Transillumination?

[jay47]

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Any practicing dentists in here use transillumination to ID caries? Any shadowers seen this before?

We looked at some stats and it seems to have a higher sensitivity to caries than Radiographs (with slightly better specificity as well) so it seems to be legitimate.

Just never knew if the real world practice of this method was feasible.

 

[Jake8]

You are talking about anterior teeth correct?

We learned the same thing recently and as far fetched as it sounds over the years of shadowing and now in D school it does seem to work very well. So well, that we were told documenting that carries on the mandibular anteriors was detected by transillumination, is valid for the insurance auditors

 

[TheWiredNerv]

For a cheap method, just use the fiber optic swivel for your high speed to shine the light.

 

[HupHolland]

You are talking about anterior teeth correct?

We learned the same thing recently and as far fetched as it sounds over the years of shadowing and now in D school it does seem to work very well. So well, that we were told documenting that carries on the mandibular anteriors was detected by transillumination, is valid for the insurance auditors

Transillumination for anterior teeth is nothing new. Typically only large class 3s are detected radiographically. Lesions penetrating the DEJ can be detected by transillumination alone; in fact, for the NERBs they don't have to be visualized on the radiograph..only clinically.

Hup

 

[tinman831]

in fact, for the NERBs they don't have to be visualized on the radiograph..only clinically.

Hup

amen to this! 😀

 

[jay47]

You are talking about anterior teeth correct?

We learned the same thing recently and as far fetched as it sounds over the years of shadowing and now in D school it does seem to work very well. So well, that we were told documenting that carries on the mandibular anteriors was detected by transillumination, is valid for the insurance auditors

Yeah, mostly.

I didn't know if you could use the fiber optic light to see them or if you needed something brighter.

I guess it doesn't seem like it would be very feasible for posterior teeth anyways, too far back and hard to see using the mirror.

 

[jay47]

Transillumination for anterior teeth is nothing new. Typically only large class 3s are detected radiographically. Lesions penetrating the DEJ can be detected by transillumination alone; in fact, for the NERBs they don't have to be visualized on the radiograph..only clinically.

Hup

Great to know. I'll be sure to keep this in mind when I get to clinic. I'll keep the HS fiberoptic ready...

 

[jay47]

On a side note, how useful might this technique be for finding cracks in posterior teeth?

 

[HupHolland]

On a side note, how useful might this technique be for finding cracks in posterior teeth?

As opposed to what? In my limited clinical experience, cracks are detected clinically, not radiographically.

Hup

 

[jay47]

As opposed to what? In my limited clinical experience, cracks are detected clinically, not radiographically.

Hup

Lol; I have no idea, just throwing that out there. I have NO clinical experience but I thought that they could be ID'd using RX.

 

[HupHolland]

Lol; I have no idea, just throwing that out there. I have NO clinical experience but I thought that they could be ID'd using RX.

You can probably detect cracks with CBCT, but the cost and amount of radiation often outweighs the benefits.

Hup

 

[StarryOrchid]

I am currently a dental hygienist and I use trans-illumination daily. It is a great tool to use when there is shadowing on a xray or overlap. It takes some practice and a trained eye, but very useful in the field.