Future Diagnostic Aids in Detecting Dental Caries

Introduction:

Although dentists currently have access to several digital diagnostic aids for detecting dental caries, it is still a known challenge in this field of dentistry to accept that they all come with certain levels of limitation, and further, not every diagnostic aid can be applied effectively in all scenarios. This is because of the economic factors related to the patients and advanced dental imaging or diagnosing methods would tend to be expensive because of the apparatus used. Though 2D (dimensional) imaging technologies radiographically such as OPG (orthopantomogram), IOPA (intra-oral periapical radiograph), and bitewing radiography are very popular among clinicians, With the advent of 3D technologies such as CBCT (cone beam computed tomography) in dentistry that can help in the analysis and treatment planning of dental caries lesions, there's still a need for discovering methods that can give an ideal performance, especially in detecting dental caries, in the initial or early stages themselves.

In modern-day dentistry, there is a pressing need to explore the potential of new digital diagnostic tools for detecting dental caries. These tools are still in the early stages of development and require further research before being utilized in a clinical setting. Despite this, they show great promise in revolutionizing the early detection of dental caries compared to current methods.

What Are the Disadvantages of Traditional Caries Detection Methods?

The traditional caries detection methods include visual inspection and the use of radiographic methods. The disadvantages of these methods include;

1. In most cases, radiographic methods cannot be used as chair-side methods or diagnostic methods.

2. Radiographic methods should be used cautiously with pregnant women.

3. Conditions like pulp vitality cannot be assessed through these methods.

What Are the Newer Methods of Caries Detection?

1. Electrical Measurements: Electrical Conductance Measurement The electrical conductance measurement devices are used for adapting a single, fixed kind of frequency that is a reference to an alternating current. These alternating currents will measure the electrical conductance of a carious tooth surface The measuring electrodes in this technique are well-designed to detect even initial dental caries such as pit and fissure caries. If no dental carious lesions are present on the tooth surface and the tooth has intact enamel, the circuit of the current flow in the method cannot be completed as such, thereby just giving the reading on the device a zero. If a carious lesion is present, the current flow would trigger the circuit to be closed, thereby providing a reading on the device.

2. Alternating Current Impedance Spectroscopy: This method of dental caries detection measures the impedance or resistance of the decayed tooth to a form of alternating current. This detection method is based on the principle of utilizing multiple frequencies of electricity to study the physical and chemical properties of the tooth. A sensing brush is used in this method that is moved by the dentist or dental operator over the suspected site of dental caries, thereby resulting in a numerical reading that would have a reference to a specific color code- detecting to what extent and which portion of the tooth surface is affected by dental caries. This method can certainly have excellent scope to even detect carious lesions at the initial stages in dental patients.

3. Ultrasound Aids: Ultrasound-based diagnostic aids have currently been developed by dental researchers into a prototype form, known as the ultrasonic caries detector. These diagnostic aids however need more investigation and testing before they can be commercially implemented in the dentistry field. The ultrasonic probe of the ultrasonic caries detector would be placed or pointed at a certain angle to detect the particular surface caries lesions on the tooth and can detect carious lesions easily.

4. Optical Coherence Tomography (OCT): Optical coherence tomography (OCT) is based on the principle of producing two or three-dimensional images, which are produced in turn by the dental tissue’s optical absorption as well as radiation scattering properties. The images that are produced by the dental tissue are based on the principle of interferometry, which is the involvement of the effect of a mutual interaction occurring between the emitted light with backscattered light. These interactions tend to produce light wave interference patterns that can be easily compared with a pattern generated from a reference light. When this technique was compared through in vitro studies with the commonly used 2D bitewing radiography, dental researchers found that the OCT is more reliable as a method for accurately detecting tooth surface lesions and even proximal caries, as well as in between tooth surfaces. A future implementation of OCT systems would pave the way for creating a non-invasive radiographic or digital caries detection method that would prove more beneficial to patients.

5. Laser-Induced Thermal Imaging: Lasers -full form standing for light amplification by stimulated emission of radiation. A laser can not only simply induce thermal signals, acoustic signals, photonic signals, etc., upon the sound or decayed tooth surface, but laser technologies also help allow the easy facilitation of dental caries detection. Thermal imaging technologies are based primarily on the rationale that the degree of porosities that one can find within a dental carious defect or lesion would be affecting the amount of water or the inorganic matrix element that's part of the enamel of the tooth. In a carious tooth, thermodynamic changes occurring in the inorganic component can help detect dental caries effectively. The rationale of this method for caries detection is that when the specimen or the tooth absorbs radiation energy, it is then eventually converted into thermal energy. This change in energy is observed also as a change in the temperature of the specimen or the tooth surface. According to current in vitro studies of this technique in the assessment of dental caries, this technology can help differentiate between the sound tooth surfaces and the decayed/carious lesions that are present in the tooth.

Conclusion:

These dental caries detection methods listed above that are future aids in dentistry can give dental practitioners access to study the detailed and fine micro-structure of dental tissues from a biological perspective. Current in vitro studies show that these techniques would have excellent future scope for higher sensitivity than all the current visual inspection methods for detecting initial, moderate, or severe dental caries.