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3.2 Stages in Caries Lesion Severity and Activity

Cavitated Caries Lesions

Cavitated occlusal caries lesion. The break is visually limited to the enamel.
Image courtesy of Margherita Fontana, D.D.S., Ph.D.

Cavitated occlusal caries lesion. The break is visually exposing the dentin.
Image courtesy of Margherita Fontana, D.D.S., Ph.D.

Cavitated lesions (also referred to as cavities) are lesions that have progressed to a more advanced stage. According to American Academy of Pediatric Dentistry guidelines, cavitation can be detected when there is at least clinical criteria of visual detection of enamel cavitation, visual identification of shadowing of the enamel, and/or X-ray recognition of enlargement of lesions over time.2 Cavitation usually occurs because of external forces that eventually lead to the collapse of the outer surface in a non-cavitated lesion, which in turn leads to a discontinuity or break in the surface. The break in the surface may be limited to the enamel, or it may expose the dentin. By this point, demineralization has usually progressed histologically, radiographically, and/or clinically into the dentin, and bacteria can invade the dentin and cause tissue infection. This stage of the disease generally requires operative intervention to restore function and to help arrest the caries process inside the tooth.