Detecting and managing caries is essential for tooth health and prevention. Caries is a complex, dynamic process involving tooth demineralisation, neutralisation and remineralisation. An imbalance in this continuum results in caries lesions. Visual examination is essential for early detection of caries. Intraoral radiographs have limited sensitivity for early caries lesions. New, sensitive technologies are becoming available for early detection.
The newer technologies are able to detect demineralisation, a critical early symptom of dental caries. By incorporating new technologies, dental practitioners can improve their diagnostic outcomes. A recent study compared cavity classification systems and found that ICDAS was the most accurate. However, visual examination is still the main basis of early caries detection. Fluorescence-based techniques may be used as a second opinion.
Non-ionizing methods such as optical coherence tomography (OCT) are another method. They measure the fluorescence of dentin and enamel, and can detect caries at an early stage. This optical change is due to increased pore volume in demineralised enamel. Laser fluorescence is another tool used for early caries detection. A laser fluorescence device emits a 655 nm monochromatic light to detect back-scattered fluorescence from the tooth. Fluorophores emitted at this wavelength are bacterial porphyrins.
The process of tooth demineralization has been better understood over the last decade. The process is affected by factors such as microbiology, saliva, and tooth ultrastructure. In addition, the process can be reversed through remineralisation, a process wherein the lost mineral is replaced by a new mineral. This remineralization process is crucial to the health of the teeth.
The modern definition of dental caries includes a continuum of tooth demineralization. The disease process is cyclical and continues as long as there are cariogenic bacteria present. The process is characterized by a balance between protective and pathological factors. The Miller 1890 process describes the cyclical process, with acid production occurring inside the tooth’s surface. This process continues despite an imbalance in the pH balance.
The spectroradiographic analysis of QLF-based imaging is a useful diagnostic aid for early demineralisation. It uses the principle of autofluorescence in enamel to detect changes in its fluorescence. Blue light is used to excite the dentine in the teeth, causing it to fluoresce, causing a yellow-green region to appear. Increasing light scattering in the tooth’s surface causes dark spots to appear on a bright green background. The resulting image can then be compared to that of healthy tissue.
Detecting dental caries is crucial in the treatment of the disease. Early detection of dental caries can help prevent serious dental problems. By detecting white spot lesions as early as possible, dentists can prevent cavities and restore dental health. The disease process can be complicated, but it’s important to keep an eye on it at all times. A white spot lesion is the earliest sign of dental caries. The affected area may cavitate into a cavity and may be remineralised if the demineralization environment is reduced.
The reduction in scattering coefficient provides important information about tooth health that cannot be obtained through visible imaging alone. The reduced scattering coefficient allows for detailed analysis of carious and healthy areas, enabling dentists to accurately detect a cavity and treat it early. A decrease in the scattering coefficient is a clear indicator of a cavity. A reduction in the scattering coefficient reveals the presence of demineralization, allowing dentists to detect it in its early stages.
