ObjectivesThe use of near infrared transillumination for caries detection is gaining recognition in daily practice. Differentiation between cavitated and non cavitated proximal lesions is recognized as a threshold for restorative treatment. This investigation focused on the use of a near infrared absorbent dye which may enhance the detection of cavitation on near infrared transillumination images. Materials and methods1: Natural teeth with artificial proximal cavitation were images with 3 different dyes to establish that near infrared absorbent dye can act like a contrast medium. 2: Natural teeth with natural cavitated lesions were used to investigate the contrast enhancing effect of indocyanine green (ICG) on near infrared transillumination images. 3: Artificial teeth with artificial cavitations were used to determine the best consistency of ICG as a contrast medium. 4: natural teeth with proximal lesions were used to confirm that ICG can differentiate between cavitated and non cavitated proximal lesions. Results1: ICG enhanced the contrast of cavitations compared to other dyes (ANOVA; p < 0.05). 2: ICG enhanced the contrast of the cavitated area on natural lesions but not significantly (t-test; p > 0.05). 3: ICG in a gel form enhanced the detection of cavitated lesions when compared to liquid ICG (t-test; p < 0.05). 4: ICG gel was able to differentiate between cavitated and non cavitated proximal lesions (ANOVA; p < 0.05). ConclusionICG can potentially be used as a contrast medium to enhance the detection of cavitated proximal lesions in vitro on near infrared transillumination images. A clinical study is required to validate these results in vivo.