European Archives of Paediatric Dentistry

, Volume 17, Issue 1, pp 13–25 | Cite as

Detection and monitoring of early caries lesions: a review

  • I. A. PrettyEmail author
  • K. R. Ekstrand
Original Scientific Article



To review the current evidence base of detecting and monitoring early carious lesions in children and adolescents and a rationale proposed to ensure that such lesions are identified and appropriately managed.


The systematic literature search identified initially a review by Gomez and co-workers from 2013 and this still represents the current state of the science in relation to caries detection and monitoring. The review described among others, visible detection systems, image-based detection systems and point-measurement approaches.


The current evidence base suggests that while there are numerous devices or technology-enabled detection systems, the use of a careful, methodical visual inspection of clean, dry teeth, supplemented where indicated by radiographic views, remains the standard of care in caries detection and diagnostics. Further, it is possible by means of existing visible and radiographical systems to monitor lesions over time. Using low-cost intra-oral cameras facilitates the recording of lesion appearance in the patient record and may be of significant benefit in monitoring early lesions over time following their detection. This benefit extends to the clinician and the patient for whom it may be a useful educational and motivational tool.


Recommendations are presented that can be adopted and adapted to local circumstances and that are both substantiated by evidence and promote a clear, simple and consistent approach to caries detection, diagnosis and monitoring in children and adolescents. The diagnoses (initial, active; moderate, active and extensive, active) are linked to appropriate management options within primary care.


Caries Detection Diagnosis Early lesions Management 



The former Chief Dental Health Officer Christian Christiansen and former Dentist Jette Christiansen, Nexö Public Dental Health Service, are both thanked for letting us use the images in Figs. 3 and 4 in this paper.


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Copyright information

© European Academy of Paediatric Dentistry 2015

Authors and Affiliations

  1. 1.The Dental Health Unit, School of DentistryThe University of ManchesterManchesterUK
  2. 2.Department of Odontology, Cariology and Endodontics, Faculty of Health and medical SciencesUniversity of CopenhagenCopenhagenDenmark

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