Caries diagnosis: the necessity for a new standard of care

Conclusive research has called for the elimination of the explorer as a means of diagnosing pit and fissure caries. It has been shown to be not only unreliable, but capable of spreading caries and damaging enamel. This technique, however, is still in use in most dental offices and is still taught in our dental schools. The well-intentioned placing of sealants on undiagnosed caries further exacerbates the problem. New technology has provided the means for reliably and conservatively dealing with this problem. These new modalities should become the standard in diagnosis and treatment. Video examination of all pits, fissures, and grooves for changes in light transmission, color, or staining. Microabrasion of all suspect areas at low pressure with 27 mu medical grade alpha alumina. Exposing and staining carious tooth structure with a propylene glycol caries indicator. Removal of decay using microabrasion. Restoration with a bonded composite.