Int. J. Environ. Res. Public Health 2009, 6, 2500-2509; doi:10.3390/ijerph6092500 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdpi.com/journal/ijerph Article Development, Methodology and Potential of the New Universal Visual Scoring System (UniViSS) for Caries Detection and Diagnosis Jan Kühnisch 1,*, Inka Goddon 2, Susanne Berger 2, Helga Senkel 2, Katharina Bücher 1, Thomas Oehme 3, Reinhard Hickel 1 and Roswitha Heinrich-Weltzien 4 1 Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-University of Munich, Munich, 80336, Germany; E-Mails: kbuecher@dent.med.uni-muenchen.de (K.B.); hickel@dent.med.uni-muenchen.de (R.H.) 2 Health Department of the Ennepe-Ruhr-District, Schwelm, 58332, Germany; E-Mails: I.Goddon@en-kreis.de (I.G.); S.Berger@en-kreis.de (S.B.); H.Senkel@en-kreis.de (H.S.) 3 Dental practice, Lichtenstein, 09350, Germany; E-Mail: t.oehme@web.de 4 Department of Preventive Dentistry, University of Jena, 07743, Germany; E-Mail: Roswitha.Heinrich-Weltzien@med.uni-jena.de * Author to whom correspondence should be addressed; E-Mail: jkuehn@dent.med.uni-muenchen.de; Tel.: +49 89 5160 9343; Fax: +49 89 5160 9349. Received: 12 August 2009 / Accepted: 22 September 2009 / Published: 23 September 2009 Abstract: Given the limitations of adjunct caries detection and diagnostic tools, e.g., imperfect validity and reproducibility, as well as the difficulties in controlling all possible confounding factors, the need for an objective visual caries detection and diagnosis system has become evident. Our work has therefore aimed at systematizing caries lesions with the Universal Visual Scoring System (UniViSS) for occlusal and smooth surface lesions, which can be used for primary and permanent teeth, as well as under clinical, epidemiological, public health and laboratory conditions. Besides the description of the development and methodology of UniViSS, it is shown that UniViSS allows an accurate and reproducible classification of caries lesions on occlusal surfaces. Keywords: dental caries; caries detection and diagnosis; visual examination; epidemiology