Salud Dental Para Todos


International Caries Detection and Assessment System (ICDAS II)

This information must be used for the purpose of promoting and protecting public health. It must not be used for commercial purposes.

D.D.S. Marcelo A. Iruretagoyena 


What is ICDAS?

ICDAS II (International Caries Detection and Assessment System) is an international caries detection and diagnosis system, agreed in Baltimore, Maryland. USA in 2005, for clinical practice, research and development of public health programs. The objective was to develop a visual method for the detection of caries, as early as possible, and also detect the severity and level of activity of the same.

The system has 70 to 85% sensitivity and a specificity of 80 to 90%; in detecting caries, in temporary and permanent dentition; depending on this difference by the degree of training and calibration of the examining staff. Kappa concordance index => 0.65. (Pubmed-Medline 19681984 - 18204251 - 19907175)

ICDAS Complete presents 7 categories, the first for healthy teeth (code 0, in green) and the next two for caries limited to enamel, white / brown spot (codes 1 and 2, marked in yellow). The following two categories (code 3 and 4, in red) are considered caries that extend to the enamel without exposed dentine. And the other two remaining categories (codes 5 and 6), considered caries with exposed dentin. See bottom image

The table below shows the codifications of the International Classification of Diseases Applied to Dentistry and Stomatology (ICD-DA), the World Health Organization (WHO) based on the decayed, lost and filled tooth criterion (DMF-T) and the full ICDAS  system and its relationship with the Visual Threshold.

Comparison of caries codes for epidemiological studies

 ICD-DA Code * WHO Code  ** Full  ICDAS Code *** Visual threshold

A - 0




(White spot)


White / Brown spot in dry enamel


White / Brown spot in wet enamel


Microcavity in dry enamel <0.5mm without visible dentin


 (Caries extending into dentine)

B-1 / C- 2



Dark dentine shadow seen through wet enamel with or without microcavity

5 Dentin exposure in cavity > 0.5 mm to half the dental surface dry
 6 Dentin exposure in cavity greater than half of the dental surface

There are minor variations between the visual signs associated with each code depending on a number of factors, including the characteristics of the surface (pits and fissures versus free surfaces), if there are adjacent teeth present (mesial and distal surfaces) and whether or not There is caries associated with a restoration or sealant. Therefore, a detailed description of each of the codes are given under the following titles to assist in the training of examiners in the use of ICDAS.

Send an e-mail to  requesting username and password, to access the contents of ICDAS II

Caries Detection Criteria

* Protocol for the visual inspection of dental surfaces.
* Full ICDAS nomenclature

Restoration, sealant and tooth missing code

* Special considerations
* Pits and fissures codes
* Free smooth surface code
* Smooth surface code (mesial and distal)
* Caries associated with restorations and sealants codes
* Root caries criteria

What is the full icdas code of the images?

* ICDAS reference

We thank the ICDAS Foundation and Professor Dr. Gail Douglas for their collaboration

Salud Dental Para Todos

The information present on this website must be used for the purpose of promoting and protecting public dental health. It must not be used for commercial purposes.

E-mail: D.D.S. Marcelo Alberto Iruretagoyena

Wilde.  Provincia de Buenos Aires. Argentina

Revised: September 2018