Assessment of early demineralization in teeth using the signal attenuation in optical coherence tomography images

Abstract

In recent years, there has been a new focus in dental care that is evolving from the drilling and filling of cavities to nonsurgical management of early dental decay, clinically known as dental caries.¹ Incipient carious lesions (i.e., early lesions) are generally detected as white spots on the tooth enamel, and result from demineralization due to acid produced by bacteria in dental plaque. If left untreated, these lesions progress from the surface inward and eventually become cavitated. Treating lesions before they cavitate with agents such as fluoride can help to arrest the lesion, remineralize the site, and restore the enamel integrity. Successful nonsurgical management of caries requires an effective and objective method of detecting early lesions and monitoring their status. Traditional methods such as clinical radiography show poor sensitivity for detecting early carious lesions since the lesions are too shallow and do not provide enough contrast when compared with the surrounding tissue to be clearly discerned on a radiograph.¹ Furthermore, clinical inspection relying on visual examination and probing with a sharp dental explorer is a subjective method depending on the examiner’s experience and training. An intense effort to develop detection techniques that enable better diagnostic decisions has occurred in recent years. Most of the emerging diagnostic techniques are photonic technologies such as the DIAGNOdent and quantitative laser fluorescence (QLF) devices that are based on light- or laser-induced fluorescence spectroscopy. Despite their potential, these methods can generate false positive results due to stains, plaque, and food debris. These and other emerging methods have been reviewed in recent papers.^{2, 3}