University of Michigan School of Dentistry logo Caries Diagnosis Risk Assessment and Management - School of Dentistry University of Michigan Ann Arbor, Michigan, USA
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Diagnosis & risk assessment
Principles
Visual Inspection and Use of Explorers
Coronal caries
On smooth tooth enamel
In pits or fissures surface
Root caries
Recurrent caries
Radiographic diagnosis of caries
Caries Management
Introduction  
Diagnosis, Risk Assessment & Management Protocols
1 Pits and Fissures
2 Proximal tooth surfaces
3 Buccal-lingual smooth tooth surfaces
4 Restored tooth surfaces
5 Sealants
6 Root Surfaces
7 Classification of caries risk status
8 Fluoride application
9 Management of patients with high caries risk
Examination and analysis forms
1 Examination Form 1
2 Examination Form 2
Notes
Cariology links
Supporting references
Diagnosis Tables
1-1 Caries in smooth surfaces
1-2 Caries in pits or fissures
1-3 Root caries
1-4 Recurrent caries
1-5 Radiographic caries
2 Dental fluorosis & opacities

Caries in smooth enamel surfaces (Table 1-1)

Active non-cavitated carious lesions on smooth enamel surfaces have the following clinical characteristics:

The examiner can differentiate between carious and non-carious enamel opacities using the characteristics described in Table 2 and shown below.

Cavitation: no signs of cavitation after visual or gentle tactile examination.

Location: located in areas where dental plaque accumulates (close to the gingival margin).

Surface characteristics: Matted (not glossy) when a tooth is dried.

Areas of demineralization that are not in close proximity to the gingival margin; are not covered by plaque; are smooth and glossy; and are non-cavitated should not be classified as active non-cavitated carious lesions.

If there is visual enamel opacity under an ostensibly sound marginal ridge then the enamel is undermined because of dental caries and the tooth surface is classified with a non-cavitated carious lesion in dentin shown below:

Where there is visual breakdown of a tooth surface, it is classified as cavitated carious lesion. An active cavity on a smooth surface has soft walls or floors shown below:

All stained smooth coronal tooth surfaces that do not have the characteristics of non-cavitated or cavitated lesions are classified as questionable shown below: