User report Dr. Klewer
Dental Practices PAR Aixcellence Olaf Klewer, Ann-Katrin Hinz
Greater reliability in caries detection is a key factor in preserving the vitality of teeth. In order to optimally assist dentists in reliable evaluation, W&H offers the new Facelight - a clinical aid for rapid detection of bacterially infected dental hard substance. Dr.med. dent. Olaf Klewer and Ann-Katrin Hinz, dentists in private practice in Aachen, Germany, have been using Facelight for several months and report on their initial experience:
In times in which quality management is of growing importance, dentists are always interested in looking after the important items: Patient treatment. We are always trying to find objective and efficient methods to improve our workflows. Our objective is to make treatment as atraumatic as possible for the patient.
The correct assessment of caries is a major challenge for every dentist at the outset - especially if the treatment extends to areas close to the pulp. When it comes to caries detection, the dilemma arises of making the correct decision for the long term. The closer you get to the pulp, the softer the dentine feels. Dyes are not satisfactory here, as their application to the dentine close to the pulp or at the enamel-dentine junction leads to a false positive result due to the special morphology in this region, even in the absence of carious infection. This therefore renders unambiguous caries diagnosis impossible. Another disadvantage of this method is that the adjacent areas are also permanently stained. The classical test using a dental probe is also uncertain for the dentist, especially if your own diagnosis is not confirmed.
The modern FACE method (Fluorescence Aided Caries Excavation) gives dentists a new perspective from which to consider and assess the treatment situation. Illuminating the cavity using a light probe proves to be a simple and fast method. The extent of the bacterially infected dentine present is clearly visible, which, above all, provides the certainty necessary for its detection. We have been using Facelight in our practice for two months now because of its outstanding properties.
The system consists of a light probe and filter goggles, which can be worn over normal prescription glasses. Using the Facelight light probe you simply illuminate the cavity - in much the same way as using a polymerisation lamp. The metabolic process taking place in the bacteria leaves porphyrins as a metabolic product. They present a clearly identifiable red fluorescence under violet light. Healthy tooth substance can be clearly distinguished by its characteristic green fluorescence. The dentist can see and clearly identify caries-infected areas, which can then be selectively removed as part of caries excavation.
Our experience with Facelight has shown that there is somewhat more to be seen with the Facelight light, mainly in profound caries. For the classical probes thin streaks or spots do present problems, they cannot be detected and diagnosed.
A total of 14 patients with 67 cavities were examined. After initial examination with the classical probe all 67 cavities seemed to be caries-free, but Facelight showed that 14 out of these 67 cavities were not totally caries free. Of these 14, in which there was caries despite the positive probe test, 11 could be classified as profound caries. This preliminary result is thought-provoking for us, so we will now continue to collect data with a second Facelight device. This will make it highly probable that all those treated in our group practice will undergo the Facelight test.