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Chapter 8. ADDITIONAL EXAMINATION METHODS

In accordance with modern principles of minimally invasive dentistry, treatment of caries at early stages is the most conservative, the best in terms of prognosis and cost-effective for the patient.

Hole in the tooth, as patients usually describe caries lesion, is a result of long-term caries process. This process goes through the following stages: caries spot, subsurface demineralization (non-cavitated lesion), and only after that it turns into a cavity. It is known that early stages of carious process are reversible.

There are several methods of treatmentof early caries. Caries spot requires remineralization therapy. Non-cavitated subsurface demineralization implies two options. First is infiltration method, which is recently developed and promising but has no long-term evidence-based results yet. Second is minimally invasive preparation and filling. Despite availability of these technologies the effectiveness of early caries treatmentis low because it is difficult to reveal without special diagnostic methods.

Thus, if the carious spot is located on the facial surface of a tooth, the dentist can easily see it, but on the approximal surfaces it is very difficult to identify a spot or small non-cavitated caries lesion with the naked eye. To reveal early caries one resorts to vital dyeing, transillumination, fluorescence methods.

DYE STAINING

Dye staining is used to detect early caries on the facial surfaces of the teeth, as well as for differential diagnosis of caries and non-carious lesions. Dye staining technique:

1. Isolation from saliva with a cotton rolls and/or retractor.

2. Cleaning the plaque.

3. Drying with water-air syringe.

4. Application of caries detector dye (also called caries marker). It is a dyeing solution e.g., fuchsine, erythrosine or methylene blue.

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