British Association for the Study of Community Dentistry (BASCD) diagnostic criteria for caries prevalence surveys-1996/97.

This paper outlines the current (1996/97) version of the diagnostic criteria relating to dental caries employed in the BASCD coordinated NHS Dental Epidemiology Programme. Some of the details as to how these criteria have evolved over the past 13 years. since the original guidelines publication (Palmer et al.

British Association for the Study of Community Dentistry (BASCD) coordinated National Health Service surveys of caries prevalence 1985/6-1995/6.

Background: The British Association for the Study of Community Dentistry (BASCD) has, in conjunction with the National Health Service (NHS), been coordinating a series of epidemiological surveys of caries prevalence across various parts of the United Kingdom (UK) since 1985/6.

The Team: mounting and maintaining this programme of surveys has relied on the hard work and enthusiasm of many individuals working within the NHS from across the UK. The whole team is vital to the success of the programme and the Dental Epidemiology NHS "regional' Coordinators and "regional' trainers play a key role.

The dental caries experience of 5-year-old children in the United Kingdom. Surveys coordinated by the British Association for the Study of Community Dentistry in 1995/96.

This paper reports the results of standardised clinical caries examinations of 172,659 five-year-old children from across the United Kingdom. These 1995/96 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. The criteria and conventions of the British Association for the Study of Community Dentistry were used.

Diagnostic tools and measurements--impact on appropriate care.

The diagnosis of primary coronal caries should be seen as a complex process, comprising both detection and measurement phases, which enables clinicians, researchers and epidemiologists to make informed decisions about the management and prognosis of the disease process. The different diagnostic thresholds employed for measurements of caries experience can be viewed as an iceberg, a metaphor which demonstrates the ambiguity of the term "caries free" and which can also represent the differing management options appropriate for the care of different types of active and inactive lesions: NAC (No Active Care). PCA (Preventive Care Advised) and OCA (Operative Care Advised).

Impedance spectroscopy of teeth with and without approximal caries lesions--an in vitro study.

Caries diagnosis by the measurement of electrical resistance is hampered by polarization effects when dc or single-low-frequency ac currents are used. Electrical impedance spectroscopy, measuring impedance over a large range of frequencies, will provide more detailed information about the electrical characteristics of teeth. It was the aim of this study (a) to characterize the complex impedance behavior of whole extracted teeth, measured at the approximal surface, and (b) to identify parameters of the complex impedance behavior of the teeth which would be useful in distinguishing between degrees of carious involvement.

The Chief Scientist reports ... Monitoring the dental health of Scottish children using routinely collected data.

Since the introduction in 1990 of the capitation scheme of payment for the dental care of children, information for those children registered in the scheme has been collected by General Dental Practitioners on a regular (usually annual) basis using form GP17C. These forms are processed centrally by the Dental Practice Division in Edinburgh. The information collected includes data on the dental caries experience of the child as assessed by the dentist.

Developmental defects of enamel in regularly attending adolescent dental patients in Scotland; prevalence and patient awareness.

Contemporary dental literature contains many reports of the prevalence of developmental defects of enamel in a variety of populations. Little information is available relating to patients' perceptions of such defects. The aim of this study was to compare the prevalence of developmental defects of enamel in a sample of regularly attending adolescent dental patients with the patients' own views as to whether they thought they had marks on their teeth.

The dental caries experience of 14-year-old children in the United Kingdom. Surveys coordinated by the British Association for the Study of Community Dentistry in 1994/95.

This paper reports the results of standardised clinical survey examinations of 127,481 14-year-old children across the United Kingdom. These 1994/95 coordinated surveys are the latest in a series which seeks to monitor the dental health of children and contribute to assessments of the provision of dental services. The criteria and conventions of the British Association for the Study of Community Dentistry trainers' pack 1992/93 were used.

Detection of dental decay and its extent using a.c. impedance spectroscopy.

Dental caries (decay), the most prevalent of diseases, represents a health problem of immense proportions. It principally affects posterior (back) teeth on occlusal (biting) and approximal (adjacent contacting) surfaces. Caries starts as a subsurface demineralization of enamel, may progress to the underlying dentine and, eventually, to cavitation of the surface.

The use of bitewing radiographs in the management of dental caries: scientific and practical considerations.

The objective of this paper is to synthesize published research on the use of radiographs in caries diagnosis in order to produce recommendations for guidelines that are clinically oriented but scientifically based. The options available include the use of various types of radiographic examination alone or in conjunction with other diagnostic aids. The outcomes should facilitate the optimal management of lesions as either preventive care advised (PCA) or operative care advised (OCA).

The dental caries experience of 5-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1993/94.

This paper reports the results of standardised clinical caries examinations of 191,770 five-year-old children from across Great Britain. These 1993/94 coordinated surveys were the latest in a series which seeks to monitor the dental health of children and to assess the provision of dental services. The criteria and conventions of the British Association for the Study of Community Dentistry trainers' pack of 1992/93 were used.

Preventive Care Advised (PCA)/Operative Care Advised (OCA)--categorising caries by the management option.

Currently a range of systems and classifications are used by clinicians, epidemiologists and clinical research workers to sub-divide carious lesions into different grades. These systems are based on the depth of the lesion and/or the presence/absence of macroscopic cavitation. In order to improve upon the meaningfulness and comparability of such systems in the light of increasing knowledge about the disease process, lesion behaviour and caries management options, the authors propose a new system of categorisation that differentiates between lesions which normally require operative intervention and those which do not.

The effect of placing a clear pit and fissure sealant on the validity and reproducibility of occlusal caries diagnosis.

The purpose of this in vitro study was to assess the validity and reproducibility of the diagnosis of fissure caries prior to and following the placement of a clear sealant. One hundred and twelve extracted molar teeth were examined by 7 experienced clinicians. Each examiner conducted four visual examinations, 2 prior to and 2 after sealing, allowing an assessment of reproducibility.

Child dental health--is it still good news?

Dental caries levels in children, according to national surveys, have improved in the last decade. However, there are indications that changes may now be occurring within the overall improving pattern of child dental health.

Topics for general dental practioner continuing education: survey of Scottish views.

The provision of continuing education for general dental practitioners is expanding with a bewildering range of presentation methods and variation in quality. The first stage in the development of any educational programme should be identification of target audience needs, but little has been published on this subject. To draw the attention of providers of continuing education material to the perceived needs of general dental practitioners in one geographical region, a questionnaire survey was employed.

Caries management strategies used by a group of Scottish dentists.

This study was designed to determine how dentists would manage carious lesions of differing severity and whether they would consider using non-invasive methods to manage lesions which were not severe enough to require a restoration. A group of 211 general dental practitioners were interviewed and asked to identify the point at which they would provide restorative treatment in a 12-year-old patient from a list of descriptions of lesions affecting buccal/lingual, occlusal and approximal surfaces. They were then asked how they would manage lesions which they would not restore.

The dental caries experience of 5-, 12- and 14-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1991/92, 1992/3 and 1990-91.

A series of caries prevalence surveys across Great Britain has been coordinated by the British Association for the Study of Community Dentistry (BASCD) since 1985/86 with the aim of monitoring caries experience in representative samples of school children aged 5, 12 and 14 years of age. The purpose of this report is to present the findings of the surveys of 14-, 5- and 12-year-old children carried out in 1990/91, 1991/92 and 1992/3 respectively. These point prevalence surveys were conducted at the caries into dentine level of diagnosis using clinical examination only and a standardised, predominantly visual, diagnostic method employed by trained and calibrated teams of examiners from each country/region of Great Britain.

Occlusal caries diagnosis: a changing challenge for clinicians and epidemiologists.

The diagnosis of occlusal caries is an integral part of an epidemiologist's task, whether carrying out cross-sectional national caries prevalence surveys to assist with planning and the evaluation of service provision, or clinical trials of caries preventive agents. Similarly, the clinician also carries out this same overall diagnostic procedure in order to plan care for individual patients, although he/she will usually have access to improved facilities and diagnostic aids. This paper reviews the different problems now being encountered by both epidemiologists and clinicians in the face of changes in the presentation of the disease at this site and the qualifications which should now be appreciated when extrapolating from the results of surveys employing comparatively gross criteria.

Assessment of reports by dentists of their restorative treatment thresholds.

Questionnaires have been used to determine the point when dentists think a filling ought to be placed (restorative treatment threshold). This study assesses the method. 211 general dental practitioners were interviewed and asked to identify the point at which they would instigate restorative treatment in a 12-yr-old patient from a list of descriptions of lesions affecting buccal/lingual, occlusal and approximal surfaces.

CO2 laser and the diagnosis of occlusal caries: in vitro study.

The diagnosis of small lesions in pit and fissure sites is becoming increasingly problematical. This study was designed to evaluate, in vitro, the potential use of a carbon dioxide (CO2) laser technique as an aid to the diagnosis of incipient pit and fissure caries. Vaporization of the organic material in the 'early' carious lesion should lead to its carbonization and thus make it more conspicuous.

Prompt visualization of the gallbladder with a rim sign--acute or subacute cholecystitis?

An immunosuppressed, neutropenic patient developed symptoms and signs of acute cholecystitis. Gallbladder ultrasound was consistent with acute cholecystitis. Technetium-99m-diisopropyl iminodiacetic acid (DISIDA) scan showed a rim sign, but with normal gallbladder visualization.

Developments in radiographic caries diagnosis.

The developments that have been taking place in radiographic caries diagnosis, within the context of the changes occurring in both the disease process and the available technology, are reviewed. The decline in caries prevalence seen in many western countries has been accompanied by changes in the pattern and behaviour of lesions. More lesions are now seen on occlusal surfaces, more are concealed (and thus imperceptible to conventional diagnostic techniques), while the average progression rates for approximal lesions have also slowed.