Radiographic diagnosis of dental caries (Table 1-5)

It is important to note that the current evidence on the validity and reliability of radiographs in caries diagnosis indicate that they cannot be considered "gold standards" in caries diagnosis. Radiographs do not provide a definitive diagnosis of the presence of dental caries and on average they have around 50% to 70% sensitivity in detecting carious lesions. The two important decisions related to radiographic examination are (1) when to take a radiograph and (2) how to evaluate a radiograph for presence of signs of dental caries. The selection criteria developed by the Food and Drug Administration of the US Department of Health and Human Services (FDA 1987) have been tested clinically and were found to be useful in deciding when to take a radiograph without any significant loss of information or misdiagnosis (White et al. 1994).

After a radiograph is exposed, the following grading system is recommended:

Type 1: Radiolucency in enamel shown below.

Type 2: Radiolucency in enamel reaching the DEJ or into dentin seen in images below.