The University of Iowa College of Dentistry and Dental Clinics logoLink to University of Iowa home pageLink to College of Dentistry and Dental Clinics home page

  college of dentistry mission graphic

Operative Dentistry - Best Practices

Caries Management: Caries Lesion Detection

(last modified September 1, 2016)

Detection and removal instruments / aids for lesion management

  • Appropriate radiographs and current pulpal status
  • Clean, gently dried tooth - avoid repeated or forceful drying to prevent pulpal damage
  • Adequate illumination
  • Magnification
  • Explorer (used for assessment of surface texture only)
    • care needed in deeper areas to avoid inadvertent pulpal damage
    • of little or no value in pit and fissure caries diagnosis
    • detection of marginal ditching on amalgam restorations does not, by itself, imply the presence or predict the development of a caries lesion
  • Sharp spoon excavator - preferred method of caries detection when possible
  • Round excavating burs on low-speed hand piece
    • largest round bur that fits in area of interest should be used to avoid unnecessary tooth structure removal and penetration
  • Caries-disclosing dyes
    • tactilely confirm the presence of caries before removal of dye-stained dentin
    • dyes are visual identification aids for the novice and advanced beginner and are not diagnostic for remaining caries
  • Most commonly missed areas are under cusp tips and at DEJ
    • always check with mirror for these access-limited areas using multiple mirror angulations
  • Non-traditional caries detection and diagnostic devices are continually being evaluated

ADA Caries Classification System