title: Activity assessment has little impact on caries parameters reduction in epidemiological surveys with preschool children.
abstract: OBJECTIVE
  This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment, in an epidemiological survey of preschool children, involving cavitated and noncavitated caries lesions.
  
  
  METHODS
  The survey was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 639 children aged between 12 months and 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and additional lesion activity assessment criteria. The mean of decayed surfaces (d-s), the mean of decayed teeth (d-t), caries prevalence, and 95% confidence intervals were calculated, initially by classifying all lesions using the various thresholds defined by the ICDAS. Caries activity status was then evaluated, and inactive lesions were classified as sound in a secondary analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children requiring assessment to change their classification from decayed to sound (number needed to be assessed) were also calculated.
  
  
  RESULTS
  The majority of lesions were classified as active, mainly at cavitated thresholds. When activity was considered, values of all caries parameters decreased. This decrease was more evident at noncavitated thresholds. The number of children requiring assessment to change their classification from decayed to sound was <20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions.
  
  
  CONCLUSIONS
  The inclusion of activity assessment in caries epidemiological surveys has little impact on the d-s, d-t and prevalence of dental caries considering both noncavitated and cavitated lesions.
authors.affiliation: Departament of Pediatric Dentistry, Faculdade de Odontologia da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Chaiana
authors.initials: C
authors.lastname: Piovesan
authors.forename: Thiago M
authors.initials: TM
authors.lastname: Ardenghi
authors.forename: Renata S
authors.initials: RS
authors.lastname: Guedes
authors.forename: Kim R
authors.initials: KR
authors.lastname: Ekstrand
authors.forename: Mariana M
authors.initials: MM
authors.lastname: Braga
authors.forename: Fausto M
authors.initials: FM
authors.lastname: Mendes
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D003732:Dental Caries Activity Tests / Q000145:classification / Q000706:statistics & numerical data*; D003743:Dental Enamel / Q000473:pathology; D003750:Dental Fissures / Q000453:epidemiology; D003804:Dentin / Q000473:pathology; D018450:Disease Progression; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D014075:Tooth Discoloration / Q000453:epidemiology; D014089:Tooth Remineralization