Types and methods of eliminating carious complications: how to get rid of the infection and minimize damage. Why caries is dangerous: complications of the disease

Caries- a disease that is characterized by the formation of defects in the tissues of the tooth and its gradual destruction. It has an infectious (effect on the tooth of pathogenic microorganisms) or dystrophic (malnutrition and metabolism in the tissues of the tooth) origin.

Prevalence of caries

Caries is one of the most common diseases. Researchers say that every adult at least once in his life goes to the dentist about caries. In childhood, dental caries ranks first in prevalence among other chronic diseases.

Statistics (according to healthypeople.gov):

80% to 90% of children with milk teeth have cavities
80% - the prevalence of pathology among adolescents
98% of adults have dental fillings due to caries

The disease is least common in equatorial countries. Most often it is found in North America, the countries of northern Europe, Scandinavia. In developing countries, the incidence is generally higher than in developed ones.

A great influence on the prevalence of caries affects the quality of preventive work that is carried out by dentists among the population.

Anatomy of teeth

Teeth are the basis of the human chewing apparatus and are part of the digestive system. These are solid formations that differ in their structure from bone, and in origin are derivatives of the oral mucosa. Each tooth is fixed in its own bone hole - the alveolus - located in the upper or lower jaw.

Features of the structure of teeth in humans:

the chewing apparatus is arranged according to the diphyodont type, that is, the change of teeth occurs twice during life;
the structure and functions of the teeth are different - this is the so-called heterodont system;
compared with primates, human teeth are smaller and the chewing apparatus is weaker;
4 types of teeth are distinguished in humans, depending on the structure and purpose: incisors (for biting off food), canines (for tearing hard food, mainly meat), premolars and molars (small and large molars - for chewing food);
a person has 20 milk teeth, which then fall out and are replaced by 32 permanent ones;
the last molars (“wisdom teeth”) in a person are poorly developed, erupt at a late age (usually at 30 years old, when most people lose part of their molars).

Anatomical structure of the tooth

Anatomical parts of the tooth:

crown- part of the tooth that protrudes above the gum and is directly involved in providing functions
neck- place of transition of the crown to the root
root- part of the tooth that is in the hole, the tooth can have 1, 2 or 3 roots
tip of the tooth- final part of the root of the tooth

The structure of the tooth and general concepts of caries

Surfaces that the crown of the tooth has:

vestibular surface- facing forward, in incisors and canines in contact with the mucous membrane of the lips, and in molars and premolars - with the mucous membrane of the cheeks;
lingual surface- facing towards the oral cavity;
contact surface- facing the teeth located on the opposite side (surfaces by which the upper teeth meet the lower ones);
contact surfaces- these are the lateral surfaces of the crown of the tooth, which merge with adjacent teeth.

Histological structure of the tooth (the tissues that make up the tooth)

Enamel- tissue that covers the outside of the crown of the tooth. It is one of the most durable tissues in the human body, as it consists of 97% minerals. The thickness of the enamel in different places varies from 0.01 to 1.5 mm. It is maximum on the chewing surface of the crown.
Cement- a fabric that is similar in structure to enamel. It covers the tooth root. Cement and enamel are in contact at the neck of the tooth. They can butt-join, run into each other. Sometimes they do not reach each other, and then there is a gap between them.
Dentine- the main substance from which human teeth are formed. Dentin is 28% organic and 72% inorganic. In dentin, the outer and inner layers are distinguished. The fibers that make up its composition, passing in the tangential and radial direction, mutually intersect. This gives the tooth extra strength. Inside the dentin has a cavity, which inside the roots of the tooth passes into the root canals.
Pulp- a set of soft tissues located inside the dental cavity and root canals. Vessels and nerves of the tooth pass through the pulp. In the region of the apex of the tooth there is a hole through which the pulp passes into the tissues surrounding the tooth (periodontal tissues).
Periodontium- tissues that are located around the tooth in the dental alveolus. They fix the root of the tooth in the hole, absorb the load during chewing, provide nutrition and normal tooth growth.

Together, the teeth located on the upper or lower jaw form the dentition. Closing, the upper and lower dentitions form a bite.

Functions of the teeth:

chewing- grinding food, necessary for its subsequent processing with saliva and swallowing;
nibble hard and hard food;
capture and hold food;
articulation- the dentition takes part in the formation of normal speech.

Causes of caries

Among the causes of caries, two are the leading ones: the effect on the dental tissues of the breakdown products of carbohydrates and pathogenic microorganisms.

Carbohydrate fermentation products

Sugars that a person consumes with food are fermented by saliva in the oral cavity, resulting in the formation of propionic, butyric, and formic acid. They affect the enamel, and then the dentin of the tooth, as a result of which defects form in the latter.

The importance of different types of sugars in the development of dental caries:

sucrose it is more prone to fermentation, therefore, the largest amount of acids is formed from it, which greatly change the pH in the oral cavity and provoke the development of caries;
glucose and fructose ferment less intensively, but still pose a danger to the teeth;
xylitol, mannitol and sorbitol are converted into fructose by an enzyme with low activity, so these sugars do not contribute to the development of caries;
starch- a polymer that has a large molecular size; it does not penetrate into plaque and does not contribute to the development of caries (except when its structure is changed during food processing).

pathogens

A certain microflora is constantly present in the human oral cavity. Two types of microorganisms have cariogenic activity:

acid-producing streptococci, which cause anaerobic (under anoxic conditions) fermentation;
lactobacilli- microorganisms that convert lactose and other sugars into lactic acid.

These microorganisms form in the course of life acidic products that destroy dental tissue. The main substrate for their reproduction are carbohydrates, which are contained in food.

Factors contributing to the development of caries:

Anatomical features of the structure of the teeth. Between the teeth there are gaps in which plaque, formed by food debris, easily accumulates. It undergoes fermentation and serves as a breeding ground for the development of pathogenic bacteria.
Fluoride content in tooth enamel. Depends on the presence of fluoride in food. This mineral forms salts - apatites, which make dental tissues more resistant to acidic conditions.
Oral hygiene. Plaque builds up on the surface of the teeth. Therefore, daily morning and evening brushing of teeth is a mandatory measure for the prevention of caries. If this condition is not met, then the likelihood of developing the disease increases.
The nature of the food. The development of caries contributes to soft foods rich in carbohydrates.
Meal frequency. With frequent meals rich in carbohydrates, the risk of developing caries increases.
nutritional value. The low content of vitamins and minerals in food contributes to the weakening of tooth enamel.
The amount of saliva. A large amount of liquid saliva helps to remove pathogens from the surface of the tooth. If there is little saliva and it is viscous, favorable conditions are created for bacteria to attach to the outer layer of tooth enamel.
The composition of saliva. Buffer properties of saliva - its ability to neutralize acids and alkalis. Their weakening increases the likelihood of developing caries. Normally, saliva contains antibodies and other protective factors that destroy pathogens. A decrease in their content leads to a more intensive development of pathogenic microflora.
genetic predisposition. If parents often suffer from dental diseases, then their child also has an increased risk.
Body condition. Severe infections, starvation, injuries, decreased immunity, chronic foci of inflammation, frequent stress are factors that weaken the body and contribute to the development of a large number of diseases, including caries.
Condition of milk teeth. The opinion that caries of milk teeth does not need treatment, since they will fall out anyway, is erroneous. If milk teeth are affected by a carious process, then with a high degree of probability it will develop in permanent teeth.

Caries can form for a long time, up to 4 years. If the oral cavity is affected by many unfavorable factors, and it is in an unsatisfactory condition, then the process can develop within months.

Types of caries

Types of dental caries in accordance with the classification of the World Health Organization (WHO):

Type of caries	Description
Enamel caries	Damage to the tooth enamel in the form of a white or brown spot. The lesion extends only to the enamel and does not reach its border with the dentin.
Dentin caries	It affects the dentin of the tooth. Pathogenic microorganisms spread deep into the tooth through the dentinal tubules.
caries cement	The cement covering the root of the tooth is affected by the carious process, most often as a result of the exposure of the root of the tooth or the formation of a pathological pocket between the gum and the root. The inflammatory process often extends to the periodontium.
Suspended caries	With increased immune forces of the body and increased deposition of minerals in the tissues of the tooth, the carious process may stop and not spread in depth.
Odontoplasia	Congenital pathological change in the structure of dental tissues.
Other and unspecified types of caries.

Types of dental caries depending on the prevalence of the process

Uncomplicated caries

Types of uncomplicated caries:

Spot stage. It is a superficial damage to the enamel. At this stage, caries is the easiest to deal with. A chalky stain appears on the tooth enamel. At the same time, the destruction of the enamel is just beginning, so its surface remains even and smooth. The formation of a stain is associated with the loss of mineral salts by the enamel.
Superficial caries. There is a more pronounced destruction of the enamel. In the area of the spot, it becomes rough. The carious process still does not reach the border between enamel and dentin.
Medium caries. The carious process extends to enamel and dentin. A carious cavity is formed.
deep caries. The pathological process reaches the pulp.

Complicated caries

Possible complications of caries:

Pulpitis. It is an inflammation of the soft tissues of the tooth - the pulp. Most often, it develops as an acute process, which is accompanied by sharp pains that spread to adjacent teeth and jaws.
Periodontitis. Most often it is the result of further progression of pulpitis. It is characterized by inflammation of the tissues that surround the root of the tooth in the hole.

Classification of caries depending on the location of the pathological focus

Caries that develops in the area of natural cracks and depressions on the surface of the teeth.
Caries developing on the contact surfaces of molars and premolars.
Caries that is located on the contact surfaces of the canines and incisors, but does not extend to the cutting edges.
Caries affecting incisors and canines, extending to their sharp and cutting edges.
The carious process in the area of the necks of the teeth is characterized by rapid progression and is the most difficult to treat.

Classification of caries depending on the time of occurrence of the pathological process

Primary caries occurs on a healthy tooth.
Secondary caries develops under a filling on a tooth that has already been treated.

caries symptoms

Symptoms of caries at the stain stage

There are no symptoms. Pain does not disturb, the patient does not make any complaints. During examination of the teeth, the stain is not noticeable. Sometimes there is an increased sensitivity of the tooth to chemical irritants - sour, salty, etc. The stain may turn brown, and then it becomes noticeable.

Symptoms of superficial caries

Pain occurs when exposed to the affected tooth chemical irritants: sour, sweet, salty, etc. It is short-lived and quickly passes after the action of the irritant is eliminated.
Pain with mechanical impact(pressure, exposure to hard food) occurs only in cases where the carious cavity is located in the neck of the tooth.
Temperature effects ( cold and hot food ) do not cause pain.
carious cavity within the enamel, which is clearly visible during a dental examination.

Symptoms of medium caries

Pain. Occurs when the tooth is exposed to chemical and thermal irritants. The patient notices that the pains arise during the reception of cold and hot food, when he goes out of a warm room into the street in winter. Pain, as before, as with superficial caries, is short-term, relatively quickly passes.
Sometimes medium caries is accompanied complete absence of pain. This is due to the destruction of the border between enamel and dentin, which is the most sensitive area of the tooth.
carious cavity, which occurs with medium caries, is clearly visible during a dental examination.
Bad breath. It is relatively rare, with a carious lesion of a large number of teeth.

Symptoms of deep caries

Pain. Occurs from all kinds of irritants. Pain syndrome is provoked by the intake of sour, sweet, salty, cold and hot foods. Getting into the carious cavity, food particles lead to its irritation. Once the irritant is removed, the pain subsides.
The presence of a cavity. It looks like a dark spot and is clearly visible on the surface of the tooth enamel.
Bad breath observed with carious lesions of a large number of teeth.

Diagnosis of caries

Diagnosis of caries should be carried out at the earliest stages. The earlier a pathological process is detected, the easier and more effective its treatment will be.

Methods for diagnosing caries

Diagnostic method	Description
Visual inspection	The appointment of a patient with a dentist should always begin with an external examination. The doctor uses a special dental mirror and probe, with the help of which he evaluates the appearance and condition of the teeth and gums.
Radiography	Types of radiography in dentistry: x-ray of one tooth X-ray of two or more adjacent teeth Panoramic X-ray showing both dentition in full view An x-ray examination can reveal hidden forms of caries, when the defect is not visible from the outside, and a carious cavity is determined inside the tooth.
ranillumination	To conduct this study, the dentist uses a bright light. Photopolymerization lamps are usually used. During transillumination, carious cavities and cracks become clearly visible as dark spots on white enamel.
Laser diagnostics	It is used to identify the initial stages of caries, its hidden forms. The diagnostic apparatus emits a laser beam, which changes its properties when reflected from the carious cavity. The doctor learns about it with the help of a special sound signal. Laser diagnostics of caries is characterized by high accuracy and efficiency. Due to its high safety, it can be used in childhood.
Electroodontometry	The study of pain sensitivity of the tooth using a weak electric current. When exposed to current on healthy dental tissues, no discomfort occurs, and when exposed to a carious cavity, the patient notes pain.
Vital staining	After drying and isolating with swabs, a small amount of 2% methylene blue dye solution is applied to the tooth. After 3 minutes, the remains of the dye are washed off. At the same time, healthy enamel practically acquires its original color. Affected areas remain blue. Vital staining allows you to detect caries at the stain stage, when the lesion is not yet visible visually.
Drying	Caries at the initial stage is often invisible under a layer of saliva. Sometimes, to identify it, it is enough just to dry the tooth and isolate it with tampons.
Fluorescent stomatoscopy	In a darkened room, ultraviolet radiation is directed to the teeth. At the same time, healthy areas of enamel begin to glow in a bluish color. Dark defects are revealed in the area of carious cavities.

caries treatment

Treatment of caries at the stain stage

This form of caries is completely reversible with a remineralization procedure. Plaque is removed, after which remineralizing medicinal substances are applied to the damaged teeth.

Remineralizing drugs:

calcium gluconate solution (10%)
solution "Remodent" (1 - 3%)
sodium fluoride solution (2 - 4%)

Remineralizing solutions can be applied to the surface of the teeth using applications or electrophoresis.

Treatment of superficial, medium and deep caries

In order to treat superficial, medium and deep caries, damaged tissues are removed from carious cavities using a drill, and then filling is performed.

The sequence of treatment of superficial, medium and deep caries:

Local anesthesia(not a prerequisite). Anesthetics can be used in the form of aerosols, injections, general anesthesia.
Cleansing the entire tooth from plaque.
Cleaning the carious cavity with a drill. The dentist removes all the affected tissues from the carious cavity, grinds down the enamel edges hanging over the cavity, forms a cavity that would be convenient for filling and would help to securely hold the filling. The greatest accuracy is required for deep caries: when using a drill, the doctor can damage the wall of the carious cavity and penetrate into the pulp. Therefore, the bottom of the carious cavity is cleaned manually, using special dental "excavators".
Disinfection of the carious cavity - its treatment with an antiseptic solution. Usually use a 2% solution of chlorhexidine, special gels.
Laying a special gasket on the bottom of the carious cavity. It is carried out if the carious cavity has a great depth.
Treatment of the walls of the carious cavity with adhesives - substances that contribute to a more reliable connection of dental tissues with filling material.
Filling of carious cavity. There are three types of fillings: from metal composites, composite materials, and ceramics. Ceramics and composite materials match the color of the tooth enamel.
Grinding. After the filling has hardened, the doctor must grind it off so that it does not interfere with normal chewing and bite, and does not cause discomfort to the patient.
Removal of the dental pulp along with the nerve - depulpation. This manipulation has to be resorted to in rare cases with deep forms of caries.

Features of caries in children

Causes of caries in children at an early age:

congenital disorders of enamel and dental tissues: due to heredity or diseases that the mother of the child suffered during pregnancy;
maternal toxicity during pregnancy;
infections and other serious illnesses transferred by the child in the first days of life;
artificial feeding sweet mixtures;
inadequate intake of minerals and vitamins into the body of a pregnant woman, and then into the body of a newborn child.

A specific type of caries in children - bottle caries.

Causes of bottle caries:

feeding the child with sweet mixtures, especially at night;
dipping nipples in sweet syrups so that the child eats better;
licking the nipple before feeding by parents: germs that are in the oral cavity of an adult remain on it.

Usually for the first time caries is detected in a child at 3 years old. But there are cases when it is detected earlier.
Features of the treatment of caries in children:

The big role of the psychological factor. The doctor must establish a trusting relationship with the child, ensure that the baby does not have fear associated with visiting the dental office.
The total duration of treatment at the dentist in childhood should be no more than 30 minutes. Otherwise, small children get tired, start to act up.
All procedures should be done as painlessly as possible.. If the doctor does injection anesthesia, then the injection site must first be treated with an anesthetic in the form of an aerosol or application.
If the child is very restless, resists treatment and does not want to make contact, then in some situations general anesthesia may be used. It is applied strictly according to indications.
The general principles of treatment of milk teeth do not differ from the principles of treatment of permanent teeth. The carious cavity is cleaned with the help of a boron machine, followed by filling.

Perspectives in the treatment of caries

A group of researchers from INSERM (French National Institute of Health and Medical Research) conducted a study on mice, during which it was proved that a special substance - melanocyte-stimulating hormone - can stimulate the process of tooth regeneration. It is enough to introduce a small amount of the hormone into the carious cavity, after which the tooth is completely restored within a month. Now scientists are trying to find out whether it is possible to use this technology on humans.

Prevention of caries

The main measures to prevent caries are careful observance of the rules of oral hygiene and regular visits to the dentist.

Oral hygiene

Hygiene measures are carried out with the help of:

toothbrush
dental floss
toothpaste
mouthwash solutions
chewing gum
tongue scraper

How to choose the right items for oral hygiene?

How to choose the right toothbrush?

The number of tufts on the bristles. On a good toothbrush, the bristles should not just cover the head evenly, but be collected in separate bundles, the tops of which should have a rounded shape. The number of tufts on a toothbrush is chosen depending on age: for children - 23 tufts, for teenagers - 39 tufts, for adults - 47 - 55 tufts. Too large bristles will not allow you to clean hard-to-reach places in the oral cavity well.
Brush head dimensions. For children's toothbrushes, the head should measure from 18 to 25 cm. For adults, about 3 cm. The length of the head should be approximately equal to the width of three teeth.
The material from which the bristle is made. Artificial bristle brushes are preferred. All natural materials absorb water well, so they are a breeding ground for the propagation of pathogens.
Toothbrush handle. Should have rubber inserts that make the process of brushing your teeth more comfortable and prevent the handle from slipping in your hand.
Connecting the handle to the head. Must be flexible: this allows you to adjust the force of pressing the brush on the teeth.
Bristle stiffness. There are brushes with very hard, hard, soft and very soft bristles. Bristles with very high stiffness should be used by people who suffer from an increased tendency to form plaque and tartar. Brushes with medium bristles are suitable for almost everyone. Soft brushes are preferably used for periodontal disease. If the brush is too hard, it can damage the gums. Too soft brush is not able to provide effective cleaning of the teeth, it will leave plaque.
Electric toothbrushes effectively clean teeth from plaque, but they are recommended to be used no more than 1-2 times a week. For people with gum and periodontal disease, such brushes are most often contraindicated.

How to choose the right toothpaste?

Compound. The most effective protection against caries is provided by toothpastes, which include components: sodium fluoride, sodium monofluorophosphate, aminofluorides, xylitol, calcium glycerophosphate.
Protection within 24 hours. The composition of such toothpastes usually includes triclosan, an antiseptic that lingers in the oral cavity for a long time. With the constant use of such toothpastes for a long time, oral dysbacteriosis and fungal infections can develop.
Whitening toothpastes. If enzymes are included in the composition of such a paste, then the whitening effect will be mild. If there are abrasive substances and hydrogen peroxide in the composition, it is advisable to use such toothpaste only under the supervision of a dentist.
Taste. The taste of toothpaste is provided by special fragrances. Most often, they do not have any effect on the quality of brushing your teeth. Therefore, the feeling of freshness in the mouth has nothing to do with the effect of toothpaste.

How to choose a mouthwash solution for an increased risk of caries?
At a high risk of caries, mouthwashes containing fluoride are used. It has been proven that the regular use of such solutions significantly reduces the risk of developing the disease.

Does chewing gum help reduce the risk of cavities?

When chewing gum, a large amount of saliva is released. This contributes to a more effective cleaning of the teeth from plaque and leaching of pathogenic microorganisms from the oral cavity. It was previously thought that xylitol, found in chewing gums, also helps fight pathogens. Today it has been proven that this is not the case.

How to brush your teeth properly?

Brushing your teeth with a toothbrush and toothpaste should be done twice a day: in the morning and in the evening. Evening hygiene procedure should be carried out after the last meal.

The sequence of actions for proper brushing of teeth:

Wash your toothbrush before brushing. It is advisable to douse it with boiling water: this will destroy the pathogenic microorganisms that are on the bristles.
A small amount of toothpaste is applied to the bristles of the toothbrush - approximately 0.5 cm for children and 1 cm for adults.
They clean the front, chewing, back surface of all teeth (see figure). You can use dental floss to clean the gaps between your teeth.
After brushing the teeth in a circular motion of the toothbrush, the gums are massaged.
Microorganisms that can lead to the development of caries accumulate not only in plaque, but also on the surface of the tongue. To remove them, special scrapers are used.
After brushing your teeth, you need to wash your toothbrush again and put it in a cup with the bristles up. In order to prevent pathogenic microorganisms from settling on the bristles, it is advisable to store the brush in a special case.

You can check the quality of cleaning your teeth by running your tongue over them and evaluating their surface for roughness. For more thorough control, pharmacies sell special tablets that stain plaque - Dinal, etc.

Other caries prevention measures

Nutrition advice	Proper balanced nutrition. All the necessary nutrients, vitamins and minerals must be supplied to the body in the required amount. You need to bite off food only with the help of incisors. Chewing to carry out molars. Thorough chewing of any food. Be sure to eat hard foods. Chew it thoroughly. Eating should be finished with hard foods: they help to clean the teeth from the remnants of soft food. Eat less sugar in sweets. Use xylitol and sorbitol instead of sugar. Don't end your meal with foods containing sugar. Do not eat foods containing sugar at night. Do not snack on sweets between main meals. Chew some gum immediately after eating.
Prevention of caries in the fetus in the prenatal period	Complete nutrition of a pregnant woman, eating enough protein. Eating a large amount of fermented milk products, which contain substances necessary for the normal formation of the teeth of the fetus. Timely effective treatment of any diseases that develop during pregnancy.
Local effects on the teeth and oral cavity	Fluoridation of teeth with tablets, gels, applications, toothpastes. Blockage of tooth pits and crevices with sealants. Application of helium-neon lasers. Under the action of laser radiation, the strength of tooth enamel increases, its resistance to harmful influences, pathogenic microorganisms are destroyed, and immune mechanisms are activated. It has been proven that 10 procedures of helium-neon laser irradiation carried out during the year can slow down caries. Mineralizing solutions. Local applications of solutions containing minerals necessary for teeth, mainly calcium and phosphorus, are used.
General effect on the body	Timely treatment of acute and chronic infectious diseases. The greatest danger in terms of the occurrence of caries is inflammatory processes in the oral cavity, tonsils. Immunity boost. The use of vitamin and mineral complexes.

How often should you visit the dentist?

Frequency of visits to the dentist:

1 time per year, if a person is absolutely healthy and has no problems with the oral cavity, if there are no factors in his life that predispose to the development of caries (see above);
1 time in 6 months, if there are predisposing factors.

During a scheduled visit, the doctor examines the teeth, if necessary, prescribes an additional examination (X-ray), gives recommendations on caring for the oral cavity. If necessary, at the request of the patient, professional teeth cleaning, sealing of pits and cracks on their surface, treatment with fluorine solutions are performed.

It is advisable to visit the same doctor every time. Depending on the presence of certain risk factors, the dentist can set an individual schedule of visits for the patient.

It is desirable to bring the child to the dentist for the first time immediately after the eruption of the first teeth. This will help to more effectively prevent carious lesions of the teeth, to accustom the child to visit the dental office earlier. In the future, he will calmly respond to medical examinations.

Unfortunately, many people consider caries a benign disease of the teeth and seek help from a dentist only when there is pain in their teeth. However, the appearance of pain in the area of the tooth suggests that the development of caries goes on as usual, moving from a simple form to more and more severe conditions. According to the depth of the carious process, caries in the stain stage, superficial, medium, acute and chronic deep caries are distinguished - all this refers to uncomplicated forms. But complications arise already when the lesion extends deep into the tooth to the pulp (dental nerve) and the bone tissue around it. At this stage, diseases such as acute, retrograde and chronic pulpitis and acute periodontitis arise and progress - the main complications of caries.

Damage to the pulp or periodontium, as a rule, is the result of an untimely visit to the dentist or poor-quality filling or prosthetics, the so-called caries under the filling. It can take from 12 to 18 months from the formation of caries in the stain stage to the defeat of the pulp, it all depends on the form of leakage, that is, it can be acute caries or chronic caries. In any case, when demineralization has passed through the enamel and dentin, an infection enters the crown cavity and root canal, causing severe inflammatory and painful processes.

What is the danger of caries in a neglected state?

So why is neglected caries so dangerous? Firstly, dental treatment in most cases will include surgical intervention, and any operation is always a risk: the risk of poor-quality treatment, the risk of edema and other undesirable consequences. Secondly, serious exacerbations of caries will certainly affect general well-being due to constant pain, which will be concentrated not only in the area of the tooth, but also in the entire jaw, in the temples, ears and eyes, swelling of the gums and a sharp increase in temperature are also possible.

If you do not treat caries and endure pain, then the nerve of the tooth dies off on its own and starts the process of decay in the carious cavity. Infection begins to penetrate into deeper tissues, causing irreparable damage. The body begins to fight inflammation on its own, forming a granuloma around the root of the tooth, which can later increase in size and transform into a cyst. As you can see, the consequences of caries can be different, but one thing is clear - they are all serious and can have a significant impact on human health.

What to do if complications have already overtaken?

First of all, seek help from a dentist and do not put off a visit to him for a day, even if you have already started caries and are set to extract a tooth! Any tooth damaged by the carious process is a source of infection, which can go to any area in the oral cavity, trachea or esophagus and cause a number of other diseases. In addition, the sooner you see a doctor, the more likely it is that the tooth can be saved.

If the clinic has modern materials and equipment important in the treatment of periodontitis and the treatment of pulpitis, you can count on a quality procedure. In particular, diseases such as advanced periodontitis and periostitis can also be cured, but already by surgery. In general, traditional treatment consists of removing the nerve, thoroughly cleaning the canals and filling. However, after such manipulations, the tooth becomes more fragile. And do not forget that with the transition to a more complicated stage of caries, the price of its treatment also increases.

Prevention of caries complications

At least once faced with a similar problem, most likely, you will no longer want to exhaust your body with a toothache and lay out decent amounts for complex treatment. Therefore, do not neglect preventive measures: visit the dentist once every six months and carry out hygienic cleaning. If, nevertheless, a hole has formed in the tooth and it is sick, you should choose a doctor with extreme caution. Remember that the result of poor-quality treatment will be a more serious complication of caries, which may require surgery, and worse, tooth extraction. In addition, complicated caries requires more expensive treatment than its initial formations.

Agree, you did not think that such a harmless caries can cause serious consequences, up to tooth extraction. Now think about what is cheaper, faster and more painless - going to the dentist for an appointment twice a year or delaying this moment for several years, then heading straight to the office of a dental surgeon? Of course, it is up to you to decide, but life is given to enjoy joyful moments, and not endure a toothache. And dentists are ready to help us with this!

Complication of caries (pulpitis, periodontitis) is a serious problem. It is important to prevent caries. If it was not possible to prevent the disease, it should immediately begin to fight. It is very important to treat caries in a timely manner. Otherwise, the disease will go into the advanced stage, which is much more difficult to treat.

Ignoring preventive examinations by the patient at the dentist often leads to the fact that it is not possible to stop the development of caries in the early stages. Carious lesions progress, bacteria penetrate the soft tissues of the tooth and provoke complications. The most common complications of caries include three diseases: pulpitis, periodontitis and granuloma.

What is dangerous running caries? Consequences and complications

To begin with, we note that the treatment of complicated caries in an advanced stage will most likely include certain surgical intervention. If neglected caries is not treated, but simply drowned out with painkillers (not a rare case), the nerve of the tooth will begin to die off very soon, and the process of decay will start in the carious cavity.

At the same time, the body begins to fight the complications of caries on its own, forming a granuloma around the root, which almost always increases in size over time and becomes a cyst. Experts also note such a type of disease as deep caries, the complications of which will be even more serious.

Prevention of complications

The most effective and reliable method of preventing possible complications of the disease, of course, is considered to be an obstacle to its occurrence. To do this, follow the following banal rules:
- Helps to avoid the appearance of insidious and terrible caries. From childhood, a person should get used to brushing his teeth twice a day. You also need to change your toothbrush to a new one in time and carefully select toothpaste for yourself, taking into account individual needs and characteristics of the oral cavity.
- The procedure requires the mandatory intervention of a dentist.
- That is, you can not leave voids in the mouth. In the very first place, this will inevitably spoil the bite. Also, even more load will be placed on each tooth, due to which inflammatory processes can begin to develop, leading to dental caries, the consequences of which can be the most unpredictable;
- Timely periodic visits to a specialist for an examination of the oral cavity will make it possible either to avoid the appearance of caries altogether, or to cure it at the stage of its first manifestations, which will help not to face serious complications.

What is pulpitis?

Pulpitis is an inflammation of the pulp resulting from the penetration of microbes into the tooth cavity from a carious defect. Its course can be acute, very painful, forcing the patient to immediately consult a doctor. The resulting pains are often pulsating, radiating to the entire half of the jaw, often to the ear and other parts of the head. The chronic course of pulpitis is less painful, mainly causative pains, i.e. arising from a specific factor, such as cold, sour or sweet drinks. If the resulting pain is prolonged and does not go away within 3-5 minutes, pulpitis should be assumed.

What is periodontitis?

Periodontitis is an inflammation of the periodontal tissues surrounding the tooth root. It can also be acute, with severe pain, including aggravated by biting on a bad tooth. If you do not seek medical help, then swelling of the gums and even an abscess near the causative tooth may occur. This process causes changes throughout the body: temperature rises, leukocytosis, ESR. This is especially true for purulent acute periodontitis, which requires urgent intervention: opening the tooth and cutting the gums. Acute non-purulent (serous) periodontitis proceeds more calmly. Drug-induced or toxic periodontitis may occur as a result of the use of drugs in the treatment of caries or pulpitis. There are traumatic periodontitis that occurs as a result of trauma or significant overload of the tooth with poor-quality prosthetics or fillings that overestimate the bite, i.e. interfering with the normal closing of the teeth. Acute periodontitis must be treated: open the tooth cavity, remove the remnants of the pulp, drain the fluid or pus that has accumulated in the periodontal area, and, if necessary, make an incision in the gums. If the general condition worsens, in order to avoid complications, the tooth should be removed. If the acute process can be stopped (stopped) and converted into a chronic one, then further dental treatment depends on the technical ability to expand the tooth canal well and seal it using modern technologies.

What is a granuloma?

Granuloma is a manifestation of chronic periodontitis, i.e. untreated acute sludge that arose gradually, as a result of the further spread of infection. Granuloma is characterized by certain formations in the root apex, diagnosed radiographically. Chronic periodontitis is often manifested by exacerbations due to hypothermia, blockage of the carious cavity of the tooth, deterioration in the general state of human health. You should know that chronic periodontitis is a foci of infection in the body that has a very adverse effect on human health, often provoking exacerbation or the appearance of cardiovascular, neurological diseases, deterioration of the functions of the excretory system, and especially the kidneys. That is why teeth with chronic periodontitis, or granuloma, must be treated (Root Canal Treatment), and if this is not possible, then removed or resected, i.e. promptly remove the apex of the root (Outpatient surgical care). Such teeth can be treated by filling with special pastes and pins, but subject to a good complete passage of the tooth canal.

Is it possible to get rid of a granuloma or cyst without surgery?

Indeed, at present there are special pastes that are injected into the root canal for a certain time, during which they control the radiographic changes occurring in the area of the granuloma or cyst, and with positive results, the temporary filling material in the tooth canal is replaced with a permanent one. Monitoring of dental treatment is also carried out on the basis of patient complaints (pain, swelling in the root of the treated tooth) and oral examinations. However, it is far from always possible to obtain good treatment results, especially in the presence of a cyst in the root apex. In this case, if conditions permit, resection of the root apex is performed.

The consequences of neglecting caries

If, nevertheless, it was not possible to prevent the disease, it is very important to cure it as soon as possible. Timely treatment will help the patient save the tooth and even avoid a large number of related problems associated with the complications of caries. Moreover, if treatment of complicated caries is required, the process will be longer and, quite possibly, less effective.

Failure to treat caries leads to a permanent focus of infection in the oral cavity, which can lead to much more serious problems:
- The development of various cardiovascular diseases;
- Inflammatory processes in the joints;
- Allergic reactions in a chronic form.
Often, patients are interested in the question of whether it is possible to die from caries. Dentists do not give any unambiguous answer to it.

Naturally, it is almost impossible to die simply from a diseased tooth, but taking into account possible serious complications that cause other diseases, a lethal outcome cannot be ruled out.

Among other things, according to experts from the Israeli University, caries leads to impotence in men. Of course, we are talking about advanced forms of the disease, as a result of which inflammatory processes spread throughout the body. This is evidenced by a large number of studies.

Recently, in dental clinics, dentists often recommend their patients to perform a special procedure to protect tooth enamel - fluoridation. Such a procedure is not cheap, and most people do not even know why it is needed.

fluoridation - what is it?

Fluoridation is a process characterized by saturation of the tooth surface with calcium fluoride. Every day, teeth experience various negative effects that affect their strength:

Constant thermal drops, especially in the cold season;

The effect of excess acid in an unbalanced diet;

A variety of inflammatory processes in the dentition, leading to the development of harmful microflora.

The natural source of fluorine is plain water. There are states that, in order to enrich the organisms of citizens with fluorine, do not chlorinate the water, but fluoride it. In the Russian Federation, such manipulations are not done, which is why about 75 percent of citizens suffer from a lack of this trace element. Citizens who are aware of this prefer toothpastes containing fluoride. To fully saturate the enamel of the teeth and prevent caries, dentists advise to carry out the fluoridation procedure.

There are two types of fluoridation:

Simple, which involves the production of special casts, the consequences and complications of dental caries, corresponding to the shape of the teeth, and their saturation with fluoride preparations. This cast is put on for fifteen minutes, during which time fluorine forms a kind of protective film. The effect of the procedure is expected to last approximately six months.

Deep. It is distinguished by a much more effective effect of the fluoride compound. This provides enhanced protection and lasts approximately 12 months. However, this procedure should be performed only on the recommendation of a dentist. An excessive amount of fluorine has a detrimental effect on possible complications of dental caries and other body systems.

Before starting fluoridation, the doctor must clean the teeth from plaque. Only then is the fluoridation of the tooth enamel performed directly. Basically, when the dentist did not advise otherwise, it is permissible to eat food immediately after the procedure is completed. The procedure itself does not cause pain, but there are some contraindications. It should not be carried out by people who have personal intolerance to fluoride compounds.

Deep fluoridation is performed only according to the indications of the dentist and gives a lasting positive effect. It can be done no more than once a year. With strict adherence to the recommendations of the dentist, you will have an impeccable smile that will surprise others with health and beauty.

2) If it is periodontitis

Everything is the same, but in addition to this, multiple temporary filling of the root canals to localize the apical inflammation under the root. In some cases, surgical manipulations are required to resect the root apex with a cyst or granuloma. Most often, it requires more time and significantly more money than the treatment of pulpitis.

3) If it is a large tooth root cyst

After repeated unsuccessful therapeutic and surgical treatment of a dental cyst, it is necessary to carry out a dental extraction.

4) If it is periostitis

With suppuration and exacerbation of periodontitis, periostitis occurs, in other words, inflammation of the periosteum or, in common parlance, a flux that must be opened and cleaned of the jaw periosteum, and then treated by the surgeon on an outpatient basis for about two weeks.

5) If it is a phlegmon

With the development of periostitis, a phlegmon or abscess of the maxillofacial region may appear, if left untreated, life-threatening conditions develop, such as mediastinitis. These diseases are treated in the maxillofacial departments and hospitals of clinical hospitals for 1-2 months.

What to do with the complications of caries?

From the previous section, we already know that postponing the treatment of carious lesions can lead to a surgical hospital, and in some cases to better worlds.

Therefore, if you already have such complications of caries as pulpitis, periodontitis, and especially periostitis, you must urgently contact a dentist. Otherwise, at best, you will have to do a tooth extraction, the worst options are mentioned above. Among other things, the presence of oral chronic infection in the form of cysts and root granulomas, multiple dental carious foci causes such formidable diseases as bacterial endocarditis, and also contributes to systemic vasculitis of various localization. Moreover, the development of these complications in dynamics is growing rapidly, like a snowball, especially in adulthood, after 55-60 years.

Pulpitis, periodontitis, granuloma and cyst - the consequences of caries or a "horror story" from dentists?
Even the hardest tissue of the body is exposed to a large number of bacteria found in the oral cavity.

A common disease, the causes of its formation lie in simple bacteria, and the consequences are not limited to tooth loss. Also, caries can cause the formation of cysts that are dangerous to human health. Infections that enter the human body can go to the gastrointestinal tract and other organs of the human body.

Caries does not immediately lead to the death of the tooth, it has several stages of destruction. To prevent early, without health complications, mild stages of caries, it is important to make a visit to the dental clinic 2-3 times to qualified specialists.

For regular visits to the dentist, caries is not the only reason for this, there are other equally important ones: increased sensitivity of the teeth, their general condition, bleeding and inflammation of the gums. It is necessary to control the internal condition of the teeth, their structure and roots, it is very desirable to take pictures 1-2 times a year.

Consider several stages in the development of caries and its consequences that are dangerous for the body:

The initial stage of caries is a carious spot, which can be either white (different from the color of the teeth) or darkish. Such spots are often mistaken for plaque. These formations are easily removed by enamel remineralization. It reduces the risk of developing caries and reduces tooth sensitivity, so the procedure should be carried out for prevention too.

The next stage is called superficial, passing into the middle, in the process of tooth destruction, not only its surface is damaged, but also the inner layer - dentin. The stage of development of caries is determined by the depth of lesions, as a result of which damage and destruction of teeth, unpleasant pain occurs. During the treatment, the affected tooth tissue is removed, then the tooth is sealed.

High probability of development or acute if caries passes under the dentin. In other words, the infection gets to the root canal, in the treatment of which an orthopedist may already be needed, because. if the damage is large, you will need a tab.

What is fraught with neglected caries:

the spread of pain throughout the jaw and its echoes on other organs (eyes, ears, throat, pain in the temples);
inflammation in the mouth (bleeding / inflammation of the gums);
the occurrence of the process of decay, penetrating lower and lower into the gum;
the formation of a granuloma (purulent sac), turning into a cyst, which leads to the extraction of a tooth;
infection (from the root of the tooth) through saliva into the gastrointestinal tract;
infection of the cardiovascular system, joints;
increased allergic reactions.

Launched caries carries with it a lot of diseases and lesions in the oral cavity, it can develop into pulpitis and acute periodontitis, can lead to the formation of both granulomas and cysts, which means tooth extraction is inevitable.