Detecting and preventing dental caries: Dental assisting

Dental caries, also known as tooth decay, is a significant, worldwide health concern for both children and adults. Prevention and early detection of dental caries help to preserve tooth structure, support long-term function, and reduce the need for costly and uncomfortable restorative treatments. As a dental assistant, you’ll play a key role in helping prevent tooth decay, identifying risk factors for dental caries, and assisting the team in spotting early signs of decay before it progresses.

Now, the primary method of detecting dental caries is through visual and tactile inspection. A round-tip, blunt explorer or probe is used to investigate areas on the teeth that look suspicious due to changes in color or texture. Caries can appear as discolored spots and have a sticky texture when the probe is pressed against it, indicating the enamel has weakened. Keep in mind that sharp instruments can damage the demineralized enamel, so only blunt explorers or probes should be used.

Radiographs, such as X-rays, are useful in identifying caries that are difficult to diagnose through inspection, such as interproximal caries, which are caries that form between two adjacent teeth, as well as secondary, or recurrent caries, that form on the edges of an existing restoration. When caries are present, they appear as dark spots or shadows on the image. It’s important to keep in mind that although imaging is an essential tool for detecting dental caries, early caries might not be visible on X-ray.

There are also some advanced caries detection technologies that can increase the accuracy of dental caries diagnosis. These tools don’t replace a thorough clinical exam, but they provide additional information that supports better diagnosis and treatment while the decay is still small.

The transillumination-fluorescence device is one of these advanced technologies. This device uses a laser to direct a light onto the surface of the tooth and then collects the resulting fluorescence emitted from the tooth. Caries and plaque biofilms emit more fluorescence than healthy, mineralized enamel. This contrast makes problems easier to spot.

Another advanced imaging tool is optical coherence tomography, or OCT. A small handheld device uses light waves to create a detailed cross-sectional image of a tooth. These images are particularly helpful in detecting decay hidden under restorations and sealants.