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The guide uses ICDAS-based staging and lesion activity assessment, patient-level caries risk assessment, synthesis and diagnosis, and personalized risk management. It links each element with risk-based recall intervals and monitoring to support improved long-term caries outcomes, under evidence-based clinical protocols.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/iccms-quick-reference-guide-for-practitioners-and-educators-caries-management-cycle/317161/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/iccms-quick-reference-guide-for-practitioners-and-educators-caries-management-cycle/317161.png","ImageObject",300,407,{"name":42,"@type":43},"Putri","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-20",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",16,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the ICCMS™ Caries Management Cycle designed to achieve?","Question",{"text":63,"@type":64},"It aims to prevent new caries lesions, prevent existing lesions from advancing, and preserve tooth structure by matching non-operative care to earlier stages and conservative operative care to more extensive stages.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which patient-level risk factors are assessed in Element 1 (History)?",{"text":68,"@type":64},"It assesses factors such as head and neck radiation, dry mouth conditions and medications, inadequate oral hygiene, deficient topical fluoride exposure, high frequency/amount of sugary drinks or snacks, symptomatic-driven attendance, access barriers, and—where applicable—children’s caregivers’ high caries experience.",{"name":70,"@type":61,"acceptedAnswer":71},"How are lesion severity and activity assessed within ICCMS™?",{"text":72,"@type":64},"Lesion severity is staged using visual examination and, when possible, combined with radiographic examination, using ICDAS-linked merged categories. Lesion activity is then judged as inactive or active regardless of stage, based on whether lesions are progressing at the time of the clinical examination.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},317161,1790275419,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":113},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","ICCMS™ Quick Reference Guide for Practitioners and Educators  \nThis HEALTH OUTCOMES FOCUSED SYSTEM presents a  \nCaries Management Cycle that aims:  \n-To prevent new caries lesions from appearing  \n-To prevent existing caries lesions from advancing further  \n-To preserve tooth structure with non-operative care at more initial caries stages and conservative operative care at more extensive caries stages  \nWhile managing risk factors and recalling patients at appropriate intervals, with periodic monitoring and reviewing.  \nUses a simple form of the  \nICDAS Caries Classification  \nmodel to stage caries severity  \nand assess lesion activity  \nDerive an appropriate,  \npersonalised, preventively  \nbased, risk-adjusted,  \ntooth preserving  \nManagement Plan.  \nThis ICCMS™ Quick Reference Guide includes a comprehensive set of clinical protocols (drawn up based on the best available evidence) to support history taking,  \nICCMSTM in order to   \nclinical examination, risk assessment and personalised care planning in order to enable improved long-term caries outcomes.  \nICCMS™ is trademarked by the ICDAS Foundation in order that the ICCMSTM can remain open and available to all.  \nThe Four ICCMSTM Elements, shown with detailed description of their components and linked by risk-based recall.  \nRiskbased Recall interval  \nHISTORY Patient-level Caries Risk Assessment  \nCLASSIFICATION  \nCaries Staging & Activity Assessment with Intraoral Assessments  \nDECISION MAKING  \nSynthesis and Diagnoses  \nRISK MANAGEMENT  \nMANAGEMENT  \nPersonalised Caries Prevention, Control & Tooth Preserving Operative Care  \nThe Caries Management Pathway is cyclical as each element follows on in turn. The figure aims to demonstrate a recommended method of implementation. The cycle restarts after each risk based recall interval.  \nElement 1-History: Patient-Level Caries Risk Assessment  \nPrior to looking into the mouth, and having ensured that there are no urgent pain related issues, patient risk factors for caries are assessed.  \n•Head and Neck Radiation  \n•Dry mouth (conditions, medications/recreational drugs/self report)  \n•Inadequate oral hygiene practices  \n•Deficient exposure to topical fluoride  \n•High frequency/ amount of sugary drinks/ snacks  \n•Symptomatic-driven dental attendance  \n•Social-economic status/Health access barriers  \n•For children: high caries experience of mothers or caregivers  \nPatient level caries risk factors  \nNote: Risk factors in red will always classify an individual as high caries risk.  \nElement 2- Classification: Caries Staging and Lesion Activity with Intraoral Caries Risk Assessments  \nPlaque is assessed for intraoral caries risk determination, but has to be removed for accurate caries staging and lesion activity assessment.  \nAssessment of Caries Risk Factors Intraorally  \n•Hypo-salivation/Gross indicators of dry mouth  \n•PUFA (Exposed pulp, Ulceration, Fistula, Absess)– Dental sepsis  \n•Caries experience  \n•Thick plaque: Evidence of sticky biofilm in plaque stagnation areas  \n•Appliances, restorations and other causes of increased biofilm retention  \n•Exposed root surfaces  \nIntraoral level caries risk factors  \nNote: Risk factors in red will always classify an individual as high caries risk.  \nThese risk factors correspond to those with higher association with caries risk status. The calculation of the patient’s caries risk status (low, moderate, high) can be done with available tests or computer-based systems, such as CAMBRA and Cariogram.  \nStaging lesions  \nThe assessment of caries will always be conducted by means of visual examination and when possible, combined with radiographic examination.  \n\n|  | Definition of ICCMS™ Caries Merged categories |  |  |\n| --- | --- | --- | --- |\n| Caries categories | Sound surfaces\u003Cbr>(ICDAS code 0) | | Sound tooth surfaces show no evidence of visible caries when viewed clean and after prolonged air-drying (5 seconds) . |\n|  | Initial stage caries\u003Cbr>(ICDAS codes 1 and 2) | | First or distinct","cbCaidrh9jaJZzFL","https://ap.wps.com/l/cbCaidrh9jaJZzFL","pdf",1443195,12,"English","# Caries Management Cycle Overview\n## Patient-Level Caries Risk Assessment (History)\n## Caries Staging & Lesion Activity Classification\n## Decision Making and Synthesis/Diagnosis\n## Risk Management and Personalized Care Planning\n## ICCMS™ Caries Merged Categories\n## ICCMS™ Combined Clinical and Radiographic Categories\n## Lesion Activity Assessment","[{\"question\":\"What is the ICCMS™ Caries Management Cycle designed to achieve?\",\"answer\":\"It aims to prevent new caries lesions, prevent existing lesions from advancing, and preserve tooth structure by matching non-operative care to earlier stages and conservative operative care to more extensive stages.\"},{\"question\":\"Which patient-level risk factors are assessed in Element 1 (History)?\",\"answer\":\"It assesses factors such as head and neck radiation, dry mouth conditions and medications, inadequate oral hygiene, deficient topical fluoride exposure, high frequency/amount of sugary drinks or snacks, symptomatic-driven attendance, access barriers, and—where applicable—children’s caregivers’ high caries experience.\"},{\"question\":\"How are lesion severity and activity assessed within ICCMS™?\",\"answer\":\"Lesion severity is staged using visual examination and, when possible, combined with radiographic examination, using ICDAS-linked merged categories. Lesion activity is then judged as inactive or active regardless of stage, based on whether lesions are progressing at the time of the clinical examination.\"}]","ICCMS™ Quick Reference Guide for Practitioners and Educators - Caries Management Cycle | PDF",1789929325]