Caries is a disease known in all corners of the globe, and it is difficult to find a person who would not have faced this problem at least once in his life. The disease affects the hard tissues of the tooth, thinning the enamel and penetrating into the deep layers of dentin, creating a carious cavity in them. Most often, damage is visually noticeable, except when only the deep layers of tissues are damaged.
Causes of disease
Dentists identify a lot of theories for the occurrence of carious lesions, but the main ones remain unchanged:
- Abuse of excessively s alty or sweet foods.
- Lack of carbohydrates and vitamins in the diet.
- Low enamel strengthening fluoride.
- Neglecting oral hygiene.
- Infectious diseases.
- Genetic predisposition.
- Features of the structure of the tooth, the presence of natural grooves on the surface of the enamel, in which microorganisms that are prone tosubsequent decay.
All of the above factors to some extent affect the acid-base balance of the oral cavity, creating a favorable environment for the development of pathogenic bacteria under the tooth enamel. As a result of the gradual washing out of calcium from the dental tissue, the enamel is destroyed, and a carious cavity is formed. There are many criteria by which the classification of caries is built, and this is quite justified. An extended classification by several parameters allows you to make the most reliable diagnosis, determine the degree of neglect of the process and treatment options for the disease.
Black classification
The most used by dentists is the Black classification of caries. It reflects not only the location of carious destruction on the surface, but also the depth of the studied lesion. Designations of a variety of the latter occur through classes - the higher the class, the more neglected the disease:
- I class. The initial stage is a very weak caries, the chewing surface of the tooth enamel is infected. Damage is concentrated in the areas of the cone-shaped grooves of the tooth. Accompanied by the gradual destruction of enamel, and subsequently dentin. With a timely visit to the dentist, the process at stage 1 can be stopped and the tooth completely cured without resorting to a drill.
- II class. Weak caries formed on the contact surface of the lower and upper chewing teeth. The enamel in this place brightens, most often the changed parts resemble small triangles. Such damage is hidden between the teeth, and in most cases cannot be identified even by an experienced specialist.
- III class. According to such a division as the classification of caries, this is a lesion of moderate severity, in which cavities are formed on the surface of the front teeth. The cutting edge of the latter at this stage remains intact. Most often, this type of caries affects people who abuse sweets and rarely use dental floss.
- IV class. Severe caries, which is a progressive stage of a class III lesion. If superficial violations of the incisors are not treated, the dentin in the area of the cutting edge of the tooth begins to collapse.
- V class. Very severe degree. The classification of dental caries characterizes this type of deep damage to the area of the tooth along the gum. Caries of this form is called cervical, it is the most dangerous, since the carious cavity is located in close proximity to the root. At the initial stage, the border between the gum and the body of the tooth is covered with almost invisible white edges. Most often, basal caries affects several organs, sometimes all are infected. If the treatment of "white caries" is ignored, complications are formed in the form of foci of carious destruction. In some cases, with a severe complication of the disease, it may be a question of removing the damaged tooth itself.
WHO/ICD classification 10
The classification of caries according to WHO (World He alth Organization) is based on the identification of a specific affectedsite and highlights the following items with codes:
- К02.0. The initial destruction of the enamel, which is expressed by the formation of white spots on the surface.
- K02.1. The code indicates the stage of damage to the dentin - the tissue under the enamel.
- K02.2. Carious destruction of cement, or basal caries. This code is used to indicate root damage.
- K02.3. Designation of the stage at which carious destruction is suspended.
- K02.4. It includes odontoclasia, children's melanodentia and melanodontoclasia.
- К02.8. Other varieties not listed in previous paragraphs.
Classification of caries according to the ICD (International Classification of Diseases) is considered the most popular in the practice of modern dentists. It is convenient in that it has clarifications in the form of paragraphs devoted to a suspended illness and its other types.
Classification by disease primacy
Dental practice divides caries by frequency of occurrence:
- Primary - caries is formed on a tooth that has not previously been exposed to diseases, the etiology, the classification of which occurs through analysis and attitude to a particular category.
- Secondary, or recurrence, - appears on the surface of the organ, previously subjected to filling. It occurs due to a violation of the fit of the filling to the tissues of the tooth, as a result of which a gap is formed in which a favorable environment is created for the development of pathogenic bacteria.
Topographicclassification
This is a gradation that distinguishes types of caries according to the degree of canal damage. It is as common in determining the diagnosis as the classification of caries according to ICD 10. The following stages of damage are determined:
- Spot formation. The initial stage, excluding the destruction of enamel. At this stage, a light or dark spot appears on the surface of the tooth. There are no damages in the structure of the enamel - it remains smooth, pain does not bother. At this time, it is easiest to cure caries, as this occurs with minimal interference in the tooth tissue - the stain is removed from the surface, the enamel is remineralized.
- Caries is superficial. This stage implies damage, the focus of which is concentrated no deeper than the area of \u200b\u200btooth enamel. It is characterized by periodic pain and reaction to hot and cold. Treatment follows the same pattern as at the initial stage.
- Medium caries. The process has gone beyond the boundaries of enamel and is progressing in the area of superficial dentin, the pains are more intense and more frequent. The treatment process involves cleaning the carious cavity and installing a filling.
- Deep caries. Tissue damage is very severe, the pulp is protected only by a thin layer of preserved dentin, the patient experiences severe pain. If the filling is not installed in time, the disease can affect the pulp, and tooth extraction cannot be avoided.
Classification by intensity
According to the intensity of infection of the oral cavitydistinguish 2 types of the course of the disease:
- Single caries - affects one tooth.
- Multiple - the disease affects several teeth at once.
Among patients with multiple caries, there are often people with diseases of the cardiovascular system. If the disease affects the child's teeth, most likely, he had been ill with scarlet fever or tonsillitis. Careful prevention of multiple caries for a child under three years old is the silvering of milk teeth.
Classification according to the formation of complications
Untimely treatment of patients with dental diseases is observed quite often. It is not difficult to guess what such ignoring of the problem is fraught with. Of course, today there is also a classification of caries by complications. According to her, it happens:
- Complicated. The disease is accompanied by inflammatory processes in the oral cavity. A variation is flux.
- Uncomplicated. The classification of caries makes it possible to understand that this is a type of disease that proceeds according to generally accepted stages, including superficial, medium and deep.
The rate of development of the carious process
The development of the disease occurs in each person with different intensity depending on external factors and individual characteristics of the organism. There are several categories of caries:
- Spicy. Signs of the disease appear very quickly - within one to two weeks.
- Chronic. The disease develops over a long time and is characterized bythe appearance of yellowish or brown spots on the affected surface of the enamel.
- Flowering. Progressive type, in which multiple enamel lesions are observed in a relatively short time.
Features of the course of the disease in children
Classification of caries in children is carried out according to the same criteria as in adults. In pediatric dentistry, there is also a gradation according to the intensity, the primacy of the disease, the presence of complications, etc. The only distinguishing feature is the division into caries of the milk and permanent teeth.
Carious lesions of the mammary organs cause no less discomfort than permanent diseases. In children, caries is much more common than in adults, so it is necessary to accustom the child to proper oral hygiene as early as possible and limit the use of sweets. Given that milk teeth are still temporary, treatment tactics may differ slightly from the treatment of a permanent tooth.
Silvering baby teeth in children
Modern parents during a preventive visit to the dentist are faced with such a thing as silvering a child's teeth. This procedure is carried out in order to prevent and treat the initial stages of caries. In fact, the process is a "freeze" of the course of the disease.
The procedure is painless, during which the dentist applies a special composition containing silver to the tooth enamel using a cotton swab. A protective film is formed on the teeth, which prevents settling andthe development of pathogenic bacteria on the surface of the enamel.
