ASSESSING THE STAGE OF CARIES LESION ACTIVITY ON THE BASIS OF CLINICAL AND MICROBIOLOGICAL EXAMINATION

The dynamic nature of caries lesion progression may require that class ification of caries lesions makes distinctions in activity status. The aim of the present review was to compile and discuss the literature w hich pertains to clinical assessment of caries lesion activity, and to examine whether recent developments in microbiological research may j ustify the use of microbiological methods for evaluation of caries act ivity. Clinical observations suggest that caries lesion progression ca n be arrested at any stage of lesion development, provided that clinic ally plaque-free conditions are obtained. However, there is no univers al level of oral hygiene to be recommended. The diagnoses ''active'' a nd ''inactive/arrested'' caries have been validated by a range of hist ological and chemical methods which have supported a separation into d istinct clinical categories. Simple microbiological methods have so fa r not been useful in differentiating between active and inactive carie s lesions. Very few studies have evaluated the inter- and intra-examin er reliability of caries diagnostic criteria based on assessment of th e activity state of lesions, but recent data indicate that active and inactive caries lesions can be diagnosed with a high degree of reliabi lity. A decision-making tree for dental caries is presented by means o f which it is possible to associate the assessment of caries lesion ac tivity with an appropriate treatment modality. It is concluded that re search into better methods of assessing caries lesion activity clinica lly should be stimulated.