Optical Methods for the Detection and Quantification of Caries

Abstract

The commonly used clinical methods are inadequate for reliable diagnosis of caries lesions until demineralization is established. By the time a reliable diagnosis can be made, the damage is often irreversible, and restorative methods may be necessary to prevent further progress of the lesions. Early detection of the caries lesion would enable the dentist, by using effective prophylactic measures, to provide remineralization and conservation of the tooth substance rather than restoration of the dentition. Attempts to improve traditional methods or to develop new methods of detecting caries lesions have been numerous. Most of the presently used diagnostic methods require visual observation of an optical signal. Reflected light is used tc detect changes in color, texture, and translucency of the tooth substance. The tools required are a bright light source and a mouth mirror. With special methods utilizing drying, magnification, and photography, the sensitivity of the method can be increased. Various optical methods for the detection and quantification of caries will be discussed - for example, fiber optic transillumination, ultraviolet illumination, the use of various dyes, and fluorescent or non-fluorescent substances to enhance the contrast between the carious and the sound enamel. This presentation will focus on the following two methods: (1) a method that uses visible laser light within the blue-green region as the light source to improve signal-to-noise ratio and increase sensitivity for detection of early caries lesions, and (2) a recently developed quantitative method based on the scattering of light by enamel crystals in relation to their surrounding environment. The possibilities and limitations of the different methods will be critically evaluated. In the near future, optical methods for the detection and quantification of early caries lesions will provide efficient tools for reliable evaluation of caries-preventive measures.

Get full access to this article

View all access options for this article.

References

Alfano, R.R. and Yao, S.S. (1981): Teeth with and without Dental Caries, Studied by Visible Luminescent Spectroscopy, J Dent Res 80:120-122.

Alman, J.E. (1982): Declining Caries Prevalence - Statistical Considerations , J Dent Res 61 (Sp Iss):1361-1363.

Arends, J. and Christoffersen, J. (1986): The Nature of Early Caries Lesions in Enamel, J Dent Res 65:2-11.

Benedict, H.C. (1928): Note on the Fluorescence of Teeth in Ultra-violet Rays, Science 67:442.

Bibby, B.G. and Shern, R.J. , Eds. (1978): Methods of Caries Prediction . Washington, DC, and London: Information Retrieval, Inc.

Bjelkhagen, H. and Sundstrom, F. (1981): A Clinically Applicable Laser Luminescence Method for the Early Detection of Dental Caries, IEEE J Quant Elect 17:266-268.

Bjelkhagen, H. ; Sundstrom, F. ; Angmar-Mansson, B. ; and Ry-Dén, H. (1982): Early Detection of Enamel Caries by the Luminescence Excited by Visible Laser Light, Swed Dent J 6:1-7.

Booij, M. and Ten Bosch, J.J. (1982): A Fluorescent Compound in Bovine Dental Enamel Matrix Compared with Synthetic Dityrosine, Arch Oral Biol 27:417-421.

Borsboom, P.C.F. and Ten Bosch, J.J. (1983): A Fibre-Optic Scattering Monitor for Application on Bulk Biological Tissue, Paper and Plastic. In: Proc. of the Max Bom Cent. Conf., SPIE, Vol 369 Bellingham, WA, USA: Soc. of Photo-Opt. Instr. Engs., pp. 417-421.

10.

Brinkman, J. ; Borsboom, P.C.F. ; and Ten Bosch, J.J. (1986): Quantitative Interteeth Comparison of Optical and Microradiographical Scanning of Natural Lesions, J Dent Res 65 (Sp Iss): 799, Abst. No. 657 (IADR).

11.

De Josselin DE Jong, E. ; Ten Bosch, J.J. ; and Noordmans, J. (1987): Optimised Microcomputer-guided Microradiography on Dental Mineralised Tissue Slices, Phys Med Biol 32:887-899.

12.

Fischman, S.L. (1984): Improvement of Diagnostic Methods in Clinical Caries Trials: Discussion of Dr. Marthaler's Presentation, J Dent Res 63 (Sp Iss):750-751.

13.

Foreman, P.C. (1980): The Excitation and Emission Spectra of Fluorescent Components of Human Dentine, Arch Oral Biol 25:641-647.

14.

Glass, R.L. (1982): The First International Conference on the Declining Prevalence of Dental Caries. The Evidence and the Impact on Dental Education, Dental Research, and Dental Practice, J Dent Res 61 (Sp Iss) :1301-1383.

15.

Hafstrom-Bjorkman, U. ; Angmar-Månsson, B. ; Strom, J. ; and Sundstrom, F. (1985): Laser Fluorescence in Clinical Studies of Caries , J Dent Res 64:769, Abst. No. 119 (Div.).

16.

Kleinberg, I. ; Chatterjee, R. ; Domokos, A. ; Castaldi, C.R. ; Fain, M. ; and Chebib, F. (1978): An Ultraviolet Photographic Technique for the Early Detection of Carious Lesions. In: Proceedings, Methods of Caries Prediction, B.G. Bibby and R.J. Shern , Eds., Washington and London: Information Retrieval Inc., pp. 271-279.

17.

Konig, K.G. (1982): Impact of Decreasing Caries Prevalence: Implications for Dental Research, J Dent Res 61 (Sp Iss):1378-1383.

18.

Marthaler, T.M. (1984): Improvement of Diagnostic Methods in Clinical Caries Trials, J Dent Res 63 (Sp Iss):746-750.

19.

Mileman, P.A. ; Purdell-Lewis, D.J. ; and Van Der Weele, L.T. (1983): Effect of Variation in Caries Diagnosis and Degree of Caries on Treatment Decisions by Dental Teachers Using Bitewing Radiographs, Community Dent Oral Epidemiol 11:356-362.

20.

Mileman, P.A. ; Vissers, T. ; and Purdell-Lewis, D.J. (1986): The Application of Decision Making Analysis to the Diagnosis of Approximal Caries, Community Dent Hlth 3:65-81.

21.

Mitropoulos, C.M. (1985): The Use of Fibre-Optic Transillumination in the Diagnosis of Posterior Approximal Caries in Clinical Trials, Caries Res 19:379-384.

22.

Naleway, C.A. ; Webster, D. ; Wozniak, W.T. ; Reynolds, S. ; Jen-Ovich, D. ; and Mengeot, M.M. (1979): Assessment of Demineralization using Luminescence , IADR Progr & Abst 58:136, Abst. No. 176.

23.

Peltola, J. and Wolf, J. (1981): Fibre Optics Transillumination in Caries Diagnosis , Proc Finn Dent Soc 77:240-244.

24.

Purdell-Lewis, D.J. and Pot, T. (1974): A Comparison of Radiographic and Fibre-Optic Diagnosis of Approximal Caries Lesions, J Dent Res 2:143-148.

25.

Rawls, H.R. ; Robert, K.O. ; Zimmerman, E.L., III ; and Owen, W.D. (1978): Fluorescent Dye Uptake as an Aid to Early Diagnosis of Incipient Carious Lesions. In: Proceedings , Methods of Caries Prediction, B.G. Bibby and R.J. Shern , Eds., Washington and London: Information Retrieval, Inc., pp. 261-265.

26.

Rawls, H.R. and Owen, W.D. (1978): Demonstration of Dye-uptake as a Potential Aid in Early Diagnosis of Incipient Caries, Caries Res 12:69-75.

27.

Shrestha, B.M. (1980): Use of Ultra-violet Light in Early Detection of Smooth Surface Carious Lesions in Rats, Caries Res 14:448-451.

28.

Spitzer, D. and Ten Bosch, J.J. (1975): The Absorption and Scattering of Light in Bovine and Human Dental Enamel, Calcif Tissue Res 17:129-137.

29.

Sundstrom, F. ; Fredriksson, K. ; Montan, S. ; Hafstrom-Bjorkman, U. ; and Strom, J. (1985): Laser-induced Fluorescence from Sound and Carious Tooth Substance: Spectroscopic Studies, Swed Dent J 9:71-80.

30.

Ten Bosch, J.J. ; Borsboom, P.C.F. ; and Ten Cate, J.M. (1980): A Nondestructive Method for Monitoring De- and Remineralization of Enamel, Caries Res 14:90-95.

31.

Ten Bosch, J.J. ; Van Der Mei, H.C. ; and Borsboom, P.C.F. (1984): Optical Monitor of in vitro Caries. A Comparison with Chemical and Microradiographical Determination of Mineral Loss in Early Lesions, Caries Res 18:540-547.

32.

Ten Bosch, J.J. ; Angmar-Mansson, B. ; Booij, M. ; and Sundstrom, F. (1986): Long Wave-length Fluorescence of Bovine Tooth Components, Caries Res 20:186.