Dental caries: what is it, causes, prevention, symptoms and treatment

The treatment tactics for caries depend on the cause of the pathological process and its neglect. This is the most common dental disease, characterized by gradual tooth decay. The pathology goes through several successive stages; at first, the patient may not feel anything; in complex cases, complete loss of dental units is possible.

It is not difficult to detect the disease, because most of the symptoms are quite obvious. However, it is better to prevent the occurrence of carious lesions by following preventive recommendations, and then a snow-white smile will delight you for many years.

What types of caries are there?

There are several stages of the disease. They have a certain appearance and symptoms.

How to determine the stage of caries:

1. In the spot stage: a white spot is observed on the surface of the enamel (focus of demineralization). The spot gradually turns brown. Enamel is the densest tissue in the human body, but due to various cariogenic factors it is gradually destroyed. Detecting the white spot is quite difficult.
2. Medium caries: characterized by damage to the enamel-dentin junction in the form of a cavity, short-term sensitivity.
3. Deep: extensive lesion affecting the deep layers of dentin. Pain appears from different types of irritants: mechanical, temperature, chemical.

Diagnosis of the disease is carried out using a visual examination and an x-ray. The image will show violations of the integrity of the enamel and dentin with uneven contours.

Treatment with preparation of hard tooth tissues

This method is based on hardware treatment of the affected areas of the tooth under anesthesia. Depending on the stage of development of the disease, there are several stages in treatment. For average caries it is:

• anesthesia
• mechanical and medicinal treatment of canals
• installation of protective lining
• filling taking into account the dental characteristics of the tooth
• grinding and polishing of tooth surfaces

Medium and deep stage treatment takes an hour on average, but in some cases it takes longer. To treat average caries, one visit is enough.

The effect of treatment procedures is determined by the professionalism of the doctor, the quality of medications and equipment, and the individual characteristics of the patient’s body. The key to maintaining the result is compliance with proper nutrition and hygiene rules, as well as maintaining the protective functions of the body.

What does caries look like on teeth?

Not all patients know how to identify dental caries. To do this, you need to come to the dentist for an examination.

Black cavities of varying sizes are found on the chewing units. The pathological process develops in the natural depressions of the enamel: fissures, pits.

This disease leads to the destruction of hard tissues and cosmetic defects. There are black cavities on the front teeth, noticeable when talking or smiling:

Symptoms

The rate of growth of signs primarily depends on why caries occurs, holes are formed, and the inflammatory process develops in the neurovascular bundle. The most common symptoms of carious lesions:

• darkening of the enamel, the appearance of dots or stripes of a white or dark shade on it (typical of the initial stage);
• increased sensitivity when consuming certain categories of foods (sour, sweet, hot, cold, hard); pain when pressing on the diseased area or in the absence of mechanical action;
• deep black holes, cracks in hard tissues;
• bad breath;
• headache, shooting sensation in the ears.

Diagnosis of dental caries

In some cases, the patient can independently diagnose himself, based on characteristic signs such as the presence of black holes and pain. However, there are situations when only a competent specialist can detect a lesion. This applies to the initial stage of the pathology in the absence of severe symptoms. At later stages, a thorough examination is also important in order to correctly differentiate the pathological process from other disorders.

The main methods used in dentistry:

• visual inspection using a mirror and other tools;
• computer images (panoramic, radiovisiography, CT, 3D study);
• functional diagnostics;
• thermal test;
• probing.

Dentik uses modern X-ray machines with safe radiation exposure and other equipment. We examine adult patients, women during pregnancy and lactation, and small children.

How does caries form?

The causes of caries are poor hygiene and the presence of bacteria in the oral cavity.

There are many bacteria in the human oral cavity. These bacteria feed on food debris that remains on the surface of the enamel after eating. Bacteria “love” foods high in carbohydrates: sweets, flour. During their life, bacteria produce acid, which destroys teeth.

Caries occurs in both adults and children. This disease spreads in each person at a different rate.

Factors contributing to the rapid development of caries:

• insufficient or lack of oral hygiene;
• excess carbohydrate foods: flour products, sweets, carbonated drinks;
• low buffering capacity of saliva, when acids and alkalis are not sufficiently neutralized in the oral cavity;
• insufficient fluorine and calcium content in enamel;
• lack of vitamins and minerals in the body;
• severe somatic pathologies suffered in childhood (tuberculosis, rickets);
• reduced immunity.

Answering a frequent question from patients: “Why do caries form on teeth?”, we note that the most important factor is insufficient hygiene. All dentists strongly recommend brushing your teeth regularly and using floss to clean the gaps. Without careful hygiene, bacteria will destroy teeth one by one, leading to serious complications.

Causes

Caries is the result of the activity of pathogenic microflora in accumulated plaque or tartar. A person’s immune status plays a major role in the development of carious defects. At particular risk are persons with autoimmune pathologies, AIDS, HIV, metabolic disorders, diabetes mellitus, and those taking immunosuppressive therapy for organ or tissue transplantation for a long time. The following factors can contribute to the development of caries:

• smoking, alcoholism;
• inadequate oral hygiene;
• natural aging (decrease in the body’s defenses, changes in the biochemical properties of saliva);
• metabolic disorders;
• endocrine pathologies;
• lack of food discipline (including prolonged fasting, poor nutrition, anorexia, bulimia);
• gum recession of various nature;
• excessive consumption of sugar and carbonated drinks;
• gastroesophageal reflux;
• bite pathologies;
• violation of hygiene rules when wearing braces and other orthodontic structures for the treatment of pathological occlusion.

Despite the variety of causes, eating disorders, bad habits and organ pathologies are the main etiological triad leading to the development of caries. Caries is not an independent disease. The pathogenetic link in the demineralization of enamel and destruction of the tooth body is a violation of the body's defenses.

What happens if caries is not treated?

1. For a long time, the disease may not bother the patient in any way. When the destruction of hard tissue has reached a significant extent, sensitivity appears during eating.
2. If you do not consult a doctor at the first stage, the carious process will go further and reach the pulp (nerve). Spontaneous severe pain appears. Treatment of pulpitis will be required.
3. If the patient does not seek help at this stage, the infection spreads beyond the root. Periodontitis occurs. The prognosis here is unfavorable, since such a tooth often needs to be removed to eliminate the infection.

Therefore, timely visit to the dental clinic will help to avoid acute pain and complications.

Classification according to the severity of the process

Clinical observations have established that the severity and speed of development of the carious process determine the methods and tactics of its treatment. Based on the results of these studies, the well-known specialist in the field of dentistry T.V. Vinogradova proposed a classification of caries according to the severity and prevalence of the carious process:

Compensated form of caries

With this form of caries, the average intensity of pathological processes is less than the average intensity for this age group. The disease spreads slowly, carious cavities are lined with hard, pigmented dentin (chronic caries).

Generalized caries

The average intensity of caries approximately corresponds to the average for a certain age group.

Decompensated form of caries

The intensity in the decompensated form significantly exceeds the average for the age groups studied. In this form, the carious process proceeds very intensively; in this form of caries, a large number of carious cavities filled with soft dentin are observed. The extreme form of acute caries is the so-called “systemic damage” of teeth by caries, in which carious lesions are observed in almost all or all teeth in the cervical area.

What to do if caries appears on teeth

First of all, you need to immediately contact your dentist. When a tooth is destroyed due to caries, treatment cannot be delayed. Otherwise, the complications described above arise. It is worth noting that no available means at home will relieve the patient of this problem. Only a dentist can cure this disease.

You should also pay attention to your oral hygiene:

1. Brush your teeth at least twice a day.
2. Use floss and mouth rinses.
3. Visit your dentist for a checkup every six months.
4. Come for professional hygiene every 6 months.

Dentists will help you select individual hygiene products (brushes, pastes, threads, rinses) at your appointment. The doctor will also determine why dental caries appears in your particular case and give the necessary recommendations.

Some additional facts

Just like that, after some time, the fillings do not need to be changed. The filling may remain with you for the rest of your life. Reason for replacement: breakage of a filling or tooth, as well as caries arising from the filling.

Minor caries is asymptomatic. By waiting for pain to appear, you are dooming yourself to more expensive and complex treatment.

In the treated tooth, caries stops. It may return after a while if the filling comes off and bacteria begin to penetrate into the resulting space between the filling and the tooth.

Often, caries occurs in places that are difficult to reach with a brush, for example, in the interdental spaces. That's why we strongly advise you to use dental floss.

Any cracks in teeth or fragments of teeth are at risk.

Not all tooth sensitivity indicates tooth decay. It can be caused, for example, by gum disease, which exposes the root of the tooth. In any case, only a doctor can name the reason.

When caries is detected in primary teeth, it is recommended to treat them, if possible, rather than remove them. After all, baby teeth save space for molars. In the absence of primary teeth, molars may be positioned incorrectly.

How is caries treated?

The treatment is carried out in professional dentistry by a general practitioner and is absolutely painless. This treatment is carried out in one visit, and several teeth can be treated in one visit.

Sequence of treatment stages:

• Examination of the oral cavity. Carrying out diagnostics: a targeted diagnostic image of one tooth or computed tomography of the jaws (if multiple caries is detected during the examination). This is done in order to make an accurate diagnosis and see the volume of destroyed tissue.

• Local anesthesia: selected individually according to health conditions. Only after the desired area of ​​the oral cavity has become numb does the doctor proceed to the next manipulations.

• Placement of isolation: the doctor places a rubber dam on the desired area - this is a latex plate that isolates the tooth from the rest of the oral cavity. The rubber dam creates comfortable conditions for the doctor, the patient, and also allows you to create dry, sterile conditions for placing a filling. This is necessary for the filling to serve for a long time and with high quality.

• Preparation of enamel, dentin: necrectomy. The doctor uses a drill to drill out the destroyed tissue.

• Treating the cavity with antiseptic solutions, applying an adhesive - a special solution that, like glue, reliably bonds hard tissue to the filling.

• Filling with light-curing materials. The anatomical shape of the tooth is restored, and the color is carefully selected.

• Polishing and grinding so that the filling does not feel different from your own teeth. Also, using special guidelines, the doctor checks whether the filling is too high or does not interfere with the normal closure of the jaws. Excess is removed, sharp edges are sanded.

• The doctor gives recommendations after treatment. If a tooth has been severely damaged by caries, then in addition to a filling, an orthopedic onlay or crown may be required. This is due to the fact that the filling is not as strong as enamel. Over time, cracks and chips are possible. Orthopedic structures will help protect the treated tooth from these complications.

After these stages, the tooth is completely free of caries. Next, you will need to maintain regular hygiene, come for preventive examinations and professional cleaning.

Why is this necessary?

1. Preservation, not restoration of health. Even at the initial stage, caries is associated with varying degrees of destruction of dental tissue. Of course, the dentist will restore the tooth and form a filling, which will be installed in place of the missing fragment. But, in any case, the filling serves only as an analogue, a more or less effective replacement for lost dental tissue. Prevention does not allow the disease itself to develop. That is, it preserves the integrity of the natural structure of the tooth, eliminating the need to use artificial substitutes.
2. Prevention is easier than cure. Treatment of carious lesions, especially in cases of large-scale spread, can be quite time-consuming. And at the same time, no one can guarantee that the disease will not appear again, on another tooth. Regular prophylaxis is much faster. This procedure only takes about an hour, does not require complex dental procedures, and should be performed on average only twice a year.
3. Finally, prevention is cheaper than cure. From a financial perspective, caries prevention is also much cheaper than a full course of treatment. Therefore, by carefully monitoring the condition of your oral cavity and preventing the development of disease, you not only take care of your health, but also save money!

What does lack of treatment lead to?

In addition to pulpitis and periodontitis, the disease can lead to the development of purulent inflammation. It occurs against the background of periodontitis. In the future, a deep inflammatory process can spread to the jaw bones. Their defeat leads to the development of purulent osteomyelitis of the jaw.

Lack of treatment is dangerous not only due to complete loss of the tooth, but also the development of purulent inflammation in the tissues (abscess). In the future, a deep abscess can become extensive (cellulitis). This condition is fraught with blood poisoning, which is life-threatening.

Symptoms of the disease

Initially, the disease is practically asymptomatic. During this period, a barely noticeable white or brown spot appears on the tooth. This is the first sign of superficial destruction of the enamel, but its integrity has not yet been compromised. Later, a carious cavity appears at the site where the spots formed.

If unpleasant sensations appear during the process of eating, and at the end of the chewing process they disappear, this indicates the presence of a carious process. If the pain does not disappear after the end of exposure to the irritant (food, liquid), perhaps the first stage of caries has ended and pulpitis has begun.

In some cases, the onset of the disease may be indicated by an unpleasant odor from the mouth.

To establish an accurate diagnosis, you need to visit a dentist.