Skip to main content

The Caries Assessment Spectrum and Treatment (CAST) Instrument

  • Chapter
  • First Online:
  • 1388 Accesses

Abstract

The Caries Assessment Spectrum and Treatment (CAST) instrument is a visual/tactile caries detection tool initially developed for global use in epidemiological surveys. As of now, the WHO criterion for caries detection is the most widespread, but it assesses only dentin cavities and restored and missing teeth. In many societies, the prevalence and severity of cavitated dentin carious lesions have decreased during the last four to five decades, emphasizing the need to develop a detection instrument that covers the total spectrum of dental caries. The CAST instrument includes the total spectrum of dental caries, from a sound tooth/surface through all stages of carious lesion development to abscessed/fistulated teeth, in addition to dental treatments (sealants and restorations). The CAST instrument has been validated, and high levels of intra- and inter-examiner agreement are reported in the literature. It provides more detailed information about the caries status of a population without increasing the examination time in comparison with the WHO criterion. Moreover, the organization of CAST codes in hierarchical order facilitates the categorization of the disease according to severity levels and provides a link to treatment needs. However, more research is still needed with respect to the applicability of CAST in different age groups and cultures.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009;140:650–7.

    Article  Google Scholar 

  2. Monse B, Heinrich-Weltzien R, Benzian H, Holmgren C, van Palenstein Helderman WH. PUFA—an index of clinical consequences of untreated dental caries. Community Dent Oral Epidemiol. 2010;38:77–82.

    Article  Google Scholar 

  3. Cavavid AS, Lince CM, Jaramillo MC. Dental caries in the primary dentition of a Colombian population according to the ICDAS criteria. Braz Oral Res. 2010;24:211–6.

    Article  Google Scholar 

  4. de Amorim RG, Figueiredo MJ, Leal SC, Mulder J, Frencken JE. Caries experience in a child population in a deprived area of Brazil, using ICDAS II. Clin Oral Investig. 2012;16:513–20.

    Article  Google Scholar 

  5. World Health Organization (WHO). Oral health surveys. 5th ed. Geneva: World Health Organization; 2013. p. 125.

    Google Scholar 

  6. Klein H, Palmer CE. Studies on dental caries: VII. Sex differences in dental caries experience of elementary school children. Public Health Rep. 1938;53:1685–90.

    Article  Google Scholar 

  7. Lagerweij MD, van Loveren C. Declining caries trends: are we satisfied? Curr Oral Health Rep. 2015;2:212–7.

    Article  Google Scholar 

  8. Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts N. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007;35:170–8.

    Article  Google Scholar 

  9. Nyvad B, Machiulskiene V, Baelum V. Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res. 1999;33:252–60.

    Article  Google Scholar 

  10. World Health Organization. The world health report 2008. Primary health care: now more than ever. Geneva: WHO; 2008.

    Google Scholar 

  11. Brazilian Ministry of Health: project oral health Brazil 2010—National Survey on Oral Health 2010. 2011. https://189.28.128.100/dab/docs/geral/apresentação_SB2010.pdf.

  12. Shidara EK, McGlothlin JD, Kobayashi S. A vicious cycle in the oral health status of schoolchildren in a primary school in rural Cambodia. Int J Dent Hyg. 2007;5:165–73.

    Article  Google Scholar 

  13. Frencken JE, Amorim RG, Faber J, Leal SC. The Caries Assessment Spectrum and Treatment (CAST) index: rational and development. Int Dent J. 2011;61:117–23.

    Article  Google Scholar 

  14. de Souza AL, Sanden WJ, Leal SC, Frencken JE. The Caries Assessment Spectrum and Treatment (CAST) index: face and content validation. Int Dent J. 2012;62:270–6.

    Article  Google Scholar 

  15. de Souza AL, Bronkhorst EM, Creugers NHJ, Leal SC, Frencken JE. The Caries Assessment Spectrum and Treatment (CAST) instrument: its reproducibility in clinical studies. Int Dent J. 2014;64:187–94.

    Article  Google Scholar 

  16. Baginska J, Rodakowska E, Kierklo A. Status of occlusal surfaces of first permanent molars in 6-8-year-old children evaluated by the CAST and DMF indices. Eur J Paediatr Dent. 2014;2:107–12.

    Google Scholar 

  17. Baginska J, Rodakowska E, Milewski R, Kierklo A. Dental caries in primary and permanent molars in 7-8-year-old schoolchildren evaluated with Caries Assessment Spectrum and Treatment (CAST) index. BMC Oral Health. 2014;14:1–8.

    Article  Google Scholar 

  18. Malik A, Shaukat MS, Qureshi A. Prevalence of dental caries using novel caries assessment index—CAST. J Dow Univ Health Sci. 2014;8:7–10.

    Google Scholar 

  19. de Souza AL, Leal SC, Bronkhorst EM, Frencken JE. Assessing caries status according to the CAST instrument and WHO criterion in epidemiological studies. BMC Oral Health. 2014;14:119.

    Article  Google Scholar 

  20. Medeiros PBV, Otero SAM, Frencken JE, Bronkhorst E, Leal SC. Effectiveness of an oral health program for mothers and their infants. Int J Paediatr Dent. 2014;7(25):29–34.

    Google Scholar 

  21. Anchala K, Challa R, Vadaganadham Y, Kamatham R, Deepak V, Nuvvula S. Assessment of dental caries in primary dentition employing caries assessment spectrum and treatment index. J Orofac Sci. 2016;8:115–9.

    Article  Google Scholar 

  22. Baginska J, Rodakowska E. Caries Assessment Spectrum and Treatment (CAST) index in the primary molars of 6- to 7-year-old polish children. Oral Health Prev Dent. 2016;14:85–92.

    PubMed  Google Scholar 

  23. Kar S, Kundu G, Maiti S, Ghosh C, Bazmi B, Mukhopadhyay S. A comparative evaluation of dental caries status among hearing-impaired and normal children of Malda, West Bengal, evaluated with the Caries Assessment Spectrum and Treatment. J Indian Soc Pedod Prev Dent. 2016;34:306–9.

    Article  Google Scholar 

  24. Mwakayoka H, Masalu JR, Namakuka Kikwilu E. Dental Caries and associated factors in children aged 2–4 years old in Mbeya City, Tanzania. J Dent (Shiraz). 2017;18(2):104–11.

    Google Scholar 

  25. Doneria D, Thakur S, Singhal P, Chauhan D, Jayam C, Uppal A. Comparative evaluation of Caries status in primary and permanent molars in 7–8-year-old schoolchildren of Shimla using Caries Assessment Spectrum and Treatment Index. Contemp Clin Dent. 2017;8(1):128–33.

    Article  Google Scholar 

  26. Frencken JE, de Souza Hilgert AL, Bronkhorst EM, Leal SC. CAST Caries Assessment Spectrum and Treatment manual. 1st ed. Nijmegen: Radboud University Nijmegen; 2015. p. 48.

    Google Scholar 

  27. de Souza Hilgert AL. Caries Assessment Spectrum and Treatment (CAST): a new epidemiological instrument. Doctoral thesis. Nijmegen: Radboud University Nijmegen; 2015.

    Google Scholar 

  28. de Souza AL, Leal SC, Chaves SB, Bronkhorst E, Frencken JE, Creugers NHJ. The Caries Assessment Spectrum and Treatment (CAST) instrument: construct validation. Eur J Oral Sci. 2014;122:149–53.

    Article  Google Scholar 

  29. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989;13(3):319–40. https://doi.org/10.2307/249008.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Leal, S., Ribeiro, A.P.D., de Souza Hilgert, A.L. (2019). The Caries Assessment Spectrum and Treatment (CAST) Instrument. In: Ferreira Zandona, A., Longbottom, C. (eds) Detection and Assessment of Dental Caries. Springer, Cham. https://doi.org/10.1007/978-3-030-16967-1_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-16967-1_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16965-7

  • Online ISBN: 978-3-030-16967-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics