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Lasers in Dentistry: Minimally Invasive Instruments for the Modern Practice

Course Number: 394

Laser Assisted Caries Diagnosis and Management

The Diagnodent caries detection laser is a portable, battery powered diode laser. Its 655 nm visible wavelength causes active caries to fluoresce. The amount of fluorescence is measurable and is correlated to the size and direction of the lesion. When combined with Caries Management by Risk Assessment (CAMBRA) it can be a very useful tool for detecting and managing early caries.13

The laser gives a reading of zero to 99. A general guideline is that occlusal lesions above 30 likely need restoration and those from ten to 30 are potentially reversible. The Diagnodent is an excellent tool for measuring the effectiveness of non-surgical interventions such as increased fluoride exposure, dietary changes, and the like.6 It also is excellent at detecting "hidden caries" in pits and fissures. Occlusal lesions in a fluoridated population can often be quite advanced before cavitation can be detected with an explorer. Laser diagnosis can help solve this vexing problem for the modern dentist when paired with risk assessment and high magnification visualization.

The Diagnodent's primary indication is for detecting class I, class V, and incisal caries. It can also be useful when paired with transillumination for detecting permanent class III and primary class 2 lesions. Experienced clinicians have found they can greatly reduce the need for radiographs to detect these particular lesions. Laser caries detection can also be used intraoperatively to check minimally restorative preparations for complete decay removal.

This image depicts a Diagnodent caries diagnostic device.

Figure 8. Diagnodent.

Diagnodent caries diagnostic device. Active caries is fluoresces when exposed to 655 nm visible laser light. The amount of fluorescence is measurable and is correlated with the size of the lesion.