The Concept of Hidden Caries
As caries levels declined in the early 1970s due to the increased availability of fluoride, it was suggested that the presence of fluoride was resulting in later cavitation and therefore making occlusal caries diagnosis more difficult. Dentinal carious lesions not detected clinically but diagnosed radiographically were termed “hidden caries”. The evidence from studies before and after the introduction of fluoride does not support this concept. It is much more likely that the reduction in caries just drew dentists’ attention to these clinically hard to detect lesions. Depending on the diagnostic criteria, the prevalence of clinically undetectable dental lesions ranges from 2 to 25%, the lower of these figures being found when a meticulous caries diagnostic system is used. To ensure no lesions are missed, radiographic examination is required.
KeywordsCaries Occlusal Diagnosis Hidden caries Fluoride
- 4.Whelton H, O’Mullane DO, McLoughlin J. Caries levels in Ireland according to varying diagnostic criteria. J Dent Res. 1996;75:85.Google Scholar
- 8.Slack GL, Jackson D, James PMC, Lawton FE. A clinical investigation into the variability of dental caries diagnosis. Br Dent J. 1958;104:399–404.Google Scholar
- 9.Weerheijm KL, Gruythuysen RJM, van Amerongen WE. Prevalence of hidden caries. J Dent Child. 1992;59:408–12.Google Scholar
- 17.Pitts NB, Ekstrand KR, ICDAS Foundation. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS)—methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol. 2013;41:e41–52.CrossRefGoogle Scholar