Most likely, you will not even be able to find a person who would not dream of having a snow-white smile and he althy teeth. How to achieve the desired result? To do this, you will need to regularly visit the dental office for the timely detection of diseases. One of the most common of the huge list of pathologies is caries. According to numerous studies, more than 98% of the inhabitants of European countries suffer from it.
Caries was known to mankind more than one millennium ago. However, the pathology was first described only in 1884 in the theory created by Miller. According to this scientist, teeth begin to decay as early as infancy, as soon as the very first ones appear.
At first glance, it seems that caries is a harmless disease. However, this is one of the most serious problems for dentists. After all, the progression of the pathological process can lead to inflammation of periodontal tissues and the dental nerve, which can causeloss of the tooth itself, as well as the occurrence of diseases of many organs and the musculoskeletal system.
Caries development
Everything starts small. At the initial stage of caries, pigmentation and demineralization of the enamel occurs. In order to understand how the pathology develops, consider the structure of the tooth itself.
The top and most durable part of it is called enamel. With poor oral hygiene or with its complete absence, a rapid process of reproduction of pathogenic microorganisms occurs in it. All this leads to the formation of harmful bacterial plaque on the surface of the tooth.
The structure of the enamel consists of several compounds that are held together by a protein matrix. When plaque is present on the teeth, the microorganisms contained in it begin to produce organic acids. That soft plaque that lingers on the enamel for a long time begins to mineralize and hardens over time. This is how tartar is formed. And now, under the surface of this formation, acids begin to act freely. They dissolve enamel cells, contributing to the development of the demineralization process. This is the primary cause of caries.
An interesting fact is that simultaneously with demineralization, that is, with destruction, the process of enamel restoration, that is, its remineralization, begins to proceed in our body. In the area where pathogenic microorganisms were able to make a hole in the tissues of the tooth, minerals in saliva begin to flow intensively. If these two processes are balanced,the enamel will remain intact. Otherwise, with the prevailing strength of bacteria, the initial stage of the disease will occur.
Causes of the pathological process
Today, scientists have already managed to explain what are the main factors leading to the occurrence of caries. Among them:
- bad food;
- small amount of fluoride in drinking water;
- weakening of the body during the period when the laying of dentin and enamel occurs;
- negative impact of environmental factors;
- heredity.
There are also some local factors that lead to the onset of the initial stage of caries. Among them:
- tartar or soft plaque on teeth;
- mouth food residue;
- violations in the biochemical composition of dentin, enamel and cement;
- failures in the processes of bookmarking and further development, as well as teething;
- not fully formed structure of dental hard tissues.
However, each of us knows that caries does not occur in every person. So, some people constantly monitor their oral cavity, however, they suffer from multiple lesions of the teeth, while others do all the procedures once, but do not even know what kind of disease it is.
There is an explanation for this phenomenon. The whole point lies in the degree that a person's individual caries resistance, that is, his resistance to pathology, has. The development of the process of enamel damage begins only when the destructive workpathogenic bacteria is able to overpower the body's resistance.
The manifestation of caries resistance can be carried out at different levels. This process proceeds as follows:
- At the molecular level. In this case, the body's ability to resist the negative effects of organic acids is directly related to the degree of enamel mineralization and the interaction between its constituent elements.
- At the fabric level. The enamel structure sometimes plays a decisive role in the development of the initial stage of caries. If there are a large number of irregularities on its surface, then it is easier for bacteria that destroy it to linger on it.
- At the level of the teeth. In this case, the important factors are the depth and shape of the fissures, as well as the structure of the protective organic film - pellicles.
- At the level of the general dental system. In this case, the body's resistance to caries will depend on the shape that the facial skeleton and jaw have, as well as on the correct bite.
As mentioned above, with the onset of the initial stage of dental caries, the body fights using the salivary glands. The secret secreted by them allows you to clean the enamel from plaque, which prevents the accumulation of bacteria. With a decrease in the rate of salivation and an increase in its viscosity, caries forms much faster.
Initial dental caries is often observed in pregnant women. The fact is that for the normal development of the fetus requires a lot of calcium. He takes it from the bones and teeth of the mother, which leads to their weakening.
The development of caries inchildren
The action of etiological factors is observed by dentists not only in adults, but also in young patients. Moreover, at an early age, caries is found much more often. This fact is explained by the fact that after the tooth has erupted, the final maturation of the enamel will take about another two years. During this period, caries most often occurs in children. Caring parents should definitely pay attention to this.
At the age of 2 to 4 years, the so-called bottle caries is often observed - the initial stage of the disease, the cause of which is the habit of drinking milk before bedtime or at night. After that, numerous food remains continue to be in the baby's oral cavity until morning. This is the main reason for the development of the initial stage of caries of milk teeth (see photo below).
Medical reference books do not contain the term "bottle caries". This name is used only in everyday life, because by the nature of the primary causes of development and further course, the pathology is a typical caries. Among them:
- Weakened immunity of the child, as well as the still low bactericidal characteristics of his saliva.
- Mistakes in the preparation of the baby's diet. When a child consumes sweet cereals and juices, flour and confectionery products, their remains will certainly linger in his teeth, and to the greatest extent will contribute to the reproduction and active life of harmful bacteria in the mouth. The absence of coarse food in the diet will also affect the condition of the enamel,for example, apples and carrots, chewing which eliminates plaque. In addition, the initial stage of caries in children is observed with a lack of foods high in fluorine and calcium, such as natural milk and fish.
- Regional factor. The initial stage of caries of milk teeth sometimes occurs in cases where there is not enough fluoride in drinking water. In this case, the enamel weakens, and it begins to be damaged by aggressive acids.
Dentists recommend that parents follow the rules for carrying out the recommended oral hygiene procedures for their baby. Milk drunk before bed will not be so harmful to the child's teeth if they are cleaned after feeding. And this is what dentists recommend to parents.
The initial stage of caries of milk teeth sometimes also occurs due to heredity. But in this case, moms and dads need to remember that a he althy nutritious diet and oral hygiene can significantly reduce the likelihood of developing pathology, even with an existing genetic predisposition.
Stages of development of initial caries
A person's teeth do not deteriorate immediately. Pathology arises, then passing through certain time intervals or stages. As you move from one of them to another, there is an increase in the degree of damage to the tooth. As a result, in the absence of treatment, the so-called point of no return occurs. It is characterized by the appearance of extensive voids in the tissues of the tooth. And this will require serious treatment.
What are the stages of the initial stage of cariesteeth (photo below)?
Among them:
- The stage, which is called the "chalky spot". At this stage, the pathology is determined by the presence of a white area. This stain is lighter when compared to the rest of the enamel.
- The stage of the so-called dark spot. This form of the disease is more serious. The pathological process thus penetrates deeper into the enamel. Food coloring easily lingers in this area. It is because of this that stains on the teeth turn brown or turn brown.
Let's take a closer look at the stages of initial caries, and start from the first stage.
Classification
"White-spotted" caries is divided into:
- Surface. This is a stable area with reduced mineralization and reduced fluorine content.
- Surface. This type of pathology is porous areas with a reduced calcium content and is characterized by highly permeable enamel.
- Central. This type of initial caries is a strong degree of enamel change with the development of its porosity and with a maximum decrease in its calcium content.
- Intermediate. In this case, microspaces are formed in the enamel.
- Internal. This type of initial manifestation of caries is characterized by the most prosperous area of the enamel with a minimum percentage of microspaces.
If in the initial stage of caries (photo below) you do not turn to a specialist for appropriate treatment, thendemineralized and porous tooth tissue, in the crystal lattice of which failures have already occurred, will continue to break down.
Pigments will begin to accumulate in areas of pathology, transferring the initial caries from the stage of a white spot to the next stage, when these areas of pathology become brown or black. Later, when a cavity forms at this site, the dentist will have to apply aggressive methods of treatment, such as preparation and restoration of the tooth.
Symptoms
What are the signs of the initial stage of dental caries (photo can be seen below)?
The main symptoms of pathology, as a rule, are associated with pain and aesthetic manifestations. What are they at this stage?
At this stage, the person does not feel any discomfort. However, upon closer examination of the tooth enamel, there is a loss of its luster and some roughness of the affected area. That is why at the stage of the beginning of the development of the pathology, which is called the "white spot", only 10-20% of patients come for a consultation with the dentist. The dimensions of such zones, as a rule, are 3-5 millimeters.
Is it possible to identify the pathology yourself? To do this, first of all, you need to know what the initial stage of caries looks like. In addition, you will need to brush your teeth and dry them with a cotton swab, and then carefully examine the enamel in good light. Especially noticeable in this case is the initial stage of cervical caries in the front row of teeth. Also visible areareas of demineralization, distinguished by their haze.
Another sign of the initial stage of pathology may be the appearance of increased sensitivity of teeth to thermal or taste stimuli.
Self Diagnosis
Sometimes patients confuse the initial stage of caries (photo below) with dental pathologies such as:
- spotted form of fluorosis;
- enamel hypoplasia.
However, it should be borne in mind that with caries, the spots on the teeth are chalky or pigmented, with a smooth or matte surface that does not have clear boundaries.
While with fluorosis, the affected areas, despite their white color, have a more pronounced color in their central part, which smoothly passes to the periphery into a normal tone for enamel. Such zones do not have shine and sometimes differ in yellow pigmentation. White spots with hypoplasia have a clear border, do not lose their luster and do not lose the smoothness of the surface.
Regular bluing can be used to establish an accurate diagnosis at home. Dentists recommend brushing your teeth thoroughly before using it, and then start treating the enamel with a 2% aqueous solution of the specified substance. If, as a result of the manipulations, the stain turned blue, then this is a clear indication of the presence of caries. In the dental office, stomatoscopy is used to diagnose pathology. The doctor directs ultraviolet rays to the teeth. In their light, he althy enamellooks light green and the affected areas have a darker tone.
Treatment of the first stage of initial caries
How to eliminate white spots that threaten further destruction of the enamel? Treatment of the initial stage of caries does not require drilling of the tooth, which is so familiar to many. The fact is that caries, which is at the stage of a white spot, manages to damage only the surface layer of the enamel, and most often is a reversible process.
In this case, the doctor can apply remineralization of the teeth, suggesting their saturation with calcium. This method allows you to restore the enamel. This is the main treatment for teeth that have white spots. In this case, medications are applied to the lesions:
- brush;
- adding to kappa;
- using applications.
Simultaneously with such therapy, dentists advise their patients to take mineral complexes containing calcium gluconate, calcium phosphate, and fluorine compounds.
Requires treatment and the initial stage of caries in children (pictured below).
Otherwise, such inaction can cause multiple defects in the teeth, up to their breaks and spalls. Very often, such processes are accompanied by discomfort during eating or even spontaneous pain. With the loss of function of a significant number of teeth, bite, chewing, digestion are disturbed, and the general well-being of the child worsens.
Steps to eliminate white spots
How to treat initialcaries stage? To do this, you will need to sequentially go through the following steps:
- Soft plaque and formed stone are removed from the enamel by the dentist. For this, abrasive pastes or hydrogen peroxide are used. After that, the surface is to be polished.
- Affected teeth are treated with special preparations, the main ingredient of which is calcium.
- Dentist applies applications using 2-3% sodium fluoride.
Treatment of the initial stage of caries consists of 10-14 procedures. After they are carried out, the enamel is dried, fixing with varnish with fluoride.
Instead of remineralization, dentists use special mouthguards that are filled with healing agents. These detachable structures are custom made, making them comfortable and airtight.
For reminalization, dentists often send their patient for electrophoresis with drugs needed to strengthen the enamel.
The recovery period after the course of treatment is not required. The patient must periodically undergo dental check-ups and properly care for their teeth.
Often, cervical caries in the initial stage is found on the enamel of babies. And in this case, it will be necessary to carry out restorative procedures. Remineralization should be done before the formation of a carious cavity. Enamel protection will be especially effective if parents take care of the proper nutrition of their child and the hygiene of his teeth.
Prevention of white spots
Often, people's teeth deteriorate for reasons beyond their control. This isgenetic prerequisites, polluted atmosphere and other similar factors. However, even at the same time, it is necessary to pay attention to your teeth, recognizing areas of demineralization on them. Otherwise, going to a specialist will require quite serious treatment.
What should be done to prevent initial caries? For this you need:
- brush your teeth in the morning and evening hours;
- rinse your mouth after eating or carry gum with you;
- purchase dental products containing fluoride;
- use dental floss or irrigator to remove food debris;
- balance the diet by reducing the amount of food high in sugars in it;
- contact a dentist not only when a focus of pathology is detected, but also for prevention purposes (at least once every six months).
To fight tooth decay will help and the rejection of bad habits. Smoking and alcohol have a very negative effect on dental he alth.
Dark spot stage
What does the initial stage of dental caries look like after its first stage? Gradually, the pathological process, if it has not been treated, changes the color of the enamel. As it develops from white, the spot becomes beige, then light brown, then dark brown, and finally black. In this case, the spot increases in size, and the pathological process covers the enamel in its deeper layers.
The most intensive development of caries occurs on the lateral surfaces of the teeth. Enamel in the dark spot stagecontinues to break down. It becomes uneven, porous and rough. In the spot area, some defects sometimes occur. They are minor chips and dotted recesses. At the same time, a person complains of a sharp painful reaction when exposed to external stimuli.
In cases where pathological lesions are located in the cervical zone, discomfort occurs even with some mechanical influences, for example, when brushing your teeth or when you press on them with your finger. The pain in this case is aching short-term. Some changes occur in the gingival zone. Here, plaque accumulates near the teeth, which has a yellowish or white color. Sometimes inflammation also covers the gum papilla.
Diagnosis of caries at this stage differs in some significant nuances. So, the doctor will definitely check the condition of the enamel by picking up a dental probe. In the case when caries is noted at the stage of a white spot, such actions are not carried out. The fact is that at the initial stage, the enamel still retains its hardness, and the tip of the probe will not indicate changes, continuing to slide over its surface. Things are quite different with deeper demineralization. This can be understood by seeing what the initial stage of caries looks like (the photo is confirmation of this) at the stage of a dark spot. In this case, probing reveals a decrease in the hardness of the enamel and its roughness. The patient during such a procedure feels slight pain.
If dark spots are located infissures, that is, in the recesses of the natural relief of the tooth, it is sometimes difficult for the doctor to determine whether such symptoms are initial caries or if this is already a more serious form. The most problematic such diagnosis becomes in young patients. The fact is that the enamel of children's teeth in the fissure zone is still not sufficiently mineralized. In this regard, pain during probing occurs in babies even on those surfaces that are not involved in the carious process. That is why many pediatric dentists do not use sharp probes at all in the diagnosis of fissure caries, since in this case enamel damage and the creation of artificial foci of its roughness are possible. To determine the pathology, in this case, they resort to the use of dyes that are firmly fixed in the pores, which makes it possible to identify demineralized areas.
Perhaps this will surprise someone, but stripes and black dots on the enamel in the fissure area are not at all evidence that the tooth has completely rotted and cannot be restored. Yes, he already has problems, but dark spots can be just one of the signs of the initial stage of caries. And in this case, the process is completely reversible.
As with white spots, a remineralization procedure can be performed by the dentist. The use of a drill in most cases is not required. However, sometimes reminalization does not lead to the desired result. In such cases, dentists offer the patient surgical treatment. Light brown spots are removed using a diamond burr. After that, the method of adhesive filling is applied. In the event that the stain has acquired a dark brown color, prompt processing of hard tissues will be required. In this case, filling is performed in the same way as with average caries, that is, with a more serious form of pathology.
Today, helium-neon lasers are successfully used by dentists. It eliminates the initial forms of caries. The light of this laser activates the enzyme system in the dental pulp. It also increases the effectiveness of anti-caries drugs lured by the doctor, actively affects the permeability of the enamel and reduces the solubility of its surface layer. After such treatment, the density of the enamel itself increases significantly, and the activity of all its protective mechanisms also increases.
Signs of successful treatment
Caries at the initial stage can be eliminated without much difficulty. Nevertheless, it should be borne in mind that with incomplete or poorly performed treatment, the disease will certainly move to its next stage. Moreover, it will be more serious and subsequently can cause various negative processes.
In what cases is it considered that the elimination of the initial caries led to the desired result? Treatment success is said to be when:
- the color of the tooth enamel became uniform, and the carious stain disappeared;
- when re-diagnosing, traces of enamel demineralization are not detected;
- the patient does not complain of a negative reaction in the presence of temperature and taste stimuli.
