Optical imaging of dental plaque pH

Tooth decay is one of the most common chronic infectious diseases worldwide. Bacteria from the oral biofilm create a local acidic environment that demineralizes the enamel in the caries disease process. By optically imaging plaque pH in pits and fissures and contacting surfaces of teeth, then medicinal therapies can be accurately applied to prevent or monitor the reversal of caries. To achieve this goal, the fluorescence emission from an aqueous solution of sodium fluorescein was measured using a multimodal scanning fiber endoscope (mmSFE). The 1.6-millimeter diameter mmSFE scans 424nm laser light and collects wide-field reflectance for navigational purposes in grayscale at 30 Hz. Two fluorescence channels centered at 520 and 549 nm are acquired and ratiometric analysis produces a pseudo-color overlay of pH. In vitro measurements calibrate the pH heat maps in the range 4.7 to 7.2 pH (0.2 standard deviation). In vivo measurements of a single case study provides informative images of interproximal biofilm before and after a sugar rinse. Post processing a time series of images provides a method that calculates the average pH changes of oral biofilm, replicating the Stephan Curve. These spatio-temporal records of oral biofilm pH can provide a new method of assessing the risk of tooth decay, guide the application of preventative therapies, and provide a quantitative monitor of overall oral health. The non-contact in vivo optical imaging of pH may be extended to measurements of wound healing, tumor environment, and other food processing surfaces since it relies on low power laser light and a US FDA approved dye.