the teeth having separated allowing direct access for examination.
To assist with the diagnosis of occlusal carious lesions three adjuncts have been
developed; FOTI as discussed above, laser fluorescence devices, and electronic caries
meters.
Laser fluorescence devices measure the fluorescence of the tooth and of particular
importance the fluorescence of bacterial by-products in the carious lesion (237HFig. 6.12).
This provides a digital reading indicating the status of the surface. Research on these
devices is very promising but false readings are generated by staining, calculus, and
hyperplasia. When used appropriately these provide a standardized, reproducible
measure, which not only helps with the diagnostic decision but allows the possibility
of monitoring over time.
Electronic caries meters also exist which measure the decrease in resistance of carious
lesions compared to sound surfaces. When used meticulously these meters have
shown good accuracy in clinical trials. The readings of electronic caries meters are
confounded by areas of hyperplasia, immature teeth, and particularly moisture.
Key Points
The stages in caries diagnostic process
- Detect,
- Diagnose,
- Record.
238H
Fig. 6.9 Clinical
appearance of white
spot lesions on the
labial and approximal
surfaces of the upper
permanent incisors.(^)