Hidden dental caries: a study of diagnosis and prevalence

Abstract

Hidden caries compromises dentine structure, but presents an apparently sound or slightly demineralized enamel. The etiology of hidden caries is still unknown, although it is believed to be related to the massive use of fluorides, which act in the re-mineralization of occlusal enamel lesions, masking their evolution. This study had the objective of determining the frequency of hidden caries lesions in equivalent groups of patients and odontology academics, seeking to compare the clinical diagnoses with the radiographic diagnoses by verifying the relationship between the presence or absence of lesions in sound surfaces with specific variables used as parameters for clinical diagnosis in an attempt to reveal indicators for this type of lesion. The methodology consisted on analyzing the occlusal faces of 748 permanent posterior teeth using visual and bitewing radiographic methods. All of the clinical information related to soundness or specific variables as indicators for suspected hidden lesions were registered in specific clinical charts. From the analysis, we observed lesions in 42.0% of the evaluated subjects, primarily in the first inferior molars. The clinical parameters used did not determine a precise diagnosis. Therefore, one may conclude that adopting the implementation of bitewing radiographies in clinical practice is an important auxiliary means for diagnosing hidden caries, even in “caries-free” patients.