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Modules

Module 3: Caries Risk Assessment

3.2 Caries Risk Assessment

Oral Health Screening

Non-Cavitated White Spot Lesions

White spots are non-cavitated carious lesions in enamel. These are commonly referred to as incipient lesions. In young children, white spot lesions are often found along the gumline of the upper front teeth. White spot lesions may be actively demineralizing, remineralizing, or arrested.

Non-Cavitated White Spot Lesions Non-Cavitated White Spot Lesions
Non-Cavitated White Spot Lesions   Non-Cavitated White Spot Lesions
Photo: Used with permission from American Academy of Pediatrics. 2008. Oral Health Risk Assessment: Training for Pediatricians and Other Child Health Professionals. Elk Grove Village, IL:
American Academy of Pediatrics.
  Used with permission from Joanna Douglass, B.D.S., D.D.S., University of Connecticut School of Dental Medicine.


Cavitated Lesions

If demineralization continues, white spot lesions can progress through the enamel into the dentin. The appearance changes to a soft brown or black as cavitation occurs.

Cavitated Lesions Cavitated Lesions
Cavitated Lesions   Cavitated Lesions
Used with permission from Joanna Douglass, B.D.S., D.D.S., University of Connecticut School of Dental Medicine.   Used with permission from Norman Tinanoff, D.D.S., M.S., University of Maryland Dental School.


Severe Decay

Once in dentin, dental caries progresses more rapidly, eventually reaching the pulp of the tooth. Formation of an abscess, an infection at the apex of the root of the tooth, may occur. In some cases the abscess forms a fistula near the site of the infection. The factors that promote caries development will likely involve most if not all of the teeth.

Severe Decay Severe Decay
Severe Decay   Severe Decay
Used with permission from Joanna Douglass, B.D.S., D.D.S., University of Connecticut School of Dental Medicine.   Used with permission from Joanna Douglass, B.D.S., D.D.S., University of Connecticut School of Dental Medicine.