For much of the last century, the diagnosis of dental caries entailed detecting only cavitation.1 Over the last few decades, however, the caries process became recognized as a biofilm disease characterized by prolonged periods of low pH in the mouth leading to dissolution and net loss of minerals from the teeth. The demineralization of the teeth is now understood as a physiological continuum, and the understanding of caries shifted from a discrete episode of cavitation to an understanding of demineralization as a spectrum that ranges from microporosity to cavitation.2 Because the emphasis in dealing with caries is shifting from surgical repair to strategies that prevent decay, the challenge now to professionals is to provide better criteria for establishing the true state of a given tooth. Therefore, the primary purpose of caries diagnosis is to identify the biofilm disease process and also early signs of tooth demineralization in order to halt its progression.1,2,3
The scientific literature points to three main reasons why caries lesion diagnosis is important:
What follows is a discussion of the different methods of caries lesion diagnosis and how diagnosis and management of the disease are intricately linked.
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