Causes of early childhood caries. Initial dental caries is the first alarm bell. At the initial stage

Enamel of baby teeth thinner than the indigenous ones, so it is more susceptible to various damages. Young children often face problems such as caries of temporary teeth.

At the same time, the carious process develops more rapidly often has a multiple form, in which they are damaged immediately several teeth.

Many parents believe that baby teeth do not need treatment, but that's not true.

Reasons for appearance

Increase in quantity pathogenic microorganisms in the child’s oral cavity (most often the causative agents of caries - bacteria of the genus streptococci enter the oral cavity through shared cutlery, toys, pacifiers).
Lack of full caring for baby teeth.
Poor nutrition(in particular, untimely introduction of complementary foods, excessive eating sweets, too much solid products, usage pacifiers And bottles with nipple, night feedings).
Carefully! Caries in primary teeth can lead to development of numerous problems in the future. It's premature loss, violation of the integrity of the dentition, formation malocclusion, carious damage to molars, and in severe cases it suffers speech and general development of the child.
Incorrect formation dentition, malocclusion.
Genetic factor determining the strength and sensitivity of tooth enamel.
Persistent disruption of the immune system, diseases respiratory, digestive, dry mouth, change quantity and composition of saliva.

Symptoms and signs

Carious process develops gradually initially changes color and structure tooth enamel. She gets covered spots, which first have a white and then a darker shade.

Photo 1. Brown spots on the surface of the enamel of the front milk teeth indicate the presence of carious lesions.

Further damage develops pretty quickly since the enamel of primary teeth is very thin and fragile. Appear on its surface more noticeable defects(chips, cracks), and subsequently a carious cavity is formed.

Attention! The clinical picture of the pathology depends on stage of its development.

As destructive processes develop, the child begins to worry about the following: complaints:

Pain syndrome(depending on the depth of the damage, the pain may be short-term or permanent, have different degree of intensity, from moderate to pronounced).
Increased sensitivity diseased tooth, which reacts most acutely to hot or cold temperature, sour or sweet products.
Unpleasant smell from the child’s mouth (food debris accumulates in the carious cavity, bacteria, decay products of tooth tissue, all these elements gradually rot, decompose, which leads to the appearance of a specific putrid odor).
Moodiness and irritability associated with pain and discomfort in the mouth.

Diagnostic methods

Stages of development and stages of pathology

Highlight 4 stages development of caries of primary teeth in children.

Early

initial stage lesions of primary teeth are characterized mild symptoms. The only sign that allows us to identify pathology is a change in tooth enamel. There are no noticeable defects on its surface yet, but specific spots. Initially the stain has unnaturally white shade, the structure of the enamel is gradually damaged, its smoothness is lost on the affected area. Over time it darkens and becomes brown or almost black tint.

Surface

At the superficial stage of a carious lesion, the focus covers only tooth enamel, without affecting deeper areas.

Children appear on the enamel defects, which can be found when visual inspection or feel it with your tongue.

The area of the carious process grows very quickly, becomes deeper.

Average

At average caries the cavity is spreading not only on enamel, but also on dentin, which has a more porous structure (the destruction process occurs in a more intense form). On the surface of the tooth it is already possible to clearly distinguish carious canal, having dark shade.

Deep

This type of caries in primary teeth is the most dangerous form of pathology. At this stage, destructive processes cover areas of dentin located near the pulp. Often there is damage to the pulp itself and the roots of the tooth. The child is being disturbed frequent and severe pain, stable appears smell of rot from the mouth.

Features of caries on the front teeth in children

Most often, caries affects the area front milk teeth. This is due to the peculiarities of their structure, increased load(used for biting off pieces of food).

The front teeth have thinner enamel and dentin, especially in the gingival area. Therefore, damage characteristic of caries is formed Firstly in these areas.

Another feature of this form is intensive development carious lesion. Initially, the child may not feel any discomfort, but as the disease progresses, the enamel begins to chip away, revealing deep carious canals.

Attention! Defects often occur on lateral walls of teeth. Due to the structural features of this area of the dentition, food remains get stuck between adjacent front teeth, while very difficult to remove. This is a prerequisite for the development pathology.

Types of carious lesions in temporary teeth

Total exists four types of caries in primary teeth.

Bottle

Shape most typical for children 1-3 years. The main reason for the development of pathology is considered eating disorder(frequent night feedings, habit of pacifiers and bottles).

Mother's milk or infant formula contains: large amounts of sugar- a favorite treat for pathogens. And if the child cannot refuse night feedings, the likelihood of developing pathology increases, after all, after such a meal, the baby immediately falls asleep without brushing his teeth, and bacteria, eating leftover milk, are actively reproducing.

Circular

This type of pathology is considered the most dangerous as it leads to rapid destruction of tooth tissue, damage to nerve endings located in soft areas. Initially defects appear in the cervical area, quickly spread to deeper areas. At the same time, the enamel in the early stages has minor damage, but, as the carious process develops, it begins break off in large pieces exposing diseased areas.

Attention! Circular caries is more often damaging front milk teeth, leading to their complete destruction. The disease requires complex and lengthy treatment.

Flowering

This form is characterized by acute and intensive development, pronounced clinical picture. Blooming caries is considered decompensated form of pathology, in which destructive processes occur much faster than regeneration.

Photo 3. Blooming caries of primary teeth is a severe form of pathology. The result can be dangerous complications.

Stages of development of pathology (from initial to deep caries) proceed quickly, and within a short period of time the child develops deep damage and develop dangerous complications.

Carefully! During several weeks blooming caries can lead to the need removal of a diseased tooth. Pathology often carries multiple character.

Cervical

This form is characterized by the formation of a carious cavity. at the base of the tooth(the area where the crown meets the gum). Cervical caries is formed as complication of gum disease, when they form in the oral cavity gum pockets. They accumulate bacteria, which release aggressive substances, destroying enamel, and then deeper areas. The crown part of the tooth does not lose its integrity, however, the presence of deep damage in the cervical area may eventually lead to chipping, separation of large pieces of enamel and dentin.

Dr. Komarovsky about childhood caries of primary teeth

Many parents don't pay attention on the appearance of defects in the enamel of a baby tooth, considering that temporary teeth do not need treatment.

They begin to show concern only when the source of destruction affects deeper layers and the child feels pain.

It is important to understand that even baby teeth, which will be replaced by permanent ones, require proper care and treatment. After all untreated caries, especially if it tends to progress rapidly, will lead to problems with the oral cavity in the future. And these problems are very unpleasant.

Starting with the fact that a child can develop damage to permanent teeth, which will replace dairy products. In the absence of therapy the correct bite is disrupted, and in severe cases this may entail speech development disorders.

A child with bad teeth cannot function normally chew food what is a common cause disorders of the digestive system. We should not forget that caries is a source of constant infections in the body, and the presence of infection steadily leads to decreased immunity, frequent viral diseases, as a result this negatively affects general development of the child. child's diet

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The main cause of any caries is the activity of acid-forming bacteria (Streptococcus mutans and others). Poor hygiene and consumption of large amounts of carbohydrates are the main factors in the formation of dental plaque with an increased concentration of pathogenic microorganisms. The disease clearly demonstrates the mechanism of decay: with initial caries, minerals and trace elements are “washed out” in the enamel. Demineralization of enamel provokes the formation of small light spots: they signal the beginning of the carious process. Under microscopic magnification, these areas appear more porous and rough compared to healthy enamel. The protective properties and aesthetics of the enamel are noticeably reduced, but its structure is not disturbed. This is how initial and superficial caries differ: with the latter, the enamel layer is destroyed, which leads to a corresponding reaction of the tooth (in particular, to a reaction to temperature stimuli).

Stages of initial dental caries

Chalk spot stage. At this stage, the stain is white, much lighter compared to healthy areas of enamel.

Dark spot stage. A more serious form of early caries affecting the deeper layer of enamel. Food coloring penetrates there, causing the stain to become brown or brown.

Diagnosis of initial caries

So, we have found out what caries looks like on teeth at the initial stage, now we need to tell you how the diagnosis is carried out. This is not as simple as it might seem at first glance. The clinical picture of initial caries is mild. The disease has practically no characteristic symptoms, and this is especially true for pain. Only occasionally the patient may feel slight discomfort after drinking cold drinks. Diagnosis of initial caries today is carried out using several methods.

Methods for diagnosing initial caries

Drying. A common visual assessment technique. The tooth is thoroughly dried with peroxide, after which the affected areas become visible.

X-ray. Not the most reliable method, but dental x-rays are an integral part of the preparation. White spots are especially noticeable in targeted photographs.

Coloring. After applying a solution of methylene blue, the affected areas turn a characteristic blue color.

Transillumination. The teeth are scanned with a special fluorescent device, as a result of which areas of demineralized enamel and their boundaries are detected.

In addition, specialists can resort to differential diagnosis. This is a set of procedures aimed at distinguishing diseases that are similar in symptoms and clinical picture. In the case of initial caries, these are non-carious lesions of the enamel (fluorosis, hypoplasia, and the like).

Treatment of initial caries

Most patients are interested in how to get rid of initial caries if you have signs of its manifestation? Initial caries in the spot stage is quite easy to treat, and, importantly, today this rarely requires the use of a drill. Modern dentistry offers non-invasive methods that cope with the disease and do not require tooth preparation.

Non-invasive methods for treating early caries

Remineralization. Before starting therapy, professional hygiene is carried out, which is designed to remove plaque and carious stains, as well as dry the teeth. The most common method is application with a solution of 10% calcium gluconate, as well as other drugs, for example, fluorides. To remove a stain, 10 to 20 treatments are usually required. In modern clinics, remineralization is often carried out using electrophoresis technology. It is also possible to carry out remineralization at home (for mild forms of the disease and for prevention). Usually special gels and pastes are used for this.

Deep fluoridation. Application of preparations containing fluoride, copper hydroxide and calcium to the surface of teeth. To consolidate the result, fluoride-containing pastes are used. Fluoridation reduces the body's ability to absorb sugar, so the procedure is not recommended for people with diabetes, as well as for those with excess fluoride in the body.

Treatment using Icon technology. This is an infiltration technique that involves treating the tooth with a special polymer composition that seals the carious cavity and prevents the development of the disease.

Installation of a filling for initial caries

Treatment of initial dental caries in most situations does not require the use of a drill, but in some cases filling is performed. This usually occurs at the dark spot stage, when the doctor is not confident in the success of remineralizing therapy, and for some reason treatment using Icon technology cannot be carried out. Light filling for initial caries is considered the most effective, since it has high functional and aesthetic indicators.

When is the outcome of treatment of initial caries considered successful?

The initial stage of caries is the easiest to correct, but incomplete or poor-quality treatment almost always leads to the transition of the disease to the next, more serious, stage. The outcome of treatment of initial caries is considered successful when:

the carious stain disappeared, the tooth color became uniform;
repeated diagnostics confirms the absence of traces of enamel demineralization;
there is no reaction to temperature stimuli and the feeling of soreness, which sometimes appears at the stage of initial caries, disappears.

Prevention of initial caries

To prevent initial caries, it is enough to follow a number of simple rules, since in most cases the disease develops against the background of poor hygiene and poor nutrition. To minimize the risk of carious spots, doctors recommend:

brushing your teeth twice (at least) using floss or irrigator to remove food particles from hard-to-reach places;

preventive visits to the dentist and professional hygiene with removal of dental plaque;

optimization of the diet, including limiting the consumption of foods high in carbohydrates, as well as sugary carbonated drinks;

if recommended by a doctor, use gels and toothpastes with a high content of calcium or fluoride.

A mother brought her 18-month-old son to the clinic for a regular check-up. The child is practically no longer fed from a bottle, but he still receives it before bed. During the day, the child uses a special drinking cup from which he drinks everything from milk to soda. His mother started giving him bottled apple juice instead of milk because the child tends to be constipated. When examining the oral cavity, the doctor noticed “white spots” on some of the child’s teeth (Fig.). The doctor talked about the child’s dental hygiene and prescribed a local fluoridated gel.

EPIDEMIOLOGY

DRAWING. Demineralization at the gum margin, which manifests itself as a characteristic whitish color .

Early childhood caries is the most common chronic disease childhood. In children in age It's 5-7 years old meets at five times more common than asthma and seven times more common than hay fever.
Caries strikes more 25% of children in the United States are between the ages of 2 and 5, and nearly half of children are between the ages of 12 and 15.
Untreated primary dental caries occurs in 32% of Mexican American and 27% of black African American children aged 2 to 11 years, compared with 18% of non-Hispanic white children.
Early childhood caries is defined as “the presence of one or more carious (superficial or cavitary) lesions, removed (due to caries) teeth, or filled dental surfaces of any primary tooth in a child aged 71 months or older.
The consequences of early childhood caries include: low self-esteem, delayed physical development, reduced learning ability, a higher risk of new caries and additional costs.

DRAWING. Severe damage to the central incisors of the maxilla and bilateral lateral incisors of the maxilla with an area of demineralization at the gum line (yellowish-brown color). The upper incisors are often the first teeth to become affected by tooth decay due to bottle feeding. .

ETIOLOGY AND PATHOPHYSIOLOGY

Dental caries is a multifactorial infectious disease that is caused by demineralization of tooth enamel in the presence of a substrate of sugar and acid-forming cariogenic bacteria, Streptococcusmutatis(also known as mutatisstreptococci), which are considered to be the primary strain causing destruction and are found in a soft gelatinous biofilm.
Tooth decay can develop any time after teeth erupt. Early teeth are in principle susceptible to caries, which is caused by transmission Streptococcusmutatis from the mouth of the person caring for the child or other children in the family into the mouth of the baby. This type of tooth decay is called formula-fed tooth decay or early childhood caries.
Risk factors for caries include: o Frequent consumption of liquids.
Frequently sipping liquids containing sugar (juice, milk, medicine, soda).
Eating sticky food.
Feeding for pleasure, sleeping with a bottle, tooth decay in the caregiver.
Drinking non-fluoridated tap water or bottled water, which often lacks fluoride.
Low socio-economic status.
Taking medications that contain sugar or cause dryness, poor oral hygiene.

DIAGNOSIS and CLINICAL SIGNS

Areas of demineralization develop on the surfaces of teeth between teeth and in crevices and cracks. These areas are painless and clinically appear as dull or brown spots.
As the infection progresses, a cavity develops that can spread into the dentin and through the dentin (the component of the tooth located under the enamel) to the pulp (consisting of nerves and blood vessels; pulp infection is called pulpitis), causing pain, necrosis and sometimes abscess.

DRAWING. Severe form of early childhood caries in a four-year-old child with intensive destruction of all four incisors of the upper jaw .

DRAWING. Severe early childhood caries in a three-year-old child with multiple areas of cavity carious lesions on the lower jaw incisors and loss of the upper jaw incisors due to carious destruction .

TYPICAL LOCATION

Areas of demineralization (white or brown spots) and carious lesions are usually observed at the gingival margins of the upper incisors, and then the first and second molars.

LABORATORY STUDIES AND RADIATION DIAGNOSTICS

Foci of demineralization are invisible on a radiograph, but radiography can reveal progressive carious lesions on and between the occlusal surfaces.

DIFFERENTIAL DIAGNOSIS

Depressions or defects in embryonic development. There are defects on the surface of the teeth (for example, the thickness of the enamel varies noticeably) or noticeable grooves.

TREATMENT

Patients are explained the importance of maintaining oral hygiene and during a preventive examination of the child, the risk of developing caries is assessed.
They refer you to a dentist for a consultation on possible sealing of cavities and cracks.
Before prescribing a fluoride supplement, the doctor should determine the fluoride concentration in the child's drinking water source. If your public water supply is not fluoridated, well water exposed to fluoride minerals and some fruits and vegetables grown in soil irrigated with fluoridated water may be sources of fluoridation. Fluoride supplements are not recommended for individuals living in areas with optimal public water fluoridation (0.7-1.2 ppm or >0.6 mg/L).
It is recommended to show your child to the dentist when the baby is one year old.
The use of fluoridated varnish twice a year in children at moderate and high risk prevents the development of caries on demineralized enamel.

The mother or caregiver should be told how the child's teeth are developing and what level of dental development should roughly correspond to the child's age. Before teething, it is necessary to clean the baby's mouth with a napkin or gauze swab to prepare the transition to using a toothbrush. A child's teeth should be brushed by an adult until the child can do it himself (usually by the age of seven). Fluoridated products are not recommended for children under three years of age, as the child may swallow the toothpaste while brushing their teeth. To brush your teeth, it is recommended to apply a pea-sized amount of toothpaste to your brush. Parents should be aware of the benefits of fluoride, as well as fluoride and the side effects of too much fluoride. You should teach your child to drink from a cup as early as possible and avoid giving your baby milk, juice or soda from a bottle or cup before putting the child to bed.

Advise the mother not to breastfeed her baby close to bedtime, as this creates an ideal environment for the growth of cavity-causing bacteria and tooth decay.

OBSERVATION

Ensure that a child with white spots on teeth or visible decay is taken to the dentist for monitoring and treatment, so that the teeth can be saved from decay or treated.

Children's tooth enamel is thin and fragile, making it vulnerable. The carious process develops very quickly. If it is not stopped in time, the baby will face not the most pleasant consequences. Premature removal of baby teeth threatens underdevelopment of the permanent root and the formation of malocclusion. With proper oral care, caries of baby teeth can be prevented in young children.

Features of the pathology

Caries is a pathological process affecting the hard tissues of the tooth. Under the influence of various factors, the coronal part gradually collapses. At the initial stages, there are practically no obvious symptoms; the child does not notice any discomfort. As caries progresses, increased sensitivity and pain appear.

Depending on the depth of destruction, pathology is divided into several types:

initial;
superficial;
average;
deep.

The sooner treatment begins, the easier it is to get rid of the problem. Initial caries is characterized by damage only to the surface of the enamel; with deep caries, all layers of the outer coating and dentin are destroyed. An advanced disease can rarely be corrected, and in this case the tooth must be removed.

Caries on the front teeth of a child

The disease most often affects the front milk teeth, which is associated with the anatomical features of the structure of the children's dentofacial apparatus. There is also such a thing as “bottle caries,” which is characterized by damage only to the anterior crowns. They are the ones who first come into contact with sweet foods - juices and milk formulas - which negatively affect the condition of the enamel. If left untreated, the process quickly progresses and begins to spread to neighboring teeth.

If caries on a child’s front teeth affects the cervical area, a circular type pathology can be diagnosed. It begins on the front surface of the tooth in the neck area, gradually covering the entire coronal part, which can result in fracture of the affected area. Inflammation of the nerve will follow and removal will be required.

Causes of caries in children

Often, dental caries begins in a child as early as 2 years old, immediately after the crowns begin to emerge. This can be triggered by various factors - from illnesses suffered by the mother to a lack of vitamins in the first months of the baby’s life.

The following causes of caries in children can be identified:

It is recommended to visit a pediatric dentist immediately after the appearance of baby teeth. Regular visits are necessary for prevention and will prevent the development of oral diseases.

While the baby crowns are appearing, the permanent teeth are forming. As they grow, they push out the temporary ones, taking their place. If the process occurs under the influence of unfavorable conditions, and baby teeth fall out prematurely, the main teeth become vulnerable to oral diseases.

Symptoms

Initial caries

The symptoms of caries are quite specific, but parents may not always notice them. The lesion often begins in places that are difficult to clean and difficult to examine without special dental instruments. Therefore, if there have been no preventive visits to the dentist, a doctor is consulted only at the stage of deep caries.

Symptoms depend on the depth of dentin damage. The initial stage is called superficial caries. Barely noticeable yellowish spots appear on the enamel, varying in size and shape. They do not cause discomfort to the child. Gradually, the formations become darker, acquiring a brown or black tint.

Average caries

When the cavity goes deep into the enamel, tooth sensitivity increases. The process of eating is accompanied by pain, and a reaction to sweet or sour foods occurs.

At the stage of average caries, acute pain appears during contact of the tooth surface with hot or cold. Food debris accumulates in the cavity, adding an unpleasant odor.

When the destruction reaches the nerve or root, pulpitis occurs - the pain becomes more acute and is not associated with food intake. Signs of intoxication may be observed:

If the affected tooth is not treated, the crown part may completely collapse and lose its chewing functions. In this case, removal is recommended.

Possible complications

At the initial stage, caries is not particularly dangerous, and it is quite easy to cure. As the cavity deepens, the tooth becomes a source of infection. A slight decrease in immunity is enough for complications to arise.

The following negative consequences are possible:

otitis;
sinusitis;
chronic runny nose;
tonsillitis;
inflammation of the bone marrow and bones;
periostitis of the periosteum.

The passage of infection deep into the soft tissue provokes gingivitis - inflammation of the gums, which gradually transforms into periodontitis. The gums become painful and loose, bleed and hold the root worse. The lesion affects the tissues of neighboring healthy teeth, which affects their condition. If treatment is not started, the result will be loosening and loss of the tooth.

Treatment of caries of primary teeth in young children

Treatment of caries of primary teeth in young children is carried out exclusively in a dental clinic; it is impossible to do it yourself at home. For a small child under three years old, a visit to the doctor is a lot of stress, and it is almost impossible to explain to him that the doctor will simply cure a bad tooth.

When treating caries in children 5 years of age and older, local anesthesia can be used. During the procedure, a special anesthetic gel is applied to the gums so that the child does not feel the anesthetic injection. If the baby is very small and cannot sit through the entire process in a chair, it is recommended to use nitrous oxide - “laughing gas”, which does not harm the small body.

At the initial stage

A specialist should decide how to treat caries in children from 2 to 6 years old. If therapy begins at the spot stage, one of the painless firming procedures may be performed.

The following treatment methods are used:

ozone therapy;
remineralization;
silvering.

Ozone therapy does not require pain relief and does not affect the appearance of teeth. This method is suitable for treating caries in children under 3 years of age. During the procedure, a small silicone cup is attached to the tooth, through which ozone is supplied to the enamel. It makes the surface sterile in a few seconds, all bacteria that cause the disease are destroyed. The tooth is treated with a strengthening compound.

Remineralization is recommended for children of primary school age if the caries does not look very advanced. This procedure is suitable for preventing the development of caries on a “complex” surface with a large number of fissures - grooves that are difficult to clean on your own, which makes them a source of bacterial growth.

Milk teeth after silvering

During the remineralization process, special solutions with phosphorus, fluorine and calcium are applied to the teeth to treat dentin. Electrophoresis, vacuum or ultrasound helps to enhance efficiency. The process does not last long, but at least four sessions must be done. The final decision on what to do with caries on a child’s baby teeth is made only by the doctor.

Silvering is one of the most accessible and painless methods of treating caries in children 4 years of age and younger. The surface of the teeth is coated with a silver solution, which has antibacterial properties and prevents the development of caries. The process has a significant drawback: the enamel is painted a dark color, and it is impossible to get rid of the shade.

Treatment of moderate and severe caries

If the enamel has already been destroyed and caries has penetrated into the dentin, more serious procedures must be carried out. A problematic tooth needs deep treatment; the most gentle method of correction is depophoresis. A solution of calcium and copper hydroxide is injected into the cavity, which allows you to clean and disinfect the dental canals.

As an alternative to depophoresis, preparation is used - exposing the tooth to a powerful thin stream of water or a special liquid.

After cleaning, the “hole” is sealed. For this purpose, special materials are used - silicophosphate or glass ionomer cements. Some clinics in large cities, for example, in Moscow, offer to make a special filling with fluoride. It gradually penetrates into the dental tissue and strengthens it.

The impact of the drill can be quite painful and prolonged, so it is important to prepare the child for the procedure. It is necessary to explain to the baby why he will have to sit in a chair for a long time. There is no need to refuse anesthesia: it reduces the stress of therapeutic manipulations, and the harm from it is minimal.

Preventive measures

Prevention of childhood caries should begin during pregnancy. The quality of the formation of tooth buds and their mineralization largely depends on the expectant mother. Unbalanced nutrition, lack of vitamins and minerals, diseases and severe toxicosis - all these factors disrupt the development of the baby's future teeth.

To avoid the development of caries in the child's front teeth, the mother needs to monitor her diet after childbirth - during lactation. Any food eaten affects the quality and composition of breast milk. Maximum attention to diet will help to avoid many problems with your child’s teeth in the future.

Teeth brushing should begin immediately after the first incisor appears. For this purpose, there are special toothbrushes for little ones. They are made of soft materials and come in the form of a fingertip. You should wipe your teeth with it every time after eating.

Photo: this is what a children's toothbrush looks like

By the age of four, the child should already be brushing his teeth on his own. Brushes for children of this age have soft bristles and can be of different shapes and colors. You should take children's pasta - such products have a softer composition and are available in different flavors.

Parents need to ensure that their child’s diet contains fewer carbohydrates. Products with a high content of them provoke caries because they are a good breeding ground for bacteria. It is better to replace rich sweets with hard fruits, which guarantee self-cleaning of teeth from plaque.

The best prevention of caries is visits to the dentist, which should become regular after reaching the age of five. Only a specialist should tell how to treat a child’s teeth at 2 years of age and later. The main thing is to start therapy at the initial stage of the lesion so that the harm from the disease is minimal.

Caries is one of the oldest diseases, which was suffered as far back as 3 thousand years BC. The causes and mechanisms of development of this pathology are very complex.

Even a highly professional dentist cannot always detect the onset of caries development at first glance. That is why it is necessary to clearly identify the symptoms of this disease at different stages of its development.

1. Chalk stain

The main cause of this disease is poor oral hygiene.. It is this factor that leads to the accumulation of pathogenic microorganisms that cause the development of caries.

Maintaining a healthy lifestyle and a balanced diet inhibits the proliferation of microbes. But, if the immune system suddenly weakens, the rhythm of life is disrupted, and bad habits appear, then microbes begin to actively attack the surface of the teeth, leading to the formation of caries.

At this stage, pathology is very difficult to identify. As a rule, development can be suspected by reduction of gloss on the crown. In this case, the shine does not disappear on the entire surface, but in limited areas.

Over time, they begin to form in this place irregularly shaped white spots. Such a manifestation signals the beginning of enamel demineralization, which quickly spreads to neighboring teeth.

At the affected area after a certain time enamel becomes thinner. Over time, the stain changes its color to brown. Possible occurrence feeling on edge.

At the first stage of caries, the infected tooth does not react in any way to external stimuli. There are also no signs of pain.

To diagnose early-stage caries, instrumental examination is not used, since the enamel in the area of destruction still remains smooth and the probe slips over it.

For diagnosis, a Methylene blue solution is used, which colors demineralized lesions blue. Before application, the enamel must be thoroughly dried.

Treatment of teeth affected by stage 1 caries involves their remineralization. For this purpose, special complex preparations containing magnesium, potassium, and calcium ions are used.

The remineralization procedure is carried out as follows:

if pain relief is required, local anesthesia is used;
the dentist performs professional cleaning of the oral cavity;
the infected crown is polished and isolated from saliva;
a remineralizing drug is applied to it.

To obtain a positive result, it is necessary to carry out a course of procedures with an average duration of 10 days.

If you find caries at the stain stage, you should not put off visiting the dentist, as after some time this can lead to complete loss of the tooth.

In the next video we will be told how to cope with the first stage of caries:

2. Superficial

The process of caries damage tends to develop. In the absence of proper treatment, a small white spot quickly increases in size, changes its color, affecting the deep layers of the enamel.

This occurs most intensely on the lateral surfaces of the crowns.

The second stage is characterized by the following manifestations:

change in enamel structure. It becomes rough, uneven, porous;
change in color of spots from white to brown or black.
at the spot of the stain you can notice defects: small pinholes, chips;
appears rare painful reaction to external stimuli. When infected lesions are located in the cervical area, discomfort is observed during mechanical action: brushing teeth, pressing with a finger. The pain is short-term aching in nature;
white or yellowish plaque accumulates on the gingival zone of the crown;
Maybe inflammation of the gingival papillae.

At the second stage of caries, the enamel can no longer be restored through remineralization. Treatment requires direct impact on the crown.

The sooner you see a doctor, the less intervention there will be on his part. Often, a visual examination is sufficient for diagnosis.

But when pathological foci are located in a poor visibility area, an X-ray machine is used.

Treatment of second stage caries includes:

processing of the collapsing surface;
grinding of porous enamel;
applying an adhesion promoting agent;
filling prepared areas.

3. Medium

The second and third stages are very similar. But unlike the superficial, medium caries penetrates deeper, covering dentin.

Symptoms of manifestation are slightly different from the previous stage:

sharp pain occurs every time when exposed to irritants. It can be caused by touch during cleaning, food, too hot or cold air, or examination with a probe. Painful sensations disappear almost immediately after the removal of the stimulus;
the affected area increases, covering most of the crown. In some cases, caries spread not across the width, but into the dentin of the tooth. The depth of the lesion is usually small and does not reach the deep layers of dentin;
the walls of the resulting cavities are solid. With the chronic development of pathology, the bottom and walls may be surrounded by dentin.

For a detailed diagnosis of the third stage, instrumental examination and radiographs are used. Based on the results obtained, treatment is prescribed, which is not much different from the treatment of superficial caries.

Also, First, the infected tissue is removed, and then the areas are filled and restored. The average degree of caries is the penultimate.

But contacting a dentist at this stage is still not the worst option. Since it is still possible to preserve a whole and healthy tooth, which is not always possible at the last stage.

4. Deep

Pathology at this stage is the most difficult option for treatment. Unfortunately, it is the fourth stage of caries that is diagnosed most often.

Fear of dentists often leads to the spread of the disease to most of the crowns of the dentition, the occurrence of secondary pathologies, and complete loss of teeth.

Caries at the fourth stage of development has the following symptoms:

When examining the oral cavity, they are found voluminous cavities penetrating deep into dentin, but not affecting the pulp;
probing of these areas causes sharp, persistent pain along the entire bottom;
painful sensations can occur both when exposed to external stimuli and at rest. Particularly often, pain occurs in the evening. This is explained by the fact that the disease affects the nerve of the tooth, which is not yet inflamed, but is already reacting sharply;
dark areas turn black;
at this stage there may be destruction of the crown and subgingival area. However, this phenomenon is not always accompanied by additional symptoms.

Treatment of the last stage of caries begins only after a detailed diagnosis. The doctor determines the area and degree of damage to the tooth tissue, after which the stages of treatment are planned.

Most often it has a standard scheme:

the patient is anesthetized at the site of treatment;
carry out aseptic treatment of crowns;
using a drill, remove damaged tissue;
form a cavity;
apply an adhesive solution to the walls of the cavity;
filling material is applied;
restore the crown.

In children

Childhood caries during the eruption and development of baby teeth is a fairly common occurrence. The most common cause of this pathology in children is:

poor quality of oral hygiene;
excess carbohydrates in the baby’s diet. In this case, it is not so much the amount of carbohydrates that matters, but the frequency of consumption. This factor is a fairly common cause of caries. Carbohydrates are the main source of nutrition for pathogenic bacteria in the mouth;
lack of minerals and vitamins.

The stages of development of temporary dental caries are no different from caries of permanent teeth. The initial stage, superficial, middle and deep, are also distinguished here.

Symptoms are the same as in adults:

first, small chalky spots form on the enamel;
Over time, they acquire a dark color and increase in size;
pain is also associated with irritating factors;
the depth of the collapsing cavity gradually increases.

The only difference between the pathology of baby teeth is that the peculiarity of their structure allows caries covers several teeth at once, developing on them with equal intensity.

If this pathology is detected, it is necessary to consult a doctor as soon as possible. Now there are many methods for restoring enamel and temporary tooth crowns.

The most common are:

remineralization;
silvering;
filling.

Prevention

Photo: fissure sealing

As you know, preventing the development of this pathology is much easier than treating it.. In order to avoid caries, you must always adhere to certain rules:

Teach your child to brush their teeth properly. Always monitor this process yourself;
visit the dentist at least twice a year;
seal fissures using the latest technologies;
balance your diet by introducing foods rich in microelements and vitamins;
minimize the consumption of sweets;
adjust fluoride intake;
carry out professional hygienic cleaning of the oral cavity in a timely manner;

Caries is a very serious and even dangerous disease that can lead to complete loss of teeth. Statistics say that over the years the number of people with this pathology is only increasing.

If the opportunity to avoid caries is minimal, then you need to try to rid yourself of at least the negative consequences.

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