Dental caries is tooth decay caused by the loss of mineral from tooth structure. Early detection can help clinicians identify possible caries before more tooth structure is affected, supporting timely assessment, patient communication, and preventive care.
Dental caries can be difficult to identify in its early stages, especially when changes are subtle or located in areas that are harder to assess visually. Clinicians traditionally use visual examinations, tactile assessment, and radiographs to support caries detection and diagnosis.
Digital workflows add another way to review suspected surface caries findings. By combining intraoral scan data with Dx software, clinicians can visualize findings on the scan and use this information as part of the overall clinical assessment.
For caries detection, an intraoral scan captures the visible tooth surfaces and creates a 3D record that clinicians can review on screen. This includes occlusal, buccal, and lingual surfaces, together with visible changes that may require further clinical review.
This article focuses on surface caries detection. Proximal caries follows a different visualization workflow and should be interpreted according to the software's current capabilities.
To understand the scanning process, see how intraoral scanners work.
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A scan used for caries detection follows the standard recommended scanning protocol for the intraoral scanner and Dx software.
Scan time can vary depending on the operator’s experience, the clinical situation, and the quality of data needed for software-based review. No additional scanning steps are required beyond following the manufacturer’s recommended scanning protocol.
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AI-assistive caries detection combines intraoral scan data with software-based analysis. In Dx software, clinicians can review suspected surface caries findings directly on the scan before deciding how they should be interpreted as part of the overall clinical assessment.
The workflow moves from scan capture to visualization, clinician review, and patient communication. The following steps explain what the clinician sees and how findings are reviewed in the software.
Le processus commence par la prise d'une empreinte numérique des dents et des tissus mous environnants. Pour l'évaluation de la récession gingivale, le scan recueille des informations relatives à la position de la marge gingivale, à la profondeur de la récession et aux contours des tissus.
Ce dossier numérique fournit les informations qui seront utilisées lors des étapes suivantes de visualisation et d'analyse assistée par logiciel.
Le processus commence par la prise d'une empreinte numérique des dents et des tissus mous environnants. Pour l'évaluation de la récession gingivale, le scan recueille des informations relatives à la position de la marge gingivale, à la profondeur de la récession et aux contours des tissus.
Ce dossier numérique fournit les informations qui seront utilisées lors des étapes suivantes de visualisation et d'analyse assistée par logiciel.
Le processus commence par la prise d'une empreinte numérique des dents et des tissus mous environnants. Pour l'évaluation de la récession gingivale, le scan recueille des informations relatives à la position de la marge gingivale, à la profondeur de la récession et aux contours des tissus.
Ce dossier numérique fournit les informations qui seront utilisées lors des étapes suivantes de visualisation et d'analyse assistée par logiciel.
Le processus commence par la prise d'une empreinte numérique des dents et des tissus mous environnants. Pour l'évaluation de la récession gingivale, le scan recueille des informations relatives à la position de la marge gingivale, à la profondeur de la récession et aux contours des tissus.
Ce dossier numérique fournit les informations qui seront utilisées lors des étapes suivantes de visualisation et d'analyse assistée par logiciel.
Le processus commence par la prise d'une empreinte numérique des dents et des tissus mous environnants. Pour l'évaluation de la récession gingivale, le scan recueille des informations relatives à la position de la marge gingivale, à la profondeur de la récession et aux contours des tissus.
Ce dossier numérique fournit les informations qui seront utilisées lors des étapes suivantes de visualisation et d'analyse assistée par logiciel.
AI-assistive caries detection follows a workflow from scan capture and visualization to clinician review and patient communication. findings are displayed on the scan for review, allowing clinicians to inspect findings, assess them alongside the clinical examination, and communicate them more clearly with patients.
For a demonstration of how surface caries findings are generated and reviewed within the software, watch the How to detect surface caries with Dx Plus video.
The International Caries Detection and Assessment System (ICDAS) provides the clinical framework used by Dx Plus for surface caries analysis. Instead of displaying numerical ICDAS classifications, Dx Plus presents findings through color-coded visualizations to support chairside review. 1
The following sections explain how ICDAS classifies caries lesions and how these findings are presented in Dx Plus.
ICDAS uses a scale from 0 to 6 to classify the severity of dental caries, ranging from sound tooth surfaces to extensive cavitated lesions. Lower scores represent early enamel changes, while higher scores represent progressively more advanced lesions involving increasing loss of tooth structure.
Dx Plus uses ICDAS as the basis for its surface caries analysis but presents findings through color-coded visualizations rather than numerical ICDAS scores.
ICDAS can also be used to assess whether a lesion is active or inactive. Dx Plus does not assess lesion activity, so active and inactive lesions may be highlighted in the same way and should always be interpreted as part of the clinician's overall clinical assessment. 1
Dx Plus presents surface caries findings using color-coded visualizations rather than numerical ICDAS scores. This allows clinicians to review findings chairside without interpreting individual ICDAS classifications.
Yellow highlights enamel caries, corresponding to ICDAS 1–3. Red highlights additional suspected surface caries findings for clinician review. The clinician can inspect each highlighted area on the scan and interpret the findings as part of the overall clinical assessment. 1
In Dx Plus, clinicians can review each highlighted area directly on the scan by rotating and zooming the model to inspect the underlying tooth surface. Selecting a finding displays additional information, including the AI confidence score, allowing the clinician to assess the finding before deciding whether it should be retained, modified, or removed.
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ICDAS classifies dental caries on a scale from 0 to 6, from sound tooth surfaces to extensive cavitated lesions. In Dx Plus, clinicians review these findings through color-coded visualizations rather than numerical ICDAS scores. 1
Caries classifications help clinicians assess the severity of a finding and support decisions about prevention, monitoring, or restorative treatment.
In Dx Plus, the software visualizes findings for clinician review. Treatment decisions are made by the clinician based on the clinical examination, patient history, radiographs where relevant, and other clinical information.
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Dental caries detection can involve several methods, including visual-tactile examination, radiography, laser fluorescence, caries detection dye, intraoral scanners and scan-based digital assessment. Each method gives the clinician different information and has its own strengths and limitations.
Digital caries detection with an intraoral scan and Dx software adds another way to visualize surface caries findings alongside these established methods. The following sections compare how each approach contributes to the clinical assessment.
Visual-tactile examination is a standard part of caries detection. The clinician examines the tooth surfaces directly and uses visual and tactile findings as part of the assessment.
Early caries can be difficult to identify when changes are subtle or located in areas that are harder to assess. Digital visualization can provide an additional view of findings, complementing the clinical examination.
Radiographs can help clinicians assess caries that may not be visible during a visual-tactile examination, particularly when lesions are located between teeth or extend into dentin.
However, early enamel changes may be more difficult to detect radiographically. Digital scan-based visualization could provide an additional view of surface caries that could be evaluated alongside radiographic findings, the clinical examination and other relevant clinical information, depending on the clinical situation.
Laser fluorescence devices use light to help identify changes in tooth structure that may indicate caries. The device measures fluorescence from the tooth surface and provides a numerical fluorescence value to support assessment. It can support caries detection, particularly on occlusal surfaces and in fissures, but results should be interpreted alongside the clinical examination and other relevant clinical information. 2
An intraoral scan gives clinicians a 3D view of the tooth surfaces that can be reviewed on screen. When combined with software-based analysis in Dx Plus, surface caries findings can be visualized directly on the scan.
Dx Plus presents findings with color-coded visualizations, AI confidence scores, and tools for clinician review. Findings can be reviewed, adjusted, documented, and shared with patients, providing an additional layer of information alongside established caries detection methods.
Treatment decisions remain the responsibility of the clinician.
One systematic review found that on-screen assessment of 3D models demonstrated diagnostic performance comparable to clinical visual inspection for detecting and classifying occlusal caries lesions on permanent teeth. 3
No single detection method is appropriate for every clinical situation. Visual-tactile examination, radiography, laser fluorescence, caries detection dye, and scan-based digital assessment each provide different information and should be interpreted as part of the overall clinical assessment.
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Dental caries is diagnosed through a review that may include visual-tactile examination, radiographs where relevant, patient history, caries risk factors, and other clinical information.
Digital tools such as Dx Plus can support this process by helping clinicians visualize and document findings. They do not replace the clinician's diagnosis.
No. AI-assistive software is designed to support not replace the clinical assessment.
In Dx Plus, findings are highlighted on the scan for clinician review. These findings should be interpreted alongside the clinical examination and other relevant clinical information before any treatment decisions are made.
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Earlier identification of possible caries findings can support preventive care, clinical follow-up, and patient conversations before more tooth structure is affected. Digital workflows provide an additional way to visualize and document surface caries findings, helping clinicians monitor changes over time and communicate them more clearly with patients.
Earlier visualization of findings can help clinicians identify areas that may benefit from closer review, preventive care, or monitoring over time.
Dx Plus supports this process by visualizing surface caries findings. Treatment decisions remain the responsibility of the clinician, who interprets the findings alongside the clinical examination and other relevant clinical information.
Digital visualization can help make suspected surface caries findings easier to review and discuss with patients. Showing findings directly on the scan can help patients understand what the clinician is seeing and why further assessment, monitoring, or preventive care may be recommended.
This can support clearer treatment conversations and shared decision-making.
Digital workflows bring scanning, visualization, documentation, and patient communication together in the same software environment. Findings can be reviewed chairside, shared through the DentalHealth app, or included in a PDF report, reducing the need to switch between multiple tools.