White Spot Carious Lesions 4

White Spot Carious Lesions 4: Diagnosing and Differentiating Between Active and Inactive lesions. The Active Lesion.

The following tables distinguishing between active and inactive caries sites based on visual (color and glossy versus non-glossy surface) and tactile information (rough versus smooth surface) obtained through limited and careful use of the explorer.

	Classification	Description
	Sound	Normal enamel texture and glossiness. Smooth surface intact, smooth and glossy. Pit and fissures intact possibly with some staining.
	White spot lesion stage 1. Activecaries (Intact surface)	Surface of enamel is whitish/yellowish opaque with loss of luster. It feels rough when the tip of the probe is gently moved across the surface which usually is covered with plaque. No clinically detectable loss of substance. Smooth surface caries lesion typically located close to gingival margin. Pit and fissures have intact fissure morphology. Lesion may extend along the walls of the fissure.
	White spot lesion stage 2. Active caries (surface discontinuity)	Surface of enamel is whitish/yellowish opaque with loss of luster and feels rough when the tip of the probe is gently moved across the surface. Localized surface defect (microcavity) in enamel only may be found. No undermined enamel or softened floor detectable with the explorer. The root/dentin lesion is soft or leathery and discolored.
	Cavitated lesion, active caries.	Enamel/dentin cavity easily visible with the naked eye; surface of cavity feels soft or leathery on gentle probing. There may or may not be pulpal involvement.

This table and classification is a modification of material found in Nyvad B, Machiulskiene V, Baelum V, Reliability of a new caries diagnostic system differentiating between active and inactive caries lesions. Caries Res, 33:252-260, 1999.