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Pediatric Dentistry Restorative Dentistry

Quick Fact: What are pre-eruptive caries?


This is a quick fact presented by Dr. Suham Alexander, Oasis Clinical Editor

Pre-eruptive caries (also referred to as occult or hidden caries) has an unclear etiology as well as pathogenesis. As the tooth is usually encased in its crypt, it is unlikely that it is exposed to any cariogenic bacteria. Some theories hypothesize that the cariogenic process is initiated by internal resorptive processes that are precipitated by pressure exerted by abutting teeth or ectopic positioning of the tooth itself. The carious lesions are most often located at the DEJ in the occlusal surface of the tooth.


The prevalence of occult caries ranges from 2-6% and may affect any of the following teeth, although usually only one tooth is affected.

  • Mandibular 1st permanent molars
  • Mandibular 1st premolars
  • Maxillary 1st permanent molars
  • Maxillary 1st premolars
  • Mandibular 2nd permanent molars


Diagnosis of pre-eruptive caries is predominantly the result of radiographic examination, with bitewing and panoramic films being the most useful adjuncts.


  1. Davidovich E, Kreiner B and Peretz B. Treatment of Severe Pre-eruptive IntracoronalResorption of a Permanent Second Molar. Pediatr Dent 2005, 27(1): 74-77.
  2. Seow WK. Pre-eruptive intracoronalresorption as an entity of occult caries. Pediatr Dent 2000, 22(5):370-376.


Do you have any particular question on this topic? Do you have any comments or suggestions? Email us at oasisdiscussions@cda-adc.ca

You are invited to comment on this post and provide further insights by posting in the comment box which you will find by clicking on “Post a reply” below. You are welcome to remain anonymous and your email address will not be posted. 


  1. Dr. Ian mcConnachie February 25, 2014

    This is an interesting and useful posting on a clinical issue that I see regularly as a pediatric dentist. The lesions are different in appearance from typical caries, often resulting in literally dropping into the lesion on its exposure. Further, the histological nature appears to differ also as measurement of the lesion by the Canary System results in essentially normal numbers compared to those obtained of demineralized and cavitated lesions. It would be useful to obtain a histological analysis of sample lesions and further discussion on the pathogenesis and lesion progression if untreated

    1. Krissy March 15, 2014

      Radiographically, what does this look like?

      1. Ian McConnachie March 18, 2014

        The defect, whether it is within an unerupted tooth or one already erupted, will be of similar appearance as a “normal” cavity with respect to radiodensity. It will be positioned commencing at the DEJ either below the occlusal or proximal surface. More often this will be under the occlusal surface. The enamel will appear intact with no evidence of demineralization. The size of the lesion will vary and can change over time

        1. Krissy March 19, 2014

          Thanks kindly for your response.

          1. Ian McConnachie March 19, 2014

            Any time Krissy. Happy to help

  2. sremac March 5, 2014

    Don’t forget wisdom teeth. I’ve seen 3 cases of this type of caries


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