Objectives: Based on their modes of operation, the available demineralization assessment methods may detect early caries at different levels of demineralization. The aim of this study was to determine the earliest possible time for detection of an early caries and the minimum level of demineralization that can be detected, by three different caries assessment methods, while using a particular technique for development of caries-like lesions. Methods: Seventy tooth blocks approximately 3 mm² were produced from extracted human teeth. The blocks were painted with two coats of colorless nail varnish, except for a window of 2 mm² diameter on the enamel surface. The blocks were subjected to demineralization in non-saturated acidified gel to produce caries-like lesions in the exposed window, with five blocks being removed every 24 hours (first removal after 48 hours) for 14 days. Demineralization of enamel was assessed using Quantitative Light-Induced Fluorescence (QLF), Microradiography (TMR) and Microcomputed Tomography (µCT). Results: Using the three caries assessment methods, caries lesion was detected with QLF after 48 hours of exposure (Fluorescence loss, ΔQ = -34.3±14.8 %.mm²), TMR after 3 days (Mineral loss, ΔZ = 389.2±72.5 vol%.µm), and µCT after 7 days (Linear attenuation coefficient, LAC = 2.0±0.5 cm^-1). At 7 days, ΔQ = -91.0±7.0, while ΔZ = 1405.2±593.0. All methods showed the level of demineralization to increase with exposure time. After 14 days of demineralization assessment, and using Linear Regression coefficient and squared Pearson correlation coefficient (r²), a linear correlation was observed between DQ and DZ (r² = 0.95), between DQ and LAC (r² = 0.87), and between DZ and LAC (r² = 0.92). Conclusions: This study demonstrated that QLF, a clinical method, is more sensitive for early caries assessment when compared to the laboratory methods of TMR and µCT. Supported by NIDCR, T32 Grant #DE14318 for the COSTAR Program.

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