Diagnostic Outcomes of Two Visual-Tactile Caries Scoring Systems

Objective:  The aim of our study was to evaluate differences in diagnostic outcomes when dentists use two caries scoring systems, the Nyvad (NY) and the ICDAS II (IC). 

Method: Four volunteer dentists were randomly allocated to one of two groups.  Both groups of dentists examined the same voluntary and purposeful sample (n=140) of 18-20 year old caries active young adults using the NY and the IC criteria in different sequences. The first group used the NY criteria during period I, followed by IC criteria during period II; the second group did the examinations in the opposite sequence. Before the first period of examinations, dentists from the first group were trained with the NY criteria, while dentists belonging to the second group were trained with the IC criteria. During the one-week washout period before the second examination, both groups of dentists were trained again: the first group with the IC criteria and the second group with the NY criteria.

Results: The mean DMFS generated by the four dentists was 41.98(SD±12.69) for the IC criteria and 32.46(SD±13.26) for the NY (p<0.0001). The prevalence of active caries lesions was 99% (IC criteria) and 94% (NY criteria). Active lesions (mean Dactive) were consistently higher for the IC (10.35(SD±7.59)) than for the NY criteria (6.02(SD±5.45), p<0.0001). The mean number of active non-cavitated carious lesions (D1) was significantly higher for the IC (6.17(SD±5.40)) than for the NY criteria (3.90(SD±3.96), p<0.0001). Active cavitated/dentinal carious lesions (mean D2) were significantly higher for the IC (4.21(SD±4.06)) than for the NY criteria (2.13(SD±3.12), p<0.0001)). 

Conclusion: The mean number of active carious lesions diagnosed, both non-cavitated and cavitated/dentinal, was significantly higher using the IC criteria, which may subsequently lead to more caries treatment needs.