Problems in caries diagnosis.

Abstract

This paper reviews some of the problems in the diagnosis of primary and secondary caries, particularly with respect to the questionable lesion that has neither penetrated to dentine nor cavitated. Because tactile diagnosis of caries with sharp probes can be unreliable as well as damaging, diagnosis should include careful visual inspection (preferably with magnification), radiographic examination, fibre optic transillumination (FOTI), and/or measurement of electrical resistance depending on the anatomical location. Probably the most important and difficult diagnostic decision for the clinician is whether the patient is at high, moderate or low risk of caries. Consideration of various factors in the patient's history, and clinical and laboratory examinations will assist in this classification of risk.