Dental caries remains a significant global health issue. It was highlighted by the World Health Organization’s 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists’ approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics.

To assess the cytotoxicity of an experimental hybrid-glass-based infiltrant and its effect on biofilm attachment, growth and metabolic activity, and to compare it to the resin-based infiltrant Icon. Cytotoxicity of hybrid-glass-based material (EXP) and resin-based infiltrant Icon (Icon) was tested in direct contact tests on freshly cured (direct_mat) and on materials kept for 24 h in cell culture medium (direct_exmat), and extract test with materials 24-h extracts (extract). Cell viability of L929 mouse fibroblast cell line was measured with MTT assay, according to ISO10993-5:2009. Biofilm attachment (5 h), growth (24 h and 48 h) and lactic-acid production (24 h and 48 h) on glass-disk specimens coated with EXP or Icon, or uncoated (control), were assessed using a microcosm biofilm model and Amsterdam Active Attachment system. At indicated time points, biofilms were harvested, plated, and CFU counts were determined, while lactic-acid production was measured colorimetrically. Cell viability reduction by EXP was below 30%-threshold in direct contact tests, while in extract test an increased cell viability was observed. Icon reduced cell viability substantially in all three tests. Significantly less bacteria attached to the surface of EXP after 5 h compared to Icon and control. Biofilm growth was significantly lower on EXP than on Icon and control after 24 h, but this difference was smaller and statistically insignificant after 48 h. There was no difference in lactic-acid production among groups. Novel hybrid-glass-based infiltrant seems to have a better biocompatibility and accumulates on its surface less bacteria than resin-based infiltrant, which makes it an attractive resin-free alternative.

Caries lesions can be arrested by the preferential deposition of mineral at the lesion surface, which inhibits diffusion of fluids into the porous lesion.^{1 – 3} Since arrested lesions do not need further intervention, the assessment of lesion activity is essential for clinical diagnosis. Many lesions have been arrested or do not require intervention. Even so, it is difficult to identify active lesions with current diagnostic methods. Accurate assessment of lesion activity, depth, and severity is important for determining whether intervention is necessary. Gold standards for lesion assessment such as transverse microradiography and polarized light microscopy either require destruction of the tooth or in the case of microCT are unsuitable for use in-vivo. New non-destructive diagnostic tools that can assess lesion activity in a single visit are needed. Effective employment of new optical diagnostic technologies that can exploit the changes in the light scattering of the lesion has great potential for diagnosing the present state of lesions. Therefore, the development of new methods, such as short wavelength infrared (SWIR) imaging, is needed for the clinical assessment of lesion activity to avoid unnecessary cavity preparations.

Objectives: To quantify the prevalence of Molar Incisor Hypomineralization (MIH) in the canton of Geneva, Switzerland. Study design: Thirty-eight dentists of the state school dental services were trained to detect and classify MIH cases. All children (32,142) from age 4 to 12 were examined during the annual dental screening offered by the state. Cases were scored as mild, moderate or severe. Results: The prevalence of hypomineralizations was found to be 7.45% when all hypomineralized teeth were taken into consideration. MIH cases were found to be at 6.6%. Out of the MIH cases, 51% scored as mild, 36% as moderate and 13% as severe. Conclusion: The mean prevalence of MIH in Geneva school children was found to be 6.6%. This seems to be lower than the European and the global average. However, with almost half cases being moderate or severe, asserting a proper management protocol is necessary.

Short-wavelength infrared (SWIR) and near-IR imaging (NIR) methods have been under development for almost 20 years for use in dentistry and several NIR clinical devices are now available commercially. Due to the high transparency of enamel at longer wavelengths, novel imaging configurations are feasible in which the tooth can be imaged from the occlusal surface after shining light at and below the gum line, which we call occlusal transillumination.^1,2 Approximal lesions, the lesions located at the proximal contact points in between teeth, can be imaged via occlusal transillumination of the proximal contact points between teeth and by directing SWIR light below the crown while imaging the occlusal surface.^{2 – 4} The latter approach is capable of imaging occlusal lesions as well with high contrast.^{1,2,5 – 8} In 2010, it was demonstrated that approximal lesions that appeared on radiographs could be detected in vivo with SWIR imaging at 1310 nm with similar sensitivity² and that occlusal transillumination could be employed clinically. This was the first step in demonstrating the clinical potential of NIR and SWIR imaging for approximal caries detection. In the most recent clinical study in 2016,⁹ SWIR transillumination and SWIR reflectance imaging probes were used to screen premolar teeth scheduled for extraction for caries lesions at wavelengths $>1300\mathrm{nm}$. The teeth were collected and sectioned into $200\text{-}\mu \mathrm{m}$ slices and examined with polarized light microscopy (PLM) and transverse microradiography that served as the gold standard. In addition, extra-oral radiographs were taken of teeth and the diagnostic performance of SWIR imaging was compared with radiography. The sensitivity of the combined SWIR imaging probes was significantly higher ($P<0.05$) than radiographs for both occlusal and approximal lesions in vivo. It was anticipated that SWIR methods would be more sensitive than radiographs for occlusal lesions since the radiographic sensitivity for occlusal lesions is extremely poor; however, the sensitivity was also much higher for approximal lesions than radiography, 0.53 versus 0.23. In addition, the sensitivity of each individual SWIR method was either individually equal to or higher than radiography.