Dental caries tells the story of a civilization

As one of the oldest of all dental diseases, caries is even observable in remains retrieved from archeological excavations. In Caries through time: An anthropological review by Lanfranco and Eggers, the authors explained, “The tooth, for its physical features tends to resist destruction and taphonomic conditions better than any other body tissue, and therefore, is a valuable element for the study on individual’s diet, and social and cultural factors related to it, from a population perspective. Because the lesions develop over the long term, the review notes, “the lesions presented at the time of the  death remain recognizable indefinitely, allowing to infer, along with other archaeological and ecological data, the types of food that a specific population consumed, the cooking technology they used, the relative frequency of consumption, and the way the food was shared among  the group.” It is interesting to see that dietary changes during certain periods, for example, during Mercantilism and the Industrial Revolution, showed an increase of carbohydrates due to agriculture which resulted in growing rates of caries compared to the diets of hunter-gatherers. Even today, tooth decay remains a growing problem. According to the Centers for Disease Control and Prevention (CDC), caries affects more than 25 percent of U.S. children 2 to 5-1/2 years old and half of 12 to 15 year olds. Approximately 28 percent of people 35 to 44 years of age and 18 percent of adults 65 and older have untreated tooth decay.

The key to keeping caries at bay is early detection. Whereas the explorer was the instrument used to find caries many years ago, now technologies have led to the production of caries detection devices that help dentists find lesions in their earliest stages, in some cases even before they can be seen on an X-ray. Here are a few of the different types:

Fluorescence technology: Blue violet light causes the enamel and dentin in the tooth and the material in cariogenic bacteria to fluoresce. Different substances emit specific colors depending on the lesion’s progress. The system detects the caries, shows a colored image of the caries, and assigns it a numerical value that corresponds to the extent of the lesion.

Laser fluorescence: The incident laser light, together with optics in the unit, allow the device to quantify reflected laser light energy. Healthy tooth structure shows little or no fluorescence, and therefore low numerical readings. Caries on the tooth structure results in higher numerical readings on the display. Some units also have a tone that sounds when caries is detected.

Near infrared transillumination technology: This type of device, which emits no ionizing radiation, bathes the tooth in near infrared light and generates an image that looks like an X-ray. The healthy enamel appears transparent while the carious areas appear dark.

Detecting caries in its earliest stages is important to save patients’ tooth structure and to prevent more invasive procedures that may be needed if the caries is left unchecked. An imaging protocol of X-rays, caries detection device, and digital photographs can offer dentists a complete view of the patients’ dentition, help patients to maintain great dental health, and boost the dentists’ reputation as caring and at the forefront of new technologies.

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