International Journal of Community Dentistry

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 9  |  Issue : 2  |  Page : 168--170

Assessment of dental caries using caries assessment spectrum and treatment index in children of age 5-10 years


V Kalaivani, R Ramiya, N Khaaviya 
 Department of Public Health and Dentistry, Indira Gandhi Institute of Dental Sciences, Puducherry, Tamil Nadu, India

Correspondence Address:
Dr. V Kalaivani
Department of Public Health and Dentistry, Indira Gandhi Institute of Dental Sciences, Puducherry, Tamil Nadu
India

Abstract

Introduction: Dental caries is the most prevalent disease of oral health in school-aged children around the world. Although different caries detection/diagnosis criteria are available, none of them includes the total spectrum of dental caries (which ranges from a sound tooth to tooth loss due to caries) other than caries assessment spectrum and treatment (CAST) Index. CAST index covers the total dental caries spectrum from no carious lesion through caries protection (sealant) and caries cure (restoration) to carious lesions in enamel and dentin, and the advanced stages of carious lesion progression in pulp and tooth surrounding tissue. Methodology: A cross-sectional study was conducted among children of age 5–10 years to detect the prevalence of dental caries using CAST index in Panchayat Union Primary School in Sundharipalayam and Koot-road (east), Villupuram. A total of 100 samples were selected based on inclusion criteria. Results: Only 33% had sound dentition, 0% had sealant and restoration, presence of caries in enamel and/or dentine ranged from 9% to 33%. Pulpal involvement was observed in 13% and abscess/fistula was present in 7% of participants in at least one tooth. 5% had lost at least one tooth due to caries. Conclusion: CAST index has been found useful in epidemiological surveys, especially in recording early carious lesions. Developers of the CAST index should throw more light on the treatment needs part of the index as well as how each code of this index can be utilized in controlling dental caries in a community.



How to cite this article:
Kalaivani V, Ramiya R, Khaaviya N. Assessment of dental caries using caries assessment spectrum and treatment index in children of age 5-10 years.Int J Community Dent 2021;9:168-170


How to cite this URL:
Kalaivani V, Ramiya R, Khaaviya N. Assessment of dental caries using caries assessment spectrum and treatment index in children of age 5-10 years. Int J Community Dent [serial online] 2021 [cited 2022 Dec 3 ];9:168-170
Available from: https://www.ijcommdent.com/text.asp?2021/9/2/168/340998


Full Text



 Introduction



Dental caries is a complex disease affecting the teeth, which is mainly caused by imbalance between demineralization and remineralization process around the tooth surface. Dental caries is the most prevalent disease of the oral health in school-aged children around the world. Dental caries leads to tooth pain, discomfort, eating impairment, loss of tooth, and delayed language development in children. Furthermore, dental caries affects children's functions and body growth and impose a financial burden on their families. In addition, children with dental caries are exposing to fear and anxiety which can result in both severity and incomplete treatment of the condition. It is a major cause of tooth loss and pain worldwide.[1]

According to the World Health Organization (WHO) reports, dental caries affect 60%–90% of schoolchildren in both developing and developed countries Caries incidence is witnessing a decline in developed countries due to proper availability of fluoride products, better oral health services, and awareness regarding etiology of caries. At the same time, the incidence of caries is increasing in developing countries.[2],[3]

Caries detection is fundamental in understanding the oral health status of a population and is the basis for caries diagnosis for individual patients. Although different caries detection/diagnosis criteria are available, none of them includes the total spectrum of dental caries (which ranges from a sound tooth to tooth lost due to caries) other than caries assessment spectrum and treatment (CAST) index.[4],[5] The CAST codes and descriptions were submitted to experienced epidemiologists from across the world for obtaining face and content validity. Its construct validity and reproducibility under field conditions were tested in child and adult populations and showed a high level of agreement between examiners. Compared to what is usually reported in the literature, CAST provides more relevant information on caries prevalence, experience, and severity. CAST is straightforward and easy to use.[2]

CAST index covers the total dental caries spectrum from no carious lesion through caries protection (sealant) and caries cure (restoration) to carious lesions in enamel and dentin, and the advanced stages of carious lesion progression in pulp and tooth surrounding tissue.[3]

Aim

The aim of this survey is to assess and improve dental caries using CAST index in children of age 5–10 years.

 Methodology



Type of study

A cross-sectional study was conducted among children of age 5–10 years to detect the prevalence of dental caries using CAST index in Panchayat Union Primary School in Sundharipalayam and Koot-road (east), Villupuram.

Informed consent was obtained from the parents or guardians of the child.

Sample size

A total of 100 samples were selected based on inclusion criteria.

Inclusion criteria

Children of age 5–10 years (both boys and girls).

Exclusion criteria

Children with congenital and systemic illnessChildren who are not interested.

Clinical examination

CAST index will be performed under available light and is recorded with mouth mirror and community periodontal index probe.

 Results



This cross-sectional study was done on 100 children in the age group of 5–10 years, out of 100, 50 were female, 50 were male. Analyses of codes of the CAST index were done as per the criteria given in the [Table 1].[5] The first level of analysis is to find out the presence of CAST codes in at least one tooth in a participant.{Table 1}

Only 33% had sound dentition, 0% had sealant and restoration, presence of caries in enamel and/or dentine ranged from 9% to 33%. Pulpal involvement was observed in 13% and abscess/fistula was present in 7% of participants in at least one tooth. Five percent had lost at least one tooth due to caries.

On the basis of the epidemiological concept of health and disease, the developers of the CAST index described findings as healthy dentition is denoted by codes 0, 1, and 2, this was observed in our study in 33% (33) individuals.

Nonhealthy dentition can be divided into:

A reversible pre morbidity stage (code 3)-this stage was the most severe condition in 9% (9) of the childrenDentition with morbidity (codes 4 and 5)-this stage was the most severe condition in 33% (9 and 24) of the children and with serious morbidity (codes 6 and 7), this stage was the most severe condition in at least 20% (13 and 7) of the children; and lastlyDentition with mortality (code 8)-this stage was the most severe condition in at least 5% (5) of the children [Figure 1]. [Figure 2] shows severity of the disease based on the maximum caries assessment spectrum and treatment score per subject.{Figure 1}{Figure 2}

 Discussion



Search for an ideal caries index is still in pursuit by many researchers worldwide. Decayed, missing, and filled (DMF) index is considered as reference index and is adopted and modified by the WHO for its oral health survey manuals.[6],[7],[8]

From the public health viewpoint, major disadvantage of using the DMF index is that it records only cavitated lesions and ignore incipient carious lesions. These lesions can be reversed by the application of various preventive measures such as fluorides if detected at earlier stages.[9],[10],[11],[12] Hence, an index should be able to record these lesions to apply primary preventive measures in a population.[4] One such attempt is the CAST index,[5] the major advantage of this index is that it records wide spectrum of lesions develops due to caries ranging from sound tooth to extraction of the tooth due to caries.

The current study is an attempt to record caries experience of children (5–10 years) in an urban Indian population using this index system.

Treatment needs can also be derived from this index such as healthy dentition requires maintenance through twice-daily cleaning of teeth with a toothbrush and fluoride-containing toothpaste.[13],[14] In a premorbidity dentition situation, management relies on the same regime as for healthy dentition, and some teeth may require extra surface protection with a sealant and/or fluoride treatment.[15],[16] Dentition with morbidity requires intra-or extra-coronal restoration or an ultraconservative treatment. Dentition with serious morbidity requires extraction or pulpotomy and dentition with mortality may require a space maintainer. It goes without saying that children with diseased dentition need to maintain their teeth, using a toothbrush and fluoride-containing toothpaste. And that parents should consider their diet, i.e., codes 4-7.[6]

 Conclusion



CAST index has been found useful in epidemiological surveys, especially in recording early carious lesions. Developers of the CAST index should throw more light on the treatment needs part of the index as well as how each code of this index can be utilized in controlling dental caries in a community. Furthermore, while recording the index, it was felt that the presence of root fragments should not be combined with the involvement of the pulp chamber only (code-6) as they are two separate conditions with different treatment protocols.

Financial support and sponsorship

Self-funded.

Conflicts of interest

There are no conflicts of interest.

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