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26

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Volume 1 Issue 7

I

ssues and

P

eople

What do you think is the key factor

in managing dental caries

successfully?

Patient engagement. If your patients aren’t

engaged in managing any disease process,

there’s going to be no success. Patients need

to understand what the disease is, and we as

clinicians need to provide them with quantifiable

information so they understand whether

things are improving or worsening. For caries

management, it’s about lesion progression or

regression. If it’s growing, we need to engage the

patient in behavioural changes.

Are there new tools to help us engage our

patients better?

Yes, there are. What I would advise dentists to

look for in a tool is one that’s linked to the

disease process—in caries it’s measuring

change in crystalline structure—that is backed

by good science and solid evidence with

results that are quantifiable, and that patients

can understand.

For example, my patients don’t understand what

that little interproximal spot is when I show them

radiographs. But when I give them a number with

a scale, they begin to understand. So looking at

devices that have repeatable, numerical results is

key. Moreover, patients have to understand what

the device is measuring.

Would you say “caries medicine” is the future

of caries management?

It has to be. We need to look at the fees for the

various services. Because when you think about

it, what’s considered prevention isn’t actually

disease prevention—it’s disease treatment. We

need enough support for practices to run a robust

preventive program, as well as a program that

covers the cause of the lesion. Prevention is in my

opinion undervalued at times. Yet that’s the one

thing that’s going to make the biggest difference

down the road.

How can organized dentistry support the

evolution of caries management?

Organizations can provide the profession with

access to literature and speakers, and knowledge

on how to critically evaluate the literature. They

can also advocate for a fee or reimbursement

system that provides support so we can treat

disease early in its process.

Finally, organized dentistry can message the fact

that it’s important that dental diseases be treated

in what I call a “dental home,” an environment

where the dentist becomes the person who

supervises, and is actively involved in, the

management of the caries disease process across

its spectrum.

a

This interviewhasbeencondensedandedited.

Theviewsexpressedarethoseoftheauthorsanddonotnecessarilyreflecttheopinionsor

officialpoliciesoftheCanadianDentalAssociation.

The Canary System

The Canary System, developed by Dr. Abrams and his team at Quantum Dental

Technologies, uses a laser to measure both release of heat and reflected light

from the tooth surface. The device provides information on the presence and

extent of carious lesions up to 5 mm beneath tooth surface, including in

the interproximal areas, cracks, beneath sealants and around the intact

margins of restorations. It uses a numbering system to help patients

understand if lesions are improving or worsening.