Early caries detection has been cited as key to optimal prevention and treatment. Air Techniques’ Spectra uses fluorescence technology to aid in the detection of plaque and caries, especially early-stage enamel caries and hard-to-detect fissure caries. The lightweight handpiece has a high-resolution, high-sensitivity CCD sensor with autoexposure. The unit’s LEDs project high-energy light onto the tooth’s surface, causing cariogenic bacteria to fluoresce red and healthy enamel to fluoresce green.
Caries Detection
The Spectra’s blue-violet light is emitted at a wavelength of 405 nm, which makes porphyrins from caries-producing bacteria to fluoresce. When used with the unit’s 10 mm distance spacer, the fixed-focus lens system brings all objects within the area of interest into focus.
When the 7 dentists who evaluated Spectra were asked about the ability of Spectra to detect plaque and caries earlier than with traditional methods alone, 2 rated it as excellent and 5 rated it as very good. One dentist “detected otherwise undetected caries” and another said it “seems superior for occlusal caries.” The same dentist, with 34 years of experience and 5 operatories, said he “liked the ability to pick up decalcified areas.”
A general practitioner in private practice said Spectra “works best with hard-to-detect fissure lesions in which the enamel surface is mostly intact, with an opening too small for the explorer tip but with caries present in the dentin.” She described the results as “repeatable and consistent when used as an adjunct to, not a substitute for, clinical judgment.” Another general practitioner “noted numerous carious lesions not noted on radiographic examination (probably clinically detectable).” This evaluator went on to say that “[Spectra] provided consistent results and was useful for detecting caries around old restorations and for helping me decide whether or not to restore.”
False-Positives
When asked about false-positives, Spectra was rated as excellent by 2 evaluators and as very good to good by 5. Two evaluators described false-positives as “not much of an issue,” and 2 reported no false-positives at all.
Ease of Use
Ease of use was rated as excellent by 2 evaluators, as very good by 3, as good by 1, and as poor by 1. One dentist noted “a slight software-related learning curve.” Another evaluator called Spectra “fairly simple,” adding that the handpiece “could use some weight trimming.” A general practitioner from New Jersey said “set up took a bit [of time]…, but the [Air Techniques] contact was very helpful.” A New York dentist noted that “once set up, the program was fairly straightforward… the handpiece software was relatively straightforward and can be mastered quickly.” Another said that “the time from box opening to use was minimal…the included Visix software was very userfriendly and easy to add to the computer.”
Patient Reaction
The fluorescence images captured with Spectra can be useful in tracking a patient’s oral hygiene, graphically describing the clinical situation, and explaining treatment plans.
The evaluators were asked to gather feedback from their patients when using Spectra. Patient reaction was rated as excellent by 2 evaluators, as very good by 3, and as good by 2. One evaluator reported “mixed reactions.” Another said her patients were “receptive to and interested in the technology” and another said patients “thought it was a great tool.”
Another dentist noted that it “helped to reinforce my treatment plan and give solid reasons for my recommendations.” This same evaluator recommended “equipping the Spectra with an intra-oral camera so patients can see the tooth in question.” Another dentist said, “The ‘wow’ factor was seeing a tooth with red lines [indicating caries]!”
Overall Satisfaction
At the end of the evaluation, the evaluators were asked if they would recommend Spectra. Five evaluators said they would definitely or probably recommend Spectra to their colleagues. When asked to rate their overall satisfaction with Spectra, 4 evaluators rated it as very good, 2 rated it as good, and 1 rated it as fair. A general practitioner who reported “no negative feedback” from patients said Spectra “definitely has value…adds to the dentist’s credibility and helps reinforce the need for treatment.”
Reference
1. Zero DT, Fontana M, Martinez-Mier EA, et al. The biology, prevention, diagnosis and treatment of dental caries: scientific advances in the United States. J Am Dent Assoc. 2009;140(Suppl 1):25S-34S.
