Laser Diagnosis of Tooth Decay (Before Fillings)
Next to preventing tooth decay before it starts, finding and and treating decay in the initial stages is one of the most critical things a dentist can do for a patient. Continuing education and adoption of innovative new technologies helps accomplish these goals and offer treatments designed to preserve teeth and treatments that are minimally invasive. The DIAGNOdent laser has drastically enhanced detection of early stage tooth decay. DIAGNOdent is approved by the American Dental Association and the U.S. Food and Drug Administration for use in detecting dental caries earlier than traditional x-rays.
The extensive use of fluoride has strengthened tooth enamel and helped to protect them against decay. Stronger tooth enamel has lowered the occurrence of tooth decay in general, but at the same time, the harder tooth surface makes it more difficult to identify tooth decay in its earliest stages. Prior to the widespread use of fluoride, caries were most commonly seen on the outer surfaces of the enamel, but are now being found more in the dentin, the softer layer below the enamel, in the irregularities in the chewing surfaces of the teeth. Cavities found in this part of the tooth tends to damage the structure of the tooth from the inside out. A tooth with this kind of damage will seem healthy until the decay is extensive enough to see on x-rays or until the discoloration can be seen through the enamel. If the probe used to locate cavities is larger than the flaw in the enamel, the decay may go undetected while the injury grows.
This is why we are thrilled to report that we have acquired the DIAGNOdent laser caries scanner. DIAGNOdent is a specialized tool that is proving to be the greatest development in tooth decay diagnostics since the traditional x-ray. The DIAGNOdent laser shines a beam of light into the tooth. The light is reflected off the tooth back to the end of the laser scanner. Where tooth decay is present, a fluorescent reflection is detected by the laser scanner. There is no other substance that naturally occurs in teeth that will fluoresce when exposed to the DIAGNOdent’s laser light beam. If even a minute amount of decay exists in the tooth, the laser scanner will warn the dentist using an audible sound and a digital screen.
The DIAGNOdent uses a Class 1 laser to send harmless, painless beams of light into the structure of the tooth at a wavelength of 655nm. The scanner compares the fluorescence reflected by the structure of the tooth against a previously determined baseline to reveal decay. Healthy teeth show very little, if any, fluorescence. Decay fluoresces dependent on the amount of decay present. When the DIAGNOdent comes across a tooth that fluoresces more than the baseline range already established for the patient, it sounds a signal the dentist can hear as well as sending data on the amount of decay to an LED screen. The greater the value on the screen, the more decay is detected.
DIAGNOdent laser fluorescence is more accurate and sensitive than traditional methods of finding tooth decay and offering an objective method of measuring breakdown in the structure of the tooth, making it an excellent addition to traditional dental examination. This does not make the DIAGNOdent a replacement for clinical examination by a dentist. Also, the DIAGNOdent cannot find decay in teeth that have been previously restored, so it cannot be used on every patient.
Why don’t x-rays show smaller, earlier stage cavities? X-rays detect variation in tissue density. Decay is softer than healthy tooth structure, and shows up as a dark spot inside the tooth. Until the degree of decay gets close to ⅓ the thickness of the entire tooth, however, the contrast isn’t distinct enough to be visible on the x-ray. By the time the decay shows up, it’s already eaten up a large portion of the tooth.
A significant number of crowns and root canals are needed because of problems occurring long after silver fillings have been used. With the DIAGNOdent laser scanner, cavities can be found when they are very small and can be repaired using a laser and much smaller fillings. Not only are the fillings smaller, but the process to place these smaller fillings will involve significantly less pain, meaning less pain medication, less recovery time, and less cost. What are you waiting for?