Digital tools for dental plaque detection: benefit for clinical application 

Reproducibility and standardization are the key factors to introduce a novel approach in dental plaque quantification: a new review by CoEHAR researchers shows that image-based systems provide a valid method of evaluating oral plaque.

LINK TO THE STUDY: https://www.sciencedirect.com/science/article/pii/S0300571223003585

Dental plaque is a biofilm that grows on the teeth surface and comprises microorganisms that co-exist within oral biofilms. The accumulation of dental plaque is linked to the onset of specific oral diseases, including dental caries and periodontitis.

Dental plaque is commonly assessed using visual scoring indices, but the are some limitations to this assessment, such as the subjective nature of the evaluation process, imprecisions for low or particularly high plaque levels and variations in the protocols used for scoring plaque level.

An image-based system represents a new frontier in the evaluation of dental plaque: new digital tools, such as 3d imaging scanner, can detect and monitor dental plaque by generating colorful 3D images in a timely manner. Using image-based techniques to detect plaque has numerous advantages, including standardizing the procedure, mitigating some of the subjectivity inherent in clinical assessment and archiving of data.

Coehar researchers conducted a scoping review to explore the most up to date literature on the validity and reliability of emerging digital tools for the dental plaque detection in clinical setting.

The study “A scoping review of new technologies for dental plaque quantitation: benefits and limitations”identified 576 articles, with a total of 13 included in the review, published between 2015 and 2023.

The studies were conducted in 9 countries worldwide: 3 in the USA, 2 in China, 2 in South Korea, one in Italy, one in Germany, one in the Netherlands, one in India, one in Argentina and one in Brazil.

Overall, according to the majority of studies included, the image-based systems provided a valid method of evaluating microbial plaque, comparable to the well-established clinical dental plaque indices.

During the acquisition and processing of digital images for dental plaque assessment, operator bias should be taken into consideration. Bias relates to the number of operators, their training, and blinding. Among the 13 studies included, only six specified blinding of examiners with respect to clinical assessment results. The blinding of operators or the inclusion of different operators for performing clinical and image-based clinical assessment is crucial in order to prevent information bias.

As explained by researchers, study data demonstrated the objectivity and reliability of these digital tools when assessing plaque accumulation and they should be used in conjunction with comprehensive clinical examination in order to ensure a holistic assessment of oral health.