Caries detection and activity
Combine visual-tactile assessment with appropriate imaging and risk history. An active lesion requires a disease-control decision, not automatically a filling.
Understand
Radiographs add information about proximal or hidden lesions but do not replace a clean, dry visual assessment. Cavitation, depth, activity and patient risk are separate questions.
Assess
Describe the surface, plaque retention, texture and progression; compare previous images where available. Consider whether a lesion can be kept clean and monitored rather than automatically prepared.
Apply
A restoration repairs a defect but does not cure caries susceptibility. Record why operative or non-operative management is chosen and set a review point.
Key distinctions
Bitewings show mineral loss rather than a direct photograph of surface cavitation; radiographic size can underestimate the true extent. Caries activity requires evidence from the surface and time course. A lesion near the pulp raises a second question about pulpal health, so restoration planning must integrate symptoms and sensibility tests.
Think through a case
A radiographic proximal shadow is present but the surface is intact and historical images are stable. A preventive plan and monitored review may be reasonable.
The distinction to remember
Do not treat the radiograph as a direct image of cavitation or active progression; correlate clinically.
Test your recall
What distinguishes caries detection from activity assessment?
Show answer
Detection finds a lesion; activity considers whether it is progressing.