[Diagnosis of primary caries. Current techniques and their consequences for treatment]

The decline in caries prevalence in The Netherlands has incited dentists to focus their attention to the detection of small carious lesions rather than large cavities. The diagnosis of primary caries is, however, still predominantly being accomplished by the traditional diagnostic methods, used in the high caries prevalence era. Today's appearance and behaviour of caries lesions have led to the situation that incipient enamel lesions, dentinal caries and cavities are frequently missed during routine recall examinations. There is increasing concern with the occurrence of large caries lesions underneath visually intact enamel. These problems have induced diagnostic research aimed at developing and evaluating new caries diagnostic methods and some of them are already used in general practice. Visual inspection and bitewing radiography, however, still constitute the most important methods in the diagnosis of primary caries. The results from these examinations are used to classify an individual's caries risk, to monitor the progression of existing caries lesions, and to aid preventive or restorative treatment decision making.