Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care

Abstract

Dental caries remains a significant global health issue. It was highlighted by the World Health Organization’s 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists’ approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics.

Performance of different cone-beam computed tomography scan modes with and without metal artifact reduction in detection of recurrent dental caries under various restorative materials

“…Although accurate diagnosis of these caries can lead to successful treatment outcomes, it remains a challenging step for clinicians. To provide better detection, visual and radiographic examinations accompanied by other diagnostic methods play a crucial role in treatment planning [ 1 , 3 ]. For these purposes and considering the high prevalence of recurrent caries, periapical and bitewing radiographs are the most common imaging modalities in clinical dentistry.…”

Atlas of Dental Near-Infrared Transillumination Images

“…Numerous publications focusing on diagnostic accuracy, acquisition time, and advantages against radiographic examinations have reported on the importance of implementing NIRT imaging technology in routine dental examinations [14,[20][21][22][23]. NIRT, described as particularly useful for detecting and monitoring the initial stages of carious lesions, can be integrated into the workflow of risk-based patient management [19,24,25].…”

“…Proximal caries appears as a loss of translucency in the enamel (dark area).Early lesions (a) appear as a triangle with the tip pointing toward the enamel-dentin junction, with the progression of the proximal carious lesion into a moderate lesion (b), the dark area will expand in the enamel before reaching the EDJ (blue circle). The exact extension of the severe proximal carious (c) lesion in dentin (blue circle) is less visible due to the smaller difference in light scattering between sound and demineralized dentin[24].…”