Salud Dental Para Todos


International Caries Detection and Assessment System (ICDAS II)

D.D.S. Marcelo Alberto Iruretagoyena

Protocol for the visual inspection of dental surfaces.

In order to use the ICDAS criteria, in clinical practice the following conditions are essential to allow examiners to assess each of the caries codes accurately:

  • Ask the patient to remove the removable prostheses from their mouth, if they were prosthetic carriers
  • Illumination of the operative field with light of 5000 Kelvin.
  • Remove the bacterial plaque from the smooth and occlusal surfaces by means of a toothbrush and wash the area with triple syringe
  • Remove superficial stains and dental calculus from dental surfaces


  • To control humidity:
    • Locate cotton rolls in the cheeks. Apply air to remove excess saliva

  • Make visual inspection of the wet surface:

    • Start from the patient's upper right quadrant

    • Continue with the orientation of the hands of the clock

    • Initially the visual examination is performed with wet surfaces.

  • Dry with triple syringe for 5 seconds to perform the dry visual examination
  • Use a probe to gently inspect the loss of structural integrity of enamel and dentin


Limits of the dental surface to perform the inspection

The limits of the tooth surface must be known so that the registration of tooth decay is standardized. The surface of the teeth is limited by the dihedral angle between two dental surfaces when viewed in a perpendicular direction

 Mesial surface


 Occlusal surface


 Distal surface


 Buccal surface


Lingual or palatal surface

Salud Dental Para Todos

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

Wilde.  Provincia de Buenos Aires. Argentina

Revised: September 2018