Caries Risk Assessment: methods available to clinicians for caries detection 6/4/10

Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Caries Risk Assessment: methods available to clinicians for caries detection
Author(s): Tranaeus, Sofia. Xie Qi Shi, et al.
Journal: Community Dentistry and Oral Epidemiology
Year. Volume (number). Page #’s: 2005. 33. 265-273
Major topic: Detecting Caries
Overview of method of research: Review
Findings: Management of dental caries has three basic components, prevention, control and treatment. These are all based on proper diagnosis of the initial lesion. The diagnosis of caries is usually synonymous with the signs of tissue damage. 1st molars are usually the first sites of decay in the permanent dentition.
Traditional diagnostic methods such as visual inspection have very low sensitivity and high specificity. Detection with an explorer also has low sensitivity. A number of reports have demonstrated that using a sharp explorer may actually cause a cavitation.
Fiber optic trans-illumination FOTI has been used since the 70’s. Basically the surface of the tooth is examined with transmitted light, and areas of decay appear dark.
Bitewings are acceptable for interproximal decay, but not so much for occlusal decay.

New Methods
Qualitative light induced Fluorescence (QLF) yellow orange light
Demineralized areas appear as dark spots. A sensitive, reproducible method, but depth of lesion detection is limited.

DIAGNOdent (DD) near infrared
In the presence of caries fluorescence increase. Good to excellent sensitivity and reproducibility.

Electrical Impedance
This technique is based on the theory that sound dental tissue shows high electrical resistance. Demineralized enamel, is porous, and filled with saliva, thus making it’s conductance higher. The more demineralized the tissue is, the less resistance there is.

Electric Caries Monitor
Used for occlusal surfaces. Shows promise, but more research is needed.


Key points/Summary: While all of these new technologies are exciting and interesting, there is still not enough evidence for any of the reviewed diagnostic systems to be recommended as a substitute for traditional techniques.

Assessment of Article: While it’s of the utmost importance that we as healthcare professionals stay current on literature and new techniques….this article was painful to read. Wicked bad.