Caries-detector dyes--how accurate and useful are they?
Commercially available caries-detector dyes are purported to aid the dentist in differentiation of infected dentin, yet research has established that these dyes are not specific for infected dentin. They are non-specific protein dyes that stain the organic matrix of less mineralized dentin, including normal circumpulpal dentin and sound dentin in the area of the amelo-dentinal junction. A considerable body of evidence indicates that conventional tactile and optical criteria provide satisfactory assessment of caries status during cavity preparation. There is reason for concern that subsequent use of a caries-detector dye would result in unnecessary removal of sound tooth structure. The use of caries-detector dyes has also been suggested as a diagnostic aid for occlusal caries. Although diagnosis of carious dentin beneath apparently sound enamel can be challenging, there is a lack of substantive evidence supporting the use of dyes for this purpose and false positives are a significant concern. Careful visual inspection combined with bitewing radiographic diagnosis has been shown to be the most reliable diagnostic method for the presence of infected dentin requiring operative treatment.
McComb
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Faculty of Dentistry, University of Toronto, ON. d.mccomb@utoronto.ca
D004396:Coloring Agents; D003731:Dental Caries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003737:Dental Cavity Preparation / Q000379:methods; D003743:Dental Enamel / Q000473:pathology; D003804:Dentin / Q000473:pathology; D005189:False Positive Reactions; D006801:Humans; D016300:Radiography, Bitewing; D015203:Reproducibility of Results
D004396:Coloring Agents