It seems that systematic reviews outnumber primary literature when it comes to caries. There seems to be low prevalence of smooth surface caries and more occlusal caries in the younger population. Sometimes with high fluoride intake after caries has begun its process, ballooning lesions can be evident under occlusal enamel which is harder to collapse.
Probes offer poor diagnostic quality and accuracy, and can cause irreversible traumatic defects. However, can using a ball-ended probe during ICDAS classification cause discontinuity and microcavitation? Other methods to aid clinical visualisation may include air drying, and fibre optic transillumination, using a high intensity, low diameter light, showing scatter where caries is present. Blue light may be helpful, as carious enamel will fluoresce and DIAGNOdent uses a red light, where by bacterial byproducts fluoresce. This may have good sensitivity but many false positives due to staining, calculus and plaque.
Bitewings have been shown to be great at aiding caries detection, but not very early caries. If grey scale values of two radiographs taken six months apart can be subtracted, this may show newly developing caries.
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