Advances in Early Diagnosis and Management of Dental Caries: A Clinical Review

Abstract

Dental caries remains one of the most prevalent chronic diseases worldwide, affecting individuals across the lifespan and placing a significant burden on healthcare systems. Contemporary understanding of caries as a dynamic, biofilm-mediated, and behaviorally driven disease has shifted the clinical focus from operative intervention to early diagnosis and minimally invasive management. Over the past two decades, major advances have been made in standardized visual criteria, optical and radiographic adjunctive technologies, and risk-based management strategies, alongside novel therapeutic agents and artificial intelligence–driven diagnostic tools. This
clinical review synthesizes current evidence on early diagnosis of dental caries and translates technological and therapeutic advances into practical recommendations for daily practice.

The review discusses epidemiology and pathophysiology, outlines conventional and advanced diagnostic methods, and examines non-operative, microinvasive, and minimally invasive management of early lesions. Special attention is given to standardized systems such as ICDAS/ICCMS, optical methods including quantitative light-induced fluorescence (QLF) and nearinfrared transillumination (NIRT), resin infiltration, silver diamine fluoride, and artificial intelligence (AI)–based systems for radiographic interpretation. The paper concludes with an integrated clinical decision-making framework for early caries detection and management and highlights future directions in personalized, data-driven caries care.