How are different types of caries treated?
Caries is the destruction of the hard shell of a tooth. It is characterized by a slow course that can last several decades. There is a pathology under the influence of various factors that affect the enamel of the tooth and destroy it. How caries is treated depends on its type, degree of neglect, age category of the patient.
What causes tooth decay?
Enamel (surface layer of a tooth) is the most durable tissue of the human body. It would seem that it is impossible to damage. But there are a number of factors that, in a certain aggregate, lead to the deterioration of enamel, and then the person is asked: “How are caries treated?” These factors include:
- Individual susceptibility of teeth to caries. This quality is formed from a number of properties: the percentage of fluoride in the enamel, anatomical surface (natural fissures and gaps), oral hygiene, diet, chronic and past diseases and, eventually, genetics.
- Cariesogenic bacteria in the mouth and their reproduction rate during the day.
- Fermentable carbohydrates and acids.
Classification of caries
Dental caries, like any other pathology, is classified according to several principles. In medicine, the generally accepted classification is used:
- Topographic stages: stage spots, superficial, medium and deep caries.
- According to the anatomical structure of the tooth: caries of enamel, dentin and cement.
- By localization (place of distribution): cervical, fissure and approximate.
- Regarding the duration of the disease: stabilized, slow and fast.
- The intensity of the lesion: systemic, single and multiple.
- According to the intensity of distribution: compensated, decompensated (the pathology is peculiar to children) and subcompensated.
How to treat dental caries at the dentist or at home depends on its type and degree of enamel damage.
Superficial caries: symptoms, treatment
The clinical picture of the pathology is as follows: the enamel softens, but there are no painful sensations during chewing. Discomfort occurs when using sour, sweet, or when injected into the oral cavity chemical irritants.
The affected area can be extensive, but not deep, that is, superficial.How is caries treated at this stage?
- The surface of the affected tooth is cleaned of plaque with an abrasive paste and a soft brush.
- Affected and cleaned areas dissect.
- Isolate the tooth from saliva on its surface.
- Treat the area with acid (degrease).
- Apply an adhesive (glue).
- Apply a filling material.
- The seal is ground and polished.
Medium caries: symptoms and treatment
When late treatment of surface caries, it flows into the middle. This stage has more pronounced symptoms: intermittent pain when different irritants (cold or hot, sweet or sour) get into the mouth. The enamel is damaged to the dentin, but the area of destruction is small. All these signs characterize the average caries of the teeth. How to treat pathology at this stage? Usually one visit to the dentist is enough. Like superficial caries, the average is treated in stages: remove plaque, smooth out and degrease the surface with the help of preparations, apply glue and filling material. The final stage is the grinding of the seal and its polishing. In most cases, treatment is carried out under local anesthesia.
Signs of deep caries
The next stage is deep caries. It is characterized by the destruction of solid tissues and the occurrence of a corrosive cavity. It is visible to the naked eye, as it has a dark shade. In the area of the cavity, pain occurs under the influence of chemical, mechanical or temperature effects. Depending on the depth of the lesion, it can be filled with food debris, which leads to infection and inflammatory processes. An x-ray of the affected tooth shows a small amount of healthy dentin, the rest is an empty cavity. If the pain does not subside after removing the irritant from the mouth, there is a risk of pulpitis.
How is deep caries treated?
The procedure is recommended to visit the dentist twice. This is due to the fact that pathogenic microorganisms can persist in healthy dentin and develop after filling. In order to avoid relapse, it is advised to walk for a while with a temporary filling, observing the dynamics. How are caries treated in dentistry in stages?
- The first stage is the removal of damaged tissue. To do this, use a dental instrument and a drill.The pulp chamber must remain closed, therefore ball nozzles (burs) are used. As a result of the work done, the bottom of the cavity is not leveled. If acute deep caries occurs, then some healthy tissue is removed. This is necessary to avoid the further spread of pathogens. After such an excision, a wide and deep cavity is formed.
- The second stage is the purification and disinfection of the cavity formed. The medical gasket that is installed is multifunctional. Due to the unique content of the components (calcium concentrate and bactericidal substances), it simultaneously protects the cavity from infection and remineralizes healthy tissue.
- The third stage - the imposition of an insulating seal. It fixes the healing layer in the cavity and protects it from the effects of a filling material.
- The fourth and final stage is the installation of a seal. As already mentioned, it can be temporary or permanent.
Cervical caries: clinical picture, causes
Cervical caries is a tooth pathology recognized by dentists as one of the most dangerous,severely treatable and adversely predictable forms of caries. It is characteristic of him to hit a tooth in the most vulnerable place: at the base (of the neck - from which it got its name). Cervical caries affects not only the body of the tooth inside and outside, but also penetrates the canals, infecting and inflaming them. The reason for the appearance of cervical caries is the activity of cariogenic microorganisms concentrated in soft plaque and stone.
How to treat cervical caries depends on the stage of the disease, each of which has its own symptoms:
- The 1st stage, also called the white spot stage. Its symptoms are demineralization of a small portion of the tooth. Thinning of enamel and loss of surface gloss.
- 2nd stage - superficial. White spots begin to degenerate into darker ones, the enamel loses its integrity, but dentin remains intact. Teeth begin to react to irritants with short-term pain.
- Stage 3 - medium. Destroyed enamel does not protect the dentin layer, and it is affected by bacteria, becomes loose, darkens. Painful sensations while eating and drinking are longer and more pronounced.
- Stage 4 is deep.Deep “hollows” are formed on the teeth at the base, which eventually reach the nerve endings.
How to treat cervical caries?
Like any other disease, cervical caries is easily treated in the initial stages. White chalk spots (symptoms of the early stage) are quickly amenable to conservative treatment with remineralization. To do this, special preparations with a high content of fluorine and calcium are applied on the surface of the teeth that has been previously cleaned of plaque and stone.
The treatment of subsequent stages, which are accompanied by a violation of the integrity of the enamel, is performed in stages:
- the teeth are cleaned of plaque and stone;
- the color of the filling material is selected;
- dissected (removed) the affected tissue;
- isolate the tooth from wet breathing and saliva;
- Enamel and dentin are treated with adhesive;
- put a filling material;
- grind and polish the filling.
Caries of the front teeth: clinical picture, causes
Against the background of the entire dentition, the percentage of caries lesions on the front teeth is on the order of 10-12%. And even at the deep stage of the lesion, the incisors can remain completely unscathed.But in the event of a pathology, people tend to resolve this issue in a short time, as caries of the front teeth is also an aesthetic problem. The causes of incisors of caries are standard: heredity, low caries resistance, rare hygiene procedures, impaired microflora. A feature of the pathology of the front teeth is the rapid spread, which is associated with a thinner layer of enamel and dentin and the rapid infection of the canals. The inner part of the incisors is prone to tartar, which is the root cause of caries.
Treatment of front teeth for caries
Dim enamel, darkening, "dents" - this is caries of the front teeth. How to treat this pathology, the dentist will say during the examination, because it is necessary to solve the aesthetic problem.
- In the first stage of caries, when it comes to chalky spots, dentists impose appliqués from high calcium and fluoride preparations on incisors. This process is called remineralization.
- How are caries of the front teeth treated in the second and third stages? Produce a filling. Particular attention during the process is given to the selection of material, it must perform practical and aesthetic functions.Due to the fact that the special load on the incisors does not occur, light-cured composites are used in modern dentistry. The advantage of this material is the maximum matching shades with the color of the dentition and high strength. Perhaps these two properties are leading when choosing a filling material.
In case of strongly pronounced defects of incisors, dentists propose to solve the problem with the help of tabs - fixed microprostheses. They recreate the anatomical shape of a tooth damaged by caries, and also protect the surface from further damage. Tabs are made directly in the patient's mouth, which allows you to maximize the color and shape of the tooth being restored. Tab setting occurs in stages:
- studying a defective tooth;
- opening the cavity (widening the gap and removing the edges) using boron and an enamel knife;
- giving a cavity (bottom and walls) of flat forms;
- setting tab.
Tabs meet aesthetic and physiological norms.
A relatively new type of correction of the front teeth after caries treatment is ceramic veneers.These linings with walls no more than 0.7 mm thick have the necessary strength. The main advantages of veneers are ease of manufacture and installation, strength, durability, resistance to food dyes. If it was not possible to restore the front tooth completely after caries, then veneers are the best option to give it a pristine appearance.
Strangely enough, but in children the teeth are also exposed to caries, as in adults. A special children's form of this disease is called "bottle". The reasons for the occurrence of such an early pathology (up to 3 years) is the failure to follow the feeding regime. Moms who at an early age allow babies to fall asleep with a bottle in their mouth, after a couple of years they will wonder: “How are caries treated in children?” Additional factors affecting the development of pathology are lack of oral hygiene. Even with 2-4 teeth, they need to be treated with a soft cloth after each feeding. How to recognize bottle caries? How to treat? Pathology develops in several stages, respectively, and the treatment process on each of them is different:
- Stage 1 - enamel demineralization of children aged 10-20 months. Caries appears in the form of white spots, which have a sponge-like structure, the cervical portion of the tooth has the appearance of a white band.
- At the second stage (usually in children 16-24 months), the enamel closer to the gum loses its integrity. Dentin is exposed. Affected areas acquire unnatural color.
- Symptoms of the third stage, which affects the teeth of children aged 20-36 months, are in-depth lesions. In this case, the child expresses his displeasure while eating or drinking, complaining of pain.
- 30-48 months. At this age, some children may experience the fourth stage of bottle caries. Enamel and dentin are destroyed, in some cases, tooth loss occurs.
How are milk teeth caries treated? At the first stage, when the integrity of the enamel is not yet broken, the teeth are “strengthened” by applying fluoride-containing preparations on them. Silvering is used in the later stages. But for some time, the effectiveness of the method is questionable: after the procedure, the affected areas turn black, and caries can develop imperceptibly for parents. In modern medicine, they use ozone and special sealants, and, of course, do not forget about the old proven method - sealing.