Caries Assessment Spectrum And Treatment Codes Research Articles

Using the Caries Assessment Spectrum and Treatment Index to Determine the Caries Incidence in Primary and Permanent Molars Among School Children of Kolkata: A Cross-Sectional Study.

Caries in their early stages cannot be properly classified using the decayed, missing, and filled teeth (DMFT) index because it does not record precavitated lesions. Thus, the caries assessment spectrum and treatment (CAST) index is a good alternative as it is equipped to record the whole range of dental illnesses and count restored teeth as healthy ones. The participants in this cross-sectional study included 300 children who were seven-to-eight years of age. We used the CAST index to assess the extent of caries in the deciduous and permanent molars of these children. For this, all the permanent and baby teeth, the primary and secondary permanent molars, as well as the first and second deciduous molars were examined to determine the prevalence of each carious stage. The correlation of the distribution of the CAST codes between the first and second molars, the second and first molars, the right and left sides of the dental bend, and the opposing jaws was analyzed using Spearman's rank correlation coefficient, while the cut-off for statistical significance was a p-value of 0.05. The quantitative analysis was conducted using IBM SPSS Experiences Version 20 for Windows. By comparing CAST codes in the right and left molars, we were able to observe how the development of caries in paired teeth might affect one another. The rank correlation value was found to be less than 0.5 only in the primary second molars (55/65 and 85/75), which were found exclusively in the deciduous first molars. Moreover, the r values for the neighboring deciduous and permanent molars were found to be below 0.3, i.e., 65/64 (0.497), 74/75 (0.327), and 84/85 (0.411), which indicated a weak connection between them. When comparing the teeth in different jaws, we found reasonable correlations (r = 0.33-0.49), with only 64/74 outliers (0.501). We found that, in the examined population, there was a well-established correlation between the stages of caries development in the deciduous molars on the left side of the mouth.

Assessment of caries diagnostic thresholds of DMFT, ICDAS II and CAST in the estimation of caries prevalence rate in first permanent molars in early permanent dentition\u2014a cross-sectional study

BackgroundThe actual burden of dental caries prevalence varies with the caries assessment tool used. Therefore, the present study evaluated the caries diagnostic potentials of Decayed, Missing and Filled Teeth (DMFT); International Caries Detection and Assessment System (ICDAS) II and Caries Assessment Spectrum and Treatment (CAST) indices in estimating the caries prevalence rate of first permanent molar (FPM) in Saudi male children aged 7–9 years.MethodsThis descriptive, cross-sectional study included 390 children by multistage stratified cluster sampling method in Al-Jouf Province, Saudi Arabia. The prevalence rates of FPM caries were determined by DMFT, ICDAS II and CAST indices at various diagnostic cut-off points. Intra- and inter-examiner reliability was determined.ResultsThe prevalence rates of FPM caries determined by DMFT (decayed), ICDAS II (codes 1–6) and CAST (codes 3–7) were 64.4% (61.6–67.2), 71.5% (69.2–73.2) and 71.0% (68.7–73.3), respectively. The prevalence rates of FPM caries determined by ICDAS II at various diagnostic cut-offs were as follows: ‘sound’ (code ‘0’), 28.5% (26.3–30.8); ‘enamel caries’ (codes 1–3), 57.2% (54.7–59.7) and ‘dentinal caries’ (codes 4–6), 14.3% (12.6–16.1). Similarly, the prevalence rates estimated by CAST at different diagnostic cut-off points were: ‘healthy’ (scores 0–2), 28.1% (25.9–30.4); ‘premorbid’ (score 3, enamel carious), 56.5% (54.0–59.0); ‘morbid’ (scores 4–5, cavitated carious dentin), 7.9% (6.6–9.3); ‘severe morbidity’ (scores 6–7, pulp exposure/fistula/abscess), 6.6% (5.4–8.1) and ‘mortality’ (score 8, lost), 0.8% (0.4–1.4).ConclusionEnamel caries lesions were found in more than half of the FPMs investigated in the current study. CAST index is preferable because it detects the complete spectrum of caries. ICDAS II at codes 1–6 and CAST at codes 3–7 projected similar caries prevalence rates in FPMs.

Application of caries assessment spectrum and treatment instrument for staging and evaluating treatment needs of an adult population - A hospital based cross-sectional study.

Application of caries assessment spectrum and treatment (CAST) instrument for staging and evaluating treatment needs of an adult population suffering from dental carious lesion. Study was conducted with aim of applying CAST instrument for staging adult urban Indian population according to severity of carious lesion and treatment needs required. Cross-sectional descriptive study was conducted on 300 adult patients. After training session and calibration of examiner, all patients were examined for the caries experience and CAST codes were recorded on a structured proforma. Of 300 adult patients, 18% (54) adults have healthy dentition denoted by codes 0,1, and 2. 12 % and 15.3% adults were in reversible premorbidity stage (code 3) and morbidity stage (codes 4 and 5) respectively. The largest number of adults 29.7% were seen in serious morbidity stage (codes 6 and 7) followed by 21.3% adults in mortality stage (code 8) requiring either root canal treatment or extraction and replacement of teeth as treatment needs. CAST instrument has been found useful in staging adult population suffering with dental carious lesion and evaluating their treatment needs. Moreover, CAST is easy to apply for staging the carious lesion due its hierarchical structure and reporting results in an understandable manner.

Assessment of Caries Spectrum of First Permanent Molars in 7- to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study

Objective: To estimate caries spectrum in first permanent molars (FPMs) of 7- to 8-year-old children in Saudi Arabia using Caries Assessment Spectrum and Treatment (CAST) index, and examine the correlation between distributions of CAST codes among contralateral and opposite arches. Material and Methods: A cross-sectional survey was conducted of 7- to 8-year-old Saudi school children in Sakaka, Aljouf, Saudi Arabia. A total of 385 children were examined. CAST codes were determined for FPMs, and their distribution was analyzed using Spearman’s rank correlation coefficient. Statistical significance was set as p<0.05. Intra-examiner reliability was determined using the unweighted kappa coefficient. Results: The results indicated most of the FPMs were scored as code 3 (enamel lesions) such as upper contralateral FPM 44.40% for right, 53.50% for left, respectively, and lower contralateral molars were 61.30% for right and 64.90% for left, respectively. It was also observed that upper FPMs had scored code 0 (sound teeth) more than that of lower FPMs. Serious morbidity (codes 6 and 7) and mortality (code 8) showed a low prevalence in FPMs. Strong correlations were observed between upper contralateral FPMs (r=0.586) and lower contralateral FPMs (r=0.567, p<0.001). Conclusion: A high prevalence of enamel caries lesions (code 3) was observed in FPMs; in addition, a strong correlation was present between upper contralateral FPMs and between lower contralateral FPMs.

Uso do instrumento CAST em levantamentos epidemiológicos: apresentação dos resultados em comparação ao critério da OMS

Caries Assessment Spectrum and Treatment (CAST) is an instrument developed for caries detection to be used in epidemiological surveys; it has been validated and is believed to provide a clearer picture of the oral health status than the criteria provided by the World Health Organization (WHO). This article aims to compare the epidemiological survey results using the CAST instrument and the WHO criteria in the same population. 680 schoolchildren aged 6-8 years from Federal District, Brazil, were evaluated by two examiners trained to use the CAST. The visible plaque index (VPI) and gingival bleeding index (GBI) were also evaluated. The maximum CAST codes per tooth were converted into the dmf/DMF, the mean scores for primary and permanent dentition were calculated. The mean age was 7.45(± 0.91) years. The prevalence of caries differed when CAST and the WHO criteria were applied. In the primary dentition, it was 65.44% and 61.61%, and for the permanent dentition, 38.19% and 10.2%, respectively. It was possible to calculate the mean dmft [2.4(± 2.7)] and the DMFT [0.16(± 0.53)] using CAST. VPI was associated with higher maximum CAST scores p < 0,005. The way CAST results are presented showed a higher sensibility to identify the presence and severity of carious lesions in comparison to the WHO criteria.

Caries assessment spectrum treatment: the severity score

To appraise the feasibility of the caries assessment spectrum and treatment (CAST) severity score according to the formula (F) recommended in the CAST manual. Data from an epidemiological survey of 680 schoolchildren (mean age ± standard deviation: 7.45± 0.91 years), living in a low-income area in Brasília, were used. The CAST instrument was used for assessing enamel carious lesions (CAST code=3), dentine carious lesions (CAST codes=4-7) and tooth loss from caries (CAST code=8). The prevalence of carious lesions including enamel and dentine in both deciduous and permanent dentitions was 49.41% and 69.12%, respectively. Calculating the CAST severity score per child using F was unsatisfactory because of the undiscriminating weight given for each CAST code. Modification of weights according to the accepted levels of disease severity for individual CAST codes resulted in a new formula (F1), in which the weight given to cavitated dentine lesions was quadrupled in relation to that given to enamel carious lesions; this was different from F, in which the weight given to such lesions was twofold. F1 was able to categorise satisfactorily the study children into one of three levels of dental caries severity: mild (34.1%); moderate (29.5%); or severe (36.4%). According to the outcomes of the present appraisal, it was concluded that the numerical score provided by the CAST severity scores allows an overview of the severity of caries disease and the classification of individuals into mild, moderate or severe levels of dental caries when the new formula (F1) is used.

Patterns of dental caries among school children assessed using Caries Assessment Spectrum and Treatment tool.

Objective:The present study aimed to assess and monitor patterns of dental caries among primary and permanent molars using Caries Assessment Spectrum and Treatment (CAST) index and to evaluate integration of CAST tool into patient health information (PHI) system of a Teaching Dental Hospital.Materials and Methods:Dental records of n = 348 children, aged 7–9-years, attending University Dental Hospital Sharjah, for routine checkup and treatment as part of School Dental Program were assessed and translated into CAST codes. Dental caries prevalence for the second primary and first permanent molars were recorded. Spearman's correlation coefficient was used to assess the correlation of the status between primary and permanent molar.Results:CAST codes 0–2 were observed only in about 3% of primary and almost 5% in permanent dentition. The prevalence of children with diseased first permanent molar (codes 4–7) was almost 67%, while it was over 70% in second primary molars. A strong correlations were observed in the status between second primary and first permanent molars in the lower jaw on both right and left sides, r was 0.694 and 0.643 (P = 0.001), respectively. In the upper jaw, both right and left second primary molars revealed moderate correlation r = 0.435 (P ≤ 0.05) between disease stages with their neighboring permanent first molars. The unweighted kappa value for the intraexaminer reliability was 0.97 for second primary and 0.95 for first permanent molars.Conclusion:Our study recommends the integration of CAST tool in the PHI system where a simple numerical value can express clinical progress, overcome interruptions of treatment, and ensures continuity of patient care in teaching hospitals.

Comparative Evaluation of Caries Status in Primary and Permanent Molars in 7-8-year-old Schoolchildren of Shimla Using Caries Assessment Spectrum and Treatment Index.

Background:A new epidemiological index is introduced for full assessment of dental caries which is known as caries assessment spectrum and treatment (CAST). “Spectrum” is considered backbone of this index as it covers from no lesion to advanced stage progression of caries. We aimed to evaluate and compare the status of caries in primary and permanent molars of 7–8-year-old schoolchildren of Shimla using CAST index and to find if any correlation exists between the status of caries in evaluated teeth.Methods:Three hundred and one schoolchildren with age group of 7–8 years were selected from schools in Shimla. CAST codes were determined for primary molars and first permanent molars. The distribution of CAST codes in the examined molars is correlated with the help of Spearman's rank correlation coefficient. The level of statistical significance was established at P < 0.05. The intraexaminer reliability was determined by the unweighted kappa coefficient.Results:Caries was assessed in 6.3%–12.3% of the permanent molars in contrast to primary molars, in which caries was near about 50%. The correlation was stronger for first and second deciduous molars for the right side of the mouth than the left side (r = 0.293 and 0.257 in the maxilla and 0.503 and 0.319 in the mandible [P < 0.001], respectively, while correlation for teeth in opposite jaws was moderate [r = 0.20–0.47]). The intraexaminer reliability was examined (k = 0.90 for the primary and 0.85 for permanent molars).Conclusion:The correlation between primary and permanent molars regarding the caries status in primary molars is weak while strongest correlation was present on the right side of the mouth for first and second deciduous molars. The study also showed the applicability of the CAST index in epidemiological surveys.

Caries Assessment Spectrum and Treatment (CAST) Index in the Primary Molars of 6- to 7-year-old Polish Children.

To evaluate the caries prevalence and experience in primary molars in Polish 6- to 7-year-old children using the Caries Assessment Spectrum and Treatment index. This cross-sectional study was carried out on a sample of 332 out of 468 invited children (140 6- and 192 7-year-olds). Cluster sampling was used to select the participating schools. Dental status was evaluated according to the criteria dedicated to CAST. The means of the individual CAST scores were assessed. Data were statistically analysed using the Mann-Whitney U-test (p < 0.05). The percentage of children according to the highest CAST score was calculated. The mean values of the dmft index, based on three different caries thresholds--CAST codes 3 to 7 (d3-7t), 4 to 7 (d4-7t) and 5 to 7 (d5-7t)--were calculated. The response rate was 70.9%. One-fifth of the participants showed a healthy, functional dentition (CAST codes 0-2). The highest percentage of children had at least one carious tooth with pulpal involvement (26.2%), followed by children having an obvious dentin caries lesion (20.8%). The means for CAST codes 3, 4 and 5 were 0.61 ± 1.0, 0.19 ± 0.53 and 1.23 ± 1.61, respectively. The means of molars with pulpal involvement was 0.83 ± 1.32 and with dental sepsis 0.07 ± 0.33. Apart from filled teeth, no age-dependent differences were observed. The d3-7mft, d4-7mft and d5-7mft were as follows: 5.18, 4.61 and 4.41, respectively. The surveyed Polish children showed high caries prevalence and severe caries experience in the primary molars. The CAST index was a useful tool for the epidemiological analysis of primary molars.

Assessment of dental caries in primary dentition employing caries assessment spectrum and treatment index

Background: Caries assessment spectrum and treatment (CAST) index was developed as an innovative instrument for evaluating dental caries in epidemiological studies. Aim: The aim of the study was to assess the usefulness of CAST in evaluating caries prevalence and treatment needs among children in primary dentition stage. Materials and Methods: Children in the age range of 5-6 years were selected and their caries status, along with the treatment needs, was recorded using CAST index. The differences in caries status between maxillary and mandibular arches, right and left quadrants as well as boys and girls were assessed using Mann–Whitney U test with the level of significance set at 0.05 and correlation of the distribution of CAST codes among the evaluated teeth was explored through Spearman's rank correlation coefficient. Results: A strong correlation was found between the status of the teeth from the right and left sides of the oral cavity. The correlation coefficient (r) for neighboring maxillary anteriors was 0.67 and 0.57, whereas 1 for all mandibular anteriors (P < 0.001). The correlation coefficient (r) for neighboring maxillary posteriors was <0.3, whereas it was 0.48 and 0.18 for mandibular posteriors (P < 0.001). Correlations were found to be weak (r 0.07-0.29) between maxillary and mandibular arches. Conclusions: In the evaluated population, the strongest correlation was found for the distribution of caries stages in primary incisors as well as molars on the right side of the mouth and the percentage of molars with carious lesions was especially high for second primary molars.

The Caries Assessment Spectrum and Treatment (CAST) instrument: its reproducibility in clinical studies

A new caries assessment instrument, the Caries Assessment Spectrum and Treatment (CAST), was developed. It covers carious lesion progression from no lesion, sealants and restorations to lesions in enamel and dentine, advanced stages in pulpal and tooth-surrounding tissues, and tooth loss owing to dental caries, in nine codes. The objective of this study was to determine the reproducibility of the CAST instrument in primary and permanent dentitions, using three age groups. Two epidemiological surveys were conducted in Brazil, covering three age groups: 2-6-year-old and 6-9-year-old children and 19-30-year-old adults. Four trained and calibrated examiners performed the examinations. Reproducibility was calculated for intra- and inter-examiner at surface and tooth levels and expressed as unweighted kappa-coefficient value (κ) and percentage of agreement (Po) for CAST codes (0-7) and for the categories healthy (0-2) versus diseased (3-7), and non-cavitated (0-3) versus cavitated (4-7) teeth. Using CAST codes (0-7) for the 2-6-year-old age group in primary dentitions, inter-examiner consistency was κ = 0.74 and Po was 98.3%. In the 6-9-year-old age group in primary dentitions, inter-examiner consistency ranged from κ = 0.68 to κ = 0.86 and Po was ≥ 93.7%. In the 19-30-year-old age group inter-examiner consistency was κ = 0.87 and Po was 94.1%. The reproducibility of the CAST instrument for use in the primary dentition of 2-6-year olds and of 6-9-year olds was 'substantial' to 'almost perfect'. The reproducibility for its use in the permanent dentition of 19-30-year olds was 'almost perfect'. The CAST instrument can reliably be applied in epidemiological studies covering these ages.

Dental caries in primary and permanent molars in 7-8-year-old schoolchildren evaluated with Caries Assessment Spectrum and Treatment (CAST) index.

BackgroundNo reports on a caries pattern covering the full spectrum of the disease could be found in the literature. The aim of this study was to evaluate caries in primary and first permanent molars of 7-8-year-old Polish children by the Caries Assessment Spectrum and Treatment (CAST) index and to find whether there was any correlation between the caries stages in such teeth.MethodsThe study covered 284 7-8-year-old children from randomly selected schools in the Bialystok District, Poland. The prevalence of CAST categories was evaluated with regard to the first and second primary, and first permanent, molars. The Spearman’s rank correlation coefficient was used to explore the correlation of the distribution of CAST codes among the evaluated teeth. The level of statistical significance was established at p < 0.05. The intra-examiner reliability was determined by the unweighted kappa coefficient.ResultsWith regard to the permanent molars, caries was observed in 14.8% to 17.3% of the molar and most lesions were scored at the non-cavitation level. Caries in primary molars was most often recorded at the stage of cavitated dentine lesion. Teeth with pulpal involvement, sepsis and extracted due to caries were found to be more prevalent in first, and then in second primary molars. A strong correlation was found between the status of teeth from the right and left sides of the oral cavity. The correlation of the status of first and second primary teeth was stronger for the left than for the right side of the mouth, r was 0.627 and 0.472 in maxilla and 0.513 and 0.483 in mandible (p < 0.001), respectively. For the neighbouring primary and permanent molars the correlation was assessed to be weak. With regard to the teeth situated in opposite jaws the study revealed that the correlations were moderate - r between 0.33 and 0.49. The intra-examiner reliability was established at 0.96 for the primary dentition and at 0.878 for permanent molars.ConclusionThe strongest correlation found in the evaluated population concerned the distribution of caries in primary molars on the left side of the mouth. The study proved the usefulness of the CAST index in epidemiological surveys.

The Caries Assessment Spectrum and Treatment (CAST) instrument: construct validation

The Caries Assessment Spectrum and Treatment (CAST) is a newly developed epidemiological instrument. The aim of this study was to investigate its construct validity. Four calibrated examiners, using CAST codes 0-6, visually examined 109 surfaces of extracted and exfoliated teeth. These teeth were then hemisectioned, photographed, and assessed histologically by two calibrated examiners using the Downer criteria. Twenty-eight of the 109 teeth were scanned using micro-computed tomography (micro-CT) and assessed by the same examiners using the same criteria. Validation was determined through calculation of the sensitivity, specificity, and Youden index for two categories of carious lesions examined visually, with histology and micro-CT as gold standards. Interexaminer consistency was κ = 0.76: SE ± 0.05 between visual and histological assessments of teeth and was κ = 0.89: SE ± 0.08 between visual and micro-CT assessments. For the category 'healthy' vs. 'diseased' (CAST codes 0-2 vs. CAST codes 3-6), sensitivity, specificity, and Youden index values of 100%, 92.9%, and 93%, respectively, for micro-CT, and 96.6%, 86%, and 83%, respectively, for histology, were obtained. For the category 'dentine' vs. 'non-dentine lesions' (CAST codes 0-3 vs. CAST codes 4-6) sensitivity, specificity, and Youden index values of 90%, 100%, and 90%, respectively, for micro-CT, and 81.4%, 100%, and 81%, respectively, for histology, were obtained. Construct validity of the CAST instrument was obtained.