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As a rule, for most of us, dentistry is associated with the noise of a drill and discomfort, therefore, caries treatment is postponed until the pain becomes unbearable. Modern standards of dentistry are fundamentally changing the idea of dental treatment, and it is better to fight diseases of the teeth and oral cavity at the initial stage – it takes less time, reduces costs and avoids undesirable consequences for health in general.
Dental caries is a pathological process in hard tissues that develops as a result of external and internal unfavorable factors and ultimately leads to tissue destruction, the formation of a cavity in dentin. In the absence of treatment, inflammatory processes occur in the pulp and periodontium.
The cause of caries development is microorganisms on the tooth surface, which can have a destructive effect on enamel. The degree of their negative impact depends on how favorable the conditions are for their reproduction and life, as well as on the body’s ability to resist their action.
The active reproduction of pathogenic microflora occurs under the influence of the following factors:
In the absence of timely treatment, it is far from always possible to stop the development of caries in the early stages, so the disease progresses, bacteria penetrate into the soft tissues, which leads to various complications. The most common of them are pulpitis, periodontitis, granuloma.
Pulpitis is the first stage of the inflammatory process in the absence of caries treatment. It develops inside the tooth, because a layer of enamel and dentin is located around the pulp itself. Pulpitis can be acute or chronic – it is manifested by periodic pain in the presence of any irritating factor, for example, sour or cold food.
If untreated, pulpitis progresses, resulting in inflamed bone tissue around the roots of the teeth. This process is called periodontitis. The acute form is characterized by an increase in body temperature, throbbing pains, and inflammation of the gums. Severe pain occurs with any contact with the tooth. This is how the symptoms of a purulent form of periodontitis look, but with a serous form, the disease proceeds quite calmly. The acute form of periodontitis often ends with tooth extraction. In a chronic process, inflammation can be eliminated by more radical methods.
In chronic periodontitis, granulomas form around the roots, which are purulent accumulations. It is quite difficult to diagnose this disorder in its initial stages, due to the absence of symptoms.
The presence of granulomas requires immediate medical attention, since they can quickly turn into a cystogranuloma, and then into a cyst. Treatment is carried out with a therapeutic and surgical method.
The following stages of caries development are distinguished:
To begin demineralization, the characteristic feature is a decrease in the natural gloss of the enamel and the appearance of matte or brown (dark or light) spots. This process is associated with the loss of minerals in this area, which leads to structural changes in the tissues.
The development of caries in the case of a white carious spot can be as follows:
The development of caries at this stage is asymptomatic. In some cases, hypersensitivity to thermal or chemical irritants is possible. During diagnosis, methylene blue is used, which is capable of staining white spots.
Superficial caries develops in the place where a white or pigmented spot has appeared. The characteristic symptoms for this stage of the development of the disease are short-term pain arising from various irritants (salty or sour food, cold or hot foods). On examination, a defect is found that is located within the tooth enamel. Quite often, the lesions are localized in the fissures (fissure caries).
Average caries is a consequence of superficial, and dentin is already involved in the pathological process. Then comes the time of deep caries, at which significant changes in dentin are recorded. During this period, short-term pain is possible as a reaction to mechanical, temperature or chemical stimuli, which disappear after the cessation of exposure to stimuli. During diagnosis, the patient has a deep cavity with softened dentin. In some cases, signs of pulpitis are recorded.
Treatment depends on the stage of the disease. If caries is at the stain stage, it is usually sufficient to saturate the tissue with fluoride and calcium. Superficial, medium and deep caries is treated by preparation – removal of carious tissues and restoration of the shape of the tooth using composite materials. Typically, two visits are required to treat deep caries.
A non-invasive or conservative method of caries treatment is used if it is in its early stages. In this case, the doctor removes plaque and mineralizes the enamel.
The treatment process consists of several stages:
Deep caries, the treatment of which is carried out with the obligatory hardware treatment of the affected parts of the tooth, is eliminated in several stages:
Treatment of deep caries before installing the lining is carried out with the obligatory control of the level of processing in order to exclude the appearance of pain after treatment due to the proximity of the sensitive pulp. If the cavity is deep and there is inflammation, root canal treatment may be required.
One of the most common types of caries is the cervical or cervical. This is due to the fact that the enamel at the gingival margin has a small thickness, so its destruction occurs faster. During hygiene procedures, this area is not cleaned well enough, therefore plaque accumulates here, tartar is deposited. Treatment of cervical caries is complicated by the location of the affected area (often under the gum): blood and saliva can enter the treatment area. At the stage of the stain, it can be removed without the use of anesthesia, and if the enamel has already darkened or partially destroyed, the doctor performs anesthesia before starting treatment.
Treatment of root caries should be carried out as early as possible, since in this case destruction occurs faster and at the base, which significantly weakens the tooth. In this case, the likelihood of developing gum disease is higher, since the lesion is located at the very edge of the gum.
For shallow caries (tissue damage – no more than 1/3 of the dentin thickness), our clinic uses the unique Icon technology, which is popular among children and adults. How is caries treatment carried out using this technique? Before starting the procedure, the dentist thoroughly cleanses the teeth and removes deposits. Using a special nozzle, the doctor applies a gel to the affected area, the main active ingredient of which is hydrochloric acid. In 2 minutes, using the drug, it is possible to remove the surface layer and gain access to the porous zone of the initial lesion of the dental tissue.
After that, the gel is removed, the surface is dried, washed with ethanol. Now the doctor can visually assess the extent of the lesion. The final step is sealing the lesion.
The main advantages of the Icon method:
The best contribution to the fight against tooth decay is prevention. Nevertheless, modern technologies, equipment and materials allow successful restorations at all stages of the disease. Treatment of caries in front teeth or molars, during pregnancy or while wearing braces – for us, each case is individual and in each of them we use our own methods and technologies. We combine classical techniques with innovative ones, using new materials and equipment. All manipulations are performed under anesthesia, and if necessary, we use sedation, which will completely relieve you of discomfort during treatment.