Restorative & Materials · single question
Visual evaluation for caries — which of the following findings is most indicative of caries?
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Correct answer: A. Dark staining fissures
Modern caries detection guidelines (ICDAS system) rely on VISUAL examination with good lighting, drying, and magnification. Dark staining in fissures indicates caries activity or arrested caries. Using an explorer to 'catch' in fissures is no longer recommended (can damage demineralized but remineralizable enamel, and explorer catch is not specific for caries). Dark staining in fissures is a reliable visual indicator of dentin caries involvement.
- A. CORRECT. Dark staining fissures are a reliable visual indicator of caries. Dark coloration in a pit or fissure indicates cariogenic bacteria producing dark pigments, and lesions with darkness extending beyond the fissure often indicate dentin caries. This is the primary visual criterion in ICDAS scoring.
- B. INCORRECT. Transillumination (FOTI — fiber optic trans-illumination) is a useful ADJUNCT caries detection method but is a tool/technique, not a visual finding.
- C. INCORRECT. Using an explorer to detect 'catch' in fissures is a OUTDATED and now discouraged technique. Explorer pressure can damage remineralizable early enamel lesions and the 'stick' finding is not specific for caries.
- D. INCORRECT. Deep fissures alone indicate anatomical risk for caries but are not diagnostic of caries — a deep fissure can be caries-free.
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