Optical Measure of Enamel Health: Ability to Triage High Risk Children in Communities without Dental Practitioners

As prevalence of dental caries in children rises worldwide, there is an increasing need for a safe, easy to use and cost-effective technique to detect and identify childhood caries at an early stage where remineralization of the tooth is possible and damage may be reversed. We have developed a simple and robust autofluorescence (AF) laboratory device that uses the dental AF spectra from 405 nm and 532 nm laser excitation and computes a ratio of the integrated areas of the spectra. Ten human extracted teeth with early stage natural caries lesions and an additional 8 human extracted teeth with artificially created erosion lesions were used for the study. The 405/532 nm AF ratio was obtained from healthy as well as unhealthy enamel regions for all teeth. A clear distinction between the ratios for healthy enamel and unhealthy enamel was seen. A percent change in 405/532 nm AF ratio of 62% was seen between natural white spot lesions and healthy enamel, with progressively more severe lesions leading to greater percent changes in AF ratios. The 405/532 nm AF ratio is a promising technique that may be used to detect the presence of early stage dental caries and triage high risk children. A cost effective clinical device can be developed which utilizes the proposed technique to screen children in underserved communities.