Electrical conductance for the detection of early tooth decay

Dentists often aim to identify tooth decay that has already advanced to a level that needs a filling. If dentists were able to find tooth decay when it has only affected the outer layer of the tooth (enamel) then it is possible to stop the decay from spreading any further and prevent the need for fillings. It is also important to avoid a false‐positive result, when treatment may be provided when caries is absent. This is one of a series of reviews on diagnostic tests for dental caries, we also have reviews on imaging modalities, transillumination, fluorescence devices and tests to detect root caries.

The aim of this Cochrane Review was to find out how accurate electrical conductance devices (non‐invasive devices that send an electrical current to the surface of the tooth) are for detecting and diagnosing early tooth decay as part of the dental ‘check‐up’ for children and adults who visit their general dentist. Researchers in Cochrane included seven studies published between 1997 and 2018 to answer this question.

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Dental imaging methods for the detection of early tooth decay

Dentists often aim to identify tooth decay that has already advanced to a level which needs a filling. If dentists were able to find tooth decay when it has only affected the outer layer of the tooth (enamel) then it is possible to stop the decay from spreading any further and prevent the need for fillings. It is also important to avoid a false-positive result, when treatment may be given when caries is absent.

This Cochrane Review aimed to find out how accurate X-ray images and other types of dental imaging are for detecting early tooth decay as part of the dental ‘check-up’ for children and adults who visit their general dentist. Researchers in Cochrane included 77 studies published between 1986 and 2018 to answer this question.

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Light‐based tests for the detection and diagnosis of early tooth decay

Dentists often aim to identify tooth decay that has already advanced to a level which needs a filling. If dentists were able to find tooth decay when it has only affected the outer layer of the tooth (enamel) then it is possible to stop the decay from spreading any further and prevent the need for fillings. It is also important to avoid a false‐positive result, when treatment may be provided when caries is absent.

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How accurate are fluorescence devices for detecting and diagnosing early tooth decay?

Dentist holding caries detector with fluorescent light for checking the teeth.

Dentists often aim to identify tooth decay that has already advanced to a level which needs a filling. If dentists were able to find tooth decay when it has only affected the outer layer of the tooth then it is possible to stop the decay from spreading any further and prevent the need for fillings. It is also important to avoid a false-positive result, when treatment may be provided when caries is absent.

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Diagnostic tools for detecting root caries: uncertain evidence

Root caries (tooth decay on the root of a tooth) is a well-recognised disease, that is on the increase as populations grow older and keep more of their natural teeth into later life. Like coronal caries (tooth decay on the crown of the tooth), root caries can be associated with pain, discomfort, and tooth loss, which can contribute to poorer oral health-related quality of life in the elderly. Detecting caries earlier can mean invasive treatment is needed, where more tooth tissue can be preserved. It could also mean less cost to the patient and to healthcare services.

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Testing for oral cancer

shutterstock_177881789Oral cancer (OSCC – oral squamous cell carcinoma) often occurs after a condition called PMD (potentially malignant disorder), which can sometimes progress to cancer. If conditions such as oral cancer or PMD are identified early enough, outcomes for patients can be improved. The current method of diagnosing cancer of the mouth or lips involves the surgical removal of a piece of affected tissue that is sent to a laboratory for histological examination using a microscope (scalpel biopsy). This is painful for patients and involves a delay. The aim of this review was to find out the accuracy of three alternative diagnostic tests that are less invasive and provide more timely results. Continue reading

New version of RevMan

rm5logoThe new version of RevMan (RevMan 5.2) is now available. Current users of RevMan will get prompted to download the new version when they open the software. The biggest changes are around Diagnostic Test Accuracy reviews, as RevMan now includes support for the new QUADAS-2 tool.

Other changes include:

  • The ability to import studies containing study data in XML format, including Study characteristics. For intervention reviews only.
  • References can now be exported in Vancouver style.
  • PDF previews of reviews can now be generated prior to publication using the “File” menu.
  • Active choice of forest plot labels is now required. A validation error will be generated if the labels are left as “default”.
  • There is now a validation check for the accuracy of references to other Cochrane reviews.

Numerous fixes have also been introduced. For further information on all the changes, go to the RevMan What’s New page. For help getting started with RevMan, check out the Documentation on the website.

New edition of the Cochrane Library is out today!

A new edition of the Cochrane Library has been published, and features one new review and 5 new protocols from the Oral Health Group, a bumper month!

New review: AntibioticsImage to prevent complications following tooth extraction
Giovanni Lodi, Lara Figini, Andrea Sardella, Antonio Carrassi, Massimo Del Fabbro, Susan Furness

This review looks at whether antibiotics, given to dental patients as part of their treatment, prevent infection after tooth extraction. There were 18 studies considered, with a total of 2456 participants who received either antibiotics (of different kinds and dosages) or placebo, immediately before and/or just after tooth extraction. Do they do more harm than good? Follow the link to read more!

New Protocol: Clinical assessment to screen for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy adults
Tanya Walsh, Joseph LY Liu, Paul Brocklehurst, Mark Lingen, Alexander R Kerr, Graham Ogden, Saman ImageWarnakulasuriya, Crispian Scully

This is a protocol for the Oral Health Group’s first review of diagnostic test accuracy, a new area of research for the Group. The objective of this review is to estimate the accuracy of the conventional oral examination (COE) used singly or in combination with another index test as a screening test for the detection of oral cancer and potentially malignant disorders (PMD) of the lip and oral cavity of apparently healthy adults.

New Protocol: Interventions for replacing missing teeth: alveolar ridge preservation techniques for oral implant site development
Momen A Atieh, Nabeel HM Alsabeeha, Alan GT Payne, Warwick Duncan, Marco Esposito

A protocol for a new review. The aim is to assess the clinical effects of various materials and techniques for alveolar ridge preservation (ARP) after tooth extraction compared with extraction alone and/or other methods of ARP for patients requiring oral implant placement following healing of extraction socket.

ImageNew Protocol:Lasers for caries removal in deciduous and permanent teeth
Alessandro Montedori, Iosief Abraha, Massimiliano Orso, Potito Giuseppe D’Errico, Stefano Pagano, Guido Lombardo

This protocol is for a new review which will compare the effects of laser-based methods to conventional mechanical methods for the removal of dental caries in deciduous and permanent teeth.

New Protocol: Maternal consumption of xylitol for preventing dental decay in children
Derek Richards, Brett Duane, Andrea Sherriff

Protocol for a new review. The aim is to evaluate the effects of xylitol (consumed by mothers) at reducing tooth decay in their children compared with alternative treatments (e.g. chlorhexidine, fluoride varnish, placebo, or no treatment).

New Protocol: Orthodontic treatment for bimaxillary proclination in children and adults
Padhraig S Fleming, Nikolaos Pandis, Zbys Fedorowicz, Reshma A Carlo, Jadbinder Seehra

This new protocol is for a Cochrane review which will assess the effects of different types of orthodontic treatment for bimaxillary proclination particularly their impact on occlusal results, facial outcomes and patient experiences.

Other highlights of the Cochrane Library, Issue 11, 2012:

There is also an editorial on Measuring the Performance of the Cochrane Library.