O-pH: Optical pH Monitor to Measure Dental Biofilm Acidity and Assist in Enamel Health Monitoring

• Published in: IEEE transactions on biomedical engineering Vol. 69; no. 9; pp. 2776 - 2786
• Main Authors: Sharma, Manuja, Lee, Lauren K., Carson, Matthew D., Park, David S., An, Se W., Bovenkamp, Micah G., Cayetano, Jess J., Berude, Ian A., Nelson, Leonard Y., Xu, Zheng, Sadr, Alireza, Patel, Shwetak N., Seibel, Eric J.
• Format: Journal Article
• Language: English
• Published: New York IEEE 01.09.2022; The Institute of Electrical and Electronics Engineers, Inc. (IEEE)
• Subjects: acidification; Acidity; Biofilms; Biomedical monitoring; Buffers; Carbohydrates; caries; Cleaning; Correlation coefficient; Correlation coefficients; Dental caries; Dental enamel; Dentistry; Endoscopes; Fluorescein; Fluorescence; In vivo methods and tests; Lesions; Monitoring; oral biofilm; Pediatrics; pH effects; plaque; ratiometric; Stephan curve; Sugar; Teeth
• ISSN: 0018-9294; 1558-2531; 1558-2531
• DOI: 10.1109/TBME.2022.3153659

Objective: Bacteria in the dental biofilm produceacid after consumption of carbohydrates which if left unmonitored leads to caries formation. We present O-pH, a device that can measure dental biofilm acidity and provide quantitative feedback to assist in oral health monitoring. Method: O-pH utilizes a ratiometric pH sensing method by capturing fluorescence of Sodium Fluorescein, an FDA approved chemical dye. The device was calibrated to a lab pH meter using buffered fluorescein solution with a correlation coefficient of 0.97. The calibration was further verified in vitro on additional buffered solution, artificial, and extracted teeth. An in vivo study on 30 pediatric subjects was performed to measure pH before (rest pH) and after (drop pH) a sugar rinse, and the resultant difference in pH (diff pH) was calculated. The study enrolled subjects with low (Post-Cleaning) and heavy (Pre-Cleaning) biofilm load, having both unhealthy/healthy surfaces. Further, we modified point-based O-pH to an image-based device using a multimode-scanning fiber endoscope (mm-SFE) and tested in vivo on one subject. Results and Conclusion: We found significant difference between Post-Cleaning and Pre-Cleaning group using drop pH and diff pH. Additionally, in Pre-Cleaning group, the rest and drop pH is lower at the caries surfaces compared to healthy surfaces. Similar trend was not noticed in the Post-Cleaning group. mm-SFE pH scope recorded image-based pH heatmap of a subject with an average diff pH of 1.5. Significance: This work builds an optical pH prototype and presents a pioneering study for non-invasively measuring pH of dental biofilm clinically.