Why should you add fiber optic transillumination (FOTI)
to your armamentarium of diagnostic instruments?
Benefits of Fiber Optic Transillumination in Dentistry
FOTI works quite simply. By placing an intense, narrow beam of light on the tooth’s surface, your visual inspections can quickly provide you with a wealth of information. When a healthy tooth is illuminated, the light will transmit uninterrupted across the tooth (1). A tooth with caries, cracks, lesions or an otherwise unhealthy tooth will interrupt the light beam in various ways (1). FOTI helps you to visualize the “changes in color, texture, tooth surface appearance, and the presence or absence of shadows" (p. 82) (2). Interpreting this information will aid immensely in your day-to-day diagnoses.
FOTI can be used alone to diagnose or in conjunction with your current clinical examination practices (3). During multiple studies with general dentistry practitioners, “clear trends were evident with FOTI being a useful adjunct to all examinations" (p.147) (3). In fact, many studies have determined that visual inspection and radiographs alone have a poor performance compared to FOTI (4). If you aid your visual inspection or supplement your radiographs with FOTI, you will much more clearly see the difference between structurally sound teeth and those with fractures, caries or decay (2-4).
While radiographs are sometimes necessary, FOTI has been found in several research studies to be a valid replacement for them for certain diagnoses. One such study in particular noted that FOTI was equivalent to or better than radiographs when diagnosing infected tooth structure (2). Additionally, general practice dentists detected more approximal enamel and dentinal lesions when using FOTI compared to other examinations in multiple other studies (3-4). These same studies concluded that using FOTI for carries performed statistically superior to using radiographs alone (4).
Also important to consider is the obligation dentists have to their patients to avoid over exposure to radiation during x-ray. Keeping radiation exposure low is a must, especially for children and patients who have had radiographs recently (3). Decrease your patients’ exposure to cumulative ionizing radiation dosages by safely evaluating with FOTI as an alternative (2). FOTI can be used repeatedly with no risk to the patient as a substitute to radiographs to evaluate and diagnose many tooth conditions.
Not only have studies found that FOTI can be used as a valid replacement for radiographs, but one study noted how general dentistry practitioners used FOTI as a tool to decide whether to take radiographs (3). A pre-radiograph inspection with FOTI can save you time and money and allow you to accurately diagnose and quickly treat your patients. Also, if radiographs are necessary, FOTI can be used to obtain more details about concerns found on radiographs (3). Multiple studies have recognized the benefits FOTI can give “before, after or instead of radiographs" (p.147) (3).”
Multiple Uses for Transillumination
FOTI has a wide variety of uses as a diagnostic aid including illuminating, exploring, evaluating, detecting and/or diagnosing. Specifically, using a FOTI instrument is
excellent for (1-2, 4):
Illuminating root canal orifices within the pulp chamber
Evaluating stained margins of composite resins
Evaluating cusp fractures
Evaluating cracked teeth
Detecting soft tissue lesions
Evaluating ceramic restorations before cementation
Detecting Fracture and craze lines in ceramic restorations
Detecting Fracture and craze lines in natural teeth
Evaluating depth of extrinsic staining
Exploring Lesion depth
Detecting dentinal approximal lesions
Diagnosing anterior and posterior interproximal carries
Diagnosing occlusal caries
An Optimal FOTI Instrument: The Titan Transilluminator
Those who have used and studied the use of FOTI have found specific features of FOTI instruments that have been the most useful and effective diagnostically. The Titan Transilluminator has been developed with these features in mind to give dentists what they need and want in order to find more success while using FOTI.
For example, thin flexible fiber-optic light guide tips with a diameter of 3mm or less provide a “sharper image for improved visualization" (p.84) (2). The Titan Transilluminator comes with disposable light guide tips at 1mm, sending an intense, narrow beam of light directly where it’s needed to help you optimally visualize various tooth conditions.
Another must have feature in FOTI is a high intensity light source to show light scattering within the tooth (4). The Titan Transilluminator was created for and is powered by Ascentcare’s HyperLUX light engine. The HyperLUX light engine emits a highly intense 20,000 LUX at 6,000K color temperature (daylight) from the tip of the Titan Transilluminator. It will give you just the right amount of light to show scattering within the tooth and is adjustable to three intensity levels.
When asked what design features dentists look for most in transillumination instruments, one of the top requests was for a compact and portable design (3). It’s compact, pen sized design with an ergonomic grip makes the Titan Transilluminator the perfect hand-held FOTI instrument. With a magnetically coupled light guide cable, there is no binding and the instrument can easily be manipulated to any angle for accurate tooth diagnoses. Additionally, the small, portable and rechargeable light engine can easily move from room to room in a multiple room practice.
Another request made by dentists was for a transillumination instrument that has a reasonable cost (3). The autoclavable Transilluminator is economically priced at $29.95. Supplying your practice with several for your daily needs is very inexpensive. Disposable replacement light guides run at a mere 33¢ each.
FOTI is a must in every dental practice. FOTI as a diagnostic aid is pain free, non-invasive and simple to use with no risk to the patient and has been shown to be more effective than radiographs for many diagnoses. The Titan Transilluminator is a cost effective, portable and compact FOTI instrument. It is designed for optimal visualization with a light guide tip that emits high intensity light providing ideal conditions to diagnose. Start using FOTI in all of your examinations today to improve your practice and give the best to your patients.
Alassaad, Samer S., DDS. Incomplete cusp fractures: Early diagnosis and communication with patients using fiber-optic transillumination and intraoral photography. General Dentistry. 2011 March/April: 132-135.
Strassler, Howard E., DMD, and Pitel, Mark L., DMD. Using Fiber-Optic Transillumination as a Diagnostic Aid in Dental Practice. Compendium of Continuing Education in Dentistry. 2014 February; V35N2: 80-88.
Davies, G. M., Worthington, H.V., Clarkson, J. E., Thomas, P., and Davies, R. M. The Use of Fibre-Optic Transillumination in General Dental Practice. British Dental Journal. 2011, August 11; V191N3: 145-147.
Côrtes, D.F., Ekstrand, K. R., Elias-Bonetac, A. R., and Ellwood, R. P. An in vitro Comparison of the Ability of Fibre-Optic Transillumination, Visual Inspection and Radiographs to Detect Occlusal Caries and Evaluate Lesion. Caries Res 2000; 34:443–447.