Where do pit and fissure caries initially develop?

Pit and fissure caries initially develop at the walls of the fissure. This is due to the fact that the structural characteristics of pits and fissures create narrow areas where plaque can accumulate, making it challenging for both patients and dental professionals to clean effectively. The bacteria that thrive in this plaque produce acids that lead to demineralization of the enamel, starting typically at the interproximal areas or the walls, rather than at the bottom of the fissure or the occlusal surface. It is at this stage of contact with the tooth structure where the first signs of caries often begin. By identifying that the walls of the fissure are the initial sites for these carious lesions, dental practitioners can focus their preventive measures on these vulnerable areas to reduce the incidence of decay.