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Caries - Classification

 The ADA CCS scores each surface of the dentition based on the following: tooth surface, presence or absence of a caries lesion, anatomic site of origin, severity of the change, and estimation of lesion activity. Clinical application of the ADA CCS relies upon examinations conducted on a clean tooth with compressed air, adequate lighting, and the use of a rounded explorer or ball-end probe.

In this classification the shape and depth of the caries lesion scored on a four point scale.

E1 Enamel First component of enamel ½ outer to be involved in carious process
E2 enamel ½ inner to be involved in carious process is the interprismatic substance.
D1. Clinically detectable enamel lesions with intact (non cavitated ) surfaces.
D2. Clinically detectable cavities limited to enamel.
D3. Clinically detectable cavities in dentin.
D4. Lesions extending into the pulp.


A, Proximal and occlusal demineralization penetrating through tooth enamel and into the dentin.
B, Proximal and occlusal tissue demineralization and cavitation nearing the pulp chamber of two vital teeth.
C, Severe demineralization and cavitation reaching the pulp chamber resulting in two nonvital pulps and periapical inflammatory disease

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