Radiographic Examination in the ICCMS™

There is a unanimous agreement that more caries lesions can be identified by combining radiographic information with clinical findings, compared to visual inspection alone. For this reason, ICCMS™ recommends the inclusion of radiographic examination, if possible and appropriate based on local safety standards. Radiographic examination is useful to confirm the extent of caries, to detect lesions where visual examination of the tooth surface is hampered and to serve as an aid in making appropriate clinical decisions.

Table 6. The ICCMS™ Radiographical Scoring System.
  ICCMS Score  
(Initial Stages)
1 Radiolucency in the outer 1/2 of the enamel
2 Radiolucency in the outer 1/2 of enamel ± EDJ
(Moderate Stages)
3 Radiolucency limited to the outer 1/3 of dentin
4 Radiolucency reaching the middle 1/3 of dentin
(Extensive Stages)
5 Radiolucency reaching the inner 1/3 of dentin, clinically cavitated
6 Radiolucency into the pulp, clinically cavitated

In addition to the use of radiographic evaluation, the ICCMS™ recognizes the potential benefits that can be gained by the use of additional, supplemental detection aids as a means of enhancing caries detection. These can include Fiber-optic Transillumination (FOTI), electrical conductivity measures and optical fluorescence techniques and are briefly discussed later in this course.