Caries assessment spectrum treatment: the severity score

Area of Science:

• Dental Public Health
• Epidemiology
• Pediatric Dentistry

Background:

• Dental caries remains a significant public health issue globally, particularly in low-income populations.
• Accurate assessment of caries severity is crucial for effective treatment planning and resource allocation.
• The Caries Assessment Spectrum and Treatment (CAST) severity score is a tool designed to quantify caries experience.

Purpose of the Study:

• To evaluate the feasibility of the standard CAST severity score formula (F).
• To develop and assess a modified CAST severity score formula (F1) for improved caries severity classification.
• To determine the effectiveness of the modified formula in categorizing children's caries levels.

Main Methods:

• Utilized data from an epidemiological survey of 680 schoolchildren aged 7.45 ± 0.91 years in a low-income area.
• Applied the CAST instrument to assess enamel and dentine carious lesions and tooth loss due to caries.
• Calculated CAST severity scores using the standard formula (F) and a modified formula (F1) with adjusted weights for different lesion severities.

Main Results:

• The prevalence of enamel and dentine caries was 49.41% and 69.12%, respectively.
• The standard CAST formula (F) proved unsatisfactory due to undiscriminating weights.
• The modified formula (F1), which quadrupled the weight for cavitated dentine lesions compared to enamel lesions, effectively categorized children into mild (34.1%), moderate (29.5%), and severe (36.4%) caries categories.

Conclusions:

• The standard CAST severity score formula (F) requires modification for accurate caries assessment.
• The newly developed formula (F1) provides a more discriminating and satisfactory method for classifying caries severity.
• The F1 formula enables a clear overview of caries disease severity and individual classification into mild, moderate, or severe levels.