Early Diagnosis of Caries and Cracks

Six Lessons Approach Podcast by Dr. David Alleman

Early diagnosis and treatment of dental pathologies allows for more conservative treatments while saving patients time and money. When developing the Six Lessons Approach to Biomimetic Dentistry, Dr. David Alleman created a risk assessment for determining if teeth were at risk of caries or cracks based on pathologies and treatment history.

Drawing on research from how teeth experience pain, the pulp’s immune response and how dental histology affects restoration, the risk assessment has been proven to be an effective tool over the last 20 years, especially where x-rays do not identify a cause of symptoms. Now that we understand how gaps and cracks cause pain and sensitivity, identifying them early is the next step for more conservative treatment.

Article referenced in this episode:

• Brannstrom M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. Journal of Endodontics. 1986;12(10):453-457
• Galler K., Et al. Inflammatory response mechanisms of the dentine–pulp complex and the periapical tissues. Int J Mol Sci. 2021 Feb; 22(3):1480
• Milicich G, Rainey J T. Clinical presentations of stress distribution in teeth and the significance in operative dentistry. Pract Periodont Aesthet Dent. 2000;12(7):695-700.
• Larson TD, Douglas WH, Geistfeld RE. Effect of prepared cavities on the strength of teeth. Oper Dent. 1981(6)2-5.

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