The surface changes of natural incipient caries in human teeth were examined by scanning electron microscopy. Numerous small round depressions due to dissolved prism ends are observed. The prism sheaths seem to be preferentially demineralized, followed by demineralization of prism cores. Perikymata are well-pronounced. Focal holes and relatively large dissolution areas can be present. A new prismatic pattern of destruction with an appearance of fish scales is found. Evidence of remineralization of the incipient carious lesions is seen on the surfaces of the lesions. This study disagrees with the concept of an intact enamel surface layer.
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