4.1 Oral Examination
Classical use of sharp explorers may produce irreversible traumatic defects in demineralized areas in occlusal fissures, creating conditions for isolated lesion progression and contributing to an increased rate of decay, especially in the fissure area.1,2 Hence, the explorer can defeat the remineralization process or interfere with sealant retention by breaking the outer enamel crystals of an incipient lesion. In addition, inoculation of cariogenic bacteria into an uninfected pit and/or fissure is a concern with explorer use.2 Since explorer use does not improve the validity of the diagnosis of pit-and-fissure caries when compared to a visual inspection alone, and since explorers may cause irreversible damage, it is preferable to use visual criteria over tactile criteria.3 A dental explorer becomes a secondary tool to sweep debris away to make it easier to see the tooth surface and to detect sealants and esthetic restorations. Use of an explorer to detect caries should be restricted. Accurately diagnosing dental caries requires the following:
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The diagnosis of pit-and-fissure caries has traditionally relied on the use of dental explorers. Dentists are taught to apply pressure to a sharp explorer to identify caries in grooves and pits. The “sticky” grooves and pits are deemed carious and in need of restoration.
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