l - IAPTER 2 . 3 The Implications of Using Ozone in General Dental Practice

The detection of dental decay has conventionally been dependent upon direct visual assessment of the dried tooth surface under good illumination, tactile assessment of open dental caries using a probe to help clean debris within fissures, clinical experience and the use of dental radiography. Studies have shown considerable variation berween clinicians in the detection of dental caries. Recent additions to assist the accurate detection of dental caries include the DIAGNOdent (KaVo GmbH, Germany), caries detector dyes and digital radiography. Pre-1980s, a sharp-tipped explorer, of various design, was used to 'probe' all accessible tooth surfaces for detection of any defects. It was thought correct to apply pressure on the explorer to detect any 'sticky' areas. The degree of 'stickiness' of an area was subjective and in general a sticky pit or fissure indicated a carious area that required conventional treatment. This comprised mechanical removal of the sticky area until crisp, hard tissue remained, and the restoration of the subsequent defect by some form of filling material. In the 1980s the dental profession acquired a better understanding of the caries process. It became known that an early carious lesion is in a constant state of balance berween the loss of dental mineral as a result of the acids produced by plaque micro-organisms, and the re-precipitation of mineral from oral saliva. With this knowledge came the realisation that aggressive use of sharp probes into early lesions would actually disrupt the dental tissue and create a physical cavity, causing more harm than good. Advice followed that an explorer should be used as gently as possible, merely acting as a tactile sensor for the detection of roughness, rather than being pressed into suspicious areas to see if the instrument would 'stick'. What changes have been made in detecting dental caries in recent times?