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Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

DOI: 10.1155/2010/270729

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A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. 1. Introduction Dental caries is one of the most prevalent chronic diseases of humans worldwide. When different stages of the disease are taken into account, from the initial to the clinically manifest lesion, very few individuals are truly unaffected. In most industrialised countries 60%–90% of school-aged children are affected. The prevalence among adults is even higher and in most countries the disease affects nearly 100% of the population [1]. During the last thirty years, however, major changes have occurred in the pattern of the disease. Progression of enamel caries is now slower [2], allowing time for preventive intervention before irreversible destruction of tooth substance occurs. During the early stages of the disease the process is reversible and can be arrested: noninvasive intervention can convert a lesion from an active to an inactive state [3, 4]. Appropriate diagnostic techniques are necessary to support such decisions about management of the individual lesion. The clinician needs to be able to monitor the outcome of noninvasive measures and in cases where there is evidence of lesion progression, make a timely decision to intervene, using minimally invasive techniques and restoring damaged tooth structure without weakening the tooth. Applying strategies to control, arrest, or reverse the disease process can reduce the economic burden, pain, and suffering of placing and replacing restorations [5]. This modern, conservative approach to clinical management of dental caries, which has been evolving during the past twenty years, has necessitated a


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