The Natural History of Dental Caries Lesions

Abstract

Dental caries is a ubiquitous disease affecting all age groups and segments of the population. It is known that not all caries lesions progress to cavitation, but little is known regarding the progression pattern of caries lesions. This study's purpose was to evaluate the natural history of dental caries using a standardized, visually based system, the International Caries Detection and Assessment System (ICDAS). The study population consisted of 565 consenting children, who were enrolled and examined at baseline and at regular intervals over 48 months with ICDAS and yearly bitewing radiographs. Of these, 338 children completed all examinations. Not all lesions cavitated at the same rate, differing by surface type and baseline ICDAS severity score and activity status. With increasing severity, the percentage of lesions progressing to cavitation increased: 19%, 32%, 68%, and 66% for ICDAS scores 1, 2, 3, and 4, respectively. Lesions on occlusal surfaces were more likely to cavitate, followed by buccal pits, lingual grooves, proximal surfaces, and buccal and lingual surfaces. Cavitation was more likely on molars, followed by pre-molars and anterior teeth. Predictors of cavitation included age, gender, surfaces and tooth types, and ICDAS severity/activity at baseline. In conclusion, characterization of lesion severity with ICDAS can be a strong predictor of lesion progression to cavitation.

Validation of Visual Caries Activity Assessment

“…Additional criteria systems for activity assessment have been investigated to be used in association with the ICDAS (ICDAS Coordinating Committee, 2005;Ekstrand et al, 2007;Braga et al, 2009;Braga et al, 2010;Ferreira-Zandona et al, 2012;Gimenez et al, 2013;Piovesan et al, 2013).…”

Ex vivoevaluation of new 2D and 3D dental radiographic technology for detecting caries

“…27,28 Assessment of lesion cavitation is also important because cavitated lesions demonstrate a much higher likelihood of progression. [28][29][30] Ultimately, the approach to identifying and treating incipient and early caries lesions non-restoratively places a maximum demand on radiographic imaging systems. [31][32][33] With regard to lesion detection, dentistry needs increased sensitivity from new diagnostic systems with no corresponding compromise in the already high specificity rates.…”

Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

“…Higher values indicate more severe caries lesions. 3,8,25,26 On the other hand, QLF is an intraoral camera that uses a high-intensity halogen lamp that emits a blue light (λ = 405 nm) for excitation of the tooth. Then, the camera captures the fluorescence coming from the tooth (green fluorescence) and from bacterial metabolites (red fluorescence).…”