Treatment of cervical caries at home. Dangerous cervical caries: treatment or how to avoid complete tooth destruction. Using special paste

One type of caries is cervical caries. Treatment of this disease should be started as early as possible, as it is characterized by rapid progression.

The affected area is at the very bottom of the tooth crown and sometimes even under the gum. The cervical form occurs for the same reasons as regular caries, most often due to improper hygiene oral cavity.

Features and Signs

Cervical caries is formed at the border with the gum in the area of the neck of the upper or lower teeth. It can be single or multiple.

The cause of its occurrence is special microorganisms localized in the area of tartar and plaque.

Cariogenic microbes lead to the appearance of organic acids, which destroy the enamel and wash away calcium from it.

The surface of the neck of the tooth is particularly susceptible to caries due to the fact that plaque accumulates abundantly on it. Under the plaque, a focus of demineralization is formed, destroying the enamel structure.

The initial form of cervical lesion is called the spot stage and consists of a disruption of the mineral composition of the enamel and the formation of microscopic pores. Subsequently, the white spot turns into a carious cavity.

Caries lesions of the cervix are one of the most serious illnesses in dentistry, since tooth decay in this case occurs near the very base. As a rule, it appears after the age of 30 and is localized on the front teeth. Cervical caries of the anterior teeth is dangerous due to the rapid destruction of enamel and inflammation of the nerve.

Due to the fact that the thickness of dentin and enamel near the base is much less than in other parts of the tooth, the infectious focus very quickly affects the pulp.

This type of caries quickly spreads to the root, and in such cases it is no longer possible to save the tooth.

The main cause of caries in this area of the tooth is poor hygiene. Due to the fact that the neck of the tooth is covered by the gum, it is difficult to clean, as a result of which food particles accumulate there, causing bacterial plaque.

Gingival caries has the same symptoms as regular caries, but its health consequences are much more detrimental. It has the ability to penetrate into the very depths of the dental crown and affect all its canals.

How to treat cervical caries?

Treatment of cervical caries of the anterior teeth is the same as for ordinary caries, except in situations where complications arise.

Complications arise when the affected area extends to the gums. The most common complications of cervical caries are:

accompanied by severe pain;
inflammation of gum tissue;
periodontitis;
enamel hypoplasia;
, abscess and phlegmon - with to a great extent caries.

Cervical caries may be a concomitant factor of diseases thyroid gland or diabetes mellitus, therefore, when establishing this diagnosis, the dentist always advises consulting an endocrinologist.

Treatment tactics are chosen depending on. In the initial stage of the disease, when it is in the form white spot, held conservative treatment. First, professional teeth cleaning is performed, plaque and stones are removed.

Cervical caries can lead to serious complications, including tooth loss

Then remineralization is carried out: with the help of special preparations, for example: Tiefenfluorid or ICON, the weakened tooth surface is saturated with calcium. In addition to professional therapy, home treatments may be prescribed to promote enamel mineralization, which includes the following elements:

highly concentrated fluoride pastes and gels;
fluoride rinses;
fluoride-impregnated dental floss.

After several months of this treatment, the enamel is regenerated and the tooth structure is restored.

In the last stages of the disease, filling is used. In this case, the tooth is cleaned of organic deposits and stones, the affected areas of tissue are removed and its anatomical shape is returned. IN difficult cases the nerve is removed.

Without timely treatment, gingival caries can develop into complications in a short period. This is due to the fact that the cervical area is the most vulnerable and is characterized by active destruction of the dental crown with the manifestation painful sensations.

Popular folk remedies

The specificity of caries is that its treatment requires exclusively professional medical care.

Only a dentist can completely eliminate cervical caries; treatment at home is ineffective.

There are few methods and they are usually aimed at reducing unpleasant symptoms rather than eliminating the disease itself.

To prepare the infusion, one tablespoon medicinal herb should be boiled in a glass of water and left for one hour.

You need to rinse your mouth with the tincture and apply a cotton wool moistened with the tincture to the sore tooth. Such infusions kill putrefactive bacteria, due to which the further development caries.

One of the most effective folk remedies from caries is propolis. A small ball of propolis should be placed on the aching tooth, covered with a cotton swab on top and held for 30 minutes.

Features of filling gingival defects

Filling is carried out in the following sequence:

the color of the filling that matches the enamel as closely as possible is selected;
anesthesia is administered to eliminate pain;
the diseased tooth is cleaned of deposits to reduce the risk of infection;
carious and age spots are removed by preparation;
the oral cavity is treated with a weak medicated antiseptic solution;
with the help of a rubber dam, the diseased tooth is isolated from saliva and moisture;
a cavity is formed for installing a filling;
Filling material is installed into the prepared cavity.

Treatment of cervical caries requires professional dental care

The peculiarity of filling carious teeth in the gingival area is the difficulty of choosing a material due to the close location of the affected area to the gum. The closer it is, the more difficult it is to install the filling efficiently.

This is due to the high probability of moisture and blood getting on the working surface. In the area of the base of the tooth, there are special loads, so especially liquid and plastic materials should be used for filling.

Due to the fact that the focus of caries is located close to the gum, and sometimes extends under the gum, the dentist needs to perform strong retraction of the gum. It must be carefully lifted up so as not to be damaged during manipulation.

In children, gingival caries is rare, but if it appears, it is most often in a circular form, i.e. covers the entire neck and is characterized by rapid carious destruction of the entire tooth.

The defect spreads along the entire neck of the tooth in a circle, reaches the middle of the crown, deepens under the gum and covers the contact surfaces. In this case baby tooth have to be deleted.

Filling of gingival lesions is complicated by their inaccessibility, which causes inconvenience during treatment.

Prevention

Prevention consists of providing comprehensive dental protection.

First of all, you need to follow the basic hygiene rules: brush your teeth in the morning and before bed, rinse your mouth or use dental floss after eating.

You need to brush your teeth correctly: from the base of the dental crown to its end. contains highly abrasive particles for better cleaning of teeth.

At least once a year you need to visit the dentist and have a professional cleaning, which allows you to remove plaque and thoroughly clean each tooth.

It is also necessary to monitor your diet and abstain completely (or consume in minimal quantities) sweet and sticky foods. Your diet should include foods rich in calcium and raw vegetables and fruits.

Useful video:

Features of the development of cervical caries and a picture of symptoms in a short video:

Cervical caries, also known as cervical caries, occurs quite often even with the capabilities of modern hygiene and is a common dental disease.

What is cervical caries

Cervical caries takes its name from its location on the neck of the tooth and spreads to nearby tissues. Due to the peculiarities of its location, cervical caries is usually not visible at the initial stage, so cases of its early diagnosis are rare. In most cases, cervical caries is diagnosed at a deep stage, when the pulp or root of the tooth is affected. In the latter case, the tooth can no longer be cured, and the doctor can only remove it. That's why early diagnosis cervical caries at the stage when the disease is asymptomatic, allows you to avoid problems in the future.

Factors causing the disease

Cervical caries appears primarily due to thinning of dentin. Dentin becomes thinner due to prolonged exposure to lactic acid, which accumulates on the neck of the tooth when left untreated. proper hygiene. Even with professional cleaning, the neck of the tooth can be very difficult to treat. The development of cervical caries is promoted by genetic factor, as well as a number chronic diseases. Dentistry identifies the following reasons for the development of cervical caries:

Enamel demineralization

The presence of lactic acid waste products of bacteria present in the oral cavity and saliva contributes to the demineralization of enamel. Their long-term impact on the enamel is possible if the rules of oral hygiene are not followed.

Avitaminosis

Vitamin deficiency has a direct impact on the condition of the gums: the gum pockets formed due to a lack of vitamins become a place for the accumulation of food debris and the proliferation of bacteria. As a result, the enamel on the neck of the tooth becomes thinner and becomes susceptible to caries.

Chalky spots

This main symptom the onset of cervical caries, which should be paid attention to. If chalky spots are not noticed in time, the disease continues to develop to deeper stages, when it is necessary to serious treatment. Unfortunately, it can be almost impossible to notice cervical caries at the spot stage; this can only be done by a dentist during a routine examination.

The following signs of cervical caries are distinguished::

chalky spots of different sizes;
discomfort and pain upon contact with food and liquids;
tooth sensitivity to high and low temperatures, acid exposure;
night toothaches;
headache;
discomfort and pain when brushing your teeth.

If you are concerned about these symptoms, you should see a dentist immediately. Otherwise, it is impossible to prevent the development of cervical caries.

Stages of caries development

The development of the carious process in the neck of the tooth occurs sequentially, replacing the stages of the lesion.

Initial

This is also the spot stage. An unnatural white spot appears on the tooth enamel, but no discomfort or other symptoms are not observed. The stain may be colored nutrients and liquids, which complicates its independent assessment.

Cervical caries at this stage is diagnosed by visual signs that can only be assessed by a dentist, however, its treatment is carried out with the most gentle non-invasive intervention. This means that opening the tooth enamel with a drill is not required, so only one visit to the dental office will be enough.

Superficial

It is at this stage that the neck of the tooth begins to react to contact with food, liquids, and temperature changes. This is due to the fact that at this stage of cervical caries the enamel is already damaged. Signs of superficial cervical caries cannot be ignored, as it inevitably progresses to more serious stages.

Average caries

At this stage, caries affects not only the enamel, but also the dentin, so the tooth’s reaction to irritants intensifies. The pain goes away quickly, so many patients do not consider dental care necessary.

Deep caries

The most last stage caries, characterized by deep damage to the tooth, down to the pulp. Symptoms of deep caries are unbearable, almost persistent pain that intensifies at night.

How is cervical caries treated?

For the treatment of the initial stage of cervical caries, conservative methods. First, it is necessary to clean the tooth of plaque and stone, then the doctor prescribes remineralizing therapy with drugs that contain calcium and fluoride. Means for remineralization and fluoridation of teeth should be prescribed by the attending physician in clearly established dosages.

The stages of treatment of cervical caries at the onset of the disease are as follows::

Professional cleaning of tooth enamel from plaque and tartar.
Application of remineralizing gels and applications of preparations containing fluoride (carried out over 2-3 sessions).
Reception medicines prescribed by a doctor.
Compliance with doctor's recommendations for hygiene measures.

Treatment of cervical caries in case of damage to tooth enamel is carried out using a drill and consists of the following stages:

Professional cleaning of plaque and stone.
Choosing the color of the composite - it must fully match the natural shade of the enamel.
Preparation of the tooth neck and adjacent tissues affected by caries using local anesthesia.
Isolation of the tooth and creation of an adhesive coating in the created cavity.
Filling a tooth and giving it an aesthetic appearance.
Grinding and polishing of teeth.

Cervical caries is complicated by the subgingival location of the lesion, so the doctor must be highly qualified. Moisture and blood can get into the working space, and cervical caries is especially inconvenient when filling. When working, the dentist must be extremely careful not to damage the delicate gum tissue.

To treat caries, fillings made of glass ionomer cements, organically modified ceramics, light-curing composites, etc. are used. Correctly selected treatment allows not only to completely cure caries, but also to give the previously affected tooth an aesthetic appearance.

Despite the difficulties associated with the treatment of cervical caries, modern capabilities make it possible to cure any stage of it, including complications such as pulpitis and other serious consequences of an advanced disease. This is largely due to technological equipment that simplifies the diagnosis and treatment of diseases of the teeth and oral cavity.

Doctors by referral

11102, 11106, 11103, 11101, 11108, 11114, 11111, 11162

Zhigunova Svetlana Yurievna

Chief physician clinics on Kolomyazhsky Ave., 20
Periodontist

Dubinskaya Anna Yakovlevna

Dentist-therapist
Pediatric dentist

IvaninaVera Rashidovna

Dentist-therapist

TikhanovaAlla Mikhailovna

Dentist-therapist
Pediatric dentist

Tsarkova Tatyana Vladimirovna

Dentist-therapist

Shashorina Darina Gennadievna

Dentist-therapist

Batyukova Oksana Ivanovna

Dentist-therapist
Pediatric dentist

Zhivotovskaya Nina Arturovna

Dentist-therapist
Periodontist

Sasha Lomako's mother:
Many thanks to Dr. Kobalia V.M. and his assistant Tamara, for clear, well-coordinated work and kindness.
Nikolaeva M.V.:
Thanks a lot for the kind attitude of Dr. Belolyubskaya S.V., she finds an approach to both babies and older children.
Kordzadze E.A.:
I did ZOOM 4 whitening, the procedure was absolutely painless! Many thanks to Dr. Golubeva A.A. for my new smile!
Voilokova A.D.:
Many thanks to the wonderful specialist Dr. Komarova E.V.! Always a great result!

Equipment used

Is it possible to cure cervical caries on your own?

It is generally accepted that it is impossible to cure caries at home. However, under some circumstances home treatment cervical caries gives good results. We are talking about caries in the stain stage, which has not yet damaged the tooth enamel, but is only developing on its surface. Treatment with remineralizing gels and preparations containing fluoride and calcium helps strengthen the enamel and allows you to postpone a trip to the dentist for a long time. However, when self-treatment caries at home, it is worth considering the following features:

Uniqueness of each case

Cervical caries manifests itself in different ways, which is determined by the properties of the enamel, the depth of its damage, the localization of the disease and many other factors. The formation of cervical caries is influenced by the age of the patient, as well as his daily habits regarding compliance with hygiene rules. The process is getting worse general condition body, the condition of the remaining teeth, etc.

When choosing a remedy for treating cervical caries at home, consider all these factors in to the fullest Only a qualified dentist can do this. A remedy chosen independently and found to be effective can have a positive effect due to a fortunate combination of circumstances, since not every patient is able to independently assess the scale of the problem.

Choice of drug

The pharmacological industry provides a wide selection of various means for the prevention and treatment of cervical caries. But no one guarantees that the remedy you choose will have the desired effect. The choice of medication and its dosage is a task for the attending physician. A pharmaceutical preparation can prevent the development of cervical caries at the spot stage in a short period of time, however, with an increased concentration of fluorides or other active substances the effect threatens to be the opposite.

Diagnostic problem

Cervical caries can be cured on its own only in the initial stage. But only an experienced dentist will determine the true extent of the disease. Moreover, visual signs that an ordinary patient mistakes for caries may in fact be ordinary pigmented plaque or tartar. Another serious pathology is often mistaken for caries: for example, enamel hypoplasia.

A characteristic symptom of cervical caries at the initial stage is a pain syndrome that accompanies a person constantly, intensifies at night or even appears only during meals. If for some reason going to the dentist is impossible, you can get rid of the pain for a while with the help of traditional medicine rather than experimenting with chemicals. And at the first opportunity you should go to the dentist for qualified treatment.

The following are effective folk methods pain relief for different types caries:

Infusions: herbs are used for rinsing the mouth - oregano, knotweed, sage, lemon balm, mallow, blackberry leaves. Blueberries are also effective.
Decoctions: decoctions of wormwood, tricolor violet, valerian, oak and aspen bark are used for rinsing the mouth.
Roots: angelica and calamus - you need to chew them.
Propolis tincture: you need to rinse your mouth with it, first diluting it with water.

Although the effect of folk remedies does not last long, they can still significantly reduce pain. But there is this method treatment back side: quenching the pain, healing tincture capable of masking developing pulpitis and other complications that threaten tooth loss. Therefore, no matter how effective traditional treatment, a visit to the dentist to relieve the disease is mandatory.

Cost of dental services

Prevention

Cervical caries develops both with a hereditary or disease-related tendency, and in its absence. This is due to the fact that most patients do not realize the importance of preventive measures, which are more effective than any, even the most modern, treatment. Dentists recommend following simple rules, allowing you to save your teeth from caries:

Limiting the amount of flour and sweets in the diet

These foods contain carbohydrates and a large number of glucose, which creates a favorable breeding ground for bacteria on the surface of the teeth. Bacteria convert glucose into acid, which damages enamel. By limiting the amount of flour and sweets, you will reduce the risk of tooth decay.

Proper consumption of carbohydrates

It is not necessary to completely exclude carbohydrates from your diet: it is enough to follow the basic rules for their use. It is not recommended to consume sweets at night and outside of main meals. After eating sweets, you need to brush your teeth well or at least rinse your mouth.

Including foods with coarse fibers in your diet

Coarse fibers found in vegetables, fruits and grains help remove plaque and food debris from tooth enamel, especially when consumed after every meal.

Regular teeth cleaning

Contrary to popular belief, brushing your teeth in the morning is not so important, since the main danger to enamel comes from food debris. It is much more important to brush your teeth immediately after eating, since it is at this time that bacteria begin to multiply on the enamel.

Teeth brushing technique

Your hygienist will teach you the essential basics. Most of people brush their teeth incorrectly, which often causes caries. Correct technique Brushing your teeth helps clean the surface of the enamel, so you should learn it from an early age.

Flossing

This is an indispensable way to prevent cervical caries, since dental floss is the easiest way to penetrate the interdental space, including the gingival areas.

Every person who is interested in preventing cervical caries should have in their arsenal:

Toothpaste containing fluoride from 1000 to 1500 pm prevents the occurrence and development of cervical caries.
Fluoridated floss (dental floss) provides not only effective mechanical cleaning of teeth, but also their remineralization.
Fluoride rinses: Complete the cleaning of teeth.

Like products for home treatment, the above hygiene products should be selected in accordance with the recommendations of a dentist. Although for the most part they are completely safe, the advisability of their use is determined by other reasons. Fillings, dentures and missing teeth, the health status and age of the patient are what must be taken into account when choosing hygiene products for the oral cavity. The concentration of fluoride in the water in your region also has an impact. Fluoridated hygiene products are not always really necessary: an overdose of fluoride is just as dangerous as a lack of it.

Therefore, in order to collect full complex oral hygiene products, it is better to consult a dentist. A competent approach to dental care and preventive measures will reduce the risk of cervical caries even if you are prone to this disease.

And, of course, a mandatory preventive measure is a scheduled visit to the dentist. This is the only way to identify caries in the early stages and avoid expensive treatment in the future.

It is customary to distinguish several parts in a tooth: tooth root, neck and crown. In normal condition, the crown is located above the gum, and the rest of the tooth is hidden behind it. Caries that occurs at the border of the gum and neck of the tooth is called cervical, or in other words, cervical.

Not taking the factors that cause cervical caries seriously, people visit the doctor only when the problem begins to seriously bother them, since the appearance of the front teeth becomes unaesthetic (a similar disease very often spreads in the smile area).

The reasons for its occurrence may be different. Not all people go to the dentist on time. After all, the appearance of such a disease is not immediately noticeable, especially in early stages. And sometimes people try to eliminate the disease on their own by using special pastes or resorting to treatment with folk remedies.

Let's look at the main reasons why cervical caries appears. First of all, they are associated with the following factors:

Diet, as well as the frequency and amount of consumption of carbohydrate-containing foods that are easily fermented.
The presence of microbes, that is, the activity of bacteria under dental plaque. This is especially true for Streptococcus mutans. In this state, bacteria begin to ferment and organic acids are formed. They have a detrimental effect on the layers of tooth enamel. As a result, areas of demineralization may occur. As a result, calcium, phosphorus, fluorine are washed out, and mineral minerals are disrupted. crystal lattice enamel and a caries stain gradually appears.

In general, the reasons that cause caries of the tooth neck are similar to those factors that cause ordinary caries. With improper or irregular oral care, root caries may begin to develop.

Dmitry Sidorov
Orthopedic dentist
With cervical caries, the transition from the initial stage of the disease to its deep development occurs very quickly.
Cervical caries begins to develop, which goes through the following stages:
formation of carious areas in the form of small spots;
transition to the superficial type of caries;
middle stage of development of root caries;
deep stage of the disease.

It is often quite difficult to recognize the extent of damage. The stages or dentin are difficult to determine. It is difficult for an uninitiated person to see the differences between caries that have just appeared in the spot stage and superficial ones, as well as between medium and deep damage to the tooth. Look at the picture below:
Circled initial stage cervical caries. Very noticeable?
This happens because in the border area, where there is a transition to the neck from the coronal part of the tooth, there is thin enamel that is weakly mineralized. If you brush your teeth incorrectly or take care of your mouth incorrectly, it wears off. Therefore, you should not put too much pressure on your toothbrush.
The video below shows the technology of proper teeth brushing:
Thus, the enamel in this place becomes thinner and thinner over the years. And if this area is not properly cleaned, then bacteria will not take long to appear. It is then that the disease begins to develop in the area of the neck of the tooth.
Many people, already in the initial stage of the basal type of lesion, may begin to experience discomfort. This is discomfort, a feeling of teeth on edge and hypersensitivity of teeth. They manifest themselves especially clearly when eating cold or hot food or when sweets come into contact with a problem area. However, such sensations quickly pass.
Dmitry Sidorov
Orthopedic dentist
If a person has cervical caries, treatment of the disease should begin as soon as possible!
But sometimes cervical caries can develop without any symptoms. Then you can recognize it only visually. It first appears as a light spot. When the lesion becomes superficial, pain appears when eating sweet, spicy, cold or hot.
If you visit a dentist, then when examined with a special probe, you can identify irregularities and roughness in the middle of the spot itself.
What are the symptoms of the disease
When root caries progresses to later stages, then other symptoms of the disease are added. This could be pain from chemical exposure or painful sensations from pieces of hard food getting under the edge of the gum. Pain may occur when cold air hits them.
Self-diagnosis of cervical caries at home is very difficult. In any case, only a dentist can make an accurate diagnosis.
You can identify root caries only at a late stage of the disease.
If there are any formations, stains, or defects in the neck of the tooth, this may mean pathologies such as:
caries under the gum;
other dental diseases - erosion, hypoplasia, etc.;
a type of pigmented dental plaque.

However, the first option is the most common. And this is the main problem with which people turn to the dentist.
Then the doctor can make an accurate diagnosis. And to confirm it, the dentist stains the surface of the tooth with a special solution. If the spot does not change color, then this is enamel hypoplasia, and not a symptom of cervical caries in the form of a white spot.
Dmitry Sidorov
Orthopedic dentist
The cervical form of caries usually develops in the form of a single spot.
How to treat cervical caries
If a person exhibits symptoms of cervical caries, how to treat such a disease? Various methods of treating this disease have been used in dental practice for quite a long time.
Treatment of cervical caries does not differ from the treatment of the usual form of the disease. But if you contact a doctor late, you may have to fill the canals and clean the canals.
How is cervical caries treated? Therapy is prescribed by a dentist based on the stage of development of the disease. How formerly man If you consult a doctor, the easier it will be to fix this problem.
Treatment of cervical caries at home can be used as additional therapy at the spot stage. In such cases you can use:
medicated toothpastes or gels that contain fluorides and phosphorus and calcium compounds;
dental floss, which is impregnated with fluoride;
rinses with fluoride (these elements very effectively affect the mineralization of tooth enamel).

However, it is worth noting that you should refrain from using medications containing fluorides on your own. They should not be used without a doctor's recommendation. All treatment is prescribed by the doctor based on the results of the examination, the stage of development of the disease, the area of enamel damage and possible risks.
Caries treatment can be carried out without resorting to the use of a drill. But in some situations, difficulties may arise here. For example, due to its close location to the gum tissue, constant leakage of gingival fluid into the working area, or thinning of the enamel. But you should not delay the treatment of root caries. Therefore, such a new technique as icon is not used in such cases, since the substances used here are harmful to tooth enamel.
Treatment of caries will be as follows:
Anesthesia is necessary to avoid any unpleasant painful sensations.
The affected area of the tooth is cleaned of deposits to reduce the infectious load.
Preparation is carried out - a type of mechanical processing. It is used to treat carious areas and pigmented tissues.
It is necessary to treat the oral cavity with medicinal antiseptic agents.
Formation of a cavity (in accordance with the selected material) for a permanent filling.
Installation of a seal.

The filling material is selected based on the location of the caries. The closer it is to the gum, the stronger the material will be needed so that the filling cannot fly when there is a load on it.
The video below will help clarify some points in this article:
Is it possible to cure subgingival caries? Doctors consider this disease to be one of the most dangerous, so it requires immediate attention to a specialist. This type of caries is destructive to the tooth because it can penetrate deeply and affect all canals. Gingival caries should be treated as quickly as possible.

It is no coincidence that cervical caries is classified as the most dangerous diseases teeth, because it affects their vulnerable spot - the base. The process affects the cervical area of the tooth: neck and area bordering the gum. This form of caries occurs quite often, especially in people over thirty.

Inaccessibility and anatomical features tooth enamel of the root area creates all the conditions for the rapid spread of the carious process. The infection, which does not initially manifest itself in any way, very quickly affects all channels.

If the process is started, it will no longer be possible to save the tooth. That is why it is so important to diagnose this pathology in a timely manner.

Symptoms

Symptoms indicating the presence of cervical caries are:

darkening of the enamel in the area of the tooth neck;
formation carious cavity on the neck;
increased sensitivity to various kinds of stimuli: mechanical, chemical, temperature;
pain syndrome, which with this type of caries has short-term nature and usually goes away as soon as exposure to the irritant stops.

Development mechanism

In its development, cervical carious lesions go through several stages with a clinical picture characteristic of each of them.

Stain stage or initial

Leaking asymptomatic. The sensitivity of the tooth to external irritants remains at the same level, although some people may experience some discomfort and a feeling of being set on edge.

The enamel becomes thinner, becomes matte, but continues to remain smooth. On it only a white or pigmented carious spot appears without roughness.

Surface

In the area of the resulting stain, a roughness zone appears, enamel begins to collapse. There is a short-term sensation of pain from exposure to various irritants: temperature, eating sweet, sour or salty foods, drinks. At this stage, the disease progresses quite quickly.

Average

The process affects dental tissues and forms carious cavity and the defect is already difficult to miss visually. Pain syndromeintensifies.

Deep

The destruction penetrates deeper into the tissue and the damage can acquire critical proportions, affecting the canals and pulp. The pain becomes unbearable. At this stage, it can be provoked, in addition to the above, mechanical impact, inhalation of cold air.

Clinical symptoms often manifest themselves individually, so sometimes it can be difficult to determine to what stage the caries lesion has reached. Especially if it concerns the superficial or initial, middle or deep stages, the transition occurs so smoothly.

Circular

Cervical caries predominantly affects the buccal (vestibular) and palatal (lingual) surfaces of the gingival areas of the anterior or lateral teeth, and in rare cases, the wisdom tooth.

As the pathology progresses, the boundaries of the lesion increase, capturing the entire cervical area of the crown in a circle. In this case, we are already dealing with circular caries, which is sometimes conventionally called a “cervical complication.”

This type of caries is considered more aggressive and, unlike cervical caries, has pronounced Clinical signs. It is also dangerous because it can lead to partial break off or break the whole crowns sick tooth.

Causes

The gingival region has its own characteristics. On the one hand, plaque accumulates here quite quickly, on the other hand, you can operate on this area with a toothbrush without the risk of injury soft fabrics, difficult.

That is why plaque containing cariogenic microorganisms most often remains in the area of the tooth neck, and in large quantities.

The thickness of the enamel in this area is very small - 0.1 mm. For comparison, we note that the same parameter in the area of the tooth cusps is 1.7 mm, and fissures are of the order 0.6 mm.

Obviously, the thinner the enamel layer, the easier it is to damage it with a hard brush or abrasive pastes, and the worse the enamel protects the tooth from the effects of pathogenic bacteria living in the oral cavity.

This also partly explains the fact that cervical caries is predominantly a human disease average and more senior age.

Let us note several more factors that contribute to the development of carious processes in the cervical area:

leftover food, stuffed into peculiar pockets formed between the gum and tooth. When they decompose, lactic acid is released, which demineralizes tooth enamel;
addiction to sour products;
abuse of foods containing easily fermentable carbohydrates, in particular sucrose. During the fermentation process, organic acids are formed that “eat away” the enamel;
flaw some vitamins, causing vitamin deficiency, for example, vitamin B1;
medicines, increasing the porosity of the enamel;
endocrine dysfunction(cervical caries with endocrine diseases affects several teeth at the same time);
pregnancy.

Diagnostics

It is extremely difficult to determine for yourself what the cause of the pain is or what the defects found in the cervical area are associated with. Dentists are well aware that spots, streaks, and deformations localized in this area are characteristic of various pathologies:

himself cervical caries;
diseases of non-carious origin, for example, wedge-shaped defect, fluorosis and another;
different options pigmented dental plaque, including the well-known “smoker’s plaque.”

Equipment for X-ray diagnostics

Therefore, when examining a patient, the dentist is not limited to clinical diagnostics, and also resorts to other research methods. In particular, they use:

method stain staining, say, a 2% solution of methylene blue;
radiography;
EOM;
radiovisiographic examination;
transillumination etc.

It is extremely important to correctly determine the diagnosis, because the choice of treatment tactics depends on this.

We must not forget that quite often under the cervical carious process in the initial stage there can be camouflage various defects more deep layers or one of the most common complications of caries - pulp inflammation and periodontitis.

Treatment

All types of caries have a similar treatment method, which is selected according to the stage of the disease. However, cervical - has one feature: treatment is carried out under the influence of anesthetic.

The neck of the tooth is extremely sensitive area, and any impact on it may be accompanied by severe pain.

Treatment at the initial stage

At the stain stage, while the surface enamel layer is still intact, you can carry out conservative treatment– remineralizing therapy. It provides:

surface cleaning teeth from stone and plaque;
applique from fluorine-containing compounds or applying special gels.

The use of drugs such as Gluftored, Belagel F or Ca/P, Fluoroden and others, allows for a few sessions to achieve complete regeneration of the outer layer of enamel and stop the development of caries.

In parallel, the patient is prescribed appropriate medications and hygiene products for home use:

rinse aids containing fluorides;
dental fluoride paste(concentration: 1000 – 1500 ppm);
flosses containing fluorine;
fluoridated water and salt, etc.

Treatment at the superficial stage

It is already necessary here grinding carious area to remove the affected tissue. After this you can carry out remineralizing therapy.

Treatment in the final stages

At the stage of intermediate caries remove damaged tissue, treat the cavity with appropriate preparations and install a filling.

The most difficult case is the case of deep caries. The doctor has to additionally remove pulp clean out root canals and seal.

Most often, the carious cavity is clearly visible, and the doctor has a convenient approach to it. However mechanical restoration the area located in the gingival area delivers mass problems, because the:

cavity of this defect inconveniently located for filling (in addition subgingival caries can further aggravate the problem);
working field not protected from moisture;
same way blood gets in, flowing from the edge of the injured gum.

How is it done? surgery? Let's list main stages of the process:

Anesthesia(anesthesia). Due to the close location of the defect to the gum, any dental manipulation can be very painful.
Cleansing affected tooth from deposits on its surface. The purpose of the procedure is to reduce the infectious load. At this stage, the dentist decides on the color of the filling.
Preparation for excision of darkened and diseased tissues.
Cavity Formation taking into account the material of the permanent filling.
Treatment cavity formed by adhesive. It promotes adhesion of the filling to the tooth surface.
Sealing. The material is introduced into the cavity layer by layer, exposing each layer to a photopolymerization lamp.
Filling correction. By grinding and polishing the filling, the tooth is given its natural shape.

Advanced stage

If treatment is not started in a timely manner, the carious process at the spot stage can quickly develop into a surface defect. Further, the disease, as a rule, progresses according to the following scenario:

enamel and dentin continue to actively deteriorate, affecting the pulp;
caries turns into complicated form;
develops pulpitis, periodontitis or other serious consequences.

Thus, if the development of pathology is not stopped in a timely manner, then the diseased tooth will most likely become lost. For example, with periodontitis it is removed immediately, but pulpitis involves nerve removal, and a “dead” tooth most often serves less.

The localization of the defect also creates conditions for caries to “spread” throughout the entire area around the neck, under the gum, etc. - the carious process eventually covers the diseased tooth round.

Modern filling materials

The formed carious cavity is localized very close to the edge of the gum, so moisture, gingival fluid or blood can get into the working area.

It is quite difficult to install a high-quality filling in such conditions. Only the high qualifications of the attending physician are not enough here; it is also important choose the right filling material.

Experienced dentists use for such cases glass ionomer cements. They are more resistant to moisture than light-cured composite materials. Although the latter are, of course, more aesthetically pleasing.

SIC VITREMER features superior characteristics: triple curing, increased strength and a wide range of colors. In terms of aesthetics, such a filling is in no way inferior to a composite one.

Innovative technologies have made it possible to create particularly effective hybrid GICs, in which composite materials combine with glass ionomer cements.

It can be said that new material absorbed them best qualities. The hybrid filling is securely fixed and does not fall out much longer; it is durable and aesthetic.

Hybrid glass ionomer cement VITREMER with triple curing mechanism

Prices

The cost of treatment depends on various factors, including the price of the materials used, the status of the clinic and the qualifications of the doctor. The table below provides an example of calculating the amount of treatment:

Treatment of teeth with damaged canals will cost more - just x-rays, cleaning, and filling a 3-canal tooth costs an average of 2,000 rubles.

Treatment at home

Many people are concerned, is it possible to treat this caries at home? Yes, it's possible, but only in the spot stage. However, diagnosing yourself is very risky. It is better to first consult a dentist - he will assess the extent of the damage and give appropriate recommendations.

Typically home treatment involves applying gels and pastes containing fluoride and calcium. As a result of these procedures, the enamel is saturated with minerals, and the development of cariogenic bacteria is stopped. Among the drugs in this series it should be noted:

PresidentUnique;
Ftorodent;
Blend-a-med Anticaries and some others.

In addition to gels and pastes, you can use special drugs, for example, Fluorlak or Icon. And also rinse your mouth aqueous solution sodium fluoride, accept calcium in tablets.

It is also important to brush your teeth with medicated paste high content fluorides and calcium. It can be applied to the affected area or applied to the teeth.

Treatment with folk remedies

Traditional methods can also help with cervical caries. Here are some useful recipes:

Sage tincture. 1 tbsp. l. sage is poured with a glass of boiling water and left for 60 minutes. Used for rinsing or as a lotion on a tooth affected by caries.
Onion peel solution. 3 tsp. The husks are poured with half a liter of water and boiled. The broth is filtered through cheesecloth and allowed to brew. After 7–8 hours, you can rinse your mouth with the decoction, preferably after eating.
Fir oil lotion. A cotton swab dipped in oil is applied to the affected area for a few minutes, then to the side walls of the tooth.
Calamus tincture. Half a glass of crushed calamus rhizomes is poured with vodka (about 0.5 liters) and infused for at least one week. Rinse your mouth for several minutes before going to bed, then spit out the tincture.

Can also be chewed well small piece calamus or angelica root, hold in your mouth for 20 minutes and spit out.

The effect of using folk remedies is only superficial, and only at the initial stage of the disease. They help reduce painful sensations only for a while.

Be careful, this way you can disguise serious changes and not notice that the carious process has already moved from the stain stage to a more complex one. It is important to understand that only a dentist can provide qualified assistance, and the earlier the treatment is carried out, the more effective and painless it will be.

Prevention

Preventing the occurrence of caries is simple. Carefully monitor oral hygiene - use exclusively for brushing teeth. a good brush (not too hard and not too soft) and high-quality pastes.

Clean the interdental space with dental floss. Rinse your teeth vigorously between snacks. If possible, use irrigator for the oral cavity - it will provide complete care.

Make regular appointments with your dentist so that he can professionally remove dental plaque and, if necessary, whitening and remineralizing Events.

Do weekly home treatments that restore and regenerate tooth enamel: gum massage, rinsing with herbal decoctions, applying to teeth special compounds(only on dentist's recommendation).

Eat right, use foods that contain calcium, rough, as well as moderately solid food, vegetables, fruits and, conversely, strictly limit the consumption of foods that contain easily fermentable carbohydrates (confectionery, candies, etc.).

This type of tooth decay is a consequence of an existing problem in the body, only after the elimination of which will the progression of caries stop. For example, these could be hormonal imbalances or gastrointestinal diseases.

After treatment

Even a completely stopped carious process against an unfavorable background can develop again.

Treatment result

Caring for it is not particularly different from regular care, but a healed tooth requires more careful treatment:

Carry out hygiene procedures more carefully and efficiently.
Rinse your mouth after every meal, as between the sealed and adjacent tooth Hard-to-reach places often form.
If this is not possible, it will help to remove food debris sugar-free chewing gum.
Regularly, at least once every six months, visit the dentist.

Patients who have undergone treatment for cervical caries note that such a problem does not occur just once. If a white spot has formed near the neck of one tooth, then in the future it will certainly appear on the enamel of neighboring crowns, if the cause of the disease itself is not detected and eliminated.

Alyona

June 14, 2016 at 04:49 pm

I have had problems with my teeth since a very young age. And every time I put off treatment until later. Now I discovered that I have caries. Moreover, after reading the article, I began to understand how serious this is and what the threat is. So far, as I understand it, I have the initial stage of cervical caries. And in order to avoid this, I decided to urgently seek help from specialists and begin treatment.

Marina

June 16, 2016 at 10:35 am

I have cervical caries of the upper two front teeth, which may have appeared during pregnancy. At first I didn’t pay attention, but when I saw dark spots, went to the dentist. They cleaned me up and gave me a filling. But after a while the filling wore off, and now we need to go to a specialist again. I delayed for a long time, but after reading this article, I decided to start dental treatment as quickly as possible.

From this article you will learn:

favorite places for caries localization on human teeth,
why does dental caries occur?
main stages of treatment of cervical caries.

Cervical caries is a carious lesion of tooth enamel localized in the area of the neck of the tooth. Patients often call this pathology the term “root caries.” It should be noted that tooth enamel in the area of the necks of teeth is one of the most common areas of development of the carious process, along with fissures on the chewing surface of large molars. This is due to the fact that it is primarily in these areas that food debris and bacterial plaque accumulate.

In dentistry, therapy for cervical dental caries, despite the apparent simplicity of localization, often ends in secondary caries next to the filling. On the part of the patient, this is usually associated with still irregular oral hygiene, but also often the cause of relapse can be the dentist’s errors during treatment (for example, poor isolation of the carious cavity from saliva, and, no less important, gingival fluid , which is released from the gingival groove around the neck of the tooth).

Cervical caries: photo

In addition to the problem of secondary caries at the filling/tooth interface, the patient may encounter another important problem that arises during the treatment of cervical caries in the area of the anterior teeth. We are talking about a mismatch between the filling (in color and transparency) and the tooth tissue. The fact is that the color and transparency of the teeth change, starting from the cutting edge to its neck. And not every dentist can use a combination of filling materials of several colors and transparency to create a filling that is invisible against the background of the tooth’s own tissues.

In addition, if you are an ordinary patient, then you need to distinguish cervical caries from caries, which are also located in the area of the necks of the teeth. The difference is that a wedge-shaped defect is a lesion of tooth enamel of non-carious origin, and the surface of such a defect will always have a smooth, shiny surface. You can read more about this pathology at the link above.

Cervical caries: causes

Let us remember that caries is caused by cariogenic microorganisms in the composition of soft plaque and hard tartar. These microbes “digest” food debris in the mouth into organic acids, which in turn leach calcium from the enamel and destroy it. Poor oral hygiene (Fig. 4-5) leads to the development of caries. You can read more about the development of caries in our review at the link below.

In the process of development, cervical caries goes through several stages: from a white spot to deep caries. So, at the very beginning, cervical caries looks like white chalky spots on the surface of the enamel in the area of the necks of the teeth (Fig. 6). At this stage, there is no actual carious defect (carious cavity) yet. These areas range in color from slightly matte to bright white.

If negative factors (soft microbial plaque and food debris) continue to act, then caries in the form of white spots transforms into a superficial, then medium and deep carious cavity.

Cervical caries: diagnosis

Diagnosis of cervical caries is not difficult, since carious defects are located on clearly visible surfaces of the teeth. White chalky spots can also be seen in the mirror even on your own, especially if you dry the surface of the teeth.

Except visual inspection special dye solutions are used. The patient is asked to rinse his mouth with this solution. At the same time, the dye from this solution cannot penetrate the enamel of healthy teeth saturated with calcium, but the dye perfectly penetrates into demineralized (deprived of calcium) areas of the enamel. Demineralized enamel is very porous. After the mouth is rinsed with running water, the dye is retained only in areas of the enamel that are subject to demineralization. A few hours after rinsing with this dye, the teeth gradually acquire their previous color.

Cervical caries: how to treat...

Depending on the stage of cervical caries, they can be used different methods treatment. At a very early stage, when caries consists only of white chalky spots without destruction of the surface layer of enamel, it is advisable to try conservative treatment. If a carious defect has already formed, then it is definitely necessary to fill such defects.

1. Treatment of cervical caries in the white spot stage -

The essence of caries therapy in the white spot stage is that the enamel deprived of calcium must be saturated with calcium again. For this purpose, special remineralizing preparations containing highly active calcium and fluorine are used. One of the best drugs for remineralization of enamel is “Enamel-sealing liquid Tiefenfluorid” (made in Germany). Also, for the treatment of caries in the white spot stage, dentists widely advertise the drug ICON (developed by the German company DMG).

The disadvantage of this drug is that it does not actually heal, but rather preserves the enamel with a special polymer composition (like plastic). In any case, before applying and applying these drugs, soft dental plaque and hard dental deposits must be removed from the teeth. It is also necessary to teach the patient proper oral hygiene, since if hygiene remains at the same level, then the success of such therapy will not be expected.

Enamel-sealing liquid “Tiefenfluorid” –

2. Treatment of cervical caries with destruction of enamel -

Treatment of root caries consists of the following steps:

Cleaning teeth from plaque and tartar(Fig.7) –
Soft plaque and hard dental deposits must be removed. This is usually done using polishing brushes and abrasive paste.
Determining the color of the enamel of filling teeth(Fig.8) –
it is necessary to choose the right color of the filling material so that it matches the color of your own tooth enamel
Preparation of a carious defect –
those. At this stage, all dental tissue affected by caries is removed using a drill.
Isolating a tooth from saliva(Fig.9) –
Qualified dentists use a rubber dam for this, which allows you to completely isolate the tooth (being treated) from saliva and wet breath. This is important if you want the filling not to fall out in a few months to a year.
A rubber dam is a thin band of latex in which holes are made for a group of teeth and then pulled over those teeth. After tensioning the scarf, a special metal fixing clasp is installed. It is needed to hold the rubber dam close to the gums. You can see how teeth are isolated using the power of a rubber dam in Fig. 9.
Treatment of the cavity with adhesive –
enamel and dentin must be treated with adhesive before adding filling material.
Filling a defect –

Filling material is introduced into the treated carious cavity to fill the lost part of the tooth. The tooth is given its physiological shape. During the layer-by-layer application of filling material, each layer is illuminated with a special photo-polymerization lamp, which leads to hardening of the filling material (Fig. 10).
Sanding and polishing –
It is performed using special fine-grained discs and burs in order to give the tooth its final shape, as well as to create a smooth and shiny surface.

Stages of treatment of cervical caries using a specific example -

In Fig. 11 you can see the initial situation: with many carious defects, treatment of the upper central and lateral incisors is planned. In Fig. 12 we can see that all tissues affected by caries have already been removed, and a rubber dam has been applied to the teeth to isolate them from saliva. Figure 13 shows a view of the finished work.

Prevention: cervical caries

As follows from the causes of caries, methods for its prevention are as follows:

Regular oral hygiene –
with a toothbrush and toothpaste, and also (after each meal). If you can’t brush your teeth, the minimum you should do is floss and then chew gum for 5 minutes.
Avoid snacking between meals –
consumption of sweets, chips, flour, etc. without subsequent brushing of teeth for 5 minutes is one of the reasons for the development of caries. Having a snack means you need to brush your teeth. Laziness? - so keep walking with rotten teeth and bad breath.
Professional hygiene –
1-2 times a year (depending on the quality of oral hygiene), remove dental deposits and pigment plaque, and also treat teeth with special fluorine- and calcium-containing products to strengthen the enamel. We hope that our article was useful to you!