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3.4 Caries Detection vs. Caries Diagnosis

The terms "caries detection" and "caries diagnosis" have distinct meanings. "Caries detection" implies finding a sign of the disease (e.g., finding a non-cavitated lesion). This is the first step in the diagnosis process. "Caries diagnosis" implies determining whether lesion(s) or disease are present (detection); determining how severe the disease is, if it is present; and deciding whether lesions are active or arrested (assessment).

  • Diagnosis, not detection alone, should inform the assessment of future dental caries risk and help guide the process of how to manage oral disease. From the caries disease perspective, only active lesions require treatment. The type of treatment depends on the severity of the active lesion (i.e., whether it is cavitated or non-cavitated).
  • Because most cavitated lesions are not self-cleansing, they are considered active lesions and therefore require treatment—usually restorative treatment.
  • Non-cavitated lesions appearing on recently erupted posterior teeth in children at high risk for dental caries are likely to be active and thus in need of treatment. In school-based dental sealant programs, sealant placement is the appropriate treatment for these lesions.4

Diagnosis, not detection alone, should inform the assessment of future dental caries risk and help guide the process of how to manage oral disease. From the caries disease perspective, only active lesions require treatment. The type of treatment depends on the severity of the active lesion (i.e., whether it is cavitated or non-cavitated).