Cavity Detection Methods These Days

One of the things that I've been told as not being favorable about a dental visit is the feeling of the nail on chalk board associated with the used of the instrument (explorer) being used to detect cavities on the teeth when having an exam done. It doesn't take long and most people don't mind it but some do..

So what to do about it? Is there a solution?

There are a variety of gadgets these days to detect cavities in the mouth. From x-rays (showing larger cavities typically or cavities between the teeth where the instruments can't go to) to various scanners/cameras that use fluorescence, infrared technology or transillumination (concentrated visible light through the tooth).

One of the more interesting gadgets that I've learned about is called the Canary system; it works based on Photothermal Radiometry and Luminescence technology (PTR-LUM). The Canary uses pulsating laser technology to detect crystallization in the tooth structure.  The computer screen vividly shows any area of caries and indicates how advanced the defect might be. The higher the Canary Number, the more advanced the decay. The system provides high sensitivity and is linked to the status of the crystalline structure of the tooth, and not to bacterial by-products. It reflects the state of tooth mineralization, a measure of the integrity of the surface being scanned. It can detect cavities on the top and side surfaces of the teeth (pit/fissure caries), in between the teeth, under old silver fillings and even fractures. The result of the scan is shown as a number from 0-100 where 0 means fully crystallized while 100 means none at all. Typically teeth with scores of above 45 needs to be restored with fillings/crowns or things alike, while areas with scores of 20-40 typically need to be treated for remineralization (fluoride varnish and/or prescription toothpastes).

So why is it that not everyone is using yet? Well, like any piece of technology, by nature, we're typically skeptical. We want to see proof before adapting it. But unfortunately it's not so much that in this case for myself personally as is the high cost associated with the machine. I am taking steps towards buying one for the office though as I think the amount of information and confidence that it'd bring for the patients is worth a lot more than the price tag.