Caries is a pathological process that manifests itself after the eruption of teeth, in which demineralization and softening of hard tissues occurs, followed by the formation of a cavity.

Caries in Latin means decay, and this word quite accurately describes the condition of the teeth in this disease. It, with a greater or lesser frequency, occurs in all regions, among all segments of the population and age categories.

At first glance, tooth decay is a harmless disease, but it is the biggest problem faced by dentistry. According to statistics, more than 95% of people suffer from an illness at one stage or another.

In this material, we will consider a common disease - caries, what it is, its initial symptoms from the photo, as well as the causes, treatment and preventive measures that will help to avoid this problem.

Causes of dental caries

The underlying cause of tooth decay is considered to be a local change in acidity on the tooth surface under plaque (or tartar) due to the formation of organic acids during the glycolysis of carbohydrates by microorganisms.

Predisposing factors that contribute to the onset of dental problems:

• unsatisfactory hygienic condition of the oral cavity;
• irregular visits to the dentist;
• weak immunity of the body;
• food rich in sugar and simple carbohydrates;
• low content of calcium, fluorine and phosphorus in drinking water;
• hereditary predisposition;
• dentures or braces that injure the enamel of the teeth and complicate hygiene procedures;
• the influence of general diseases of the body (for example, diseases gastrointestinal tract... Also, the disease can be provoked - scurvy, rickets, exudative diathesis,.

In general, the main cause of tooth decay is inadequate oral care, the use of poor toothpastes, and neglect by dentists. In this regard, it is worthwhile to take care of the prevention of caries in advance, since it is clearly more difficult and more expensive to treat this problem.

Symptoms and stages

Caries, as a progressive disease, has several stages of its development. Let's take a quick look at the main stages:

1. Spot stage. When examined, a white or dark speck is found on the surface of the tooth. At this stage, the person usually does not experience any unpleasant sensations.
2. Superficial. In the absence of treatment, a carious spot develops into enamel caries, and the hard shell of the tooth is destroyed. At this stage, a depression or a cavity can already be discerned on the enamel surface, and sensitivity to cold or hot appears.
3. Average . Patients with this type of caries complain of pain from temperature, chemical and mechanical stimuli, when eliminated, the discomfort disappears very quickly. The middle type is characterized by the appearance of a cavity, but only affects the superficial layers of dentin.
4. Deep. It develops when, as a result of the lack of treatment, the pathological process penetrates the peri-pulpal dentin. The carious cavity is filled with softened dentin, it becomes larger, touching it causes tangible pain. The continuing degradation of dentin leads to damage to the dental pulp, as a result of which it occurs, and in the near future, and.

The process of the appearance of stains on the teeth is slow, so it is visually easy to notice for an adult and in order to get rid of caries on initial stage, you should immediately make an appointment with the dentist.

Cervical or root is the most dangerous type of caries that occurs on the tooth in the area where it comes into contact with the gum and directly under it at the root zone of the tooth.

The disease begins with darkening of the enamel of the tooth, the appearance of a small dark spot in its cervical area with time. The final symptom of cervical caries is the formation of a hole, the so-called "hollow" in the tooth.

The bottle type affects the cervical areas of the upper incisors and canines and goes through several stages: the stage of demineralization, destruction of enamel, destruction of the enamel-dentin junction, deep damage to the hard tissues of the tooth. It is mainly found in young children.

The first sign of this disease is the appearance of light white spots that are located on the front teeth. Contacting a dentist at this stage guarantees a complete cure with special remineralizing gels without damaging the integrity of the teeth and unpleasant manipulations.

The most difficult in terms of treatment and dangerous in its complications is the root lesion of the teeth. This form of the disease develops in the root area. The cause of this type of caries is anatomical features this zone.

The main symptom of the onset of root damage to the tooth is the appearance of sharp, but short-term painful sensations when touching the causative tooth. You can also note the darkening of the enamel, a change in its integrity, the appearance of bad breath.

Caries in children

The disease can appear in a child at a very early age, when all milk teeth have not yet had time to form and take their place. And even then the teeth need treatment. Otherwise, children's caries can "develop" into an adult, damaging a permanent tooth even before it occurs.

In case of small destruction of the milk tooth, the enamel silvering procedure is performed, with big damage its tissues - filling. A feature of the treatment of children's caries is a psychological factor: it is important for the dentist to calm down the baby and inspire confidence in him, and overcoming his fear, carry out the treatment within 30 minutes.

Caries treatment

First of all, the treatment of dental caries depends on the form and stage of the disease.

1. At the initial stage, caries is treated by remineralizing therapy (application) with preliminary cleaning of the tooth from plaque. The procedure is repeated until the stain disappears.
2. Treatment of superficial caries, in most cases, does not require preparation and filling. It is enough to grind the enamel surface in the affected area and carry out remineralizing therapy as in the initial form.
3. If caries has reached the middle stage, then the treatment procedures are to remove the affected area of ​​the tooth. After that, processing is carried out drugs and installation of a seal.
4. With deep caries, it is sometimes advisable to depulp the tooth, that is, to remove the nerve. Severely decayed teeth are covered with a crown.

Modern dentistry uses a variety of anesthetics, sedatives, allowing the patient to painlessly survive the caries treatment procedure. Therefore, you should not be afraid of the dentist, because it will be much more difficult to treat advanced stages.

How to treat tooth decay at home

If the treatment of caries is not carried out on time, then it is able to acquire a more severe form, for example, go into periodontitis or pulpitis, with the subsequent loss of a tooth.

Therefore, if the process of tooth decay has already begun, then it is not possible to cure caries at home. All home treatment comes down to eliminating the unpleasant manifestations of the disease.

If you are at home, you have a toothache and swelling of your face or jaw:

1. Apply ice on outer part cheeks (in no case should you apply a hot heating pad).
2. Take an over-the-counter pain reliever such as ibuprofen, acetaminophen.
3. Aspirin also relieves swelling, but has some contraindications. It should not be taken by pregnant women, people with bleeding gums and people under 20 years of age.

It is important to understand that if tooth decay has begun, then it will not heal on its own and will only progress, while folk remedies also will not help get rid of tooth decay.

Prevention of caries

It should also be remembered that you need to brush your teeth twice every day: in the morning, after eating, and in the evening, before going to bed. The process itself should take at least 4 minutes. The brush must be circular motion, or do it so that the movements go from the gum to the edge of the tooth.

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Almost everyone suffers from dental diseases from time to time. The most common dental disease is tooth decay. It is a process of destruction of hard tooth tissues. First, caries affects the tooth enamel and if left untreated, the process begins to affect the deeper layers of the tooth and can lead to its complete destruction. If the disease is started, a hole appears in the tooth enamel, it gradually enlarges, opening access to pathogenic bacteria inside the tooth. This leads to the fact that other diseases join caries, exacerbating the situation. What are the causes of caries and can you protect yourself from it?

This disease does not occur by itself. It is caused by special cariogenic bacteria Streptococcus mutans, Streptococcus sanguis and actinomycetes living in the oral cavity. But why do some people rarely have caries, while others have to go to the dentist every year, or even more often? The fact is that each organism has a different resistance to these microorganisms. It has been noticed that people with weak immunity are more susceptible to the effects of cariogenic bacteria.

Attention! Bacteria live and multiply in plaque. While brushing your teeth removes plaque, only soft deposits can be removed with a toothbrush. Within a few days, the plaque turns into hard tartar, which cannot be removed on your own. To get rid of it, you need to see a doctor.

With the help of special tools, the doctor will break up and remove the hard deposits. If tartar is not removed in time, cariogenic bacteria will continuously attack the tooth, and this will sooner or later lead to caries.

There are many reasons for the occurrence of caries, but we encounter some every day: improper care of mouthwashing, poor water quality, lack of vitamins and minerals in the body - it is necessary to pay attention to these factors, because we can control them.

For active reproduction of bacteria, certain conditions are required. These conditions are:

• poor oral care;
• poor quality cleaning;
• the predominance in the diet of foods rich in carbohydrates (flour, sweet), as well as a lack of fresh vegetables and fruits;
• poor-quality drinking water with a low content of calcium, fluorine, phosphorus;
• lack of vitamins;
• decreased immunity;
• diseases of the digestive system;
• violation of the formation of teeth, which can be triggered by diseases transferred in childhood (tuberculosis, rickets).

Under the influence of these factors, plaque begins to accumulate on the teeth - a favorable environment for bacteria. The enamel becomes thinner, becomes fragile and is affected by caries. To avoid this, it is necessary to eliminate or reduce the influence of harmful factors.

Why else does tooth decay occur?

As mentioned above, the main causes of the onset of the disease are cariogenic bacteria, which actively multiply in food debris and dental plaque. But, in addition to this, there are several additional factors that increase the risk of caries. What does this refer to?

Caries diagnostics

If the carious process has already developed, it becomes visible to the naked eye, but at the initial stage it is impossible to independently determine the presence of the disease. This can only be done by a dentist using special equipment. Three main types of examination are used: vital staining of tooth enamel, ultraviolet irradiation, and X-ray.

Stages of the disease

Like any disease, caries develops gradually and has several stages. Dentists distinguish three stages in the development of the disease.

• Early caries. At this stage, the tooth retains its integrity, but a small white spot appears on its surface. Gradually, the enamel becomes pigmented, acquiring a grayish tint, and its surface becomes rough.
• Medium caries. At this stage, the carious process affects not only the enamel, but also the next layer of the tooth - dentin, as a result of which a cavity appears in it, which gradually increases in size.
• Deep caries. If the patient does not consult a doctor, the carious process continues its destructive effect and affects the deep layers of the tooth. At this stage, others can join the underlying disease.

This picture shows caries in three stages: early, middle and deep caries.

Each person develops caries at a different rate - someone quickly, someone slowly. Usually, in adults, the disease is chronic, sluggish in nature. In children, this process proceeds much faster, since milk teeth are not as strong as permanent ones. Fast flow the disease is called acute caries.

Patients who neglect dental health and do not treat caries are at risk of complications. Untreated caries destroys the hard tissues of the tooth and goes beyond them. What complications can arise?

Pulpitis

Inside the tooth there is a neurovascular bundle - the pulp. When the inflammatory process affects it, pulpitis develops. The disease is characterized by severe pain. If you do not take action, the pulp tissue dies off and the tooth is deprived of a source of nutrition.

Periodontitis

Periodontitis is an inflammation of the periodontium. Periodontal tissue is the tissue around the tooth. The inflammatory process spreads to the canals located inside the tooth and covers nearby tissues. If pus accumulates in the root area, this indicates the development of a periodontal abscess.

Tooth cyst

Dental tissues are destroyed, leading to the growth of granulations and the formation of a cavity that fills with pus. To treat the cyst, the dentist makes a puncture and removes the formation.

Flux

Often, patients with swollen cheeks come to the dentist's office. This condition indicates the development of the flux. Flux occurs when the periosteum, the tissue that covers the bone, is inflamed. The periosteum exfoliates, and the resulting cavity fills with pus. In this case, the patient needs urgent treatment. The doctor makes a small incision, releases the pus, cleans the cavity, and then prescribes a course of antibiotics for the patient. If the tooth can still be saved, pulpitis and periodontitis treatment will be required. In this case, the flux will not develop again.

Many people believe that caries is not a serious dental disease and go to the dentist after the onset of pain. But the pain indicates that caries has already passed into a severe stage and may appear dangerous consequences in the form of pulpitis, periodontitis, cysts or flux.

Prevention of caries

In order not to suffer from tooth decay and its consequences, you need to try to prevent the disease. Caries prevention methods:

• Regular brushing of your teeth. To keep your teeth healthy, you need to brush them twice a day - in the morning, upon waking up and in the evening, before going to bed. In time, the procedure should take at least two minutes and not be limited to cleaning the surface of the teeth. It is also necessary to clean the interdental, peri-gingival spaces and the tongue, since germs also accumulate there. To make cleaning as effective as possible, you need to choose the right toothpaste and brush.
• Rinsing the mouth. In addition to brushing your teeth regularly, dentists recommend rinsing your mouth with water after every meal. This helps to wash away acids left by acid-containing foods from the surface of the teeth, as well as get rid of food particles stuck in the interdental spaces. In the morning and in the evening, after brushing your teeth, you need to use special mouth rinses. They freshen breath, slow down the formation of plaque, and also strengthen the enamel, saturating it with minerals.
• Replenishment of the lack of fluoride.

  Attention! Fluoride is an important trace element that affects the strength of tooth tissues. It is found in drinking water, but not all regions of the water have a sufficient amount of this substance. Lack of fluoride leads to thinning of the tooth enamel.

  This problem can be solved by fluoridation of drinking water. But the easiest way is to use mouthwashes that contain fluoride to care for your oral cavity. Another way to make up for fluoride deficiencies is to eat foods rich in fluoride, such as fish and other seafood.

• Food temperature. Sudden changes in temperature are harmful to tooth enamel, since such an effect leads to the appearance of microcracks, into which microbes then penetrate. To avoid this, you should not eat too hot, cold or contrasting food.
• Regular visits to the dentist. Often, patients go to the doctor only when their teeth start to hurt. It is not right. To prevent caries, it is recommended to undergo periodic medical examinations with a dentist in order to timely identify the first signs of the disease. Adults need to see a doctor at least every six months, and children every three months, since their teeth decay much faster.

Do not neglect preventive examinations. This will help to detect dental problems in time and avoid possible complications.

Almost everyone has heard about caries modern people... It causes many problems and often requires difficult and expensive treatment. Quite often, this attack leads to the loss of teeth. In addition, caries untreated in time leads to severe pain, which can deprive a person of working capacity. What kind of ailment is this and how do you get rid of it?

What is tooth decay and why does it appear?

Tooth decay is a disease of the tooth, which is a pathological process that, over time, leads to demineralization of enamel and its destruction. This forms a cavity or hole. Tooth decay is usually accompanied by increased sensitivity, and in advanced cases, severe pain.

According to some reports, tooth decay is the most common disease on Earth, as it affects approximately 97% of its population.

There are types of caries and their localization:

• Fissure - located in the pits and grooves on the chewing surface of the molars;
• Cervical - localized at the sites of transition of the neck of the tooth to the root;
• Latent can develop in dentin, hiding under a layer of virtually undisturbed enamel. Such hardness of the tooth surface is caused by frequent processing with a paste with a high fluoride content or by disturbance of metabolic processes inside the tooth. Most often, this type of disease occurs in young people;
• Root occurs in the elderly with gum recession;
• Caries of milk teeth develops in children who abuse sweets with insufficient oral hygiene.

General treatment algorithm (Video)

Caries can be cured only by official dentistry methods.... Unfortunately, most popular advice does not help and only makes the problem worse. And in a dental office, a standard treatment algorithm is usually offered:

• Removal of plaque, which involves cleaning a diseased tooth and adjacent ones using abrasive pastes and a special nozzle on the drill.
• Determination of the tooth shade using a special scale, which is necessary for the selection of a suitable filling material.
• Anesthesia is used for medium and deep caries for more comfortable removal of the affected tissue. Local anesthesia is usually used, which lasts from half an hour to several hours.
• Drilling or removing broken tissue.
• Isolating the tooth or protecting it from the ingress of saliva with a Cofferdam - a thin latex fabric in which holes are made for the teeth.
• Treatment of a carious cavity with antiseptics.
• Applying a special insulating gasket under the seal made of glass ionomer cement.
• Filling or application of special materials into the tooth cavity and their processing for hardening.
• Grinding and polishing fillings for a smooth and aesthetic tooth.

Caries treatment depending on its stage

Although the algorithm for dental treatment is standard, depending on the stage of caries and the complexity of the situation, the list of necessary operations may vary. If the disease is in the stain stage, then there is no need to drill the tooth. The reason for the appearance of such a defect is the leaching of calcium from the enamel, therefore, it can be cured with the help of remineralizing therapy.

In men, caries occurs almost two times less often than in women, this is usually associated with the fact that pregnancy and breastfeeding lead to large losses of calcium in the body, which negatively affects the quality of tooth enamel.

Carrying out such treatment involves cleaning the tooth from plaque and calculus, and polishing its surface. Then the affected areas are treated with drugs based on fluoride and calcium ions. After that, the patient is recommended correct and thorough dental care and a new examination no later than two months later. If you listen to the doctor's recommendations and follow them, then the tooth can fully recover. If the stain has already darkened, the destroyed tissue will have to be removed by drilling and the resulting void should be filled with filling material.

Eskimos and representatives of the Gunzu tribe, which lives in the southern Pamirs, never get sick with caries, scientists have not yet been able to figure out the reasons for this phenomenon.

When treating deep caries, the number of stages can be increased... Sometimes, when dentin is almost destroyed, it is necessary to carry out therapy in several stages. First, a temporary filling is installed and after 3-4 days, if there is no pain, it is changed to a permanent one. With especially severe damage, the pathological process can also affect the nerve, so sometimes it has to be removed.

How to behave after treatment

After carrying out medical procedures, it is very important to listen to all the recommendations of the dentist.... If you are told not to eat or drink anything for several hours, then you should do so. In addition, for the first time after the installation of the seal, it is advisable not to use any coloring products, as this can change its color.

Brushing your teeth is the key to their health

If the tooth continues to hurt after the temporary filling is placed, you can take an anesthetic, but you must inform the doctor about it. You can also do it after setting a permanent seal. If the pain is too severe or does not go away within two days, you need to go to the dentist again. It is possible that mistakes were made during the treatment and the earlier you visit the doctor, the easier it will be to eliminate them.

Prevention of caries

Prevention of this disease is important both for those who have never had caries and for those who only recently got rid of it. To avoid dental problems, it is important to follow eight simple tips:

• The teeth should be brushed thoroughly and thoroughly twice a day, at least 2-3 minutes with cleaning the gums and tongue.
• After each meal, even a minimal snack, you need to rinse your mouth with water or chew gum, but no longer than 10 minutes.
• Do not forget about dental floss and toothpicks, they will help get rid of food debris that lingers between the teeth. But they must be used very carefully so as not to accidentally injure the gums.
• You should always choose a toothbrush and toothpaste based on the condition of your teeth and gums. If you cannot make up your mind, it is better to consult a dentist, as the wrong choice can lead to damage to the gums and enamel.
• Do not allow the mucous membranes of the mouth to dry out. Saliva is one of the factors that protect teeth, and a lack of it can trigger the development of caries.
• If your area lacks natural fluoride in water, you need to add it using special filters, adjust your diet and use pastes enriched with this element.
• Avoid eating food that is too cold and hot, as this can lead to micro cracks in the enamel.
• Visit the dentist every six months, he will be able to identify caries on early stage and prevent tooth decay.

These statistics confirm the conclusions of dentists that every year the number of people suffering from caries is constantly increasing.

Today, almost 90% of the population has this disease in one of its stages.

The root cause of this condition is poor oral hygiene. It is this circumstance that leads to the concentration of pathogenic flora that provokes the appearance of caries.

To restrain the reproduction and spread of microorganisms, in addition to hygiene, they help healthy image life, strong immunity and proper nutrition... If, for any reason, the action of one of the named inhibiting factors is excluded, the microbes will intensify their activity and lead to caries.

It is quite difficult to identify the disease on your own at this stage, since it does not manifest itself in any way... This can only be done by an experienced specialist. But its presence can be suspected by weakening the tooth shine. Gloss in this situation does not disappear from the entire tooth surface, but only to an insignificant area.

Small shapeless white or matte spots will subsequently form on it. Their appearance indicates the development of demineralization, which quickly enough covers all units. Over time, the enamel of demineralized teeth begins to thin out, and the spots themselves darken and become brown. A similar change in many patients is sore.

Important: at this stage, the affected unit does not react to stimuli. There is no discomfort or soreness.

The use of methylene solution will help diagnose caries at the initial stage. It tints the problem units blue. Instrumental diagnostics is powerless, because in the destructive areas the enamel is still smooth, and the probe slides over it.

We will be told about the treatment of caries in the stain stage in the following video:

Treatment of carious teeth excludes the use of preparation and filling. Their therapy consists in enriching the enamel with the necessary ions of calcium, magnesium, potassium (remineralization). The procedure itself is performed in the following sequence:

• local anesthesia is performed (if necessary);
• professional cleaning of the oral cavity is performed;
• the affected tooth is polished and isolated from the access of saliva;
• one of the remineralizing agents is applied to its dried surface.

Caries at the 1st stage is a reversible process, subject to timely referral to a specialist and treatment.

Surface

The initial stage left untreated tends to further development... The stain begins to grow rapidly, changes color, but does not affect the deep layers of the enamel. The greatest intensity of the process is observed on its lateral and internal surfaces.

The surface stage is characterized by the following manifestations:

• the structure and structure of the enamel changes: it acquires porosity, unevenness, roughness;
• the color of the spots themselves changes: from matte (white) it changes to brown or even black;
• depressions, cracks, chips become well on the spots;
• an aching short-term pain reaction to the action of stimuli develops (especially from hot, sour, sweet, cold food), and with the additional presence of a focus of infection, there is discomfort from brushing teeth or pressing on them with a finger;
• plaque accumulates in the pre-gingival region;
• inflammation of the papillae develops (rarely).

Superficial caries is easily diagnosed by visual inspection or probing.

It is impossible to return the enamel to its original state using remineralization. Dentists at this stage apply a direct action on the tooth itself, and the sooner it is started, the much less effort will be required to restore it.

Treatment for superficial caries consists of:

• problem surface treatment;
• grinding off the changed enamel;
• coatings with an adhesion-increasing composition;
• filling.

Upon completion of the procedure, the filling is necessarily sanded, corrected for the bite, fissures (bumps) are formed on its surface.

Average

At this stage, the disease is visible visually, so it is pointless and dangerous to ignore its presence. With each passing day, unpleasant sensations and pain will manifest themselves on the increase.

Medium caries is manifested by the following symptoms:

1. Sharp but not intense pain caused by stimuli: brushing teeth, food, contrasting air temperature. The pain goes away almost immediately after the annoying factor is eliminated.

   In isolated cases, it may be completely absent due to the fact that the dentinoemal junction was destroyed and replacement dentin was formed. He then weakened the sensitivity of the pulp to the action of stimuli.

2. Increased lesion area covering most of the tooth. Caries affects the middle layers of enamel, captures dentin.
3. Noticeable aesthetic impairment. A dark carious spot appears on the tooth hollow, the enamel on the affected unit loses its shine and becomes rough.
4. Solid walls of the cavities that appeared.
5. Bad breath... Its appearance is associated with rotting and decomposition of food debris accumulated in carious cavities. Daily hygiene cannot completely clean them out, which is why the food begins to rot.

For a detailed study of the oral cavity, an X-ray, visual (mirror) and instrumental examination are used. The examination reveals a characteristic carious spot, brown (less often gray and beige), a carious cavity of varying depth.

The use of the probe allows you to determine the degree of coverage of the pathological process of the enamel, the depth of the cavity, sensitivity on those teeth that are poorly visible visually.

Based on the results of the data obtained, appropriate treatment is prescribed. If you do not delay with a visit to the doctor, tooth decay at this stage can be easily stopped. The scheme of his treatment is as follows:

• Anesthesia is done.
• Infected tissues are eliminated.
• Aseptic processing is carried out using fluorine and calcium-containing preparations (their use strengthens tissues and prevents the development and spread of caries in the future).
• An insulating gasket is applied.
• A seal is placed.
• The tooth is polished and ground.

Important: usually such caries is treated in one visit. The patient still has a chance to save his tooth, which cannot be done at the next stage.

Deep

Unfortunately, but it is this stage of the disease that is most often detected. Fear of the dentist makes many people postpone their visit, which leads to the further spread of the disease and worsening of the condition: the development of secondary diseases, the loss of the tooth itself.

Pathology is characterized by the following features:

• voluminous deep carious cavities extending to the dentin (but they do not affect the pulp);
• sharp, long-lasting pain, which can develop not only from the action of stimuli, but also at rest (pain is more often manifested in the evening and at night);
• affecting the dental nerve;
• the affected areas turn black;
• the tooth and the subgingival region are gradually destroyed.

Caries treatment at this stage is a long process and may take more than one visit to the dentist.

It is carried out in the following order:

1. Local anesthesia is done.
2. Using a mirror and a probe, the doctor examines the carious cavity, determines its depth, explains the course of treatment to the patient.
3. Necrotic, carious soft and hard tissues are removed.
4. A cavity is formed.
5. Aseptic processing is carried out.
6. A medical pad is applied to the bottom of the cavity in order to prevent the development of complications.
7. After it, an insulating gasket is laid to fix the first and protect it from the ingress of the composite.
8. An adhesive material is applied to the walls.
9. A seal is placed.
10. The tooth is being restored.

If the treatment takes place in 2 stages, then instead of a permanent filling, a temporary one is placed. This is done if the patient complains of pain, the disease turns into pulpitis, dentin is severely thinned or absent, the pulp chamber is open.

Multiple

The acute stage of the disease, in which immediately 6 or more units are subject to destruction, moreover, one may have several "holes" at the same time. It manifests itself in the presence of neuro-somatic, endocrine, infectious and other chronic conditions.

Among the "unfavorable" factors leading to this condition are the lack of vitamins and minerals in the food and water used, poor ecology, stress, diet, work in hazardous industries, heredity, etc.

A characteristic feature of pathology is its rapid development and spread. So, in just a year, almost all units of a person can collapse. Simultaneously with the development of the pathological process in humans, there is a viscosity and high viscosity of saliva, scanty salivation, dry mouth.

Other clinical signs of tooth decay include:

• slight destruction of enamel with extensive dentin damage;
• the appearance of several cavities on one tooth;
• the rapid appearance of plaque;
• the simultaneous presence of caries at different stages of development.

Another sign of illness is the loss of relatively fresh fillings. This is due to the development of a secondary focus of caries under them, as a result of which the enamel becomes soft and the fixation of the composite weakens.

Treatment for multiple stages includes:

• removal of the affected dentin;
• the formation of cavities;
• their treatment with antiseptics;
• filling.

The success of treatment directly depends on how successfully the underlying disease that caused multiple caries is being treated. Additionally, the patient is recommended to take drugs that increase immunity, restoring mineral balance. A diet is being developed that includes foods rich in proteins, minerals, vitamins.

A good result is given by physiotherapy: fluoridation, silvering, calcination of teeth with special means or electrophoresis.

Relapsing

It arises and develops in the filled tooth (under the filling itself or at the edge of the filled cavity). The pathology can be recognized by the darkening of the filling along its edge, the appearance of visible cracks or chips on the enamel.

Several reasons can lead to its development:

• incorrect transition of the filling material into the tooth (with a joint);
• the outer tooth surface is poorly prepared for the imposition of the composite;
• the carious cavity was not completely cleaned out during the first filling.

Important: in order to prevent the development of repeated caries, it is necessary to periodically come to the dentist to check the condition of the standing fillings.

If unevenness, roughness of the filling is found, and especially in the place where it joins the tooth, the doctor, using polishing, will return it to its original appearance and protect it from caries. In the event of an illness, the treatment consists in replacing the filling.

Carious tooth decay can be stopped at any of these stages.... The main thing is to establish and eliminate the cause of the onset of the disease in time.

By location

On this basis, the disease is divided into 4 types:

Fissure (occlusive)

The most common type that affects the natural depressions of the chewing tooth surfaces: fissures. It is in these depressions that the most deposits accumulate, which cannot always be completely cleaned out.

Interdental (approximal)

Destroys the contact surfaces of the teeth, and is not visualized for a long time. Its "hiddenness" is explained by the peculiarity of the development of pathology: affecting the chewing units, the disease develops to their center, while the carious cavity itself remains covered by the preserved enamel for some time. An X-ray photograph allows you to locate its location.

Cervical (cervical)

The focus of the disease is located in the area near the gums (in the neck). It may be covered for some time by the reddened gum area.

Caries is characterized by softening of the enamel and the formation of a defect in the form of a carious hole. The health of our teeth flows into these "black holes". The disease has not one, but a whole variety of reasons: hygiene, nutrition, the chemical composition of the secretion of the salivary glands, heredity and others.

There are more than 400 theories of the onset of caries, but only one of them is unambiguous: teeth are spoiled by "bad" cariogenic bacteria (Streptococcus mutans, Aktinomyces viscosus, etc.). They live in the mouth of every person, including you personally.

5 theories of tooth decay

Neurotrophic

According to this 1934 concept, disease arises from a reaction nervous system to irritants of the external environment. For example, stress, emotional stress, unfavorable social conditions worsen the state of the central nervous system (central nervous system). As a result, pathological reflexes arise that disrupt the trophism (nutrition) of hard tissues.

Proteolysis-chelation

According to this paradigm, caries is promoted by the simultaneous processes of proteolysis and chelation:

• Proteolysis - the breakdown of proteins under the influence of enzymes (enzymatic attack of microbes on enamel proteins).
• Chelation is the destruction of the enamel layer due to the compounds of calcium ions with aions (negatively charged ions) of acids.

The scheme of action of caries

Back in the 19th century, the German dentist V. Miller conducted research and proved that caries is a consequence of the destructive effect of organic acids. Oral bacteria ferment carbohydrates (sucrose) and fermentation begins.

As a result of fermentation, acids (formic, acetic, etc.) are released, which destroy the tooth coating. It is Miller's theory that underlies modern ideas about the etiology of caries.

Physico-chemical theory of Entin

This model states that tooth enamel is a membrane that separates two media (saliva and blood). The membrane passes osmotic currents due to different pressures of the internal and external environment. Due to metabolic disorders, as well as the chemical composition of the secretion of the salivary glands, the strength and direction of the current change. As a result, resistance to unfavorable factors decreases.

Trophic (biological) theory according to Lukomsky

Lukomsky argues that the basis of carious pathogenesis is a deficiency of vitamins (especially vitamin D), as well as an insufficient or excessive content of minerals (calcium, fluoride) in food. Because of this, the nutrition of enamel and dentin worsens, their composition changes, therefore a destructive carious reaction occurs. External conditions are also important, because it is known that vitamin D is produced in the body under the influence of sunlight.

Why does caries develop in adults?

The main danger to teeth is the bacterial microflora of the oral cavity. Bacteria literally "stick" to the enamel along with saliva, forming a dense biofilm.

The main causative agents of caries are streptococci, actinomycetes and veilonella. In the course of their vital activity, they process sugar, releasing organic acids. Acids "eat away" the enamel and wash out the calcium.

The source of sucrose and other carbohydrates is the microparticles of food that remain in the mouth after eating. Sweet and flour foods are a true nourishing paradise for bacteria. The first 20 minutes are especially dangerous, during this period the acidity of the oral cavity increases sharply. Therefore, it is very important to rinse your mouth after eating, or even better, use a toothbrush.

Now it is obvious that caries is a problem for people who neglect hygienic care, therefore:

1. Bacteria must be removed daily.
2. Brush your teeth at least 2 times a day.
3. Use an antiseptic rinse aid.
4. Pieces of food stuck between the teeth should be eliminated with a floss.

Here are other conditions for the appearance of caries that are typical for adult patients.

Gum recession

A recession is a decrease in the level of the gums. This problem is a consequence age changes... Due to lack nutrients and oxygen, the gums lose their elasticity and sink. Plaque adheres to the exposed roots of the teeth, and caries begins.

Decreased production of saliva (xerostomia)

Saliva plays important role in the fight against tooth decay. This liquid contains valuable immunoglobulin proteins with antibacterial properties. It also neutralizes lactic, acetic and other organic acids through an alkaline environment.

Many older people experience decreased oral fluid production and, as a result, dry mouth. These patients are at high risk of developing tooth decay. The appearance of insufficient salivation is also facilitated by taking medications - antidepressants, hormonal drugs, etc.

Bad habits

Smoking and alcohol abuse have not yet improved dental health for anyone. Cariogenic bacteria feel perfectly protected under the yellow nicotine coating. In addition, hot smoke together with resin particles dry out and injure the enamel. Microcracks form on the surface of the teeth, where bacteria and acids penetrate.

The occurrence of caries in children

The cause of caries in children is exactly the same as in adult patients: a violation of hygiene rules and the accumulation of microbial plaque. However, children's teeth decay faster, they are more prone to carious process.

The highest caries activity is observed at the age from 2 to 11 years. And that's why:

• milk teeth are covered with a thin enamel layer with high permeability;
• dentin (inner tissue) of milk teeth has a special structure, it is penetrated by hundreds of microtubules;
• local immunity is still very weak and cannot fully cope with harmful bacteria.

About 30% of children under the age of 2 have caries. First of all, the upper and lower incisors are destroyed. Behind these troubles is a bottle filled with a sweet drink. If before going to bed you give your baby juice, compote or fermented milk products, active reproduction of cariogenic bacteria reads in your mouth.

At night, the salivary glands "sleep", the liquid is not produced in sufficient quantities, so nothing prevents microbes from destroying the enamel of the teeth. It is also not recommended to introduce a child to sweets, chocolates and other sweets under 3 years old.

Baby bottle caries is often the result of a calcium deficiency in the mother during the first trimester of pregnancy. Severe toxicosis at the beginning of term, viral, infectious diseases also affect the laying and growth of dental tissues.

Caries in adolescents

Promotes tooth decay in adolescents wearing braces. Of course, the braces themselves are not dangerous, but after their installation, dental care becomes much more difficult. Between the grooves, food particles constantly accumulate, which are difficult to remove with a conventional toothbrush. A special brush is needed here.

But if the child does not take care of his teeth during the period of orthodontic correction, and is also fond of chips, toffee, popcorn and other prohibited food, then caries is guaranteed! All pulling and crunchy foods get stuck between the braces and create a breeding ground for bacteria.

Another caveat: caries in adolescents is often activated against the background of hormonal changes.

Risk Factors for Caries Formation

Local

• Crowded teeth - it is impossible to carry out high-quality hygienic care, food particles remain between the teeth, which contributes to the process of fermentation and decay;
• excessive consumption of food rich in carbohydrates - this applies to lovers of sweets, cakes, sweet soda, flour products;
• lowered pH of the oral cavity - within a few minutes after taking sucrose (sugar), the pH level drops from 6 to 4. The destruction of the surface enamel layer begins at a pH of 4.5;
• lack of rough food in the diet - rough food of natural origin, for example, apples, carrots, pumpkin, provide natural mechanical cleaning of the enamel;
• the presence of fissures - small bumps on the chewing surface, in such areas plaque accumulates more often and caries occurs.

Another "popular" cause is tartar accumulation. Due to poor hygiene, a soft coating forms, which eventually turns into hard, stony deposits. They can no longer be removed at home, it is necessary to undergo ultrasonic cleaning at the dentist.

Neglect of hygienic care also leads to the formation of a pellicle. It is a thin organic film that covers the enamel and helps to fix microorganisms on the tooth surface.

General

• Lack of calcium, fluorine and phosphorus - these minerals are the main building materials for teeth;
• deficiency of vitamin D - calcium is absorbed thanks to vitamin D, which is produced by the body under the influence of ultraviolet rays, and also comes with food (fish, caviar, fatty dairy products);
• weakened immunity - the fight against any bacteria, including caries causative agents, is difficult with low immunity;
• systemic diseases of the body - chronic diseases of the gastrointestinal tract, cardiovascular, endocrine system;
• various extreme effects on the body - radiation, high, low temperatures, stress;
• poor quality drinking water;
• heredity - determines the shape, size of the teeth, as well as the structure of hard tissues and the chemical composition of saliva.