Changing Diagnostic Beliefs.

It has previously been believed that enamel that is undermined by decay will collapse. wpe10.jpg (2140 bytes)

This belief is now changing and it is believed to be due to the use of fluoride.
-While fluoride has reduced smooth surface caries, it has also had the unexpected effect of strengthening the enamel thereby decreasing the possibility of collapse when undermined by decay..

wpe12.jpg (1699 bytes)     

X-ray showing very deep dentinal caries with intact enamel.

 

 

wpe1C.jpg (5823 bytes)

Enamel undermined by decay. Note dark shadow under tthe enamel.

 

 

 

 

References:
Chan, DCN: Current methods and criteria for caries diagnosis in North America. J dent edu 57 (6):422-427,
1993.
Magid, KS: Caries diagnosis: the necessity for a new standard of care. Alpha Omegan 89 (3):6-10, 1996.