The term enamel caries here is used as a definition of a visible disintegration of enamel surface. A noncavitated lesion is also one of the forms of enamel caries but, due to relevant clinical differences and management of noncavitated and cavitated stages of carious defects these two forms of caries are discussed separately.

Breakdown of enamel surface occurs due to progressing mineral loss

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Created by mechanical injuries during mastication or careless probing

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A rapid progression of the tissue destruction may occur

The newly formed cavity will harbor microbial mass and will provide favorable conditions for their metabolic activity. Especially it concerns the occlusal surfaces where development of the lesion in the deepest parts of the groove - fosse system already is protected against physical wear or any other disturbances of microbial life.

A clinical notable superficial surface discontinuity may not always be supported by a histological validation of a modest enamel demineralization. More often it shows involvement of deeper parts of hard dental tissue, including dentin.

TYPICAL LOCATION

• Approximal surfaces involves an interdental facet area toword the gingival margin, possible extentions buccally and lingually.
• Occlusal surfaces natural pitts and fissures are the most vulnerable () sites. The process starts in the deepest parts of the groove fossa system, depending on tooth specific anatomy
• Smooth surfaces along the gingival margin

PATIENT COMPLAINS

• Short  pain as reaction to sweets or thermal agents
• Aesthetical discomfort especially in anterior teeth

CLINICAL APPEARANCE

1. ACTIVE LESION

·        Whitish, Opaque, Chalky

·        On smooth surfaces shalow defect close to gingival margin

·        Coverd by plaque

·        In fissurses local enamel defect

2. INACTIVE LESION 

·        Whitish, Yellowish, brownish

·        Glossy and shiny

·        On smooth surfaces with small distance from gingival margin

·        Clean from plaque

·        On occlusal surfaces localized enamel defect

DIAGNOSIS

·        Gentle probing

o       Active lesion feels rough

o       Inactive feels smooth and hard

·        Radiograph detection conical shape in enamel, EDJ and outer dentin involve too.

·        FOTI for approximal surfaces a shadow in the area of a carious demineralization

·        Electrometrical test show normal tooth vitality.

DIFFERENTIAL DIAGNOSIS enamel hypoplasia, dental fluorosis, usura cervicalis, dental erosion.