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Lesion classification

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Carious lesion classification

A treatment-based classification of carious lesions is provided below. This includes the terminology used in this guidance and descriptions of carious lesions in primary and permanent teeth. See Caries management in primary teeth and Caries management in permanent teeth for details of the management of each type of lesion.

Carious lesion classification in primary teeth

Classification Description Illustration
Occlusal - initial  Noncavitated, dentine shadow or minimal enamel cavitation
Radiograph: outer third dentine 		 Cartoon of a primary tooth with an initial occlusal lesion
Occlusal - advanced Dentine shadow or cavitation with visible dentine
Radiograph: middle or inner third dentine 		 Cartoon of a primary tooth with an advanced occlusal lesion
Proximal - initial White spot lesions or shadow
Radiograph: lesion confined to enamel 		 Cartoon of a primary tooth with an inital proximal lesion
Proximal - advanced Enamel cavitation and dentine shadow or cavity with visible dentine
Radiograph: may extend into inner third dentine		 Cartoon of a primary tooth with an advanced proximal lesion
Anterior - initial White spot lesions but no dentinal caries   
Anterior - advanced Cavitation or dentine shadow  
Pulpal involvement Any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically  
Near to exfoliation Clinically mobile
Radiograph: root resorption		  
Arrested caries Any tooth with arrested caries and where aesthetics is not a priority  
Unrestorable Crown destroyed by caries or fractured, or pulp exposed with pulp polyp (pain/infection free)  

 

Carious lesion classification in permanent teeth

Classification Description Illustration
Occlusal - initial Noncavitated enamel carious lesions: white spot lesions; discoloured or stained fissures
Radiograph: up to the enamel-dentine junction or not visible		 Cartoon of a permanent tooth with an initial occlusal lesion
Occlusal - moderate Enamel cavitation and dentine shadow or cavity with visible dentine
Radiograph: up to and including middle third dentine		 Cartoon of a permanent tooth with a moderate occlusal lesion
Occlusal - extensive Cavitation with visible dentine or widespread dentine shadow
Radiograph: inner third dentine		 Cartoon of a permanent tooth with an advanced occlusal lesion
Proximal - initial White spot lesions or dentine shadow. Enamel intact
Radiograph: outer third dentine		 Cartoon of a permanent tooth with an initial proximal lesion
Proximal - moderate Enamel cavitation or dentine shadow
Radiograph: outer or middle third dentine		 Cartoon of a permanent tooth with a moderate proximal lesion
Proximal - extensive Cavitation with visible dentine or widespread dentine shadow
Radiograph: inner third dentine		 Cartoon of a permanent tooth with an advanced proximal lesion

Anterior - initial

 White spot lesions but no dentinal caries  
Anterior - advanced Cavitation or dentine shadow  
Pulpal involvement Any tooth with clinical pulpal exposure or no clear separation between carious lesion and dental pulp radiographically  
Unrestorable Crown destroyed by caries or fractured, or pulp exposed with pulp polyp (pain/infection free)