Assessment of an orthodontic patient

A young patient, undergoing orthodontic treatment, came in for a regular check. Standard visual inspection did not give rise to any serious concerns (see the white light images below, made with the QLF-D camera).
white-light image, end-to-end white-light image, occlusal
However, as part of the standard procedure in Tilburg, all patients undergoing orthodontic treatment are photographed with the QLF-D camera (frontal, lateral, occlusal and lingual views) before orthodontic treatment is started, at every control visit during treatment and at the end of the treatment.
The QLF-images showed, surprisingly, very serious amounts of red fluorescence.
QLF image, end-to-end QLF image, end-to-end
Especially the red fluorescence emanating from the distal side of molar 16 (on the lower left side of the right picture) strongly suggested an interproximal lesion. On the basis of the QLF images it was decided to remove the orthodontic devices in order to make an X-ray.
X-ray image
The X-ray image clearly confirmed the findings of QLF and the interproximal lesion was treated restoratively.
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