academy_articleA High-Tech Necessity

DIAGNOdent Diagnostic Dental Laser

By David Eshom, DDS

Are you neglecting your patient’s health? I know you think your exams are thorough and you couldn’t possibly miss occlusal decay in your patients. You use magnifying loops and caries detecting solution and caries is the last thing that gets by you “CSI” eyes. Unless you are using the low cost laser technology of the DIAGNOdent (KavoUSA), your patients are being left with active caries in their mouths — all under your watchful eyes.

Dr. Rella Christiansen (wife of Gordon) reported in the November 2001 Compendium that 92% of discolored pits and fissures are decayed, and sealants over 10 years old are decayed 90% of the time. Read her article to learn the details, but the bottom line is that there is a tremendous amount of decay being missed by our eyes and explorers.

The good news is that we now have the technology to differentiate the 90% of stained grooves that are decayed, and especially the 10% that are sound. Don’t let this scare you, but the technology is laser technology. It is not expensive — just $3,200. The DIAGNO-dent is a low-level diode wavelength laser that fluoresces bacteria that exists in fissures. The amount of reflected fluorescence is measured by a ring at the top of the laser. Depending on the amount of fluorescence, a cavity/sealant or no treatment is diagnosed.

Our profession has been quite successful in reducing occlusal decay with fluoride, sealants and education. However, now a new model of decay have developed that does not stick to our explorer and festers in fissures and attacks the weakest part of the tooth-dentin. We have seen it in our offices — that small pit that should be incipient decay that turns into deep decay and leaves us scratching our heads as to “why?” Studies have shown our explorers and eyes are only 25% accurate. That means flipping a coin is more accurate when deciding “decay or no decay!”

Lasers are a great technology to add value and more precise treatment to your practice. The DIAGNOdent is a great first step to understanding the benefit of dental lasers. Why not add this inexpensive laser to your armamentarium, improve your diagnostic skills, and save your patients’ teeth from decaying from the inside out!

1. R. Christiansen, Poeger, T. Palmer. Pit-and-fissure Discoloration in Caries Assessment. Compendium 22(11a), November 2001

2. Al-Sehaibany, White & Rainey. J Clin Pediatr Dent 20(4):293-298, 1996

For more info:, DIAGNOdent manufacturer

For details of use:, Microdentistry learning materials

For more on Microdentistry:
World Congress of Minimally Invasive Dentistry,, WCMID annual meeting is in August in San Diego, CA. See web site for details.

For a San Diego study club on this topic:
Dr. Eshom has established a study club for Cosmetic Dentistry, Laser Dentistry and Minimally Invasive Dentistry which meets every other month. For more information call (858) 455-9151, ask for Cynthia.