AQUINO, MADELYN DOLOR H.

▪ Without clinical visual signs of dentinal

ICDAS
involvement.
 There’s already a cavitation until enamel only, no
ICDAS—INTERNATIONAL CARIES DETECTION AND dentin involved.
ASSESSMENT SYSTEM.
ICDAS comes in codes:
FULL CLASSIFICATION.
CODE 0/SOUND TOOTH
▪ No evidence of visible caries when viewed
cleaned and after prolonged air drying (5secs).
 No caries at all.
 Indicate “Code 0” always.

CODE 4/ UNDERLYING DARK SHADOW FROM

DENTIN
 Shadow of the destroyed dentin/infection coming
from dentin.
 Comes from within (dentin)
 Appears as shadow on intact enamel surface;
there could be breakdown but not visible by the
naked eye.

CODE 1/ FIRST VISUAL CHANGE IN ENAMEL

▪ Seen only after prolonged air drying or restricted
to within the confines of a pit and fissure.
 Seen after air dried for 5 seconds. (prolonged air
dried)
 Demineralization on surface of enamel; no
cavitation/breakdown. CODE 5/DISTINCT CAVITY WITH VISIBLE DENTIN
 There’s already cavitation, involvement of caries
until dentin.
 The amount of structure that is infected should
not involve 50% of surface.

CODE 2/DISTINCT VISUAL CHANGE IN ENAMEL

 Demineralization distinctly seen on enamel
surface w/o drying etc..
 No breakdown of enamel surfaces but there’s
discoloration/ evident “incipient caries”.
 Discoloration (brown) with no cavitation, should
not be stain.
CODE 6/ EXTENSIVE DISTINCT CAVITY WITH
VISIBLE DENTIN

CODE 3/ LOCALIZED ENAMEL BREAKDOWN

 Also coded as: code A (initial stage caries)

 Depth of infection has already reached the pulp. MODERATE STAGE CARIES/CODE B
—codes 3 and 4.
MODIFIED ICDAS:

EXTENSIVE STAGE CARIES/CODE C—codes 5 and 6.

ICDAS RADIOGRAPHIC:

Code A—includes 1&2; used when there’s a doubt.

Merged ICDAS—combined classification.

SOUND SURFACE/Code 0—sound surface.

INITIAL STAGE CARIES: lesions under codes 1,2

(CODE A)
 Full ICDAS: CODE 5; merged: EXTENSIVE STAGE
CARIES
Radiographically: RC5
EXTENSIVECR

COMBINED RADIOGRAPH AND CLINICAL:

EXAMPLES:

Clinically: Moderate stage caries

Radiographically: RA2
MODERATECR
 ICDAS—ROOT CARIES
CODE 0/ SOUND: No discoloration associated CODE 1/INITIAL LESION
with caries

Color demarcation on the root surface or at the CEJ that is

discolored but no cavitation present of anatomical contour
• may exhibit a definite loss of surface <0.5mm.
• continuity/ anatomical contour that is not consistent
with dental caries process
• loss maybe associated with dietary influences or
abrasion/ erosion
MODERATE/EXTENSIVE LESION CODE E/MODERATE/EXTENSIVE LESION (seen only
through radiograph)

Color demarcation on the root surface or at the CEJ that is

discolored and there is cavitation (loss of anatomical
contour > 0.5mm <2mm (moderate) >2mm (extensive))

If for any reason a root surface cannot be visualized directly

even with the assistance of gentle air drying.

ICDAS—CARIES ASSOCIATED WITH/RESTORATIONS/SEALANT

CODE 0/ SOUNDTOOTH
• No questionable signs of caries/discoloration after
air drying (5 secs)
• With marginal defects less than 0.5mm in width
• Developmental defects: enamel hypoplasias,
fluorosis, tooth wear stains)
CODE 1/ FIRST VISUAL CHANGE IN ENAMEL
No evidence of color change attributed with caries activity
when seen wet
Opacity/discoloration consistent with demineralization is
visible after prolonged air drying (5 secs)
 CODE 2 DISTINCT VISUAL CHANGE IN
ENAMEL/DENTIN ADJACENT TO RESTORATION OR
SEALANT MARGIN
If restoration is placed on enamel:
• Opacity consistent with demineralization or
discoloration not consistent with clinical
appearance of sound enamel when viewed wet
dry.
• Discoloration not consistent with clinical
appearance of sound dentin/cementum.
CODE 4/Marginal caries in enamel /cementum
adjacent to restoration/ with underlying dark shadow
from dentin.
The tooth surface may have characteristics of code 2 and
has a shadow of discolored dentin which is visible through
an apparently intact enamel surface or with localized
breakdown in enamel but no visible dentin -is a darkening
and intrinsic shadow which may be grey, blue, orange, or
brown in color.
CODE 6/ EXTENSIVE CAVITY WITH VISIBLE DENTIN
Obvious loss of tooth structure, the extensive cavity may
be deep or wide and dentin is clearly visible on both the
walls and at the base.
CODE 3/ CARIOUS DEFECTS OF <0.5 THE SIGNS OF
CODE 2
Cavitation at the margin of the restoration/sealant less than
0.5mm, in addition to either an opacity or discoloration
consistent with demineralization that is not consistent with
the clinical appearance of sound enamel or with a shadow
of discolored dentin.
CODE 5 DISTINCT CAVITY ADJACENT
RESTORATION/SEALANT
Distinct cavity adjacent to restoration/sealant with visible
dentin in the interfacial space with signs of caries as
described in code 4, in addition to a gap > 0.5mm in width
In instances where margins are not visible, there is
evidence of discontinuity at the margin of the
restoration/sealant and tooth substance of the dentin as
detected by 0.5mm ball-ended probe run along the
restoration/sealant margin.