Comparison of simple screening criteria with the International Caries Detection and Assessment System classification in determining restorative treatment need.
BACKGROUND
The Finnish Defence Forces' unique oral health-screening protocol (FDFsp) has been in use for decades. In FDFsp, restorative treatment need is determined based on the World Health Organization (WHO) criteria. The aim of this study was to compare the outcome of screening restorative treatment need with the outcome of using the International Caries Detection and Assessment System (ICDAS) classification at both individual and tooth levels. Our hypothesis was that the outcome of screening with FDFsp agrees with the outcome of using the ICDAS classification.


METHODS
In this study, a trained, calibrated examiner estimated, in a visual-tactile manner the restorative treatment need of 337 young healthy adults using the FDFsp. During the screening, 74 conscripts were selected for a thorough inspection. The inclusion criteria for those selected were: having no, having one to five, or having six or more caries lesions needing restorative treatment. In the thorough inspection, the participants were inspected in a visual-tactile manner using the ICDAS classification. The association of the outcomes achieved using the two different methods was analysed at individual and tooth levels. Sensitivity, specificity, and kappa values were calculated. Wisdom teeth were excluded.


RESULTS
At the individual level, the agreement between the outcomes of using FDFsp and ICDAS ≥4 was excellent: sensitivity, 94.1%; specificity, 97.5%; and kappa = 0.92. When ICDAS ≥3 was used, the values were 72.7%, 96.7%, and 0.66%, respectively.


CONCLUSIONS
Screening performed by a trained examiner using specific criteria is a reliable method for detecting individuals with restorative treatment need. The outcome of screening agrees strongly with results using the ICDAS classification.
Institute of Dentistry, University of Oulu, Oulu, Finland.
Antti
A
Kämppi
Institute of Dentistry, University of Oulu, Oulu, Finland.
Tarja
T
Tanner
Department of Mathematical Sciences, University of Oulu, Oulu, Finland.
Jari
J
Päkkilä
Centre for Military Medicine, Finnish Defence Forces, Riihimäki, Finland.
Pertti
P
Patinen
Institute of Dentistry, University of Oulu, Oulu, Finland.|Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.|Oulu University Hospital, Oulu, Finland.
Leo
L
Tjäderhane
Institute of Dentistry, University of Oulu, Oulu, Finland.|Oulu University Hospital, Oulu, Finland.
Vuokko
V
Anttonen
D000293:Adolescent; D000328:Adult; D004245:DMF Index; D003731:Dental Caries / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008403:Mass Screening; D008889:Military Personnel; D020380:Needs Assessment / Q000706:statistics & numerical data*; D010808:Physical Examination; D012680:Sensitivity and Specificity; D055815:Young Adult
Adolescent; ICDAS; dental caries; epidemiology; screening