399 East 72nd Street Suite 1A
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   Simon W Rosenberg, DMD

Prosthodontics and Cosmetic Dentistry
The Center for High Tech Dentistry
"Improving Smiles One Patient at a Time
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DIAGNOdent -- Laser Diagnosis of Early Decay or Caries

Diagnodent - Laser Caries DetectionDIAGNOdent is the revolutionary new way to find even the smallest areas of tooth decay. By using this new technology, we are able to target and treat all of your small problem areas before they turn into larger issues that require more complicated procedures.

Diagnodent technology enables us to detect the earliest signs of dental decay. The better and earlier the diagnosis, the better suitable therapy can be planned. This enables us to provide minimally invasive and tooth preserving treatment.

Diagnodent operates by means of a laser light. The light is passed via an optical fibre to the area of decay. The decayed area fluoresces, and this fluorescence passes back to the probe, and the decay is displayed and indicated both visibly and audibly.

The benefits of a Diagnodent check up

  1. No sharp probing of teeth
  2. Less exposure to radiation because less x-rays need to be taken
  3. Great for children and anxious patients
  4. Catching decay in the earlier stages means minimal treatment is necessary and can often be carried out with no drill or needles using the Biolase Waterlase MD dental Laser.
  5. Best preventive care
  6. Visual and acoustic measurements make it easier for patients to understand the diagnosis
  7. Results are documented so that some lesions can be accurately monitored

Q: Does it hurt?

A: No! DIAGNOdent is completely painless. It’s energy level similar to that of a laser pointer, the laser beam is harmless to surrounding tissues.

Q: What are the shortcomings of the traditional dental techniques like probing and x-ray imaging?

A: Believe it or not, as much as 50% of tooth decay may go undetected by traditional dental methods of probing and other diagnostic techniques.
View of Molar Tooth from the Top with Decay Cross Section of Same Tooth Showing Decay Under Intact Enamel below the Groove
Above (left) tooth has decay in the groove that would not be detected by x-ray or the dental explorer.  The cross-sectioned same tooth on the right shows the decay under the central groove of the tooth. 

Q: How long has this technology been around?

A: While the device has been in use in Europe for several years, the FDA has recently approved the use of the cavity-detecting laser for use by dentists in the U.S.

Q: Where does most tooth decay start today?

A: Today most tooth decay starts in the hard-to-see valleys and canyon-like anatomy of the tooth surface.

Q: Why are these pit and valley cavities more important to detect today than in the past?

Cavity at base of Center Groove of Molar Tooth
A: In the past tooth decay predominated in between teeth. With the widespread use of fluoride, the very nature of tooth decay has changed. The outer surfaces of teeth are strengthened and more resistant. Today the pit and valley cavities are more prevalent than cavities in between teeth.

Q: Why can’t traditional methods like x-rays see these pit and valley cavities?

A: Pit and valley cavities are traditionally the most difficult to detect using x-rays due to the direction the images are taken from. Images are taken from the side of the tooth, which essentially hides the cavity from the dentists view.

 

Q: If DIAGNOdent is good at finding pit and fissure cavities do I still need x-rays?

A: Yes, x-ray imaging is an indispensable diagnostic tool for dentistry. X-rays and DIAGNOdent complement each other. X-rays are good at finding cavities in between teeth and on the roots. DIAGNOdent is good at find cavities on the tooth’s biting surface.

Q: If you can’t see it with your naked eye then why should one be concerned?

A: An almost undetectable area of decay can aggressively penetrate inward towards the soft surfaces of the tooth and literally destroy the tooth from the inside out. This can happen before a cavity is even visible to the naked eye.

Q: Why can’t traditional methods like the dental probe (pick) find these pit and valley cavities?

 Why a Dental Explorer can't get into grooves Diagnodent 'probes' into the groove and if decay is present the reflected light fluoresces and is detected

A: This type of decay can make diagnosis with traditional methods difficult because the outer tooth surface often appears to be intact and the probe may be too large to detect the cavity.  Diagnodent 'probes' into the groove with a harmless red laser light and looks for reflected light of a different wave-length the indicates decay.  If decay is present the reflected light fluoresces and is detected by the unit

Q: How does DIAGNOdent work?

Diagnodent shines laser light to detect Decay

A: DIAGNOdent is first calibrated to your unique tooth structure by scanning a cleaned tooth surface with a harmless laser beam. After calibration a team member will gently scan your teeth. A small countertop unit emits an audio signal and registers a digital read-out, which identifies cavities developing below the surface “the higher the amount of fluorescence detected by the machine, the greater the degree of decay within the tooth.

Scanning a tooth with Diagnodent  Diagnodent Unit

Q: What is the benefit to me?

A: Because the decay is detected earlier, the number of dental procedures - and hence, the cost - can often be reduced. It’s a great way to keep little problems from becoming big problems. With early carious lesions we can usually treat the decay without the need for the local anesthesia shot and we frequently do this using the Biolase Waterlase MD dental laser instead of the usual dental drill.

Q: How long does the DIAGNOdent process take?

A: A few minutes are all it takes to scan your entire mouth.

Q: How much does it cost?

A: We use the DIAGNOdent laser as a routine part of exams and there is no additional fee associated with the scan.

Q: What is the DIAGNOdent actually measuring?

A: The DIAGNOdent measures laser fluorescence within the tooth structure. As the incident laser light is propagated into the site, two-way handpiece optics allows the unit to simultaneously quantify the reflected laser light energy. At the specific wavelength that the DIAGNOdent laser operates, clean healthy tooth structure exhibits little or no fluorescence, resulting in very low scale readings on the display. However, carious tooth structure will exhibit fluorescence, proportionate to the degree of caries, resulting in elevated scale readings on the display.

Fluoresence in a Tooth  Screen of Diagnodent show the current and peak readings

Q: Can DIAGNOdent be used around existing composite resin restorations?

A: No. Because some composite resins can fluoresce, prompting elevated readings, the DIAGNOdent is not reliable when used on these materials.

Q: Can DIAGNOdent read caries under an existing amalgam?

A: If there is caries at the margin, it will give an accurate reading; however if the caries is under the floor of the amalgam the decay may not be illuminated by the laser or the silver amalgam by block any reflection and fluoresence from reaching the Diagnodent and thus the reading will not be accurate.

Q: Can DIAGNOdent be used on both primary and permanent teeth?

A: Studies have shown the unit is equally accurate in both primary and permanent teeth.

Q: As the device is a laser, is protective eye wear required?

A: No. The device is harmless when used as directed.

Conservative dentistry is always the best option for patients. When we find decay early, teeth incur less damage and more natural tooth structure can be retained during restoration. DIAGNOdent can also find areas prone to future decay. Demineralization in teeth makes them susceptible to decay. By re-mineralizing with fluoride, patients may deter cavity formation. Our team believes prevention is best for the patient because it will reduce your need for future reconstructive dental procedures. Modern advances in dentistry, like DIAGNOdent, allow us to give you the most conservative and precise treatment available, and you deserve it. Now that’s something to smile about!

If you still have any other questions about DIAGNOdent and the best ways to prevent tooth decay just contact us for more information.

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