Clinical tissue changes in 1,080 approximal carious lesions at the time of operative treatment were recorded by 263 Danish dentists. The findings were related to type of tooth, age of the patient, and available information from radiographs. Results showed that observed tissue changes in operatively treated approximal surfaces varied considerably ranging from barely visible ‘white spot’ lesions to frank cavitation. This variation occurred irrespective of information available from radiographical examination. The most frequently observed stage of lesion formation was a stage preceding cavitation, whilst true cavitation accounted for less than 10% of the restored surfaces. The findings indicate that the rationale for doing operative treatment should be reconsidered in accordance with present possibilities to arrest caries progression without the use of operative treatment.
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Thylstrup et al. (2009) studied this question.