Today’s Caries Detection Systems & Technologies
When a new tool or technology is introduced in the dental industry, as in any other consumer-driven market, inevitably other companies will get in on the action by introducing their own version of the same product.
That’s the great thing about competitive markets: someone’s always bound to make a better mousetrap. A downside to this is that the market is often flooded with a bevy of “me too” products that simply copy each other and don’t offer any real competitive advantages. However, a positive effect of a free-market economy is innovation.
Applying inspired and innovative technologies to an existing category of devices can help turn a “me too” product into a “gotta have it!” product that’s truly in a league of its own. That’s the route that Quantum Dental Technologies, a company located in Ontario, Canada, took when they designed and developed their evidence-based caries detection system called The Canary System.
In addition to the new Canary System, there are several other caries detection systems on the market today, including DIAGNOdent by KaVo, The Caries ID by Dentsply Midwest, Spectra Caries Detection Aid System by Air Techniques, and the CS 1600 by Carestream Dental. Each of these employs a different technological means of caries detection.
DIAGNOdent uses digital imaging fiber-optic transillumination, which identifies zones of demineralization by recording transmitted visible light that’s directed at the tooth; The Caries ID device uses a wavelength of light to identify areas of demineralization; the Spectra Caries Detection Aid System is a light-emitting diode device that illuminates the tooth structure and simultaneously captures its image, which is then analyzed by software; and the CS 1600 uses reflectance and fluorescence signals to help in the detection of suspicious incipient caries.
The Canary System is unique in that its caries detection technology combines both laser luminescence (light) and photo-thermal radiometry (heat) that enables it to detect decay as deep as 5mm inside the tooth and to a size as small as 50 microns. Early mineral loss from a tooth causes small changes in its structure, which creates a more porous, less dense structure. This affects the location, rate and transport of the heat and light—generated by the tip of the Canary System probe—throughout the tooth structure. By measuring these parameters, the system can determine the extent of decay in a particular tooth.
Additionally, the luminescence from the tooth is measured by a photo-detector also mounted on the probe. Similar to other purely light-based techniques on the market, the scattering of the light limits its ability to penetrate deeper inside the tooth and therefore is highly influenced by surface features.
However, unlike current systems that employ a continuous luminescence, The Canary System uses an ac (alternating current) luminescence technique instead. The ac luminescence signal is unique in that its frequency changes according to the degree of demineralization in tooth enamel, so it carries information about the integrity of the tooth that can be measured.
In addition to the infrared laser and ac luminescence detectors, the handheld probe on The Canary System also contains an intra-oral camera so that real-time video and still images can also be captured along with the data regarding the health of the tooth. The image data can be used by dental professionals to provide a visual indicator of the state of the tooth, as well as a basis from which to compare any subsequent visual changes that might occur to the tooth over time.
To assess a tooth, the clinician simply places the probe over the tooth and activates the probe. In less than 3 seconds, The Canary System will provide a Canary number for that tooth. The Canary number, ranging from 0 to 100, is created from an algorithm combining the thermal properties and luminescence from the tooth. A Canary number of less than 20 indicates a healthy tooth surface; greater than 70 indicates a large lesion that may justify restoration. Canary numbers between 20 and 70 indicate the presence of an early carious lesion that does not requires a restoration but can be remineralized. Using this simple numbering system allows the clinician to communicate with their patients and easily explain the evolution or changes in caries lesions. It also allows clinicians to track progress of remineralization of early lesions and the outcomes of various preventive measures they may employ.
Research has demonstrated that the photothermal radiometry and luminescence technology used in The Canary System can detect all lesion types, including occlusal pit-and-fissure caries; smooth surface caries; acid erosion lesions; root caries; interproximal carious lesions; and demineralization and remineralization of early carious lesions.
Does your office use a computerized caries detection device and if so, which device(s) or technologies have you used, and how would you rate your experience with these devices? Do you plan to stick with conventional detection methods, such as x-rays and explorers? If so, why? Please let us know—post your feedback as a comment below.