Caries Detection and Diagnostic Techniques in Pediatric Dentistry

Pediatric dental caries remains a leading global health challenge, often beginning as subclinical enamel demineralisation before progressing to cavitation. Early and accurate detection is essential to guide minimally invasive interventions, reduce treatment burden and improve long-term oral health outcomes in children. Traditional visual-tactile inspection, guided by standardised systems such as the International Caries Detection and Assessment System (ICDAS), continues to serve as the primary screening tool in clinical and community settings. Complementary radiographic methods, principally bitewing radiography, enable detection of proximal lesions but involve ionising radiation. Recent decades have seen rapid development of non-ionising optical techniques, including quantitative light-induced fluorescence (QLF), laser fluorescence devices, fibre-optic and near-infrared transillumination, which exploit changes in tissue fluorescence or scattering to reveal demineralisation. Electrical conductance and impedance methods offer additional contrast by probing mineral loss. Advances in digital imaging, three-dimensional intra-oral scanning and artificial intelligence (AI)-based interpretation aids promise automated, remote and highly sensitive screening capable of monitoring lesion activity and sealant microleakage. Integration of these modalities supports risk-based management, reinforcing preventive care, sealant efficacy and patient engagement.

Research from Nature Portfolio

Quantitative light-induced fluorescence (QLF) has been evaluated for noninvasive detection and severity assessment of pit and fissure sealant microleakage. In vitro studies demonstrated that fluorescence loss correlates strongly with histological dye-penetration scores, achieving high diagnostic accuracy (area under the curve up to 0.91). These findings suggest that QLF can monitor sealant integrity over time, potentially guiding reapplication decisions and enhancing preventive programmes in children at high caries risk.

Caries Detection and Diagnostic Techniques in Pediatric Dentistry publication trend

The graph below shows the total number of articles in caries detection and diagnostic techniques in pediatric dentistry across all publications each year (not limited to Nature Index journals).

Technical terms

Visual-tactile inspection: Clinical examination using sight and an explorer to detect surface changes and cavitation.

Bitewing radiography: Intra-oral X-ray technique for visualising proximal surfaces and early interproximal lesions.

Quantitative light-induced fluorescence (QLF): Optical method measuring fluorescence loss in demineralised enamel to quantify lesion extent.

Near-infrared transillumination (NIT): Imaging technique that transmits NIR light through tooth tissues to reveal demineralised areas without ionising radiation.

International Caries Detection and Assessment System (ICDAS): Standardised scoring system for visual classification of caries severity from initial enamel changes to extensive cavitation.

Microleakage: Penetration of fluids and bacteria at the tooth–sealant or restoration interface, indicating seal integrity failure.

References

1. Detection of pit and fissure sealant microleakage using quantitative light-induced fluorescence technology: an in vitro study. Scientific Reports (2024).
2. Global Research Trends in the Detection and Diagnosis of Dental Caries: A Bibliometric Analysis. International Dental Journal (2024).
3. Detection and diagnosis of the early caries lesion. BMC Oral Health (2015).
4. Reflected near-infrared light versus bite-wing radiography for the detection of proximal caries: A multicenter prospective clinical study conducted in private practices. Journal of Dentistry (2021).