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J Conserv Dent. 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.

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Department of Dentistry, Pondicherry Institute of Medical Sciences, Pondicherry, India.


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.


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

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