Risk Classification: The moderate risk patient (caries active or inactive).

Host Factors:

• Will have several white spot lesions that may be caries active (white spot surface is rough and not shinny) or caries inactive (white spot area is smooth and shinny). See diagnosing white spot lesions.
•  Check past dental and medical history.
• No cavitated lesions.
• Has a moderate DMF with D= 0.
• Which surfaces are involved should be noted.
• Check fluoride intake.
• Check salivary flow rate.
   Pit and fissures-enamel. Most common lesion.
    -Does not respond well to preventive therapy. Use pit and fissure sealants.
  Smooth surface-proximal-enamel. Next most common lesion.
    -Responds well to preventive therapy such as F, cleaning, diet control.
  Other smooth surfaces-enamel. Least common lesion and the one suggesting greater susceptibility.   -Responds well to preventive therapy such as F, cleaning, diet control.
  Root caries-non enamel surface.
     -In older individual, responds well to F, diet control and cleaning.

Diet Factors:

• Check sugar intake.
  

Bacterial Factors:

• MS test is not required since morphology of enamel white spot lesion is a good indicator of caries activity.
• Lactobacilli test may have a use in caries activity determination.  This test helps to monitor sugar intake.

To help verify the patient as caries active:

• Use white spot caries activity evaluation, which surfaces are involved and clinical assessment.