The improvement in the detection of caries offers the possibility for dramatic improvement in dental healthcare. Current caries detection rates suggest that there may be scope for improvement. This paper describes a preliminary study to examine applications of terahertz pulse imaging (TPI) to caries detection. We present results for the detection of early stage caries in the occlusal enamel layer of a range of human tooth cross sections using TPI. Higher attenuation of terahertz radiation was observed in carious enamel as compared with healthy enamel. Hypomineralised enamel had different absorption spectra and contrast compared to carious enamel in TPI images. These results have important implications for extending TPI to other medical imaging applications where both early diagnosis and safety issues are important. Copyright (C) 2003 S. Karger AG, Basel.