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Key Points
- A thorough oral examination includes an evaluation of the patient’s medical history, general health status, dental history, soft and hard tissues, orthodontic status, temporomandibular joint, periodontal health, and prostheses, as well as a caries assessment.
- 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.
- Accurately diagnosing dental caries requires a skilled diagnostician, dental and medical histories, clean teeth, dry teeth, good lighting, and X-rays.
- X-rays should be used to confirm lesions that have been discovered during the examination; they should not be the primary tool for diagnosing interproximal caries.
- Issues important for thorough caries diagnosis, documentation, and treatment include, size, quality, and location of lesions; location and quality of stained fissures; activity of non-cavitated and cavitated lesions; depth of lesions; rate of progression of lesions; recurrent caries; defective restorations; and previous extractions.
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