PFI:BIC - Smart Laser-Based Imaging and Optical Spectroscopy System: optical quantification of bacterial load, oral health surveillance, and caries prediction.

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Caries and gum disease are especially prevalent and severe in low-income and rural communities, which often lack access to convenient and affordable dental care. Members of these communities are more likely to visit hospital emergency departments with advanced stages of oral disease that need surgical treatment; this increases the cost of dental care for families and burdens hospital resources. Tooth decay is the most common chronic disease in American children and adolescents age 6-19 despite being a preventable disease. In 2010, untreated tooth decay, or caries, affected 2.4 billion people worldwide. Early childhood caries leads to pain, infection, and discomfort. And in adults, chronic oral infections may increase the risk of preterm birth and diseases like diabetes and atherosclerosis (hardening of the arteries). This project will develop a hand-held electric-toothbrush-like device with a user-friendly interface that can be used in the home or by community health workers in schools or rural clinics. The wand, which uses a safe optical scanning method, will send data and images to a dentist, who will be able to monitor how well dental treatments are working. The data and images collected by the device can be analyzed to discover where plaque and bacteria are present, providing a way to predict, and then prevent, disease. The wand will be able to prompt the user to address problem areas. This system, which will connect remote users to a dental provider, has the potential to improve the prevention and treatment of oral disease and the quality of life for people who do not have convenient access to regular, in-person dental care. To enable this vision, this project will develop a smart system that offers screening, surveillance, and prediction for people to improve their oral health and prevent disease. A mature technology of laser-based imaging that is spatially registered with fluorescence spectral analysis will be used to study the complexities of the oral biofilm and dental demineralization. The bacterial measurement is performed with a hand-held single wavelength optical scanning probe that forms images from both reflectance and fluorescence contrast, with the option of taking laser-induced fluorescence spectra for diagnosis of enamel demineralization. To provide a smart interface, the optical information will be analyzed to identify trends, a new modality for the dental field. With analyses of the fluorescence signal from the plaque deposits displayed as a trend, the user, in collaboration with clinician, can monitor variations in oral health and the effectiveness of treatments. The research team will use an iterative process to develop, design, evaluate, and refine the tool. The tool will be tested for three scenarios: (1) a plaque- and caries-screening program for a trained lay user on an untrained "patient" (e.g., parent for a child, school nurse for pupils, pediatrician for young children, or staff at a remote rural clinic for patients); (2) a caries surveillance program for trained lay users electronically connected to a dentist who can guide the use of the tool; and (3) a caries prediction program, initially for clinical users. This project brings together a multidisciplinary team from the University of Washington (UW), in Seattle, Washington, with expertise in human centered design, engineering, sensing and machine learning, oral biology, and dentistry: Eric J. Seibel (Principal Investigator, PI), Mechanical Engineering; Sean Munson (co-PI), Human Centered Design & Engineering; Shwetak Patel, Computer Science & Engineering; Zheng Xu, DDS, School of Dentistry, Pediatric Dentistry; Jeff McLean, School of Dentistry, Periodontics. Lead industry partner Water Pik, Inc. (Fort Collins, CO), brings experience and knowledge about building, marketing, and distributing advanced dental devices to consumers: Deborah Lyle, Director of Professional & Clinical Affairs, and Jay McCulloch, Vice President, Global Marketing, Oral Care. Broader context partners are UW CoMotion (Seattle, WA), a technology transfer partner; QualComm Tech, Inc. (San Diego, CA), a wireless technology leader; Open Photonics, Inc. (Winter Park, FL), a business partner; and the Alaska Native Tribal Health Consortium (Anchorage, AK), a non-profit community partner interested in the development of an optical diagnosis device for use with its rural beneficiaries.This award is partially supported by funds from the Directorate for Computer and Information Science and Engineering (CISE), Division of Computer and Network Systems (CNS).