It is unfortunate that the reader equates a thorough review of research findings with "vilification" of the object of that research. In fact, we did not conduct any of the research studies included in our review.
What we did was report objectively the results of other investigators who had evaluated the DIAGNOdent (DD) device. Space constraints made it impossible to summarize all aspects of the evaluation protocols used in those studies. For the reader’s information, a majority, but not all, of the studies included indicated that their devices were calibrated before each patient or set of patients. All but four of the studies indicated that the occlusal surfaces were cleaned, although most methods involved use of chemicals, toothbrushes or rubber cup and pumice, and did not specifically mention use of an air-polishing device. Several studies mentioned excluding teeth with various types of stains. All studies used the conical tip and none reported tip fractures.
We detected no relationship between cleaning method and higher specificity values. As we noted in our discussion, and consistent with the conclusions reported in most of the studies, the propensity of the DD for false positive identification of dentin lesions, which may or may not be associated with lack of thorough cleaning or operator error, suggests that clinicians should not rely on DD scores as the principal basis for decisions to intervene surgically. This limitation does not prevent clinicians from employing the DD to detect lesions in enamel, where remineralization is the preferred strategy and where false positives do not lead to needless loss of tooth structure.
