Caries detection and assessment

The pits and fissures on the occlusal surfaces of posterior teeth are the sites most commonly affected by carious demineralisation. Unfortunately, their microscopic anatomy is variable and complex, with no external indicators of depth or sub-surface morphology. Incipient carious demineralisation is often hidden at the base of fissures in areas that are inaccessible to tooth brushing and benefit least from fluoride and from the buffering and clearance actions of saliva for plaque and dietary acids.

Early detection is one of the fundamental principles of minimally invasive dentistry as there is incontrovertible evidence that, up to a certain point, the disease process is reversible by remineralisation and carious lesions may be arrested. Detection is defined as an objective method of determining whether or not disease is present. Diagnosis of a detected lesion is the summation of all available data to inform decisions regarding lesion activity, prognosis, recall frequency and management options tailored to the need of the individual.