With all the different types of patients that come through our
doors each day, it’s practical to have different types of examination
tools that aid in diagnosis. While bitewing X-rays are a standard
modality for detecting caries, as we all know, there are many times
when the patient is not able to tolerate or even refuses radiographs.
We can often feel as if our hands are tied as we try to
make determinations based on just our visual exams. This is when
it’s good to have another way to “look inside” our patient’s teeth.
Earlier this year I started using the DEXIS CariVu caries
detection device. This new portable unit helps me easily detect a
range of carious lesions (occlusal, interproximal, recurrent) and
cracks using transillumination technology—without radiation. The
infrared light source is in the unit’s handpiece, and you can capture
images from this handpiece directly into the DEXIS software.
CariVu lets me verify what I see in visual exams or on radiographs.
In the images that CariVu captures, the natural tooth
looks transparent, and caries is dark, similar to radiographs. This
view is familiar and easy to read. Another great benefit of CariVu
is that it identifies the carious lesion’s location, shape and its relative
size to the tooth under review.
I’ve used DEXIS products for well over 15 years and appreciate
having all my X-ray and camera images centralized. CariVu
images are captured and stored with the patient’s intra-oral Xrays
and camera images. When I select a tooth number, these
images appear at the top of the screen. I can easily compare them
side-by-side to make a diagnosis and decide on a course of treatment.
My patients find these images easy to understand as well,
and that means they can better understand the need for preventive
or restorative care.
We have all faced the patient who is very insistent about not
having any X-rays. They may go year after year after year without
letting us take any radiographs on them. This system has been a
godsend for these patients. It takes about the same amount of
time to scan all the posterior occlusal surfaces as it does to take
bitewings, so no time is lost in the appointment. The amount of
information gathered can help give me the patient the best clinical
diagnosis under their imposed constraints.
Another situation where the system can be of value is when
we are monitoring areas between routine exams. While decay
may spread before it’s time to take bitewings again, capturing a
quick CariVu image of the area lets me know if it’s OK to wait
to take radiographs until the next recall visit or begin treatment.
I have found it to be very useful for children with small
mouths where it is very difficult to take any radiographs—
regardless if sensor- or film-based—due to their cavity size, gag
reflex, behavioral problems, etc. I can comfortably capture
CariVu images of their posterior teeth, and they love watching
their images appear on the screen.
Lastly, the system is simple to use; just plug-and-play.
Everyone in the office was up and running with it within the
first few minutes of plugging it in. I see CariVu as a very valuable
adjunct to exams and radiographs for the identification of
tooth decay and cracks in every dental office—it’s a great diagnostic