and widespread adoption continues using a flexible choice of formats from the ICDAS ICCMS™ Wardrobe
• ICDAS Domains o Since 2002, this has been across four domains, for: Clinicians, Educators,
Researchers and those in Public Health
• Next steps in use of ICDAS for Clinicians and Educatorso A range of developments are in train, many of which should help clinicians and
educators to plan, deliver and monitor appropriate caries treatment
University of Copenhagen
Methods for staging of the caries process to enable dentists to manage caries
SummaryInternational Caries Detection and Assessment System (ICDAS)
AcknowledgementsThe work and concepts included in this presentation have been the result of collaborations ‐ within Dundee, within the core ICDAS Committee, with ORCA, FDI and IADR colleagues and with other academic and clinical colleagues worldwide.
We would like to specifically acknowledge: the significant contributions that all these individuals have made by generously sharing their time, effort and expertise, as well as the support of a wide range of funding agencies as well as a number of international oral health companies
Specific thanks to: Colgate, Smile‐on and other companies who have supported this work through no‐strings educational grants over the years: including J&J, Cadbury and CariesScan.
University of Copenhagen
www.icdas.org