Dental caries is a communicable infectious disease that affects the hard dental tissues. It has a multifactorial etiology that involves interactions between the host, diet, microorganisms, and time.
The development of this disease is an episodic and clinical process, since there is a balance between the process of demineralization and dental remineralization. So tooth decay occurs when there is an imbalance and the demineralization phase is favored. Tooth destruction is due to the pathogenic action of acidic products derived from bacteria that form dental plaque.
There are different types of cavities depending on their location. According to Black’s classification, they are distinguished into 5 classes:
- Class I: it is located on the occlusal surface of the tooth, where it is chewed.
- Class II: it is located in the interproximal area of the posterior teeth (molars and premolars). It includes the occlusal surface and the proximal surface, the surface between the teeth.
- Class III: it is located in the interproximal area of the anterior sector (the canines and incisors) without affecting the incisal edge, where it is cut.
- Class IV: this type is located in the interproximal area of the anterior teeth and in this class there is involvement of the incisal edge.
- Class V: it is located on the cervical surface of the teeth, in the neck of the tooth.
The cavities of pits and fissures, or occlusal caries, is the caries that forms on the occlusal surfaces of the posterior teeth (premolars and molars), the chewing area of the molars. Also included as pit and fissure caries are caries produced in the buccal fossa of the lower molars and caries in the palatal fossa of the upper molars. In addition, caries found at the cingles of the incisors and canines are also considered within this type of caries.
By radiological techniques, early occlusal caries cannot be easily identified. This is due to the amount of radiopaque tissue existing around the cusps in this anatomical area.
Moderate occlusal caries is the first to produce specific radiological changes, allowing its presence to be confirmed. Radiologically, it is seen as a thin, irregular, broad-based radiolucent area in the dentin with little or no change in the enamel.
Moderate occlusal caries extends along the dentin-amelo boundary (the boundary between enamel and dentin) and is seen as a radiolucent line. Although radiography may provide the first indication of occlusal caries, the clinical examination reveals a greater extent of it.
As the carious process spreads, the radiolucent area extends under the enamel and towards the pulp in a spherical pattern. Severe occlusal injuries are easily seen on radiographic examinations.
Although radiologically no changes are observed in the dental tissues, a meticulous clinical examination, using the probe or other diagnostic techniques, may reveal the presence of dental caries. For this reason, performing an intraoral clinical examination is of great importance.
