Velscope: Advantages and Disadvantages

What Is a Velscope?

Velscope is an oral assessment device designed for the early detection of intraoral cancerous lesions; it is a non-invasive technique for screening any oral lesion on the intraoral soft tissues. Velscope is a hand-held device that uses natural tissue fluorescence to detect any abnormalities, if present, which can be unnoticed or invisible to the naked eye. This is the only device available worldwide that scans intra-oral soft tissues. The device is user-friendly and is utilized for a noble cause which can prevent cancer in its initial stages and save many lives. Velscope uses blue light with a wavelength of 400 to 460 nanometers; this light penetrates the epithelial and basal layers and reaches the stroma. This characteristic property of the velscope is known as autofluorescence, where the fluorescent light is filtered from the blue light, which makes the velscope efficient in differentiating normal and abnormal tissues.

What Is a Velscope Used For?

Velscope is a soft tissue screening device that is superior and more advanced than conventional screening methods. It can detect or suspect malignancy in its precancerous or cancerous stage. It is also effective in diagnosing conditions like candidiasis. Other uses of velscope include:

• Early detection of oral cancer as it uses blue light fluorescence to visualize the changes in the deeper skin tissues, which are not visible to the naked eye.

• Velscope can detect intra-oral infections: The scanning device can determine the oral cavity's bacterial, viral, or fungal growth.

• Determines the exact line of demarcation between the healthy and cancerous tissue:

• Through its blue light fluorescence, this scan helps determine the exact line, which helps in the complete surgical excision of the cancerous tissue and prevents recurrence in almost every case.

How Does Velscope Work?

Velscope works on the principle of immunofluorescence; it uses blue light, which stimulates the cells in the deeper layers of skin in the oral cavity. These stimulated cells have the potential to emit their own light in the shades of green, yellow, and red. It is possible to visualize different colors as the velscope reduces the intensity of the reflected light and enhances the color contrast between normal and abnormal tissue.

Abnormal florence can be observed under various conditions, which include:

• Hyperactive epithelial tissue.

• A breakdown of the collagen fibers in the connective tissue layer beneath the basement membrane.

• Increased vascularity of the tissue due to inflammation or angiogenesis. This increased blood flow to the tissue strongly absorbs blue light and reflects fluorescence change on the screen.

• The velscope also detects the presence of excess melanin pigmentation or amalgam particles that absorb light.

What Are the Diagnostic Findings?

The abnormality diagnosis is based on the color change on the screen.

• When observed with the velscope, normal tissue will present as fluorescent green.

• Keratotic patches appear white.

• Fungal or bacterial growth appears red.

• Any other changes that are dysplastic or potentially malignant appear black.

• Based on the color change, a probable diagnosis can be made. But a velscope is not the gold standard; therefore, if any lesion is suspected, it should be further evaluated by diagnostic tests like DNA ploidy or biopsy.

What Type of Light Is Used in a Velscope?

The velscope is a device that emits a bright blue, harmless light that is used for inspecting the mouth and tongue. The device is sensitive to abnormal tissue changes and the distinctive blue-spectrum light that causes the oral mucosa or the soft tissue of the mouth to naturally fluoresce. The velscope works by using a shining blue light emitted by light-emitting diodes into the mouth. It does not involve the use of chemicals, radiation, dyes, rinses, or other harmful substances.

What Are the Advantages of Velscope?

The advantages of velscope include:

• Early Detection and Prevention of Cancer: Cancer is a problem worldwide; most cases turn malignant because they are not detected in their early stages. Early diagnosis can not only cure and reduce mortality due to cancer but can also prevent the development of the disease, which is the biggest advantage of velscope.

• Detection of Fungal or Bacterial Growth: If the bacterial and fungal growth is noted initially when it has just begun, it can prevent the occurrence of more severe conditions in immunocompromised individuals who are more likely to develop conditions like candidiasis.

• Marking Margins Before Surgical Removal of Any Cancerous Lesion: velscope can provide a line of demarcation between the affected and healthy tissue, making it easier to excise the affected lesion and prevent the lesion's recurrence.

• Intraoperative Function: The excised margins and the surrounding tissue is checked with a velscope to determine if all the dysplastic tissue (development of cells within tissues or organs) is removed completely.

• The device is easy to handle and user-friendly.

• High accuracy rates.

What Are the Disadvantages of Velscope?

The disadvantages of velscope include:

• Velscope can scan only intraoral tissue, including oral mucosa of the cheeks, hard palate, tongue, and the floor of the tongue.

• Even after the scan is done, it cannot be used as a gold standard and requires other diagnostic tests.

• The device being costly is not very commonly used by dentists.

• There is a possibility of obtaining false positive results.

• It can be used as an adjuvant diagnostic only.

Conclusion

Velscope is a device that was introduced in the year 2006, which is based on immunofluorescence and is used to diagnose cancer in its premalignant stages (potential to turn malignant) the device is a boon to dentistry as it helps in diagnosis without any invasive procedures like biopsy, but the ADA (American Dental Association) guidelines have subjected the model to be in its trial phase even today, it was concluded that the evidence present is not enough to prove the efficiency of the device based on its potential to detect lesions based on tactile and visual sensations. Therefore ADA guidelines have suggested that more research and studies are required in order to declare and bring in the use of the device for screening and prevention of oral cancers.