Overview

This course introduces the dental professional to the importance of caries diagnosis in prevention of the disease, as well as the intricate link between caries diagnosis and treatment. The two main methods of lesion diagnosis used today, the visual-tactile or visual methods and bitewing radiography, are discussed; particularly with regard to their application in the ICDAS system.

Clinical Significance Snapshots

What is the difference between Diagnosis and Assessment of dental caries?

Dental caries assessment identifies the presence or absences of disease indicators. Diagnosis links the level of appropriate care to the stage of the disease. Diagnosis is performed at the tooth surface or tooth level. Risk assessment is conducted at the patient level and should include evaluation of medical and dental histories, biological, social and behavioral risk factors, and all clinical evidence gained from a thorough examination using visual and tactile methods. Further evidence gained from other tests such as bitewing radiography is also considered. Once identified, the individual lesions should be assessed for their activity status, which will determine the specific management strategies for each caries lesion. Preventive care should be risk-based and provided for all patients. Low, medium and high caries risk patients should receive preventive and behavioral interventions adjusted to their risk status. Lesion severity (initial, moderate, or extensive) should determine the need for non-surgical or surgical dental care to control caries or eliminate it. The inclusion of non-cavitated lesions in this assessment is essential, as the measurement of these lesions is a relevant indicator for long-term dental health.

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