Multiple caries in children: causes, treatment

What types of caries are there?

There are several stages of the disease. They have a certain appearance and symptoms.

How to determine the stage of caries:

1. In the spot stage: a white spot is observed on the surface of the enamel (focus of demineralization). The spot gradually turns brown. Enamel is the densest tissue in the human body, but due to various cariogenic factors it is gradually destroyed. Detecting the white spot is quite difficult.
2. Medium caries: characterized by damage to the enamel-dentin junction in the form of a cavity, short-term sensitivity.
3. Deep: extensive lesion affecting the deep layers of dentin. Pain appears from different types of irritants: mechanical, temperature, chemical.

Diagnosis of the disease is carried out using a visual examination and an x-ray. The image will show violations of the integrity of the enamel and dentin with uneven contours.

Symptoms and diagnosis of generalized caries

Generalized, multiple or blooming caries often develops with intense demineralization of teeth against the background of infectious and chronic diseases, with decreased immunity.
Often, teenagers who experience hormonal changes become victims of generalized caries. Multiple caries is characterized by the fact that not one, but many (from 6 to 20) teeth, and there is carious lesions on different surfaces of the teeth and at different stages of the disease - from initial to periodontitis, there may be several carious lesions on one tooth. Generalized caries is accompanied by a decrease in saliva viscosity, painful sensations when eating cold, hot, sour or sweet foods, and bad breath. The disease usually occurs in an acute form and requires immediate intervention by a dentist. Without proper treatment, the patient is at risk of losing all of his teeth. The development of blooming caries is facilitated by a deficiency of minerals in water and food, infectious diseases, severe stress, and unfavorable ecology.

What does caries look like on teeth?

Not all patients know how to identify dental caries. To do this, you need to come to the dentist for an examination.

Black cavities of varying sizes are found on the chewing units. The pathological process develops in the natural depressions of the enamel: fissures, pits.

This disease leads to the destruction of hard tissues and cosmetic defects. There are black cavities on the front teeth, noticeable when talking or smiling:

Cost of caries treatment

Other

How does caries form?

The causes of caries are poor hygiene and the presence of bacteria in the oral cavity.

There are many bacteria in the human oral cavity. These bacteria feed on food debris that remains on the surface of the enamel after eating. Bacteria “love” foods high in carbohydrates: sweets, flour. During their life, bacteria produce acid, which destroys teeth.

Caries occurs in both adults and children. This disease spreads in each person at a different rate.

Factors contributing to the rapid development of caries:

• insufficient or lack of oral hygiene;
• excess carbohydrate foods: flour products, sweets, carbonated drinks;
• low buffering capacity of saliva, when acids and alkalis are not sufficiently neutralized in the oral cavity;
• insufficient fluorine and calcium content in enamel;
• lack of vitamins and minerals in the body;
• severe somatic pathologies suffered in childhood (tuberculosis, rickets);
• reduced immunity.

Answering a frequent question from patients: “Why do caries form on teeth?”, we note that the most important factor is insufficient hygiene. All dentists strongly recommend brushing your teeth regularly and using floss to clean the gaps. Without careful hygiene, bacteria will destroy teeth one by one, leading to serious complications.

Causes

Caries is the result of the activity of pathogenic microflora in accumulated plaque or tartar. A person’s immune status plays a major role in the development of carious defects. At particular risk are persons with autoimmune pathologies, AIDS, HIV, metabolic disorders, diabetes mellitus, and those taking immunosuppressive therapy for organ or tissue transplantation for a long time. The following factors can contribute to the development of caries:

• smoking, alcoholism;
• inadequate oral hygiene;
• natural aging (decrease in the body’s defenses, changes in the biochemical properties of saliva);
• metabolic disorders;
• endocrine pathologies;
• lack of food discipline (including prolonged fasting, poor nutrition, anorexia, bulimia);
• gum recession of various nature;
• excessive consumption of sugar and carbonated drinks;
• gastroesophageal reflux;
• bite pathologies;
• violation of hygiene rules when wearing braces and other orthodontic structures for the treatment of pathological occlusion.

Despite the variety of causes, eating disorders, bad habits and organ pathologies are the main etiological triad leading to the development of caries. Caries is not an independent disease. The pathogenetic link in the demineralization of enamel and destruction of the tooth body is a violation of the body's defenses.

What happens if caries is not treated?

1. For a long time, the disease may not bother the patient in any way. When the destruction of hard tissue has reached a significant extent, sensitivity appears during eating.
2. If you do not consult a doctor at the first stage, the carious process will go further and reach the pulp (nerve). Spontaneous severe pain appears. Treatment of pulpitis will be required.
3. If the patient does not seek help at this stage, the infection spreads beyond the root. Periodontitis occurs. The prognosis here is unfavorable, since such a tooth often needs to be removed to eliminate the infection.

Therefore, timely visit to the dental clinic will help to avoid acute pain and complications.

How dangerous is caries in its advanced state?

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

If caries is not treated and the pain is tolerated, the nerve of the tooth dies on its own and starts the process of decay in the carious cavity. The infection begins to penetrate deeper tissues, causing irreparable damage. The body begins to fight inflammation on its own, forming a granuloma around the tooth root, 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 caries appears on teeth

First of all, you need to immediately contact your dentist. When a tooth is destroyed due to caries, treatment cannot be delayed. Otherwise, the complications described above arise. It is worth noting that no available means at home will relieve the patient of this problem. Only a dentist can cure this disease.

You should also pay attention to your oral hygiene:

1. Brush your teeth at least twice a day.
2. Use floss and mouth rinses.
3. Visit your dentist for a checkup every six months.
4. Come for professional hygiene every 6 months.

Dentists will help you select individual hygiene products (brushes, pastes, threads, rinses) at your appointment. The doctor will also determine why dental caries appears in your particular case and give the necessary recommendations.

Pulpitis

Pulpitis is an inflammatory lesion of the neurovascular bundle of the tooth. The disease develops if the caries treatment process is not started in time. In this case, the carious defect, together with pathogenic microflora, spreads to the dentin, and then through the dentinal tubules to the pulp.

There are two known forms of pulpitis:

1. Spicy.
2. Chronic.

Acute pulpitis is characterized by pain in the tooth that is not associated with the action of irritants. The pain may radiate to the ear or other dental units. Therefore, it is sometimes difficult to establish the causative tooth.

Symptoms of chronic pulpitis are pain from cold, sweet and sour irritants. The pain is short-term - lasts no more than five minutes after the stimulus has stopped.

Dr. Granov’s dental clinic, like the World Dental Society, offers the following treatment regimen for pulpitis:

• For traumatic pulpitis, which forms during the therapeutic treatment of dental caries, a biological treatment method is used. Its essence is that the pulp is completely preserved. A small amount of calcium-containing filling material is placed on the exposed pulp horn; it plays the role of a therapeutic pad and serves to form replacement dentin. An insulating pad and a permanent chemical-curing filling are placed on top of the treatment pad.
• If the causative tooth has all the signs of inflammation of the neurovascular bundle, then delayed endodontic treatment is used. To do this, first, a medicinal anti-inflammatory paste, an insulating gasket and temporary filling material are applied to the mouth of the canal. After a week, if the inflammatory phenomena stop, complete endodontic treatment of the tooth is performed.

How is caries treated?

The treatment is carried out in professional dentistry by a general practitioner and is absolutely painless. This treatment is carried out in one visit, and several teeth can be treated in one visit.

Sequence of treatment stages:

• Examination of the oral cavity. Carrying out diagnostics: a targeted diagnostic image of one tooth or computed tomography of the jaws (if multiple caries is detected during the examination). This is done in order to make an accurate diagnosis and see the volume of destroyed tissue.

• Local anesthesia: selected individually according to health conditions. Only after the desired area of ​​the oral cavity has become numb does the doctor proceed to the next manipulations.

• Placement of isolation: the doctor places a rubber dam on the desired area - this is a latex plate that isolates the tooth from the rest of the oral cavity. The rubber dam creates comfortable conditions for the doctor, the patient, and also allows you to create dry, sterile conditions for placing a filling. This is necessary for the filling to serve for a long time and with high quality.

• Preparation of enamel, dentin: necrectomy. The doctor uses a drill to drill out the destroyed tissue.

• Treating the cavity with antiseptic solutions, applying an adhesive - a special solution that, like glue, reliably bonds hard tissue to the filling.

• Filling with light-curing materials. The anatomical shape of the tooth is restored, and the color is carefully selected.

• Polishing and grinding so that the filling does not feel different from your own teeth. Also, using special guidelines, the doctor checks whether the filling is too high or does not interfere with the normal closure of the jaws. Excess is removed, sharp edges are sanded.

• The doctor gives recommendations after treatment. If a tooth has been severely damaged by caries, then in addition to a filling, an orthopedic onlay or crown may be required. This is due to the fact that the filling is not as strong as enamel. Over time, cracks and chips are possible. Orthopedic structures will help protect the treated tooth from these complications.

After these stages, the tooth is completely free of caries. Next, you will need to maintain regular hygiene, come for preventive examinations and professional cleaning.

Classification of disease severity according to ICDAS

To register the status, this system also suggests using 6 codes:

1. Initial focal changes in the color of the enamel surface of the tooth, which are visible only after drying.
2. Clear, clearly visible changes in the enamel in the form of whitish and dark spots.
3. Localized enamel lesions, which manifest themselves in limited areas of destruction.
4. Destruction of enamel in a certain place along the entire thickness of its layer, down to dentin.
5. The presence of a clearly visible carious cavity in the dentin.
6. Severe destruction of dentin, which extends to at least half the volume of the crown.