It is important that on the first presentation of the patient,
all caries lesions are identified and that on each subsequent visit,
they are reviewed to predict their likely progress.
We need to understand and review caries activity
(progress of currently identified lesions);
caries prevalence (history);
and caries risk (prediction of possible future caries development).
This is achieved through visual examination and inspection,
palpation and a variety of radiographic and other diagnostic tests.
It is important to then design unique treatment programs
according to individual assessment and need.

Interview examination/inspection/palpation/X ray examination/thermal test/electrical resistance measurement etc An accurate assessment of the current caries activity, recognized as either advanced cavitated or early pre cavitated lesions is crucial for the practice of an effective MI treatment program. When dentists find carious lesions, including white spot lesions, they should firstly correctly identify whether the lesion is active or inactive. Then they should decide if the lesion can be “healed” or controlled through remineralization, utilizing recognized preventive measures. This assessment of caries activity is greatly influenced by the location and individual risk factors. As such and in order to more accurately assess the future likelihood of caries activity, caries risk assessment is also required.

Interview examination(caries prevalence and treatment history)/inspection/palpation etc. Estimation of caries prevalence indicates how much the patient has been exposed to and could control caries risk factors in the past. It is important to realise that not all caries risk factors are under the control of the patient and are influenced by factors such as the environment, both social and economic. This is particularly relevant to children and certain disadvantaged groups such as the elderly and the disabled. Currently, individual caries prevalence (experience) is calculated using the DMFT index. This is achieved by examining the total number of teeth (T) that have become affected by dental caries to the extent that they are cavitated lesions requiring restoration, missing due to extraction because of caries, or filled because of past caries experience; i.e. decayed (D); missing (M) due to caries; or filled (F).

Interview examination(caries prevalence and treatment history)/inspection/palpation etc. Caries risk assessment is an important and growing part of the diagnostic process that seeks to estimate both the current and future likelihood of caries progression, manifest as new or recurrent caries. Ideally, if dentists could estimate risk factors early and easily when examining the patient, then following diagnosis, preventive and treatment protocols could be more readily selected. Today, salivary assessment is becoming an important tool in assisting in determining a patient’s overall caries risk, by measuring the number of cariogenic bacteria present in and the flow rate and buffering capacity of saliva.