Assessment of early childhood caries using ICDAS and Snyder caries activity test among preschool children: a cross-sectional study

The aim of the present study was to elucidate the correlation between the International Caries Detection and Assessment System (ICDAS) and the Snyder caries activity test (SCAT) for the assessment of early dental caries in preschool children. Dental health status of 153 children aged 3-5 years was evaluated by oral examination. The ICDAS stage (enamel opacity stage to cavitated dentine caries stage (stages 1-6)) was assigned based on the evaluation of each tooth surface by a trained dentist based on the number of decayed (d) and filled teeth (ft). In this study, scores of d3-6t (t, teeth), d3-6s (s, tooth surface), d3-6ft and d3-6fs were the cut-off points for enamel caries, set to ICDAS code 3 (d3). SCAT score was assigned based on the acid production level of lactic acid bacteria in plaque (scores: 1-4). Linear correlation analysis was used to determine the correlation between ICDAS and SCAT scores. The proportion of children for each of the dental caries status were as follows: d0, 46.4%; d1-2, 28.1%; d3-4, 9.8%; d5-6, 15.7%. Regarding SCAT scores, 30%, 30.1%, 26.8% and 12.4% children had no, mild, moderate and severe caries activity, respectively. The d3-6t, d3-6s, d3-6ft and d3-6fs indices increased with age and were 0.56, 0.82, 2.03 and 5.05, respectively. Children with a higher SCAT score had higher ICDAS scores (p < 0.05). Our findings suggest that a combination of ICDAS and SCAT scores is beneficial for diagnosing caries progression and highly active caries. Early childhood caries should be managed early to prevent the enamel opacity stage to progress to cavitation.