Caries Diagnosis Aided by Fluorescence

Abstract

Because of the limitations of visual inspection and dental radiographs for detecting early or hidden forms of dental caries, much effort has been expended developing addi- tional methods to supplement traditional examination, Foremost amongst these has been fluorescence, which exploits the light emitting properties of bacteria deposits or of normal tooth structure. Key considerations when using fluorescence are the differ- ences between the light emitting properties of carious versus sound tooth structure, the excitation wavelengths of light that are chosen, and the methods used to analyze fluo- rescence emissions. Provided that technical issues such as false positive and negative signals can be addressed, devices that employ fluorescence can improve the detection and management of dental caries, and help guide the removal of carious tooth structure during restorative procedures. Clinical recommendations for using fluorescence as an aid to caries diagnosis are based on appreciating the effects of moisture, stains, and quenching agents on readings, and altering the ambient light conditions to maximize the signal to noise ratio. Any quantitative fluorescence techniques require calibration of the device, and checks for contamination of the optics. Differences in the perfor- mance of fluorescence devices must also be considered when comparing results against thresholds for intervention.