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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 2. Differential Diagnosis between Milder Forms of Dental Fluorosis (Questionable, Very Mild, And Mild) and Nonfluoride Opacities of Enamel.

Characteristic Milder Forms of Fluorosis Nonfluoride Enamel Opacities
Area affected Usually seen on or near tips of cusps or incisal edges. Usually centered in smooth surface; may affect entire crown.
Shape of lesion Resembles line shading in pencil sketch; lines follow incremental lines in enamel, form irregular caps on cusps. Often round or oval.
Demarcation Shades off imperceptibly into surrounding normal enamel. Clearly differentiated from adjacent normal enamel.
Color Slightly more opaque than normal enamel; paper-white. Incisal edges, tips of cusps may have frosted appearance. Does not show stain at time of eruption (in these milder degrees, rarely at any time). Usually pigmented at time of eruption often creamy-yellow to dark reddish-orange.
Teeth Affected Most frequent on teeth that calcify slowly (cuspids (canines), bicuspids (premolars), second and third molars). Rare on mandibular incisors. Usually seen on six or eight homologous teeth. Extremely rare in deciduous teeth. Any tooth may be affected. Frequent on labial surfaces of mandibular incisors. May occur singlely. Usually one to three teeth affected. Common in deciduous teeth.
Gross hypoplasia None. Pitting of enamel does not occur in the milder forms. Enamel surface has glazed appearance, is smooth to point of explorer. Absent to severe. Enamel surface may seem etched, be rough to explorer.
Detection Often invisible under strong light; most easily detected by line of sight tangential to tooth crown. Seen most easily under strong light on line of sight perpendicular to tooth surface.

Russell AL. The differential diagnosis of fluoride and nonfluoride enamel opacities. J Public Health Dent 1961;21:143-6.