MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

University of Copenhagen

05/29/2012

InternationalCariesDetection &AssessmentSystemICDAS: Methodsforstagingofthecariesprocess toenabledentiststomanagecaries

Whohasbeeninvolvedsince2002?
TheICDASCoreGroupcomprises: UniversityofDundee (NigelPitts+team) TempleUniversity(wasMichigan) (AmidIsmail+team) IndianaUniversity (DomZero+team) UniversityofCopenhagen (KimEkstrand) (ElmarReich>MartinTyas>MichelGlick) FDI[whenabletocontribute] NIH/NIDCR:(wasRobSelwitz>) (AlKingman)

InternationalCariesDetectionand AssessmentSystem(ICDAS)
ProfessorNigelPitts
DentalHealthServicesResearchUnit &CentreforClinicalInnovations

ProfessorKimEkstrand
CariologyandEndodontics SchoolofDentistry

UniversityofDundee

UniversityofCopenhagen
www.icdas.org

AllworkingwithGailDouglasandthewiderICDASCoordinatingCommittee, withwideinvolvementfrommanyCountries,foroveradecade
www.icdas.org

OnbehalfoftheICDASFoundation

University of Copenhagen

University of Copenhagen

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

Outline
InternationalCariesDetectionandAssessmentSystem(ICDAS)

Outline
InternationalCariesDetectionandAssessmentSystem(ICDAS)

IntroductionandHistoricalDevelopment IntroductionandHistoricalDevelopment Evidencetosupportvalidityofstagingandadoptiontodate ICDASDomains NextstepsinuseofICDASforCliniciansandEducators Summary

Background WhatisICDASin2012? Developmentsinrecentyears ICDAStoICCMS

Evidencetosupportvalidityofstagingandadoptiontodate ICDASDomains NextstepsinuseofICDASforCliniciansandEducators Summary

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

For more on Pitts N B, Community Dental Health 2004 21:193-198 ICDAS see:- http://www.icdas.org

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

The iceberg of dental caries

Diagnostic thresholds in surveys, research & practice
Diagnostic threshold determines what is recorded as diseased or sound

Stagingthecariesprocess comparetooncologydecisionmaking

lesions into pulp

+ clinically detectable D3
lesions in dentine

D3
2

Mislabelled "caries free" at the D 3 threshold

+ clinically detectable "cavities" limited to enamel +

clinically detectable enamel lesions with intact surfaces diagnostic aids

D3 + enamel= D1

+ lesions detectable only with traditional +

sub-clinical initial lesions in a dynamic state of progression/regression
N B Pitts 2006

ICDASCariesSeverityCodesinsummary thankstoIndiana University

www.icdas.org

www.icdas.org

InternationalConsensusWorkshoponCariesClinicalTrials AgreeingWheretheEvidenceLeads ICWCCTSystematicReviewofprevious CARIESCLASSIFICATIONSYTEMS IsmailAI.Visualandvisuotactiledetectionof dentalcaries.JDentRes2004;83:C5666. Thisreviewcompileddetailsofthe(many)previously publishedsystemsforclassifyingcaries,inwhichthe variablediagnosticcriteriainmanycaseslacked constructvalidityandalsomadecomparisonof evidencefromdifferentstudiesimpossible
www.icdas.org

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

Terminology:
ICW-CCT Consensus Statements
The consensus was to separate out three key terms:

TheEvidenceBaseinCaries DetectionandAssessment
Reliable inclusion of clinical visual enamel & dentine caries detection is not new

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)

BackerDirks1951> Marthaler1966> WHO1979 Pitts&Fyffe1988 Ismail1992 Ekstrand,Ricketts&Kidd98 Fyffeetal2000 Nyvad2001 Andmany,manymore

(seeSystematicReviewsNIHCDC andICWCCT)

ICDAS

Pitts N B and Stamm J. ICW-CCT Statements. J Dent Research 2004 83C: 125-128.

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

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
For ICDAS references see http://www.icdas.org

The ICDAS Committee recognised the urgent need for valid comparability and a histological basis, both for Systematic Reviews and getting evidence into practice

ICDAS Wardrobe
Epidemiology / Public Health Clinical Practice

ICDAS

ICDAS
CVA

Clinical Practice

Education ICDAS

Clinical Research

ICDAS

ICDAS Wardrobe

ICDAS
Lesion Detection Tool

Activity Assessment Tool

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

http://www.icdas.org
ICDAS in the literature e-learning programme

How should we best Control dental caries in 2012?

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 g.v.a.douglas@leeds.ac.uk

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 ofDrDomenickT.Zero IndianaUniversity

http://www.icdas.org

ARegisteredCharity

FollowingtheJuly2011ICDASReviewinKaunas,Lithuania Theshared Vision fortheInternational CariesDetectionandAssessmentSystem ICDASis:

ICDAS:employs anevidence basedandpreventivelyorientedapproach ICDASis:adetection &assessmentsystemclassifying stagesofthecariesprocess ICDASisfor:useindentaleducation, clinical practice,researchandpublichealth ICDASprovides:allstakeholderswithacommon carieslanguage ICDAShasevolved:tocompriseanumberofapproved, compatible formats ICDASsupportsdecisionmaking:atbothindividual &public healthlevels ICDAShasgeneratedICCMStoenable:improvedlongtermcariesoutcomes

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

www.icdas.org

www.icdas.org

www.icdas.org

www.icdas.org

ICDAS and the International Caries Classification and Management System ICCMS

ICCMS Practice Prevention-focussed Clinical Care for individual patients

ICDAS & ICCMS Research Population and Clinical Research on caries and caries management

ICDAS & ICCMS Public Health Population focussed Health Promotion, Prevention and Needs Assessment

ICCMS Education Standardized and EBD Cariology Education

www.icdas.org

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

University of Copenhagen

05/29/2012

FDIWorldDental Federation

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

Outline
InternationalCariesDetectionandAssessmentSystem(ICDAS)

IntroductionandHistoricalDevelopment Evidencetosupportvalidityofstagingandadoptiontodate
Histologicalvalidation ICDASintheliterature Stagingdiseaselinkingtoplanningandmonitoringtreatment

ICDASDomains NextstepsinuseofICDASforCliniciansandEducators Summary

a)Soundb)Visibleafterairdryingc)visiblewithoutairdrying a)Soundb)Visibleafterairdryingc)visiblewithoutairdrying

d)Visiblewithoutairdryinge)Microcavitationorshadowedf)dentinecavitation d)visiblewithoutairdryinge)Microcavitationorshadowedf)dentinecavitation

1.1

Fig.1

Fig.2 Lesionopenforassessment(extracted)

Fig.3

ICDASintheliterature
Worldwideadoption (asofMay2012) Country ofstudyorfirstauthor
Australia Baileyetal.(2009)JournalofDentalResearch Brazil Arruda etal.(2012)CommunityDentistryandOralEpidemiology Bragaetal.(2010)CommunityDentistryandOralEpidemiology Bragaetal.(2010)JournalofBiomedicalOptics Bragaetal.(2010)DentalClinicsofNorthAmerica Bragaetal.(2010)CariesResearch Bragaetal.(2009)CariesResearch Bragaetal.(2009)CariesResearch Bragaetal.(2009)OralSurg OralMedOralPathol OralRadiol Endod. Cadavid etal.(2010) BrazilianOralResearch deAmorim etal.(2011)ClinicalOralInvestigation Diniz etal.(2012) JournaloftheAmericanDentalAssociation[Brazil] Diniz etal.(2011) OperativeDentistry Diniz etal.(2010) JournalofDentalEducation Diniz etal.(2009) CommunityDentistryandOralEpidemiology

Peer Reviewed Papers using ICDAS 2012 2011 2010 2009 2008 2007 2006 2004 12 23 19 12 10 6 5 1

Total to date 88 + Books/Chapters 6 + Abstracts/others 45

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

Frencken etal.(2011)InternationalDentalJournal Lealetal.(2012)CariesResearch Mendesetal.(2010)CommunityDentistryandOralEpidemiology Matosetal.(2011) CariesResearch Novaes etal.(2012) InternationalJournalofPaediatricDentistry Novaes etal.(2010) CariesResearch Vidmar etal.(2012)NMRBiomed Soviero etal.(2011)JournalofDentistry Hungary Pinkeetal.(2011)FogorvosiSzemle Iceland Agustsdottir etal.(2010)CommunityDentistryandOralEpidemiology India Shivakumar etal.(2009)JournalofConservativeDentistry Kuwait AlKhatrash etal.(2011)OperativeDentistry Honkala etal.(2011) InternationalDentalJournal Malaysia Shoaib etal.(2009) CariesResearch Mexico Cooketal.(2008)InternationalJournalofPaediatricDentistry Guidoetal.(2011)InternationalJournalofPaediatricDentistry SotoRojasetal.(2012)InternationalJournalofPaediatricDentistry PuertoRico Fontanaetal.(2011) JournalofDentalResearch

05/29/2012

Colombia DazCrdenasandGonzlezMartnez(2010)RevistadeSaludPblica Martignonetal.(2010)CommunityDentalHealth Denmark Bakhshandeh etal.(2011)CariesResearch Ekstrandetal.(2010) CariesResearch Ekstrandetal.(2011) CariesResearch Ekstrandetal.(2007) OperativeDentistry France Aidara etal.(2011)InternationalDentalJournal Josephetal.(2011)EuropeanArchivesofPaediatricDentistry Germany Bergeretal.(2009)ClinicalOralInvestigation JablonskeMomeni (2012)LasersinMedicalScience JablonskiMomeni etal.(2011)CariesResearch JablonskiMomeni etal.(2010)LasersinMedicalResearch JablonskiMomeni etal.(2009)JournalofDentistry JablonskiMomeni etal.(2009)InternationalJournalofDentistry JablonskiMomeni etal.(2008)CariesResearch Khnisch etal.(2008)CommunityDentistryandOralEpidemiology Parisetal.(2011)EuropeanJournalofOralScience Greece Michalaki etal.(2010) EuropeanArchivesofPaediatricDentistry Mitropoulis etal.(2012)CariesResearch Mitropoulis etal.(2010)JournalofDentistry Parapanisiou etal.(2009)EuropeanArchivesofPaediatricDentistry

Romania a Societ ii de Medici i Naturaliti din Maxim DC, Dnila I, Dasclu CG, Balcos C. (2010) Revista medico-chirurgical Iai Sweden Baeshen etal.(2011)AmericanJournalofOrthodonticsandDentofacial Orthopedics Switzerland Neuhausetal.(2010)ClinicalOralInvestigation Rodriques etal.(2008) CariesResearch UK Banerjee etal.(2011)JournalofDentistry Bonneretal.(2011)PrimaryDentalCare Ormondetal.(2010) PrimaryDentalCare Nazir etal.(2011)JournalofOrthodontics Pretty,I.A.(2006)JournalofDentistry

Pittsetal.(2011) EuropeanJournalofDentalEducation Pitts,N.B.(2004)CommunityDentalHealth Pitts,N.B.(2011)JournalofDentistry Varma etal.(2008)JournalofDentistry

ICDAS codes and histological extent of caries

Images provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana

USA Burtetal.(2006)CariesResearch Graye etal.(2012)JournalofClinicalDentistry FerreiraZandon etal.(2010)CariesResearch FerreiraZandon andZero(2006)JournalofAmericanDentalAss. Finlaysonetal.(2007)CommunityDentistryandOralEpidemiology Ismailetal.(2011)CommunityDentistryandOralEpidemiology Ismailetal.(2008)CommunityDentistryandOralEpidemiology Ismailetal.(2008)Pediatric Dentistry Ismailetal.(2007)CommunityDentistryandOralEpidemiology Kolker etal.(2007)Pediatric Dentistry Limetal.(2008)JournaloftheAmericanDentalAssociation Nriagu etal.(2006) InternationalJournalofHygieneandEnvironmentalHealth Nelsonetal.(2011)CommunityDentalHealth Rechmann etal.(2012) JournalofBiomedicalOptics Reisine etal.(2008) CommunityDentistryandOralEpidemiology Sohn etal.(2008)JournaloftheAmericanDentalAssociation Sohn etal.(2007)JournaloftheAmericanDentalAssociation StahlandFerreiraZandon (2007) GeneralDentistry Tellezetal.(2012)CommunityDentalHealth Tellezetal.(2006)JournalofPublicHealthDentistry Zandona etal.(2009) OperativeDentistry

Traditionally a binary choice: sound vs end stage disease

www.icdas.org

ICDAS codes and histological extent of caries

Images provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana

ICDAS codes and histological extent of caries

Images provided courtesy of Dr Andrea Ferreira Zandona, University of Indiana

Someconventions allowsmall cavitiesinenamelanddentine shadows:variabilityhigh!

ICDAScodesstagethecontinuumofcaries
www.icdas.org www.icdas.org

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

University of Copenhagen

05/29/2012

ICCMS ICCMS ICDAS ICDAS and and thethe International International Caries Caries Classification Classification and and Management Management System System

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

for Clinicians
ICCMS Practice Prevention-focussed Clinical Care for individual patients

Outline
InternationalCariesDetectionandAssessmentSystem(ICDAS)

IntroductionandHistoricalDevelopment Evidencetosupportvalidityofstagingandadoptiontodate ICDASDomains

Clinicians Educators Researchers DentalPublicHealthandEpidemiology*
ICDAS & ICCMS Research Population and Clinical Research on caries and caries management

ICDAS & ICCMS Public Health Population focussed Health Promotion, Prevention and Needs Assessment

NextstepsinuseofICDASforCliniciansandEducators Summary
ICCMS Education Standardized and EBD Cariology Education

www.icdas.org

ICDAS-enabled, patient-centred, Caries Management

Tooth/Surface
Clinical Visual Lesion Detection Lesion Detection Aids Lesion Activity Assessment synthesis
Lesion Diagnosis Lesion Prognosis Prognosis for Patient Assessment of Patient

Patient
Patient: Caries Risk Assessment Patient: Dentition / Lesion History Patient: Behavioural Assessment

integrated, personalised

Treatment Planning

BLC
Background Level Care

PTO
Preventive Treatment Options:

OTO
Operative Treatment Options

RRM
Recall, Reassessment & Monitoring

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

2010-2: Development of ICDASs 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

www.Cariescan.com

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

The International Caries Classification and Management System (ICDAS-ICCMS )

With parallel Upstream Common Risk Factor Approach Activities

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)

In concert with other improvements in Oral and General Health

Monitoring & Review

Caries Classification & Management System

including e-Learning, software and data aspects

Initial Patient Caries Risk Assessment

Clinical Treatments Detection, Activity and Enhanced Risk Assessment Synthesis and Decision Making
(Non-surgical & Surgical) with prevention

Monitoring & Review

Conventional Dental Caries Classifications

A holistic view of the The International Caries Classification and Management System

Health
ICDAS stages

Disease
1
Initial

Health
0
Wellness

Disease
1
Initial

Dental Caries: The ICDAS* Caries Continuum (using ICDAS stages and assessment with PUFA)

0
Wellness

2
Caries

3
Moderate

4
Caries

5
Extensive

6
Caries

PUFA
Pain / Sepsis

2
Caries

3
Moderate

4
Caries

5
Extensive

6
Caries

PUFA
Pain / Sepsis

Caries Prevention & Control

Caries Prevention & Control

* ICDAS is a Charitable Foundation committed to open access

How to stay healthy?

Non-cavitated D1 Lesions (can derive D1MFT (or S)

Traditional cavitated d3mft

Pain. Pulp & Sepsis

How to stay healthy?

Non-cavitated d1 lesions (can derive d3mft or d3mfs)

Traditional cavitated d3mft

Pain, Pulp & Sepsis

www.icdas.org

www.icdas.org

ICDASbased personalised care in Japan The ICDAS Framework develops into the ICCMS
dmft DMFT
2 1 0 2 5

CariesRisk

0 10

0 1 2 3 0 2 4 6 3 3

50 100 100 6

1,000 10 1

4 1 3

Common Information

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

ICDAS and the International Caries Classification and Management System ICCMS

05/29/2012

ORCA and ADEE / ADEA

ICCMS Practice Prevention-focussed Clinical Care for individual patients

ICDAS & ICCMS Research Population and Clinical Research on caries and caries management

ICDAS & ICCMS Public Health Population focussed Health Promotion, Prevention and Needs Assessment

for Educators
ICCMS Education Standardized and EBD Cariology Education

www.icdas.org

Domains comprising the European Core Curriculum in Cariology

Domain I The Knowledge Base

Domain II Risk Assessment, Diagnosis and Synthesis

Domain III
Caries Management Decision Making & Preventive Non-Surgical Therapy

Clinical Decision Making

Domain IV
Caries Management Decision Making & Surgical Therapy

Monitoring&Review
Domain V Evidence-based Cariology in Clinical & Public Health Practice
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

ICCMS ICCMS ICDAS ICDAS and and thethe International International Caries Caries Classification Classification and and Management Management System System

Clinical Decision Making - most challenging for Moderate Caries

Domain I The Knowledge Base ICCMS Practice Prevention-focussed Clinical Care for individual patients

Domain II Risk Assessment, Diagnosis and Synthesis

for Researchers
ICDAS & ICCMS Research Population and Clinical Research on caries and caries management ICDAS & ICCMS Public Health Population focussed Health Promotion, Prevention and Needs Assessment

Domain III
Caries Management Decision Making & Preventive Non-Surgical Therapy

Clinical Decision Making

Domain IV
Caries Management Decision Making & Surgical Therapy

0
Wellness

1
Initial

2
Caries

6
Caries

PUFA
Pain / Sepsis

Moderate Caries Extensive The ICDAS Caries Continuum

MonitoringandReview
Domain V Evidence-based Cariology in Clinical & Public Health Practice
PittsN,MeloP,MartignonS,EkstrandK,IsmailA.Cariesriskassessment,diagnosisandsynthesisinthecontext ofaEuropean CoreCurriculuminCariology. European Journal ofDentalEducation2011,15,Supplement 1

ICCMS Education Standardized and EBD Cariology Education

www.icdas.org

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MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

Research

ICCMS ICCMS ICDAS ICDAS and and thethe International International Caries Caries Classification Classification and and Management Management System System

VENEZUELA
COLOMBIA ECUADOR

ICCMS Practice Prevention-focussed Clinical Care for individual patients

PERU

BRASIL

for Public Health

ICDAS & ICCMS Research Population and Clinical Research on caries and caries management

CHILE

URUGUAY

ICDAS & ICCMS Public Health Population focussed Health Promotion, Prevention and Needs Assessment

ARGENTINA

ICCMS Education Standardized and EBD Cariology Education

www.icdas.org

ICDAS coding for restoration status and caries severity

Firstdigit=Restoration/Sealantcode

ICDASCode:14

Seconddigit=Cariescode

Restoration and Sealant Codes 0 = Not sealed or restored 1 = Sealant, partial 2 = Sealant, full 3 = Tooth coloured restoration 4 = Amalgam restoration 5 = Stainless steel crown 6 = Porcelain, gold, PFM crown or veneer 7 = Lost or broken restoration 8 = Temporary restoration 8 = Temporary restoration

Caries Severity Codes 0 1 2 3 4 5 6 = = = = = = = Sound tooth surface First visual change in enamel Distinct visual change in enamel Enamel breakdown, no dentine visible Dentinal shadow (not cavitated into dentine) Distinct cavity with visible dentine Extensive distinct cavity with visible dentine

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%!
www.icdas.org

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MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

Acknowledgementsto: Smileon forpartnering withdevelopment andto Colgate/GABAforanEducational Granttosupport theProject

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MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

13

MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

05/29/2012

University of Copenhagen

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

Outline
InternationalCariesDetectionandAssessmentSystem(ICDAS)

IntroductionandHistoricalDevelopment Evidencetosupportvalidityofstagingandadoptiontodate ICDASDomains NextstepsinuseofICDASforCliniciansandEducators

Workingwithpartners: Webdevelopments UpdatedeLearningandcasestudies ICDASBook Moresoftwaretools.

Summary
ICDASelearning training Programmedeveloped withSmileon.com, supported byEducational Grant fromColgate Palmolive

CASESTUDIES

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MethodsforStagingoftheCariesProcess toEnableDentiststoManageCaries| ProfessorNigelPitts,ProfessorKimEkstrand

University of Copenhagen University of Copenhagen

05/29/2012

Methodsforstagingofthecariesprocesstoenabledentiststomanage caries

Summary
InternationalCariesDetectionandAssessmentSystem(ICDAS)

www.icdas.org

IntroductionandHistoricalDevelopment
o Formorethanadecade anInternational Group,constitutesd asaCharitable Foundation, hasbeen synthesising bestevidencetostagethecariesprocessto obtainbetterqualityinformation toinformdecisionsaboutappropriate clinical management atboththeindividual andpublic health levels

Acknowledgements
Theworkandconceptsincludedinthispresentationhavebeen theresultofcollaborations withinDundee,withinthecore ICDASCommittee,withORCA,FDIandIADRcolleaguesandwith otheracademicandclinicalcolleaguesworldwide. Wewouldliketospecificallyacknowledge:thesignificant contributionsthatalltheseindividualshavemadebygenerously sharingtheirtime,effortandexpertise,aswellasthesupportof awiderangeoffundingagenciesaswellasanumberof internationaloralhealthcompanies Specificthanksto:Colgate,Smileonandothercompanieswho havesupportedthisworkthroughnostringseducationalgrants overtheyears:including J&J,CadburyandCariesScan.

Evidencetosupportvalidityofstagingandadoptiontodate
o Thereisnowawealthofpublished international evidencetosupport the validityandutilityofthismethodofstagingcariesandwidespread adoption continues using aflexiblechoiceofformatsfromtheICDASICCMSWardrobe

ICDASDomains
o Since2002,thishasbeen acrossfourdomains,for:Clinicians, Educators, ResearchersandthoseinPublicHealth

NextstepsinuseofICDASforCliniciansandEducators
o Arangeofdevelopmentsareintrain,manyofwhich shouldhelp clinicians and educators toplan, deliverandmonitorappropriate cariestreatment

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