Transillumination of teeth has been advocated for caries detection for over 100 years and requires minimal experience to implement in clinical practice. Fibre-optic light sources are readily available and when used appropriately, help to enhance the contrast between sound tooth tissue and caries lesions. To improve the validity of fibre-optic transillumination (FOTI), a scoring index is available to enable the combined assessment of lesions using ICDAS and FOTI.
Improvements in technology have spawned digital methods of capturing images of transilluminated teeth, permitting longitudinal assessment of lesion status via appraisal by the clinician. More recently, technologies employing near-infrared wavelengths of light have become commercially available and permit the capture of transillumination images less confounded by extrinsic staining and with increased penetration into the tooth structure.
Fibre-optic transillumination of teeth, both traditional and digital, is simple to employ in clinical practice, well tolerated by patients and offers a non-invasive and non-irradiating adjunct to visual detection. With increasing experience of their use, FOTI and DIFOTI can significantly enhance the clinician’s ability to detect caries lesions on all surfaces and of varying severity.