Tooth cavities are a major concern for individuals around the world. Advanced cavities can cause pain and discomfort, or worse: the loss of teeth.
Early detection is key to treating and preventing the advancement of cavities. A new laser cavity detector, DIAGNOdent, is available on the market, but does it actually work as advertised?
How DIAGNOdent Cavity Detector Works
The DIAGNOdent cavity detector works by fluorescing the tooth by means of a laser. Healthy enamel show a low level of fluorescence. The more advanced the cavities, the more fluorescence is demonstrated. The level of fluorescence is directly proportional to the degree of cavities present and shows little variation across patients. The net effect of this is that a scale has been determined to diagnose the severity of the cavities and thus the recommended treatment by local dentists near me.
There are many different techniques in use for detecting cavities. These techniques include, among others, visual examination, radiography, Vista Proof and DIAGNOdent or laser fluorescence. DIAGNOdent was compared to these various techniques in terms of sensitivity and specificity.
Supporting Science & Studies
A study was conducted by the American Academy of Pediatric Dentists to compare visual examination, bitewing radiography and DIAGNOdent in terms of sensitivity and accuracy. The same two examiners made use of all three techniques to determine the severity and extent of cavities in an array of teeth presented for examination. The study concluded that visual examination is moderately sensitive and substantially specific, radiography showed low sensitivity and high specificity. DIAGNOdent showed higher scores on both sensitivity and specificity.
The problem that was found with the DIAGNOdent was the likelihood ratio being lower than for the other two techniques. Due to the sensitivity of the device to discolouration and reflective materials that may naturally accumulate on the tooth surface a far higher ratio of false positives were given by the device. This may lead to unnecessary treatment. However, it should also be noted that the other techniques examined showed a higher false negative ratio which may lead to cavities going untreated due to it not being detected.
Pitfalls of Laser Cavity Detection
It has also been found that although the number shown by the DIAGNOdent does indicate the severity of the cavities, it does not indicate the depth of the decay. The laser does not penetrate the surface of the tooth and so cannot determine how much of the tooth substrate has been compromised. This would require the use of additional diagnostic equipment such as bitewing radiography.
The detection of cavities beneath caps and other tooth restorations can be tricky. The DIAGNOdent laser has been shown capable of penetrating the composites used in restorations and so can detect underlying cavities.
The conclusion with regards to the efficacy of this cavity detection technology is that it is indeed effective at detecting cavities. However, it may be too effective and lead to an increase in unnecessary treatment. The device is best used in conjunction with other techniques in order to eliminate the false positives as much as possible. In order to further eliminate false positives it can be helpful to perform a thorough polish or the tooth surface to eliminate plaque and other bacteria generated products.