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

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.

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.

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.

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.