Feasibility Of ICDAS-Ⅱin Children Caries Detection And Association Between Obesity And Dental Caries In Children

Objective:TO evaluate the application of ICDAS-II system and WHO criteria in children caries detection and compare ICDAS-II system with WHO criteria. And the present study sought to analyze the association between dental caries and overweight/obesity in children, and to investigate the risk and protective factors of dental caries.Methods:(1) Two hundred and eighty children (7-12years old) who attended the oral health examination in stomatological hospital of Tianjin Medical University via newspaper advertisement, were examined by4examiners using ICDAS-II system or WHO criteria respectively. The caries prevalence were analyzed using data obtained by WHO criteria (DMFT, DMFS, dmft and dmfs index) and by ICDAS-Ⅱ. According to different thresholds of caries, divided ICDAS-II system into sound and decayed at four cut-offs:D1(code1-6classified as carious); D2(code0and1as sound,2-6as carious); D3(code0-2sound,3-6carious); D4(0-3sound,4-6carious).(2) A cross-sectional survey was conducted. A total of280children aged7-12years voluntarily answered the caries examination and questionnaire. Caries severity was measured using the International Caries Detection and Assessment System (ICDAS-II). The number of DMF-T/DMF-S and dmf-t/dmf-s were recorded to calculate the caries prevalence and the mean DMF-T/S and dmf-t/s. The body mass index (BMI, kg/m2) of all the children were calculated. According to the Chinese BMI index, the participants were grouped into overweight and non-overweight. Using a logistic regression model, the correlation between dental caries and overweight/obesity, as well as caries-related factors, was analyzed.Results:(1) Kappa values for inter-examiner reproducibility were0.74-0.84for ICDAS-II system, and0.82for WHO criteria. For ICDAS-II system, prevalence of caries and dmft value were significantly higher than that of WHO criteria, while the rate was86.1%and50.2%, and dmft value was2.38and1.19, the difference was statistically significant (P<0.001). Caries prevalence rate and dmft value of D1,D2 and D3evalued by ICDAS-II system were significantly higher than that of WHO criteria, and the difference was statistically significant (P<0.001). There was no significant difference of mean dmft between D4and WHO criteria (P=0.31).(2) Caries was measured using the ICDAS-II system. The prevalence of dental caries was84.3%and the mean DMF-T was2.91. The caries prevalence in girls (86.1%) was a little higher than boys (82.8%). The difference was not statistically significant (p=0.454). The caries prevalence was86.3%in the normal-weight group which was higher than the overweight group (81.0%), but the difference was not statistically significant (p=0.24). The mean DMF-T value for the overweight group and the normal-weight group was2.81and2.98, respectively. The difference of the mean DMF-T value between the overweight group and the normal-weight group was not statistically significant (p=0.237). The logistic regression model further showed no correlation between dental caries and overweight/obesity. The multivariate logistic regression showed that drinking yogurt2-4times/week, chewing gum3to4times/week, oral breathing, and genetic predisposition to caries are significantly associated with caries development.Conclusions:(1) ICDAS-II presented good feasibility in detecting the caries lesions, especially non-cavitated caries lesions were described and classified in details.(2) Dental caries and overweight/obesity did not exhibit significant association with each other despite controlling the age and gender. Drinking yogurt2-4times/week and chewing gum3-4times/week are beneficial for oral health, whereas oral breathing and genetic predisposition to caries are risk factors.