Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jul;12(3):87-100.
doi: 10.4103/0972-0707.57631.

Dental caries: A complete changeover (Part II)-Changeover in the diagnosis and prognosis

Usha Carounanidy  1 , R Sathyanarayanan
Affiliations

Dental caries: A complete changeover (Part II)-Changeover in the diagnosis and prognosis

Usha Carounanidy et al. J Conserv Dent. 2009 Jul.

Abstract

Realization that dental caries is a reversible, dynamic biochemical event at a micron level has changed the way the profession recognizes the caries disease and the caries lesion. The diagnosis of dental caries poses challenges due to the complex interaction of multiple endogenous causal factors. The most appropriate diagnostic aid for this purpose is the risk model of caries risk assessment. The analyses of the biological determinants provide clues to the dominant causal factor. The detection of a carious lesion has undergone a rigorous revision and revolution in order to identify the earliest mineral change so that it can be controlled without resorting to invasive management options. Apart from detection, it became mandatory to assess the extent of the lesion (noncavitated/cavitated), assess the activity status of the lesion (active/arrested), monitor the lesion progress (progression/regression over a period of time), and finally to predict the prognosis of the lesion as well as the disease. The prognosis of the disease can be best assessed by analyzing the predictor factors in caries risk assessment. The ultimate objective of such a meticulous and methodical approach aids in devising a tailor-made treatment plan, using preventing measures precisely and restorative measures minimally. This ensures the best oral health outcome of the patient.

Keywords: Active caries; caries activity; cavitated caries; dental caries; detection; diagnosis; inactive caries; noncavitated caries; prediction; prognosis; risk assessment; sensitivity; specificity.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Illustration depicting the micro biochemical events occurring on the tooth- biofilm interface over time. (a) The mineral loss and gain balanced and lesion not visible (b) The mineral loss and gain not balanced and lesion is visible as white spot[6]
Figure 2
Figure 2
Illustration depicting a new concept on Dental caries (a) Essentialistic concept: The causes result in a disease that manifest as signs and symptoms. (b) Nominalistic concept: The disease name is no more than a label given to certain characteristics of the signs[10]
Figure 3
Figure 3
Illustration depicting a ‘Caries Iceberg’, showing various diagnostic thresholds[26]
Figure 4
Figure 4
Illustration depicting a ‘Caries cube’, showing the three assessment parameters[52]
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Usha C, Sathyanarayanan R. Dental caries: A complete changeover (Part 1) J Conserv Dent. 2009;12:46–54. - PMC - PubMed
    1. Available from: http://en.wikipedia.org/wiki/Medical_diagnosis.
    1. Nyvad B. Diagnosis versus detection of caries. Caries Res. 2004;38:192–8. - PubMed
    1. Nyvad B, Fejerskov O, Baelum V. Visual-tactile caries diagnosis. In: Fejerskov O, Kidd E, Nyvad B, Baelum V, editors. Dental Caries -The disease and its clinical management. 2nd ed. Blackwell Munksgaard Ltd; 2008. pp. 49–68.
    1. Bader JD, Shugars DA. What do we know about how dentists make caries-related treatment decisions? Community Dent Oral Epidemiol. 1997;25:97–103. - PubMed