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Dental Laser Assisted Caries Diagnosis

The Diagnodent caries detection laser is a portable, battery powered diode laser.

“Especially in the pits and fissures on the surfaces of molars, it’s easy to miss early signs of tooth decay,” said Dr. Howard Strassler, a professor and the director of restorative dentistry at the University of Maryland Dental School. “And sometimes what you think is a cavity isn’t.”

The widespread use of fluoride, which hardens the enamel surface of teeth, has dramatically reduced tooth decay nationwide.

But it has also made detecting cavities trickier. The harder enamel is, the more difficult it is for dentists to detect small hidden cavities by poking into suspicious-looking areas with the sharp tip of an explorer, the metal tool traditionally used for diagnosis.

Now thousands of dentists are getting help Diagnodent, which shines new light on easy-to-miss cavities. The hand-held instrument uses a red laser to penetrate the outer layer of teeth. By measuring the way light reflects back, Diagnodent detects signs of decay, but is reassuringly gentle.

Diagnodent is used by an estimated 20,000 dentists in the United States, since its approval by the Food and Drug Administration in 2000, according to the KaVo Dental Corporation, the manufacturer.

“It has become a significant piece of equipment in many areas of dentistry,” said Dr. Kenneth Malament, a clinical professor who specializes in aesthetic and reconstructive dentistry at Tufts University. “People who have it use it every day.”

Some studies have shown it significantly improves cavity detection. “The great thing is that we can pick up cavities when we visually have no evidence,” Dr. Malament explained. “By catching them early, we can treat them before there’s much damage.”

The popular device has its limitations, though. It doesn’t work on teeth that already have fillings. And it occasionally makes mistakes. It’s useful as assisted caries diagnosis. Dentists still need to do a careful visual inspection and poke around with their explorers.

The Diagnodent can be an excellent tool for measuring the effectiveness of non-surgical interventions such as increased fluoride exposure, dietary changes. It also is excellent at detecting “hidden caries” in pits and fissures.


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