A Nanoparticle, Fluorescence-Based Rinse for Caries Activity Assessment, an in Vitro Study

This in vitro study aimed to compare the agreement of a starch-based nanoparticle fluorescence rinse (FR) (LumiCare™ Caries Detection Rinse, GreenMark Biomedical Inc.) in the assessment of caries activity of initial smooth surface carious lesions with the International Caries Classification and Management System (ICCMS) Lesion Activity Assessment.

A convenience sample of permanent extracted human teeth (N = 57) were scored by visual assessment (VA) using the ICCMS activity criteria by 2 calibrated examiners. VA categories included: sound, inactive and active. For fluorescence assessment (FA), each tooth was fully immersed in FR for 30 seconds, rinsed with water for 10 seconds, compressed air dried and examined under an orange filter while illuminating with a curing light. Fluorescence was assessed as no fluorescence or fluorescence. Both VA and FA were repeated after at least 24 hours and Kappa was calculated for inter- and intra-examiner agreement.

Based on VA, 12 teeth (21%) were classified into the active category, while 45 teeth (79%) were classified into the sound (n = 20) or inactive (n = 25) categories. When combining the latter 2 categories, VA and FA's classifications were concordant in 100% of cases (all 12 teeth in VA's active category exhibited fluorescence, and all 45 teeth in VA's sound/inactive category did not exhibit fluorescence according to FA; Kappa = 1).

FA with FR demonstrated perfect agreement with VA using ICCMS when comparing active versus inactive and/or sound surfaces suggesting it has potential as an objective indicator of caries activity.

A fluorescence rinse could improve clinical detection of smooth surface caries activity and could easily be integrated as part of the dental hygiene appointment.