Inside Dentistry
August 2014
Volume 10, Issue 8

Practice Building with Caries-Detecting Technology

Clinical and patient benefits add practice value

Jeffrey Dalin, DDS

During the course of my career, methods of caries detection have evolved from the very basic to the most state-of-the-art technology. What follows is my experience of that evolution.

Years ago, I used an explorer to catch the cavity along with film radiography; then we moved on to the explorer and digital radiography. Eventually, I added the intraoral camera and a fluorescence caries detector (KaVo DIAGNOdent®, www.kavousa.com) to that armamentarium. In 2014, my practice took caries detection to an even higher level, and I switched my caries detection to transillumination technology (DEXIS CariVu™, www.dexis.com).

Clinical and Patient Benefits

For the most comprehensive diagnosis of caries, I want to see, verify, and use as many technology tools as possible to make sure that I am finding all of the existing decay. My digital radiography system (DEXIS) is already the center of many applications integrated into my office, and now I can add caries detection to that list. The CariVu integrates with DEXIS software, so that I can use it seamlessly together with my digital radiography and intraoral camera.

Practice building also means updating technology as newer, more effective ways are introduced. Over the years, dentists have searched for caries using various methods. Quantitative light-induced (QLF) fluorescence detects caries by visible light system. With this type of system, the light causes the teeth to fluoresce in green (or red) with a contrast resulting on the demineralized tooth tissue. Another caries system that I have used in the office in the past is DIAGNOdent’s laser fluorescence, which displayed a numerical value instead of producing a colored image of the tooth. The newest caries detection from DEXIS, CariVu, uses a unique transillumination technology to bathe the tooth in safe, near-infrared light. Transillumination technology makes the enamel appear transparent, while the porous lesions trap and absorb the light. As a result, the images appear similar to x-ray images: healthy tooth is light, caries is dark. This technology can detect interproximal, occlusal, and recurrent caries, even in the early stages.

One aspect that makes transillumination a practice-building technology is that it does not expose the patient to radiation. As clinicians, we all have patients that are so anti-radiation that they absolutely refuse to take x-rays. Even after my team and I explain that we will not be able to give them an optimal diagnosis without radiography, some still decline. Besides patients who wish to avoid radiation, there is another segment of dental patients who can benefit from this technology. CariVu is ideal those who have a severe gag reflex, those who have had radiation therapy for cancer, or people for whom it is too difficult to use any sensor (or film) on such as small children or adults with large tori. With this technology, I can get much of the information needed to formulate a diagnosis and get the work done.

Promoting Practice Advances

As soon as I implemented this efficient caries-detecting technology, I wanted to share my enthusiasm and at the same time send the message to patients that this practice is up-to-date, innovative, and gives the patient options. Radiation reduction is a hot topic with current and potential patients, and it is important to everyone to know that we are doing our best to reduce exposure when possible. Our management communications software partner, Solutionreach Smile Reminder (www.solutionreach.com), helps us to send out email newsletters every few months. Using this, we spread the news that we implemented CariVu to see into their teeth without radiation, as well as DEXshield™, another new radiation-reducing technology from DEXIS. We tell patients that we estimate potentially lowering radiation by 75% by switching from film to digital x-rays, and now, using DEXshield in combination with the DEXIS Platinum Sensor, we can further estimate that we have lowered those settings by another 30%. Every patient loves hearing that story.

We also use social media and share our newest technologies on our office’s Facebook page. An innovative way to reach our potential audience is through my local Fox affiliate TV station. Every few months I appear on their morning show to provide a dental story. A few months ago, I took my CariVu along and scanned the news anchor’s teeth live on TV! (Yes, this unit is also that compact and portable.) It made for great TV and great dentistry and was very well received by viewers.

Once the patients are in the chair, they get to see directly how the CariVu benefits their dental care. Since I have monitors in all operatories, my patients have the opportunity to watch the image as we use the unit. And because of the capacity for integration, I can then show the CariVu image side-by-side with the intraoral camera image and digital x-rays. Together, these are powerful images to show when you want to co-diagnose and share a treatment plan with patients. When patients see these easy-to-understand images, they more readily accept preventive or restorative care.

Final Thought

My patients are not surprised to read about my experience of my new technology in my newsletters, on social media, or on TV. Because I use all of these media often, they now expect our office to keep up with innovation. Word gets around that our practice strives to deliver outstanding comprehensive care using the most modern technologies, and bringing the best of contemporary dentistry to those who entrust their dental care to us.


Dr. Dalin evaluated CariVu for DEXIS; he has no financial interests in DEXIS, LLC.

About the Author

Second-generation dentist Jeffrey Dalin, DDS, received his BA in chemistry from Emory University and his DDS from Indiana University School of Dentistry. He has earned a fellowship in geriatric dentistry from the University of Missouri-Kansas City School of Dentistry and fellowships from the American College of Dentists, the Academy of General Dentistry, the International College of Dentists and the Academy of Dentistry International. Dr. Dalin is the cofounder of the Give Kids A Smile (GKAS) program, which has now been adopted by the American Dental Association. He currently is chairperson of the National Advisory Board of the GKAS program. Dr. Dalin maintains a private practice in St. Louis, Missouri.

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