Nobody likes visiting the dentist but in a project led by Durham University, with dentists from Kings College London, novel methods of imaging early dental disease using light are being developed. The method utilises components more normally found in a CD player and webcam to record X-ray like images through the tooth using only near infrared light.
Early dental disease results in the enamel rods, which make up the hard external structure of the tooth, being damaged below the surface. This affects the way that near infrared light travels through the tooth. Crucially at this stage of the disease the process can be reversed through the application of local fluoride varnishes and good dental hygiene and the resulting structure is normally stronger than the original tooth, potentially removing the need for a ‘drill and fill’ treatment.
Until the new method of imaging such early problems were very hard to detect appearing as a white spot on a white background and the new instrument enables such lesions to be seen more clearly at this early stage.
A prototype instrument has been used in an initial clinical assessment and advanced prototype is currently being built for a second stage trial. Meanwhile in the lab the patented technology is being advanced for higher resolution and to provide more clinical information to the dentist.
The instrument has a role in both disease detection and diagnosis, monitoring treatment and also for improving orthodontic and endo-dontic treatments. As the risk of ionizing radiation, even at low doses, is fully understood an instrument which replaces dental X-rays, in addition to detecting early problems not seen by X-rays is clearly important.
Discussions are underway to commercialise the instrument with the goal of reducing the stress of trips to the dentist.
The enamel which makes up the outer surface of a tooth consists for rod of mineral which guide light, when health, exactly likely an optical fibre which carries most ground based telecommunications information. One can also simulate a tooth in a jaw using an extracted tooth and a meat chop as this has the correct mixture of bone, fat and tissue!
“By understanding how light travels through the enamel in a tooth and being aware of the components present it certain high volume consumer goods it is possible to design clinical diagnostic instruments to fulfill a real patient and clinician need. The ability of the tooth to remineralise itself has been known for many years but the method of detecting such early problems has not been available so treatments were only possible when the problem was in a more advanced stage.”
Prof John Girkin, Director Biophysical Sciences Institute, Durham University