In the human mouth, a lot of conditionally pathogenic microorganisms live, which negatively affect the enamel of the teeth. Bacteria cause its destruction, which often leads to the development of caries. Without effective and timely treatment, the disease progresses rapidly and spreads to healthy teeth.
What is caries?
Translation of the name of pathology from Latin - decay. The disease under consideration is a complex and slow process of destruction of hard tooth tissues by microbes. The appearance of caries is explained by the demineralization of enamel and the destruction of its structure under the influence of internal and external factors. Gradually affected and other hard tissues of the tooth, including dentin. If there is no correct treatment, periodontitis and pulp become inflamed.
Causes of caries:
- incorrect or insufficient oral hygiene;
- deficiency of vitamins;
- inefficient nutrition with a predominance of soft carbohydrate food;
- chronic dental tissue formation disorders;
- pathology of the gastrointestinal tract;
- rickets or tuberculosis in anamnesis;
- diseases of the immune system;
- lack of phosphorus, calcium or fluorine;
- gaps and gaps between teeth;
- incorrect bite without treatment;
- small amount, pathogenic composition of saliva;
- genetic predisposition.
Types of caries
There are different classifications of the disease, but practicing doctors often use division by location and stage. Depending on the place of rot, the following types of pathology are distinguished:
- Cervical - caries in the lower part of the tooth, on the border with the gum.
- Fissure (contact) - destruction in the hollows of molars.
- Interdental - caries in the spaces between the teeth.
- Neck - cervical lesion with putrefactive processes under the gum.
- Caries of anterior teeth - destruction of incisors along the edges.
- Iatrogenic - damage around prostheses, braces and other structures for treatment.
Stages of caries
According to the degree of destruction of hard tooth tissues, the disease is classified into the following forms:
- Stage of the spot. Tooth enamel in some places changes color, becomes white. Treatment of caries at this stage is quick and painless. Cretaceous stain is characterized by minimal tissue destruction.
- Superficial caries. Enamel loses its minerals, acquires a rough structure. There is an increased sensitivity of teeth to hot, cold, sweet and sour.
- Average caries. Ruins not only enamel, but also its border with dentin. Damage to the tooth is clearly visible, pain is felt, especially when exposed to irritating food and drinks.
- Deep caries. Rotting reaches the dentin and the layer located near the pulp. Pain syndrome is permanent and strong.
What is dangerous caries?
Without timely treatment, pathology rapidly progresses and causes complications. Deep dental caries can lead to the following consequences:
- Pulpitis is an inflammation of the soft internal structures, including nerves, blood vessels and connective tissues.
- Periodontitis is the defeat and disruption of the integrity of the ligaments that hold the tooth in the gum and jawbone.
- Granuloma - a pouch (cyst) filled with pus. Located at the root of the tooth, is the focus of chronic infection in the body.
Treatment of caries with drilling
Preparation of damaged areas ensures the removal of all decayed tissues and cavities. While this is the only way how to get rid of caries at a deep stage of the disease. The removed tissues are replaced by artificial substitutes in the form of seals. Modern materials look completely natural and do not differ in color from their own healthy teeth.
Treatment of caries - stages
Classical therapy with drilling of the affected areas is performed according to the standard scheme, some steps can be adjusted by the dentist depending on the individual characteristics of the patient. Treatment of caries includes the following stages:
- Cleansing. A plaque and a stone are removed from the diseased tooth and adjacent areas.
- Anesthesia. In mild cases, anesthesia is not required. It is necessary when the deep and prickly caries is removed, the treatment involves injecting an anesthetic into the gum.
- Elimination of affected areas. The preparation of rotted areas and nearby tissues is carried out.
- Insulation. To ensure that the seal lasts as long as possible, it is necessary to exclude any moisture (saliva, water from the exhaled air) from getting into the treated tooth. Previously, cotton swabs and gauze wipes were used for this purpose, which were applied to the prepared area. Modern treatment of caries involves the use of cofferdam. It is a latex plate that provides complete isolation of the tooth.
- Preparing for sealing. The drilled zones are treated with antiseptics, the enamel is etched with phosphoric acid and an adhesive. These stages of treatment prevent infection and promote better adhesion of the material to the dental tissue. When the contact points and side walls are destroyed, the dentist restores them.
- Sealing. A gasket of glass-ionomer cement is laid on the bottom of the prepared cavity. A photopolymer material is superimposed on top, selected for the natural color of the available healthy teeth. Each layer is illuminated by a special lamp, which ensures the hardening of the seal.
- Grinding. The final stage of treatment is necessary to restore the chewing abilities of the tooth and the original shape. Grinding makes it smooth and smooth, like enamel.
Types of dental fillings
The materials described are divided into temporary and permanent. In the first case, artificial dentin is used. They close the cavity in which arsenic is placed to neutralize and then remove the nerve. After 1-3 days, this seal is removed and one of the permanent options for treatment is set:
- Cement. Inexpensive, easy-to-use material, quickly wears off, badly adheres to the teeth.
- Metal. The most durable, but complex in terms of installation seals. The material is almost not used in treatment because of unsatisfactory physical and aesthetic properties.
- Plastic or composite. Durable materials, easily chosen by color to the natural shade of teeth. Such seals can be toxic, quickly darken and become porous, which provokes secondary decay.
- Photopolymers. Modern, safe and durable materials for treatment, harden under the influence of ultraviolet radiation. Thanks to the excellent aesthetic characteristics, such seals can be used to cure cavities on the front teeth. Expensiveness of the installation is compensated by a long service life.
- Depoforez. At the mouth of the exposed channel, hydroxide of copper and calcium is introduced, a negative electrode is inserted, a positive electrode is applied to the cheek. After giving a discharge in 2 mA, all microorganisms are destroyed. With the help of depophoresis, even caries complications are treated.
- Filling of hot gutta-percha. A material with a temperature of up to 100 degrees is fed into the channel. The resin fills all cavities and quickly hardens.
- Cold gutta-percha filling. One or several prefabricated pins corresponding to the shape of the cavity are inserted into the channel.
- Two-layer seal (with gasket). The sandwich technique in dentistry is the combination of glass ionomer cement (inner layer) and composite (outer part).
Modern methods of caries treatment
In progressive dentistry the following therapy technologies are used:
Treatment of caries without drilling teeth
At the easy stages of development of pathology, one can not rush with the preparation and removal of hard tissues. The most effective ways how to treat cavities without a drill:
- laser exposure;
- gel treatment;
- icon-technology.
Treatment of caries by laser
A new technique for removing damaged enamel by evaporation. The treatment of caries without drilling is suitable only for the treatment of superficial forms of the disease. If decay has reached dentin, laser exposure will not produce the desired effect. In such cases, it is necessary to carry out a standard caries treatment with preparation. After laser treatment, a filling is required.
Treatment of caries with gel
The presented technology has not yet been introduced into dentistry, the drug was tested only in mice. Presumably, this technique will allow caries to be treated in the spot or early stages of progression. The essence of therapy is the introduction into the damaged cavity of a special gel with peptides. It changes the genetics of the bacteria that causes rotting, and provokes the division of cells, of which the enamel consists. As a result, the affected area grows itself.
Icon-technology - treatment of caries
This method of therapy is not effective at medium and deep forms of the disease. Icon technology provides treatment for early caries while it is in the stain stage. After thorough cleansing of the affected tooth, the enamel is smeared with an etching gel that kills pathogenic microorganisms. After 2 minutes, the drug is washed off and the surface is dried. On the prepared areas infiltrate Icon is applied and its polymerization by ultraviolet is carried out. The affected microscopic cavities are "sealed" and the tooth enamel is restored.
Prophylaxis of caries
To prevent putrefactive processes in the oral cavity it is important to visit the dentist regularly and conduct scheduled examinations, every 4-6 months.
Complex prevention of dental caries:
- daily cleaning, at least 2 times a day;
- balanced diet;
- limiting consumption of carbohydrate foods, sweets;
- inclusion of fish and seafood in the menu;
- thorough chewing food;
- the use of fermented milk products or additives with calcium;
- timely treatment of oral diseases;
- regular professional cleaning of teeth (once every 6-12 months);
- mouth rinse or use of chewing gum after eating;
- restriction in the diet of products with low or high temperature.