Caries in dentistry is a common pathology. This disease has 2 forms - chronic and acute. In both types, extensive damage to the teeth develops. Without treatment, proper care and diet correction, chronic caries is incurable. The reasons for the appearance of pathology and treatment are described in the article.
Features
Chronic caries is a sluggish form of the disease, in which there is a gradual defeat of all layers of dentin. The disease progresses over several years with few and unexpressed symptoms. With this pathology, pain does not appear (with the exception of the last stage).
Signs
Chronic caries causes the following symptoms:
- There are small lesions with dark enamel, but it has a dense unchanged structure.
- As the situation worsens, the enamel becomes uneven and rough.
- Painful sensations are practically absent or appearweakly and not for long, only as a reaction to thermal or mechanical impact. There is a sharp reaction to sweets. Pain quickly disappears if the cause is removed.
- Enamel with a compensated form is practically not affected, but with the development of a destructive process, dentin is quickly damaged. Therefore, dentists are often faced with a situation where, with intact enamel, a cavity with dead tissues quickly appears.
- The emerging cavity is characterized by sheer, flat edges and a wide entrance. There is pigmented and dense dentin on its bottom and sides.
The course of chronic caries is characterized by incomplete remission, that is, it can persist throughout life and recur due to various factors.
Reasons
Dentists have repeatedly put forward different theories of the occurrence of chronic caries. But Miller's chemical-parasitic concept, which was developed and proven at the end of the 18th century, is considered the most accurate. According to her, caries occurs under the influence of organic acids produced by pathogens.
The causes of acute and chronic caries are the same. Pathology develops under the influence of various factors. Common reasons include:
- Unbalanced diet, which is dominated by fast carbohydrates, but there are no products that help saturate the enamel with vitamins and trace elements.
- Complex pathologies suffered during the appearance of hard dental tissues.
- Lack of fluoride in water.
- Genetic factor.
Dentists have found that compensated caries usually occurs in people with a history of chronic metabolic and endocrine pathologies, as well as weak immunity. Local causes include:
- Lack of or insufficient oral hygiene, due to which bacteria actively multiply.
- Enamel demineralization.
- Pathologies that lead to a decrease in the formation of saliva and a change in its composition.
- Congenital anomalies in the structure of the teeth and jaw.
- Low resistance and changes in the structure of all dental tissues.
With the timely elimination of these factors, it will be possible to reduce the likelihood of developing the disease. A timely visit to the dentist and careful oral care helps in this.
In children
Chronic caries of milk teeth appears more often. The main reason for the disease is that some parents are late in teaching their children about oral care. To avoid pathologies, brush your teeth immediately after the eruption of the first incisor. With rare or no oral cleaning, saliva is not able to completely suppress the activity of bacteria and cope with the appearance of certain diseases.
Parents mistakenly believe that caries of milk teeth can be left untreated, since they still change with permanent ones, therefore they do not take their children to the dentist. But in fact, the he alth of milk teeth affects the condition of permanent ones. In the absence of treatment with caries, their rudiments are affected, thereforenew teeth erupt already sick.
Stages
This disease has 4 stages. The transition of pathology from one to another is slow and almost imperceptible:
- Chalky spots. The disease is manifested by the appearance of an unnaturally white small spot on the enamel, which is similar in color to chalk. This period is called the “chalky spot stage” by dentists. It is completely reversible, that is, the development of caries can be stopped. The appearance of the stain is associated with the leaching of vitamin and mineral components from the enamel.
- Superficial chronic caries. During this stage, destruction of the enamel is observed, when small holes and cavities with gentle edges appear on it. Whitish spots gradually darken. Their color can be from light brown to dark gray. There is no pain symptom, and during the examination of the affected area, it is revealed that the surface is heterogeneous and loose.
- Chronic medium caries. It penetrates into the surface layer of dentin. It can be identified by an increase in the size of the spot, the appearance of causative pain, which disappears after the elimination of the irritating factor, and also by the formation of a narrow cavity.
- Chronic deep caries. This stage is considered the most difficult. With it, large dark brown or black cavities appear. There is also an expansion of the interdental spaces. The edge of the tooth is destroyed so that its edges can be felt with the tongue. When caries destroys enamel and dentin, it moves to the pulp. There is no constant severe pain. This symptom is temporary and occursonly under the influence of irritating factors.
Diagnosis
To confirm the presence of a chronic degree of caries, several types of examinations are required:
- Visual inspection. The dentist examines the condition of the oral cavity, determines the degree of damage to the teeth.
- Treatment of hard tissues with a special dye, which allows you to establish the pathological process at the beginning of its development. If dark places are noticeable, then it will be possible to diagnose the beginning of the carious process in them.
- Electroodontometry. The technique helps to establish the sensitivity of the pulp. If a short-term pain reaction appears when exposed to current, then this indicates that this fragment of the tooth is affected by caries.
- Examination on the device "Diagnodent". By acting on the enamel with light waves, it analyzes the reflected light. If changes in the composition and structure of the enamel are noticeable, the device notifies about this.
- X-ray. Invisible during visual inspection, caries is quite simply detected on an x-ray. In the image, he althy tissues will be light, and destructive areas will be black. An x-ray will help determine the depth of penetration of caries into the tissues.
Therapy
The treatment of chronic caries is similar to the treatment of acute. The difference is that in the chronic form of the disease, therapy is aimed at stopping the carious process, as well as at eliminating the cause that led to the disease. Based on the stage of the disease, the dentistchooses the method of therapy. The person's age and state of he alth must be taken into account.
Remineralization
This procedure involves saturation of the enamel with calcium and phosphorus. With remineralization, the enamel density and its mineral composition are restored, sensitivity is reduced. For this purpose, 2 means are used:
- Solution "Remodent" 3%.
- Calcium Gluconate 10%.
Each of these composition is applied to cleaned teeth for 10-15 minutes. To improve the penetration of minerals, exposure to special light is required during this time.
All products are applied in several layers, then washed off with a special solution using a swab. Let the enamel dry. The number of sessions is set by the doctor, taking into account the level of tissue damage. The procedure is effective for primary enamel lesions.
Fluoridation
Treatment of chronic deep caries in this way is similar to remineralization. Only the teeth are covered with products containing fluoride. With their application, crystals are formed that fill microcracks in the enamel. To improve the penetration of the agent, the tooth is exposed to ultraviolet rays.
Fluoridation reduces the spread of caries, prevents its occurrence in other teeth. The procedure improves the quality of all tissues in the oral cavity, increases the density of the enamel. Fluoridation is performed no more than once a year at the initial stage of the disease.
Sealingfissure
The procedure is performed for superficial caries, when sealing of the furrows on the molars is observed. First, the doctor performs the preparation of fissures to eliminate the affected tissues from them. Then the treated clean surface is covered with a heavy-duty mass, which contains remineralizing components. Sealing is fast, the furrows of one element are closed no more than 15 minutes.
Filling
The technique is used if the destructive process has affected the deep layers of dentin. It involves the elimination of destroyed tissues and the creation of a cavity for the installation of a seal. If the inflammation affects the pulp, then the treatment is carried out with the extraction of the nerve.
When cleansing is done, the cavity is treated with an antiseptic solution, the root canals and the cavity are closed with a composite. The material for the filling is selected depending on the location of the diseased tooth and its functionality. The duration of filling lasts 40-50 minutes, and if you do not need to extract the nerve, then the time is reduced by almost half.
Prevention
To prevent the occurrence of chronic caries will allow the elimination of the main factor in its development. It is necessary to follow simple rules:
- Timely treatment of dental diseases is required, which lead to the reproduction and spread of pathogenic microflora.
- It is necessary to regularly and efficiently clean the oral cavity using remineralizinganti-inflammatory pastes and rinses.
- Daily toothbrushing should be complemented by the use of floss, irrigator, dental brush.
- The diet should be balanced. Eliminate or reduce the amount of baked goods and simple carbohydrates consumed.
- Don't chew on nuts, crack seeds, or use sharp objects to clear stuck food.
- It is important not to injure the enamel.
- Go to the dentist every six months for the prevention and timely treatment of identified ailments.
The implementation of these recommendations allows you to maintain he althy teeth. If there are symptoms of the disease, then you should contact your dentist for quality treatment.
