[Caries diagnosis: the lesions are central]

In this paper two new visual scoring systems are described, aimed at estimating both depth and activity of occlusal lesions. Their validity is acceptable for lesion depth estimation. However, the validity of the activity estimate is to be questioned. Both for approximal enamel and dentine lesions as for deep dentinal occlusal lesions, bite-wing radiographs are still useful for evaluation of new lesions and lesion progression. Many quantitative caries diagnostic methods are being developed, but to this date none of them has been shown to be reliably applicable in lesion monitoring. The evaluation of caries risk factors is primarily useful for selecting preventive treatment options. Other caries prediction-tests than those based on the present caries lesions are of little value. The main disadvantage of such prediction models is that they are usually limited to application in children, where caries is a disease that affects all ages.