Caries Management Cycle

The CarieScan Caries Management Support Cycle can be delivered by:

• CarieScan PRO
• CarieScan Plus

The CarieScan Caries Management Cycle helps the dental team co-ordinate caries management and explain the various steps to patients.

This technology employed in CarieScan PRO differs from conventional caries detection methods, which can sometimes lead to errors which allow caries to continue as irreversible and progressive decay leading, in turn, to early and then repeated restorations and spiralling costs.

The choice of clinical action(s) for individual patients will vary, according to their current caries status and risk profile, from preventive to restorative or combinations of both. The use of CarieScan PRO as part of a dental assessment can reveal established hidden dentine lesions (not seen as part of a careful conventional visual examination) which need prompt restorative care. CarieScan PRO may also detect initial lesions where preventive care can stablilse or even reverse the caries process. Most of these hidden and initial lesions would not be clearly evident to the dentist, even if radiographic examination were used.

To consider the CarieScan Caries Management Cycle in a little more detail, set out below are definitions and then key elements of the seven steps in the Cycle:

CarieScan Caries Management Support Cycle Step 1: Detection

Once caries has been detected (by means of clinical, radiographic or CarieScan PRO examinations) we can start to move on to step 2.

It should be appreciated that as the Sensitivity of CarieScan PRO is over 92%, it will detect many more lesions than visual or radiographic methods alone. In particular hidden dentine lesions which may be missed by other examination methods will be picked up using CarieScan PRO.

CarieScan Caries Management Support Cycle Step 2: Diagnosis:

A Dentist will now use clinical judgement and knowledge of the patient’s history to make a clinical diagnosis for each part of each tooth surface. 

The different risk factors which are evident from the patient history will all play a part in the clincian’s initial diagnosis and assessment

They may decide that the extent of the lesion, as evidenced by the progression up the CarieScan PRO pyramid scale to the red zone (where both Preventive and Operative Care is advised), is such that a “just in time” restoration is now indicated and provide a restoration. If a dentist makes this decision, then by using the CarieScan PRO they can be reassured that that they will be drilling at the right time, and in the right place.

In some circumstances where the CarieScan PRO shows a green indicator on the pyramid, the dentist can reassure the patient that the tooth surface in question is likely to be sound. Unlike many other sensitive lesion detection methods, CarieScan PRO has a specificity exceeding 92% and is therefore reliable in assessing sound surfaces as truly sound.

When the CarieScan PRO pyramid indicates that the lesion extent is in the yellow zone, then the dentist may decide that a lesion with initial caries is present. In such circumstances preventive care and review is an appropriate care strategy. In this case, the next step, monitoring lesion behaviour over time in order to assess the outcome of preventive care, becomes very important.

CarieScan Caries Management Support Cycle Step 3: Monitoring:

When the CarieScan PRO pyramid indicates that the lesion extent is in the yellow zone, then you may decide to provide preventive care and review. The numerical scale provides an indication of the risk of established dentine caries being present. Changes in the numerical value may be used, in conjunction with other signs, to indicate changes in this risk level and help you in motivating the patient.

You will find the monitoring process considerably easier with the aid of CarieScan PRO than trying to record changes in subjective and often inaccurate visual assessments of lesion extent.

CarieScan Caries Management Support Cycle Step 4: Prognosis:

The next step in the Caries Management Cycle is concerned with Prognosis, determining the likely next steps in the caries picture for this patient.

CarieScan Caries Management Support Cycle Step 5: Preventative Care Enabled:

The next step is enabling preventive care, using the CarieScan PRO results to demonstrate success or slippage in Caries Control between visits can be useful.

CarieScan Caries Management Support Cycle Step 6: Patient Records:

Patient records can be enhanced by recording both the Pyramid colour and, if in the Yellow zone, the numerical value corresponding to each lesion.

CarieScan Caries Management Support Cycle Step 7: Individualised Recall enabled:

The recall interval for each patient can be individualised on the basis of the number of lesions detected, their extent and the rate of progression revealed by monitoring of initial lesions.

CarieScan Caries Management Support Cycle Step 8: Cycle complete:

This is a continuing cycle which will take place over months and years