emerging diagnostic tools for early

Emerging Diagnostic Tools for Early Caries Detection

Though dental caries remains among the most prevalent of diseases

globally, the developed world has seen a decrease in prevalence.1 This

decline in prevalence has come about through the use of

remineralization techniques, especially those involving fluoride. The

resultant slower progression of carious lesions offers dental care

providers the challenge of diagnosing and intervening in the disease

process at an earlier stage, before cavities exist.

The standard diagnostic armamentarium in use by most dental care

providers today comprises visual inspection, use of an explorer, and

radiography. The diagnosis is typically "You do, or you don't have a

cavity," and refinements of those techniques continue. For example,

the International Caries Detection and Assessment System provides a

unified set of visual criteria by which the level and activity of

caries can be classified. Explorers are used to lightly assess surface

hardness rather than for forceful probing. Both developments

acknowledge that caries is a dynamic disease process involving cycles

of demineralization and remineralization that occur before a cavity

presents.

An ideal early detection system would allow the monitoring of the

continuum of caries development, and allow for appropriate

intervention before cavitation occurs.1 The system would have high

sensitivity, specificity, precision, and accuracy. It would be easy to

use, applicable to all surfaces and to all patients, and would allow

the assessment of a lesion's activity by identifying whether it is

remineralizing, demineralizing, or dormant.