**4. Treatment**

The present Chapter focuses on techniques applicable to the diagnosis of hidden dentin caries. However, as a complement to the measures recommended in the above intervention protocol, we will outline the therapeutic approach applicable to each diagnosis.

#### **4.1 Fissure aperture**

Fissure aperture applies when we believe but cannot fully confirm that dentin caries exists. A fissurotomy drill is used to open the fissure, crack or pit until reaching the dentin. A finetipped probe is then used to check dentin hardness, and if there are no carious lesions, crack sealant is applied. In contrast, if caries is identified, the lesion is eliminated, followed by filling with composite resin or silver amalgam.

#### **4.2 Enamel monitorization**

In this case the doubt is whether enamel caries exists or not. Bacterial plaque control is indicated in these situations, based on oral and dental hygiene measures and topical fluor application. If the suspicion of caries results from high LF readings with normal VI findings, monitorization fundamentally should be carried out with LF. The detection of positive VI signs or increased LF readings during follow-up, potentially indicative of lesion progression, requires fissure aperture.

If caries is suspected on the basis of the VI findings, with normal LF results, the subsequent controls should be centered on VI. The detection of an increase in positive VI signs or increased LF readings during follow-up, potentially indicative of dentin involvement, requires fissure aperture.
