The views and experiences of general dental practitioners (GDP’s) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research

Autoři: Maria Ishaq Khattak aff001;  Julia Csikar aff001;  Karen Vinall aff001;  Gail Douglas aff001
Působiště autorů: School of Dentistry, University of Leeds, Leeds, United Kingdom aff001;  Institute of Public Health & Social Sciences, Khyber Medical University, Khyber Pakhtunkhwa, Peshawar, Pakistan aff002
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223376



To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries.


This qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis.


GDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care.


The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment.

Klíčová slova:

Caries – Finance – Charts – Nurses – Qualitative studies – Undergraduates – Social influence – Dentin


1. Featherstone JDB. Prevention and reversal of dental caries: role of low level fluoride. Community Dentistry and Oral Epidemiology. Wiley; 1999;27: 31–40. doi: 10.1111/j.1600-0528.1999.tb01989.x 10086924

2. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Untreated Caries. Journal of Dental Research. SAGE Publications; 2015;94: 650–658. doi: 10.1177/0022034515573272 25740856

3. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dentistry and Oral Epidemiology. Wiley; 2007;35: 170–178. doi: 10.1111/j.1600-0528.2007.00347.x 17518963

4. Ismail AI. Visual and Visuo-tactile Detection of Dental Caries. Journal of Dental Research. SAGE Publications; 2004;83: 56–66. doi: 10.1177/154405910408301s12 15286124

5. Bader JD, Shugars DA, Bonito AJ. A systematic review of selected caries prevention and management methods. Community Dentistry and Oral Epidemiology. Wiley; 2001;29: 399–411. doi: 10.1034/j.1600-0528.2001.290601.x 11784283

6. Dikmen B. ICDAS II CRITERIA (INTERNATIONAL CARIES DETECTION AND ASSESSMENT SYSTEM). Journal of Istanbul University Faculty of Dentistry. Istanbul University; 2015;49: 63. doi: 10.17096/jiufd.38691 28955548

7. Topping GVA, Pitts NB. Clinical Visual Caries Detection. Monographs in Oral Science. KARGER; 2009. pp. 15–41. doi: 10.1159/000224210 19494673

8. Shivakumar K, Prasad S, Chandu G. International Caries Detection and Assessment System: A new paradigm in detection of dental caries. Journal of Conservative Dentistry. Medknow; 2009;12: 10. doi: 10.4103/0972-0707.53335 20379434

9. Anderson P, Beeley J, Monteiro PM, de Soet H, Andrian S, Amaechi B, et al. A European Core Curriculum in Cariology: the knowledge base. European Journal of Dental Education. Wiley; 2011;15: 18–22. doi: 10.1111/j.1600-0579.2011.00709.x 22023542

10. Nunn J, Morris J, Pine C, Pitts N, Bradnock G, Steele J. The condition of teeth in the UK in 1998 and implications for the future. British Dental Journal. Springer Nature; 2000;189: 639–644.

11. SHEIHAM A. Changing Trends in Dental Caries. International Journal of Epidemiology. Oxford University Press (OUP); 1984;13: 142–147. doi: 10.1093/ije/13.2.142 6376384

12. ARTA G, CAGETTI MG, COCCO F, SALE S, LINGSTRÖM P, CAMPUS G. Caries-risk profiles in Italian adults using computer caries assessment system and ICDAS. Brazilian Oral Research. FapUNIFESP (SciELO); 2015;29. doi: 10.1590/1807-3107bor-2015.vol29.0126 26892361

13. de Amorim RG, Figueiredo MJ, Leal SC, Mulder J, Frencken JE. Caries experience in a child population in a deprived area of Brazil, using ICDAS II. Clinical Oral Investigations. Springer Nature; 2011;16: 513–520. doi: 10.1007/s00784-011-0528-9 21384127

14. Braga MM, Oliveira LB, Bonini GAVC, Bönecker M, Mendes FM. Feasibility of the International Caries Detection and Assessment System (ICDAS-II) in Epidemiological Surveys and Comparability with Standard World Health Organization Criteria. Caries Research. S. Karger AG; 2009;43: 245–249. doi: 10.1159/000217855 19439944

15. Honkala E, Runnel R, Honkala S, Olak J, Vahlberg T, Saag M, et al. Measuring Dental Caries in the Mixed Dentition by ICDAS. International Journal of Dentistry. Hindawi Limited; 2011;2011: 1–6. doi: 10.1155/2011/150424 22114594

16. Braga MM, Mendes FM, Ekstrand KR. Detection Activity Assessment and Diagnosis of Dental Caries Lesions. Dental Clinics of North America. Elsevier BV; 2010;54: 479–493. doi: 10.1016/j.cden.2010.03.006 20630191

17. Kühnisch J, Berger S, Goddon I, Senkel H, Pitts N, Heinrich-Weltzien R. Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements. Community Dentistry and Oral Epidemiology. Wiley; 2008;36: 475–484. doi: 10.1111/j.1600-0528.2008.00436.x 18422704

18. Mehta A. Comprehensive review of caries assessment systems developed over the last decade [Internet]. 2012 [cited 6 August 2019].

19. Gomez J, Ellwood RP, Martignon S, Pretty IA, Gomez Bulla J. Dentists’ perspectives on caries-related treatment decisions. Community Dental Health. 2014;31(2):91–98. 25055606

20. Bader JD, Shugars DA. Variation in Dentists’ Clinical Decisions. Journal of Public Health Dentistry. Wiley; 1995;55: 181–188. doi: 10.1111/j.1752-7325.1995.tb02364.x 7562733

21. Pitts NB, Richards D. Personalized Treatment Planning. Monographs in Oral Science. KARGER; 2009. pp. 128–143. doi: 10.1159/000224217 19494680

22. Deery C. Caries detection and diagnosis, sealants and management of the possibly carious fissure. British Dental Journal. Springer Science and Business Media LLC; 2013;214: 551–557. doi: 10.1038/sj.bdj.2013.525 23744208

23. Luz PB, Stringhini CH, Otto BR, Port ALF, Zaleski V, Oliveira RS, et al. Performance of undergraduate dental students on ICDAS clinical caries detection after different learning strategies. European Journal of Dental Education. Wiley; 2014;19: 235–241. doi: 10.1111/eje.12131 25495379

24. Almerich-Silla J, Boronat-Ferrer T, Montiel-Company J, Iranzo-Cortes J. Caries Prevalence in Children from Valencia (Spain) using ICDAS II criteria, 2010. Medicina Oral Patología Oral y Cirugia Bucal. Medicina Oral, S.L.; 2014; e574–e580. doi: 10.4317/medoral.19890 25350591

25. El-Damanhoury H, Fakhruddin K, Awad M. Effectiveness of teaching International Caries Detection and Assessment System II and its e-learning program to freshman dental students on occlusal caries detection. European Journal of Dentistry. Georg Thieme Verlag KG; 2014;8: 493. doi: 10.4103/1305-7456.143631 25512730

26. Norlyk A, Harder I. What Makes a Phenomenological Study Phenomenological? An Analysis of Peer-Reviewed Empirical Nursing Studies. Qualitative Health Research. SAGE Publications; 2010;20: 420–431. doi: 10.1177/1049732309357435 20068190

27. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. Informa UK Limited; 2006;3: 77–101. doi: 10.1191/1478088706qp063oa

28. Miles M, Huberman A. Qualitative data analysis an expanded sourcebook. Thousand Oaks: SAGE; 1994.

29. Francis JJ, O’Connor D, Curran J. Theories of behaviour change synthesised into a set of theoretical groupings: introducing a thematic series on the theoretical domains framework. Implementation Science. Springer Nature; 2012;7. doi: 10.1186/1748-5908-7-35 22531601

30. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science. Springer Nature; 2012;7. doi: 10.1186/1748-5908-7-37 22530986

31. Locock L, Dopson S, Chambers D, Gabbay J. Understanding the role of opinion leaders in improving clinical effectiveness. Social Science & Medicine. Elsevier BV; 2001;53: 745–757. doi: 10.1016/s0277-9536(00)00387-7

32. Fitzgerald L, Ferlie E, Wood M, Hawkins C. Interlocking Interactions, the Diffusion of Innovations in Health Care. Human Relations. SAGE Publications; 2002;55: 1429–1449. doi: 10.1177/001872602128782213

33. Berwick DM, Nolan TW, Whittington J. The Triple Aim: Care, Health, And Cost. Health Affairs. Health Affairs (Project Hope); 2008;27: 759–769. doi: 10.1377/hlthaff.27.3.759 18474969

34. Rogers EM. Evolution: Diffusion of Innovations. International Encyclopedia of the Social & Behavioral Sciences. Elsevier; 2015. pp. 378–381.

35. Pitts N, Ekstrand K. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS)—methods for staging of the caries process and enabling dentists to manage caries. Community Dentistry and Oral Epidemiology. Wiley; 2013;41: e41–e52. doi: 10.1111/cdoe.12025 24916677

36. Leung L. Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care. Medknow; 2015;4: 324. doi: 10.4103/2249-4863.161306 26288766

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