Hidden caries is a term used to describe occlusal dentine caries that is missed on a visual examination, but is large and demineralised enough to be detected by another examination for example, radiographs.
Tooth has irregular upper surface with lot of pit and fissures. Hidden caries are found in pit or fissure lesions that develop through tiny enamel defects, progressing under seemingly intact tooth structure.
Many dental practitioners find hidden caries when they start to intervene operatively into what they suspect is a small carious lesion, revealing instead an extended carious lesion that is well into dentin i.e sensitive layer of tooth.
Diagnosis of hidden caries is usually missed because of complex tooth structure specially upper biting part, caries lesion extension and nature of the lesion, and usually these hidden caries are detected on special radiograph named bitewing radiographs.
The incidence of hidden caries is increasing due to the use of fluoride, which remineralizes the upper carious lesion of enamel, hidding the caries below which leads to slow progression of caries into the dentine
Early and accurate diagnosis of hidden caries enables successful prevention and minimal restorative procedures for the tooth.