Caries is a common dental disease. It leads to deformation of the structure of the teeth. In an advanced stage, the disease provokes complete loss of teeth. It is for this reason that it is so important to diagnose the lesion in time and begin its complex treatment. Unfortunately, many people with such a problem try not to pay attention to it until the last moment, when they can no longer do without the help of a dentist. In the acute stage, the treatment of cement caries will already be radical, in some cases the doctor will amputate the damaged tooth.
Description of defeat
Cement caries is a partial lesion, in which the disease is distributed mainly in the cement part. The problem progresses against the background of the exposure of the root of the tooth and the development of the pocket, which is referred to as an anomaly. Most often, the lesion is diagnosed as cementum root caries.
When diseased, harmful pathogens and bacteria spread through the inside of the tooth without affecting the enamel and dentin.
Classification of cement caries in ICD-10 - KO2.2. This condition is most often diagnosed in older people who haveDue to age and physiological processes, atrophy of the gum bone tissue begins, which provokes incomplete exposure of the tooth root.
Causes of caries
The main cause of dental caries is the negative effect on the tooth tissue of bacteria and microorganisms such as Lactobacillus and Streptococcus mutans.
Such pathogenic microorganisms in the oral cavity arise and actively spread due to the following factors:
- Xerostomia - an abnormal decrease in the amount of saliva that washes the mucous membranes and dentition, as well as problems with its qualitative composition Such processes provoke demineralization of the enamel on the teeth. Enamel with prolonged exposure to such a process simply cannot maintain the condition of the teeth and protect them from pathogens. It should be noted that xerostomia can occur as a result of the use of certain antihistamines, sedatives and diuretics.
- Poor oral care - Improper oral care or its complete absence leads to the fact that the root of the teeth remains contaminated, plaque and stony deposits accumulate on it over time.
- Cervical caries - an unrepaired lesion quickly moves to the root area and affects other nearby tissues.
- Incorrect prosthetics - in this case, the artificial crown does not adhere well to the gum surface, and a large amount ofpathogens.
- Incorrect diet - a systematic lack of minerals and vitamins provokes the process of demineralization of hard tissues, and due to the large amount of carbohydrates in the oral cavity, bacteria begin to spread rapidly. It is these pathogens that provoke the onset of caries.
- Development of periodontitis.
- Oncological formations in the brain during radiation treatment.
The risk of cement caries does not depend on the age category of a person. Most often, the lesion appears with periodontal tissue disease or after radiation therapy.
Main symptoms
Depending on the place of development of caries, each patient will show their own symptoms of the disease. At the same time, signs of damage can be mild and hardly attract the attention of the patient if caries is hidden in the periodontal pocket.
In this case, cement caries is diagnosed already at a late stage of its development, when acute and pronounced pulpitis has already begun.
At an advanced stage of development of the lesion, a person has the following symptoms:
- aesthetic defects of the smile - this is especially noticeable on the front part of the jaws, when noticeable deformation and destructive processes occur at the base of the tooth;
- discomfort and pain when chewing food - when pieces of food get in or under the influence of cold and hot temperatures of the dish, a person develops pain of varying intensity.
Diagnostic measures
For the diagnosis and treatment of dental caries in the clinic, it is important to visit the appropriate doctor. Professional methods for diagnosing a lesion include a set of techniques using various equipment and dental instruments.
Diagnosis of cement caries in the clinic is carried out through the following procedures:
- Careful cleaning of teeth from plaque and stones, since in most cases they provoke the onset of the disease. When cleaning, specialized curettes, scalers, ultrasonic caps, as well as devices for hardware cleaning are used.
- Separation of the diseased tooth base from the salivary mass. For this, specialists use a rubber dam.
- Direct probing of the root of a diseased tooth. In this case, a specialized pointed probe is fixed on the diseased area along the rough surface of the tissue.
- Carrying out x-rays. The pictures will help determine if the diagnosed crown has pockets. Root caries will appear darker on x-ray compared to nearby tissues. To reveal the hidden type of the disease, the dentist uses a visograph - the procedure helps to carefully examine the affected area of the oral cavity in various projections.
- Thermodiagnostics is the most accurate and effective method that helps to determine the severity of caries of the cementum of the tooth root. In this case, the affected tooth is exposed to hot or, conversely, cold water - if the pain does not last long and it is not strongexpressed, then this is the initial degree of development of the lesion, but if the syndrome is strong and not passing, then this is a clear symptom of the presence of pulpitis.
- Electrometry - a point effect on the pulp area with electrical impulses of various strengths. The stronger the burning sensation in the affected area of the body, the more advanced the stage of the disease and the more dangerous the syndrome.
Treatment measures
Treatment of cement caries will be prescribed by a doctor after diagnostic measures, depending on the severity of the disease. There are two methods to eliminate the disease:
- conservative technique;
- surgical intervention.
Treatment with drugs and physiological procedures is best used when the processes of tooth decay have not yet started. Surgery is used in the development of pockets, when filling is the only possible method of eliminating caries.
Conservative treatment
In the treatment of root cement caries, specialists carry out the following procedures:
- professional cleaning of the dentition - cleaning of layers and stone deposits;
- elimination of the root cause of the development of the disease and dangerous factors - correction of improperly selected prostheses, elimination of periodontitis and other inflammatory lesions in the oral cavity;
- impact on the crown through remineralizing components - this method includes the use of fluorine-containing agents and antiseptic components. For better results and fasterrestore the condition of the oral cavity, additionally apply calcium crystals and copper ions.
Surgery
With this method of treatment, the doctor surgically removes pathology from diseased tissues and the crown part of the tooth. The procedure includes a set of the following activities:
- Local anesthesia, in which drugs directly affect the diseased area, depriving it of sensitivity. The injection site is pre-treated with an antiseptic and a special gel or spray that helps eliminate pain.
- Since it is quite difficult to isolate the affected area with a rubber dam, the specialist performs a partial dissection of the gums through diathermocoagulation.
- Next, the doctor performs a corrective contraction of the marginal surface of the affected gum tissue with special hemostatic threads.
- After the doctor removes the diseased area of the dentin, treating nearby tissues. When carrying out diagnostic measures, a special composition is used - a caries marker.
- If necessary, the dentist removes the nerve and fills the canals.
- At the end of the surgical treatment, the patient's oral cavity is comprehensively disinfected with an antiseptic.
The filling materials used during the procedure will be selected depending on the condition of the patient's oral cavity, the main symptoms of the disease, the location of caries, its severity and the general condition of the gum tissues.
BIn this case, the following components are used to seal the channels:
- Amalgams are used in rare cases, since when using them, it is necessary to create conditions for complete dryness in the oral cavity, and it is extremely difficult to achieve such a state. In addition, the material contains mercury, and its mixing requires personal protection.
- Compomers - help to create a strong and reliable filling that can easily withstand the load of any force. This tool is recommended for use in the treatment of a small cavity. The main drawback of the material is too strong fixation.
- Glass ionomer is the best option that will help restore the affected areas, improve the condition of tissues and teeth. The tool is well fixed, and is also not affected by moisture, it contains remineralizing substances that help restore the structure of the organ.
Price per procedure
The cost of complex surgical treatment will depend on many factors, namely: the severity of the disease, the treatment used, filling materials and the clinic itself.
Treatment of superficial caries will cost in the region of 2,000 to 3,000 rubles, for complex cases you will have to pay much more. If we take into account the price for filling material, then the cost will vary from 3,500 to 6,000 rubles.
Negative Consequences
If you do not start timely treatment of dental caries, the following complications may occur in the oral cavity:
- Pulpitis -inflammatory process, the focus of which is located in the pulp of the organ. The complication is distinguished by its chronic and acute form. The treatment of the disease is carried out through a comprehensive cleaning of the roots and their subsequent filling with good material.
- Periodontitis is a lesion of the internal tissues of apical periodontitis, in which a person has severe acute pain.
- Jaw periostitis is a disease that appears as a result of a complication of the stage of development of periodontitis. It is characterized by an inflammatory process in the tissues of the periosteum. In this condition, the patient develops fever, pain, feeling unwell and general weakness.
- Osteomyelitis is a lesion in which the patient has purulent foci. In this case, the clinical picture includes pain in the jaws, swelling of the cheeks, general fatigue, poor he alth.
- Abscesses are complicated inflammatory processes with a complex course and severe symptoms. Characterized by its odontogenic appearance. With untimely treatment, it goes into an acute stage and becomes a serious threat not only to he alth, but also to human life.
Prevention measures
Dentists advise every patient to take daily steps to help reduce the risk of dental caries:
- clean your mouth several times a day with special professional pastes;
- floss regularly;
- reduce the amount of sweets and confectionery consumed;
- use fluoride products;
- include as many fresh fruits and vegetables as possible on the menu.
Danger of defeat
Like other diseases of the oral cavity, cement caries provokes various complications. Timely initiation of treatment of the disease will help prevent the following conditions:
- spread of the infectious process to the root area, which often leads to periodontitis;
- will prevent severe tissue damage, as such a process can affect the pulp and lead to pulpitis;
- if the disease has reached the nerve, then the tooth dies and in some cases it even has to be removed.
Regular visits to the doctor will help to identify the lesion in a timely manner and quickly get rid of it even at the initial stages of development.
Symptoms and stages of the lesion
When caries occurs, the patient shows the following symptoms of the lesion:
- pain syndrome on any external factors: mechanical, chemical, thermal;
- discomfort in the neck;
- affected area darkens over time.
As the disease progresses, other symptoms of the lesion begin to appear in a person, which are characteristic of a particular stage:
- The initial stage of caries. This condition is characterized by extensive demineralization of tooth tissues. The affected area in the oral cavity changes its color from white to brown. At this stage of lesion development, the cemento-dentinal bordercontinues to persist.
- Superficial root damage. In this condition, the process of destruction of dentin and cement begins, followed by the appearance of a small pigmented gap. The hole depth is up to 0.5 mm. The borders are composed of mantle dentine.
- Deep defeat. Caries in this case extends to deep tissues, the cavity exceeds 0.5 mm. Most often, the free space is separated from the pulp only by a thin layer of dentin. The bottom and borders of the affected area begin to turn dark.
Timely diagnosis and proper treatment of cement caries are the main factors that help keep the tooth intact and avoid its extraction. The laser procedure will help to cure the diseased area quickly and painlessly. You should not self-medicate with the development of caries, since in this case you can only waste time. The he alth of your teeth is best left to a professional dentist.
