Contribution of International Caries Classification and Management System (ICCMSTM) in diminishing divergences in the caries diagnosis to dental care systems: a randomized controlled trial

• DOI: 10.22533/at.ed.6102321092

• Palavras-chave: -

• Keywords: Dental Audit, Health Management, Dental Caries, Sensitivity and Specificity.

• Abstract: Background: The continuing high burden of pain and suffering caused by dental caries makes accurate diagnosis an indispensable condition for correct management of this most prevalent of all oral conditions. This study evaluated the efficacy of the International Caries Classification and Management System - ICCMS™ for decreasing the chance of disagreement between auditors and dentists occurring within the context of a dental care system. Methods: Twenty dentists from a private company in the city of Pompeia-SP, BR, responsible for performing a large number of dental fillings due tooth decay and, voluntarily agreed to participate. Initially three dental auditors were trained and calibrated for use of ICCMS™, and subsequently auditor 1, 2 and 3 achieved a Kappa index of 0.867; 0.829 and 0.718, respectively. Afterwards, from among 20 dentists, 10 who were trained and qualified to use ICCMS™, and were randomly selected for the intervention group. To the other 10 dentists were assigned to the control group. Three stages were carried out to assess the effects of training on ICDAS: Stage 1 – baseline; Stage 2 - training of auditors only; and Stage 3 - training of dentists. The effects were analyzed by observing the data recorded for 08 months after Stages 2 and 3, such as disagreements between auditors and dentists of the two groups, as well as between the 2 groups in the third stage of the study. Results: When compared with baseline (pre interventions), auditor training decreased the chance of divergence by 47% (OR 0.5349; 95% CI: 0.4425-0.6465). After dentists’ training, the chance of divergence decreased by 52% (OR = 0.4804; 95% CI: 0.3902-0.5915), also when compared with baseline (pre training with ICDAS). Moreover, professionals (dentists) of the trained group were found to have 33% less chance of divergence when compared with the control group, who received no training (OR = 0.6697; 95% CI: 0.5631 to 0.7964). Conclusions: The adoption of the ICCMS™ after training and calibration of auditors and dentists resulted in significant decrease in events of divergence compared with the control group, who received no training.