RECENT CLASSIFICATION

OF DENTAL CARIES
Resource faculties: Submitted by:

Indrajeet yadav
Dr. Mannu Vikram
Dr. Navin Agrawal Roll no : 842
Dr. Vimmi Singh Batch : 2018
Dr. Ashok Ayer
Dr. Arbind Rai
Dr. Sushmita Shrestha
 CONTENTS
1 INTRODUCTION
2 CLASSIFICATION

WHO SYSTEM

G.J Mount’s
SITE OF CARIES
SIZE OF CARIES

3 International Caries Detection and Assessment System

DENTAL CARIES

Dental Caries is an irreversible microbial disease of the calcified

tissues of the teeth, characterized by de-mineralisation of
inorganic portion and destruction of organic substance of the
tooth, which often leads to cavitation
(Shafer 1993)
• GV Black “classification of carious cavities” is out of date.
• New approach to the identification and recording caries .
• Encourage the profession to minimise the amount of
normal healthy tooth structure that is often sacrificed in
pursuit of the cavity designs as suggested by Black.
 World Health Organisation (WHO)system

In this system the shape and depth of carious lesion can be scored on a
four point scale.

D1 Clinically detectable enamel lesions with intact surfaces.

D2 Clinically detectable cavities limited to enamel.
D3 Clinically detectable cavities in dentin.
D4 Lesions extending into the pulp.
Classification by Mount and Hume(1998)
G.J Mount’s classification

SITE OF CARIES:
Site 1:Pit and fissure
Site 2 :Proximal surface
Site 3 :Cervical areas
SIZE OF CARIES

Size 0 –Carious lesion without cavitation can be remineralized.

Size 1 –Small cavitation,just beyond healing through remineralization
Size 2 – Moderate cavitation not extended to cusps
Size 3 – enlarged cavitation with at least one cusp which is
undermined and which needs protection from occlusal load.

Size 4 – extensive decay with at least one lost cusp or incisal edge.
ICDAS Classification of dental caries

CODES FOR CORONAL PRIMARY CARIES

 CODES FOR DETECTION OF CARIES IN ROOT SURFACES

CODES FOR CORONAL PRIMARY CARIES
CODES
Code 0 Sound tooth surface
Code 1 First Visual Change in
Enamel
PIT AND FISSURES
There should be no evidence of
caries after 5 sec air
drying.Surfaces with
developmental defects such as
enamel hypoplasia; fluorosis; tooth
wear and extrinsic or intrinsic
stains will be recorded as sound.
When seen wet there is no
evidence of any change in color
attributable to carious activity, but
after prolonged air drying, a
carious opacity or discoloration
(white or brown lesion) is visible
SMOOTH SURFACE
There should be no evidence of
caries. Surfaces with
developmental defects such as
enamel hypoplasia; fluorosis; tooth
wear and extrinsic or intrinsic
stains will be recorded as sound
When seen wet there is no
evidence of any change in color
attributable to carious activity, but
after prolonged air drying a carious
opacity (white or brown lesion) is
visible that is not consistent with
the clinical appearance of sound
enamel. This will be seen from the
buccal or lingual surface.
Code 2 Distinct Visual Change in
Enamel
Code 3 Localized Enamel Breakdown
The tooth must be viewed wet. When
wet there is a carious opacity (white
spot lesion)and/or brown carious
discoloration which is wider than the
natural fissure/fossa
localized enamel breakdown with no
visible dentin or underlying shadow;
discontinuity of surface enamel,
widening of fissure
There is a carious opacity or
discoloration (white or brown lesion)
that is not consistent with the clinical
appearance of sound enamel. This
lesion may be seen directly when
viewed from the buccal or lingual
direction. In addition, when viewed
from the occlusal direction, this
opacity or discoloration may be seen
as a shadow confined to enamel, seen
through the marginal ridge
Once dried for approximately 5
seconds there is distinct loss of
enamel integrity, viewed from the
buccal or lingual direction. The base
and walls of the cavity are within
enamel and dentin is NOT visible
Code 4 Underlying Dark Shadow from
Dentin
Code 5 Distinct Cavity with Visible Dentin
Code 6 Extensive Distinct Cavity with
Visible Dentin
This lesion appears as a shadow of
discolored dentin visible through an
apparently intact enamel surface which
may or may not show signs of localized
breakdown (loss of continuity of the
surface that is not showing the dentin).
The shadow appearance is often seen
more easily when the tooth is wet
Cavitation in opaque or discolored
enamel exposing the dentin beneath
involving less than half of the tooth
surface
Cavitation in opaque or discolored
enamel exposing the dentin beneath
involving at least half of the tooth surface involving at least half of the tooth surface
This lesion appears as a shadow of
discolored dentin visible through an
apparently intact marginal ridge, buccal
or lingual walls of enamel. This
appearance is often seen more easily
when the tooth is wet. The darkened
area is an intrinsic shadow which may
appear as grey, blue or brown in color
Cavitation in opaque or discolored
enamel exposing the dentin beneath
involving less than half of the tooth
surface
Cavitation in opaque or discolored
enamel exposing the dentin beneath
This severity code is paired with a restorative/sealant code 0–8:
• 0 = sound not sealed or restored
• 1 = sealant, partial
• 2 = sealant, full;
• 3=tooth-coloured restoration
• 4 = amalgam restoration
• 5 = stainless steel restoration
• 6 = ceramic, gold, porcelain-fused-to-metal (PFM) crown
or veneer
• 7 = lost or broken restoration
• 8 = temporary restoration
CODES FOR DETECTION OF CARIES IN ROOT SURFACES

Code Description

Code E If the root surface cannot be visualized directly as a result of gingival recession or by gentle air-
drying, then it is excluded. Surfaces covered entirely by calculus can be excluded or, preferably,
the calculus can be removed prior
Code 0 The root surface does not exhibit any unusual discoloration that distinguishes it from the
surrounding or adjacent root areas nor does it exhibit a surface defect either at the cemento-
enamel junction or wholly on the root surface
Code 1 There is a clearly demarcated area on the root surface or at the cemento-enamel junction (cej)
that is discoloured (light/dark brown, black) but there is no cavitation (loss of anatomical
contour < 0.5 mm) present.
Code 2 There is a clearly demarcated area on the root surface or at the cemento-enamel junction (cej)
that is discoloured (light/dark brown, black) and there is cavitation (loss of anatomical contour ≥
0.5 mm) present
 CRITERIA FOR BITEWING RADIOGRAPH
SCORES
• C0: No radiographic evidence for caries

• C1:radiolucent in outer half of enamel

• C2:radiolucency in inner half of enamel

• C3:radiolucency involving just dentin

• C4:radiolucency in outer 1/3rd of dentin

• C5:radiolucency in inner 2/3rd of dentin or involving pulp

References
1.Sturdevant’s Art and Science of Operative Dentistry, South Asian
Edition
2.Preservation and Restoration of Tooth Structure / Graham J.
Mount, Wyatt R. Hume, Hien C. Ngo, Mark S. Wolff - 3rd Ed - Wiley
(2016)
3.Textbook of Operative Dentistry Nisha Garg,Amit Garg 4th edition
4.International Dental Journal Volume 56, Issue 2,April 2006, Pages
82- 91
5.Australian Dental Journal Volume 53, Issue 1, 2008, Pages 83-92