Assessing caries status according to the CAST instrument and WHO criterion in epidemiological studies.

Ana Luiza De Souza,Ewald M Bronkhorst,Jo E Frencken,Soraya Coelho Leal

doi:10.1186/1472-6831-14-119

Abstract

BackgroundThe Caries Assessment Spectrum and Treatment (CAST) is a new epidemiological instrument for detection and treatment of dental caries. Worldwide, the WHO criterion constitutes the epidemiological tool most commonly used for caries detection. The objective of the present study is to determine the levels of similarity and difference between the CAST instrument and WHO criterion on the basis of caries prevalence, dmf/DMF counts, examination time and reporting of results.MethodsAn epidemiological survey was carried out in Brazil among 6-11-year-old schoolchildren. Time of examinations was recorded. dmft, dmfs, DMFT and DMFS counts and dental caries prevalence were obtained according to the WHO criterion and the CAST instrument, as well the correlation coefficient between the two instruments.ResultsFour hundred nineteen children were examined. dmft and dmfs counts were 1.92 and 5.31 (CAST), 1.99 and 5.34 (WHO) with correlation coefficients (r) of 0.95 and 0.93, respectively. DMFT and DMFS counts were 0.20 and 0.33 (CAST), 0.19 and 0.30 (WHO), with r = 0.78 and r =0.72, respectively. Kappa coefficient values for intra-examiner consistency were CAST = 0.91-0.92; WHO = 0.95-0.96 and those for inter-examiner consistency were CAST = 0.90-0.96; WHO = 0.94-1.00. Mean time spent on applying CAST and WHO were 66.3 and 64.7 sec, respectively p = 0.26. The prevalence of dental caries using CAST (codes 2, 5-8) and the WHO criterion for the primary dentition were 63.0% and 65.9%, respectively, and for the permanent dentition they were 12.7% and 12.8%, respectively.ConclusionsThe CAST instrument provided similar prevalence of dental caries values and dmf/DMF counts as the WHO criterion in this age group. Time spent on examining children was identical for both caries assessment methods. Presentation of results from use of the CAST instrument, in comparison to WHO criterion, allowed a more detailed reporting of stages of dental caries, which will be useful for oral health planners.

Highlights

The Caries Assessment Spectrum and Treatment (CAST) is a new epidemiological instrument for detection and treatment of dental caries
The CAST instrument differs from other caries assessment instruments by the fact that the codes are ordered in increasing level of severity of the effects of the caries process
The implications of the rationale upon which CAST has been built leads to a different calculation of the prevalence of dental caries, which is not based on the presence of a dmf/DMF count of ≥1 but on that of d/D ≥1

Summary

Introduction

The Caries Assessment Spectrum and Treatment (CAST) is a new epidemiological instrument for detection and treatment of dental caries. A new caries assessment instrument termed Caries Assessment Spectrum and Treatment (CAST) was promulgated in 2011 [2] It was designed for use in international epidemiological surveys and permits registration of sound teeth, sealants, restorations, enamel and dentine caries lesions, advanced stages of caries lesions into the pulp and tooth-surrounding tissues, and teeth lost due to dental caries (Table 1) [2,3]. The CAST instrument differs from other caries assessment instruments by the fact that the codes are ordered in increasing level of severity of the effects of the caries process In this hierarchical order, a tooth surface containing a sealant and one having a restoration are considered healthy surfaces. CAST codes allow the calculation of a dmf/ DMF count of an individual tooth, in comparison to those of other caries assessment indices [3]

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