Development of QLF Handpiece for Early Caries Detection

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DESCRIPTION (provided by applicant): During the past 40 years there has been a remarkable decline in the prevalence of dental caries due to the widespread use of fluoride in public health programs, such as communal water fluoridation, dental practice and in oral hygiene products. In spite of this, dental caries continues to be the most prevalent dental disease. It is known that the traditional visual-tactile clinical caries examination procedure cannot detect lesions until they advance to the stage where they are difficult to reverse with fluorides and other measures. The understanding of the caries process has progressed far beyond the point of restricting the evidence for dental caries at the E2 (caries in enamel only) or D3 (caries in enamel and dentin) levels of cavitations. Recording lesions only at the cavitation level is no longer acceptable (ICCCT, 2002). Quantitative Light Fluorescence (QLF) is a technology that has been shown to detect and quantify the progress of lesions at an early stage (pre-cavitation). This technology will allow dental practitioners to: (a) identify early enamel demineralization reflecting caries risk prior to cavitation; (b) implement appropriate interventions to reverse the disease process at an earlier stage with more efficient outcomes; and (c) monitor the success or failure of the applied intervention measures. The overall goal of this program is to develop a QLF research system for use in clinical dental practice. The Phase I program successfully overcame the limitations of a research hand-piece to permit routine clinical use. The Phase 2 program seeks to further refine the instrument hardware and user software to make the technique practical within clinical practice. The specific aims of this application are to: (1) refine the instrument to make it more ergonomic and facilitate practical infection control procedures; (2) verify the ability of the redesigned instrument to detect early caries and monitor changes in a laboratory; (3) develop user-friendly computer software interfaces that are compatible with the existing software for use by dental professionals; (4) develop appropriate training materials; (5) verify efficacy of the system through a clinical investigation. The results of this research should improve dental health of the general population by identifying dental patients at greater risk of developing dental caries and result in the implementation of interventions to reverse the process and reduce or prevent the need for restorations.