OBJECTIVE: To propose an individual-level indicator of caries severity based on the maximum score generated using the international caries detection and assessment system (ICDAS) and test validity of this individual-level indicator by assessing differences between this proposed indicator and the traditional decayed, missing, and filled surfaces (DMFS or dmfs for primary teeth) index. METHODS: Data on caries severity were collected using a representative sample of children from Detroit, Michigan, aged less than 6 years (N = 749) examined in 2002-2003 (W1) and 2004-2005 (W2). For each wave, each child was assigned to six caries severity groups based on the maximum ICDAS scores. This individual-level indicator was then compared with the surface-level dental caries measure (dmfs + DMFS). In addition, caries progression between W1 and W2 were assessed using individual-level and tooth surface-level indicators. RESULTS: Both measures were linearly related, and the relationship was statistically significant (P < 0.001). CONCLUSION: An individual-level caries progression indicator can be developed that is simple and has the ability to communicate with policymakers and the public the severity and impact of dental caries and it can add value to the conventional presentation of DMF/dmf data.
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