Dental Caries Classifications

Based on anatomic site

Occlusal/Pit and Fissure Caries

It is the caries that results in pit and fissures which are developed by the imperfect coalescence of the enamel during developmental stage of the tooth.

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This caries can be represented as cone with base towards dentin enamel junction and apex towards enamel surface.

Smooth Surface Caries

The carious lesion on the smooth surface of tooth is called as smooth surface caries. It doesn’t begin in the clean enamel but rather in an area that is habitually unclean.

The base of the cone is towards enamel surface and apex is towards dentin enamel junction.

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Root/Senile Caries

Dental caries occurring on tooth that has been exposed to oral environment and it is called as root or senile caries.

This is usually more rapid than other forms of caries especially in older patients.

Based on severity

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Incipient caries

Incipient caries is an early caries lesion which is seen on the smooth surfaces of the teeth as a “White spot”.

It occurs due to subsurface demineralization below the intact surface layer and can undergo demineralization.

It may be confused with developmental defects of enamel. The incipient caries disappear on wetting, while the developmental defect persists.

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Occult (hidden) caries

Occult caries is not clinically diagnosed but can be seen on the radiographs. Caries usually increase with time, if untreated.

Increase in fluoride exposure inhibits the superficial enamel caries but the caries underneath the enamel spreads in dentin.

The lesion is covered by relatively intact layer of enamel. Therefore, such hidden lesions are called as “Fluoride bombs or Fluoride syndrome”.

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Cavitations

Once the caries reaches to the dentin enamel junction, it spreads rapidly to the pulp along the tubules and is seen as a definite cavitations on the clinical examination.

Based on progress

Arrested caries

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With change in the oral echo system, the carious lesion may become arrested. The arrested carious lesion of dentin appears as a dark brown pigmentation.

Recurrent/secondary caries

The caries occurring at the borders or underneath the restoration is called as secondary caries. It occurs due to the poor marginal adaptation of the restoration and subsequent marginal leakage.

Based on chronology

Acute/rampant caries

Acute carious lesion is infectious, light-colored lesion which spreads rapidly.

Chronic/Slow Caries

Chronic carious lesion is discolored and fairly hard. Slow destruction rate allows for extrinsic pigmentation.

Based on direction of spread

Forward Caries

Caries cone in the enamel is larger or same than that of dentin. It spreads in forward direction from enamel to dentin.

Backward Caries

Once enters the enamel, caries spread along the dentin enamel junction rapidly and again extends towards the enamel in backward direction.

The caries that remains in a completed cavity preparation whether by operational intention or by accident is called as residual caries?