The growing understanding of dental caries as a disease process has led to increasing emphasis on diagnostic and risk assessment tools. Objectives: The purpose of this study was to test the efficacy of a new impression-type caries risk assay to detect, site-specifically, the metabolic activity of different amounts of lactic acid-producing bacteria in early primary carious lesions. The material changes color in the presence of lactic acid. Methods: Carious lesions were developed using an in vitro microbial caries model with Streptococcus mutans and Lactobacillus casei, and were evaluated using bacterial quantitation, infrared laser analysis (DIAGNOdent-DG), quantitative light-induced fluorescence (QLF), and confocal microscopy (CLSM). The study included four groups=1: 7 days, uninoculated (control), n=10; 2: 7 days, inoculated, n=9; 3: 5 days, inoculated, n=11; 4: 2 days, inoculated, n=10. Impressions of the lesions were made upon removal from the test apparatus and evaluated for positive color change. Lesion parameters were evaluated using a single factor ANOVA with significance at p<0.05. DG and QLF data were not normal and Kruskal-Wallis One-way ANOVA with Dunn¢s pairwise method was performed. Results: Bacterial quantitation showed increasing trends with time of exposure. DG showed significantly larger lesion size for groups 2 and 3. QLF showed group 2>3>4,1. CLSM showed 2,3>4>1. These results are consistent with expectations. The positive impressions for each group were: 1:0%; 2:100%; 3:100%; 4:60%. Conclusions: These results indicate that the new impression-type caries risk assay is capable of indicating metabolic activity of lactic acid producing cariogenic bacteria.

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