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

Table 1-2: Caries in pits or fissures

Lesion
Description
Comments
Questionable Discolored pits or fissures with no signs of undermining and softness of the area. Gentle exploring*
Non-cavitated
  Enamel: Light or dark brown discoloration at the base of the pit or fissure with or without white demineralization at the sides of the pit or fissure that could be detected visually after cleaning and drying the teeth. No breakdown in enamel (no cavity) but the area is soft (sticky) upon gentle exploring.  
  Dentin: Non-cavitated lesions in dentin have signs of enamel undermining that show as opacity or discoloration inside the surface.
Cavitated An actual hole in the tooth in which an explorer can easily enter the space. An active cavity should have soft walls or floors.
Sound

Not questionable, non-cavitated, or cavitated.

A pit or fissure that is "retentive" to a sharp explorer should not be classified as carious unless there are other signs of dental caries as described in this Table.