It has previously been believed that enamel that is undermined by decay will collapse.

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..

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

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.

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