Classification of Dental Caries II.

Based on Rapidity of the Caries

Cariology - Acute dental caries
Dr. Hellen Halare

Classification of Dental Caries

1. Based on location
2. Based on progression
3. Based on extent of caries
- Chronic dental caries
4. Based on virginity of lesion
5. Based on number of tooth surface involved
6. Based on age of patient
7. Based on the treatment and restorative design (GV
Black)
8. Bite Wing Radiograph Classification (Grandchi,
- Arrested dental caries
modified from Moller and Paulsen)
9. Bases on Clinical Scoring of Proximal Lesion at the
base of Approximal Box (by Billie and Thystrup)
10. According to the World Health Organization (WHO
System)
11. Based on Visual Examination and Radiographs III. Based on Extent of Caries
(Epelid et al and Tveit, et al) - Incipient/ reversible
12. Sturdevant Classification
13. According to Dental Clinics of North America
14. Classification by GJ Mount
15. DR. Skriae™’s Classification
16. ADA Caries Classification System
17. Classification of Root Caries by Billings
18. Classification of Root CAries by Nyvad and - Cavitated/ Non-reversible
Fejerskav

I. Based on Location
- Pits and fissures

IV. Based on Virginity of the Lesion

- Primary caries
- Smooth surface caries

- Secondary/ recurrent caries

- Root surface caries (senile caries)

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 V. Based on Number of Surfaces Involved
- Simple caries ( 1 surface)

B. Class II
- Proximal surfaces (mesial/distal of molars
and premolars)

- Compound caries ( 2 surfaces)

C. Class III
- Proximal surfaces of canines, and incisors
not involving the incisal angles.

- Complex caries ( More than 2 surfaces)

D. Class IV
- Proximal surfaces of incisors or canines
involving both incisal angles

VI. Based on the Age of the Patient

- Nursing bottle caries (early infancy, usually
on maxillary incisors)

E. Class V
- Located in the gingival third of the labial,
buccal, palatal, and lingual surfaces of any
tooth
- Adolescent caries (common in teens due
to dietary factors)

- Root caries (old patients; cemental caries)

F. Class VI
- On incisal edges and cuspal tips of
molars and premolars, axial angles of
teeth or any highly cleansable areas.

VII. Based on Treatment and Restorative Design (GV

Black)
A. Class I
- Occlusals of molars and premolars
- Lingual surfaces of maxillary incisors
- Occasionally labial middle 3rd
- Facial and lingual surfaces of molars

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VIII. Bite Wing Radiograph Classification X.
( Grondahl, modified from Moller and Poulsen)
0- Sound on the bitewing
1- Radiolucency confined to enamel
2- Radiolucency in enamel up to DEJ
3- Radiolucency in enamel and outer half of dentin
4- Radiolucency in enamel and reaching the inner
half of the dentin
XI.
IX. Based on Clinical Scoring of the Proximal Lesion
at the Base of Approximal Box
➔ Scores 1 and 2 - Progressive changes in the enamel.
➔ Score 3 - Changes in dentin, without cavitation in
the enamel.
➔ Scores 4 and 5 - Changes in dentin and
progressive- cavitation in the enamel
➔ Score 6 - Cavitation involving dentin (indication for
operative intervention)
According to WHO System
The shape and the depth of the caries can be
scored on a four point scale
● D1 - clinically detectable enamel lesions with
intact (non-cavitated surfaces)
● D2- clinically detectable cavities limited to the
enamel
● D3- clinically detectable lesions in dentin (with
and without cavitation of dentin)
● D4- lesions into pulp
Based on visual examination and radiographs
(Epelid, et al and Tveit, et al)
● Grade 1 - Non-cavitated white spot or slightly
discolored carious lesion in enamel (no lesion
detectable in the radiograph)
● Grade 2 - some superficial cavitation on the
entrance of the tissues, some non-cavitated
mineral loss in the surfaces of the enamel
surrounding the fissures and/or a carious lesion
in enamel (detectable in the radiograph)
● Grade 3 - moderate mineral loss with limited
cavitation in the entrance of the fissure and/or a
carious lesion in enamel (detectable on
radiograph)
● Grade 4 - considerable mineral loss with
cavitation and/or lesion extended into middle
third of dentin (detectable on radiograph)
● Grade 5 - advanced cavitation and/or a lesion
extended into the inner third of the dentin
(detectable on the radiograph)
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XII. Sturdevant Classification ● Size 3 - enlarged with weakened cusps or
Divided dental caries mainly in three categories: incisal edges (need protection from occlusal
A. Location load)
● Primary caries ● Size 4 - extensive loss of tooth structure
- Of pit and fissure origin
- Of smooth surface origin XV. Dr. Sikriae Classification
● Backward caries Class I
● Forward caries ● Div 1 - pits and fissures of occlusal surfaces
● Residual caries ● Div 2 - buccal and lingual pits of post & anterior
● Root surface caries teeth
● Secondary (recurrent) caries Class II
B. Extent ● Div 1 - one prox surface of posterior teeth
● Incipient caries (reversible) ● Div 2 - both proximal surfaces of posterior teeth
● Cavitated (irreversible) Class III
C. Rate ● Div 1 - one proximal surface of anterior teeth
● Acute (rampant) caries ● Div 2 - both proximal surfaces of anterior teeth
● Chronic (slow or arrested) Class IV
● Div 1 - cervical ⅓ of labial & lingual surfaces of
XIII. According to Dental Clinics of North America all teeth
A. According to tooth type ● Div 2 - labial & lingual line angles of all teeth
● Deciduous (A-T) Class V
● Permanent (1-32) ● Div 1 - cavities on labial surfaces of anterior
B. According to anatomic site teeth other than cervical ⅓
● Pit and fissure ● Div 2 - cavities on lingual surfaces of anterior
● Smooth surface - interproximal, cervical teeth other than pits and cervical ⅓
● Root surface Class VI
C. According to hard tissue affected ● Div 1 - cavities on incisal tips
● Enamel ● Div 2 - cavities on occlusal cusp tips
● Dentin
● cementum
D. Others
● Primary, secondary
● Nursing caries
● Radiation caries
● Rampant caries
XVI. ADA Classification System
XIV. Classification of GJ Mount Categorized based on extent of lesion and characterized the
Caries lesions occur in three main sites and are of site of origin:
four different sizes: ➢ Initial - visibly non-cavitated or micro-cavitated
● Site 1 - pits and fissures, enamel defects on lesion limited to enamel
occlusal surfaces of posterior teeth or other ➢ Moderate - breakdown of enamel with
smooth surfaces non-cavitated carious dentin or loss of root
● Site 2 - approximal enamel in relation to areas cementum with non-cavitated carious dentin
in contact with adjacent teeth ➢ Severe - are lesions extending into dentin
● Site 3 - cervical one-third of the crown or ➢ Pits & fissure - on anatomical pits & fissures of all
following gingival recession, the exposed root teeth
Categorized based on extent of lesion and characterized the
Each size is further categorized according to the site of origin:
size: ➢ Proximal - at immediate proximity to the contact
● Size 0 - small and early enough to be area of adjacent tooth surface (may be any
remineralized lesion with only residual stain tooth)
● Size 1 - minimal dentinal spread, can be ➢ Cervical - at cervical area or any other smooth
remineralized surface of the anatomical crown (may exist
● Size 2 - moderated involvement of dentin anywhere around the full circumference of teeth)
➢ Root surface - caries of the root surface (apical to
the anatomical crown)

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XVII. Classification of Root Caries by Billings XVIII. Classification of Root caries by Nyval and
Grade I (incipient) Fejerskov
● Surface texture: soft, can be penetrated with dental 1. Active or inactive
explorer 2. With or without cavitation
● Surface defect: none 3. According to texture ( soft, leathery. hard)
● pigmentation : variable; light tan to brown and color (yellow, light brown, dark
Grade II (shallow) brown-black)
● Surface texture: soft, irregular, rough, can be
penetrated with dental explorer
● Surface defect: <0.5 mm in depth
● Pigmentation: variable; tan to dark brown
Grade III (cavitation)
● Surface texture: soft, can be penetrated with dental
explorer
● Surface defect: cavitation present, >0.5 mm in
depth, no pulpal involvement
● Pigmentation: variable; brown to dark brown
Grade VI (pulpal)
● Surface texture: deeply penetrating lesion with
pulpal or root canal involvement
● Pigmentation: variable; brown to dark brown

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