How is it Diagnosed?
Dental caries (tooth decay) is diagnosed through a systematic evaluation involving
patient history, clinical examination, and diagnostic aids. The condition arises due to
demineralization of the tooth enamel by acids produced by bacterial fermentation of
dietary carbohydrates.
Diagnosis begins with a detailed history, including dietary habits, oral hygiene practices,
fluoride exposure, and previous dental issues. Clinical examination involves inspecting all
surfaces of the teeth using a dental mirror and explorer to detect soft, discolored, or
sticky areas that may indicate demineralization or cavitation.
Visual-tactile inspection remains the primary diagnostic method. Dentists look for white
spot lesions (early caries), brown or black discolorations, or cavitated surfaces.
Transillumination or fiber-optic devices can enhance the visibility of lesions, especially in
anterior teeth.
Radiographs, particularly bitewing X-rays, are crucial for detecting interproximal
(between teeth) and occlusal caries that may not be visible during a routine exam. They
help assess the depth of decay and monitor progression over time.
Advanced diagnostic tools include laser fluorescence devices (like DIAGNOdent) that
quantify changes in enamel structure, and digital imaging fiber-optic transillumination
(DIFOTI) that uses light to detect early decay.
Saliva testing to measure bacterial load and pH may be performed in high-risk
individuals. Regular dental check-ups and early diagnosis are vital to arrest and manage
caries before extensive tooth damage occurs.