Caries prevalence and feasibility of using ICDAS System in children with special needs
From a dental point of view, the Costarican population with special needs has been the least studied. The present is an exploratory observational descriptive cross-sectional study aimed at determining the feasibility of using the ICDAS (International Caries Detection and Assessment System) system in children aged 5 to 12 years attending the Special Education Center “Fernando Centeno Güell” in San Jose, Costa Rica (2009). The prevalence of dental caries in this population was recorded as well as the time required to examine all teeth and tooth surfaces, localization of the carious lesions and the presence of restorations and sealants. In order to achieve this, a dentist calibrated in ICDAS system (inter and intra examiner Kappa 0.8 and 0.86) recruited participants from the Departments of Mental Retardation (MR) (n = 19), Hearing and Speech or Hearing Impaired (DA) (n = 17) and Visually Impaired or Visual Impairment with multiple disabilities (DV) (n = 6). The criteria for viability was defined as the absence of active use of physical restraint as for the time variable, it was stated as the length of time required to complete the clinical examination of all teeth present. Results: for the total group of participants, the viability was 79% (n=33): 88.3% for HI, 73.7% for MR and 33.3% for DV. In relation to the ICDAS code lesions, code 2 was the most prevalent (49%), followed by the code 1 (18%), 3 (16%), 5 (10%), 6 (4%) and 4 (3%). The caries prevalence for DV (n=3) was 62%, for MR (n=14) 42.8%, for DA (n=15) 37.6%. The average time taken to complete the visual inspection was 9 minutes for infants, 8.4 and 10.2 minutes for the 5 and 12 years old groups respectively. Conclusions: This study confirms the feasibility of using the ICDAS System in children with special needs. Further studies have to be conducted, in a larger group of people presenting disabilities, in order to study the prevalence and the pattern of dental caries in this population.
Keywords: tooth decay, special needs, icdas system, special education center, caries prevalence