The treatment tactics for caries depend on the cause of the pathological process and its neglect. This is the most common dental disease, characterized by gradual tooth decay. The pathology goes through several successive stages; at first, the patient may not feel anything; in complex cases, complete loss of dental units is possible.
It is not difficult to detect the disease, because most of the symptoms are quite obvious. However, it is better to prevent the occurrence of carious lesions by following preventive recommendations, and then a snow-white smile will delight you for many years.
Caries - what is it?
More than 95% of the inhabitants of our planet face the disease. Thus, it can be called the most common dental problem. At the very beginning, the pathological process affects only the enamel, and in the absence of therapy it penetrates into the deep hard layers. Then the soft tissues with nerve fibers and blood vessels become inflamed.
The disease is insidious because in the earliest stages it does not manifest itself in any way, and the patient begins to sound the alarm only when acute pain and a large hole appear that cannot be eliminated by conservative methods.
How is caries treated without drilling?
Many adults are even more afraid of dentists than children, and prefer to treat dental caries using non-invasive methods, without the use of dental burs. Conservative treatment without drilling teeth can be carried out using several methods.
The first option is remineralization. When caries just begins to affect the tooth enamel, a small white spot forms on it. This is the focus of demineralization - the zone in which the loss of mineral components of the enamel began. If you notice a change in enamel color in time and contact your dentist, your doctor may prescribe remineralization therapy to restore mineral balance. The dentist treats the patient’s teeth with special fluoride and calcium-containing preparations, makes medicinal applications, or prescribes home use of medications with a similar effect. Deep fluoridation is considered the most effective method of remineralization therapy.
Causes of caries development
Oral disease develops under the influence of pathogenic microorganisms that multiply in a favorable environment. Dentists are of the opinion that the disease occurs due to changes in the acid-base balance on tooth surfaces. Fermentation of carbohydrates caused by pathogenic bacteria releases destructive amounts of organic acids.
The main factors that contribute to the formation of carious cavities:
- improper hygiene care;
- eating problems;
- systemic chronic or acute diseases of the gastrointestinal tract;
- reduced concentration of vitamins and minerals in the body;
- hereditary predisposition, etc.
Bacterial plaque and tartar
Streptococci are microorganisms that live in organic acids, leading to the destruction of enamel and dentin. During brushing, soft structures are easily removed, but hardened structures cannot be removed. They also contain pathogens that cause destructive phenomena.
Poor nutrition
Every person knows from an early age that you can’t eat a lot of sweets. However, adults often ignore this rule and consume large amounts of carbohydrates, sugar, baked goods, and starchy foods. The enamel layer becomes thinner and more susceptible to external factors. Bacteria multiply better in a carbohydrate environment.
Decreased salivation
During the day, a person secretes about 2 liters of saliva. The secretion washes away food debris from dental surfaces and protects them from the negative effects of pathogenic microflora. If the salivary glands do not function well enough, a lot of food particles settle on the crowns, which the microbes feed on.
Violation of the mineral composition of enamel
This factor is directly related to diet. Demineralization is observed with a meager, monotonous menu, lack of calcium, phosphorus and fluorine. Seeds, cottage cheese, cheese, red beans, and buckwheat are rich in such microelements.
Genetic predisposition also influences mineralization. This means that the disease can be inherited from parents and other relatives.
The problem occurs in pregnant women at different gestational stages. The fetus takes all the useful minerals, and the expectant mother experiences a lack of them. Subsequent intervention is complicated by the inability to use anesthesia.
Is it necessary to treat caries on baby teeth?
This question plagues many parents, but it is important to listen to experts. It is imperative to treat baby teeth at the first signs of pathology. The condition of baby teeth affects the formation of the jaw and the growth of permanent teeth. If baby teeth fall out prematurely, the molars will grow crooked.
Damaged teeth in the oral cavity will lead to the appearance of chronic infectious diseases, as well as serious allergies. This can be avoided if you monitor the condition of your child's teeth.
Diagnosis of cervical caries
Often the first question that patients ask is “How much does it cost to treat cervical caries?”... There is no definite answer to this, since each case is individual and requires the same individual approach to treatment. Before developing its tactics, CELT dentists carry out diagnostics, which make it possible to determine the stage of the disease, the extent of the pathological process and the amount of tissue destroyed by it. Based on the results obtained, they determine treatment methods, the need for intervention by an endodontist (if the pulp is affected) and an orthodontist (if a crown is needed). Depending on this, the exact price for treatment of cervical caries is calculated.
- Finding out from the patient information about pain symptoms, its nature and the circumstances under which it appears;
- Carrying out temperature tests, which make it possible to differentiate caries from other dental diseases;
- X-ray of the affected unit, from which one can determine the size and depth of the lesion, the presence/absence of a boundary between cement and dentinal tissue;
- Electroodontometry, thanks to which it is possible to determine the condition of the pulp and its reaction to exposure to a current of a certain strength.
Cervical caries must be differentiated from:
- Local destruction of the vestibular surface of hard dental tissues of canines, incisors and molars in the shape of a wedge (“wedge-shaped defect”);
- Non-carious lesions of the vestibular surface of fangs, incisors and molars, which is characterized by defects of dentin and enamel (“erosion”);
- Damage to tooth enamel that occurs due to constant, prolonged exposure to excess fluoride in the body (“fluorosis”).
Tooth root caries
This type of caries is rarely diagnosed at the initial stage. A person cannot see the darkening or a small cavity on his own, since the roots of the tooth are hidden in the gum. The patient turns to the doctor when the tooth begins to hurt, and this is already medium or deep caries.
A tooth with root caries cannot always be saved. The dentist decides whether to treat or remove the tooth after diagnosis. If a significant part of the tissue is destroyed, but there is a chance to save the tooth, the doctor recommends surgical treatment. If the carious process has affected most of the tissue, in most cases the tooth has to be removed and then prosthetic treatment or an implant installed.
How does caries develop and what are the consequences?
Conventionally, there are 3 stages of caries:
1
2
3
- Superficial caries (or spot caries)
- Average caries, when tooth decay is only at the enamel level
- Deep caries, when a cavity forms in dentin
If caries has reached the pulp (the soft tissue of the tooth with blood vessels and nerves), then doctors call it pulpitis. Typically, pulpitis is accompanied by severe and persistent pain, which even prevents sleep.
If pulpitis is not cured, a complication will appear, inflammation of the jaw bone tissue or, in medical terms, periodontitis.
- Caries
- Pulpitis
- Periodontitis
Caries is a source of infection in the oral cavity. It not only imperceptibly deteriorates teeth, but also undermines a person’s overall health.
At the initial stage, caries can be easily, completely and inexpensively cured. By postponing a trip to the dentist, a person does not save, but on the contrary, significantly (manifold!) increases the cost of his treatment.
If at the initial stage treatment would cost up to 2,500 rubles, then treatment of pulpitis of one tooth may require about 15,000 rubles. Most often, the costs are more modest, but if you delay going to consultation and treatment, the situation will only get worse.
Caries leads to tooth loss. Even the absence of one tooth brings a lot of inconvenience (it is inconvenient to eat, aesthetics suffer, asymmetry occurs on the face, other teeth are displaced).
And the loss of several is a tragedy for the body. Dozens of people who have experienced this themselves contact us every month. They come to get implants to restore comfort and eat, smile and live with pleasure again. Implantation is a high-tech treatment that requires expensive materials, equipment and enormous doctor qualifications. Therefore, a new artificial tooth costs 60,000-100,000 thousand. It’s not cheap, but those who have experienced a life full of restrictions and inconveniences due to the absence of a tooth(s) already understand the value and know that it’s worth it.
Preventive measures for cervical caries
It is important for patients to remember that this type of pathology develops very quickly, so if even minimal changes are detected in the cervical area, they should seek dental help as soon as possible. Modern techniques make it possible to completely restore the appearance and functionality of the affected tooth with uncomplicated caries. Treatment is cheaper, faster and easier for the patient, and the risk of complications is reduced to zero.
As for preventive measures, they consist of ensuring effective and regular hygiene measures for the oral cavity using individually selected toothpaste, brushes, floss and rinse. In addition, you should regularly visit the dentist for preventive examinations and professional oral hygiene, to prevent the development of gum diseases.
Professional treatment of cervical caries in CELT allows you to preserve the functionality and aesthetics of the dental unit. You can make an appointment with our specialists online or by phone: +7 (495) 788‑33‑88.
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
Driving directions
How long does it take to treat caries?
Very often you can hear the question: “how long will the treatment take?” It is difficult to give a definite answer, because a huge number of factors influence the duration of treatment.
So what can affect treatment time?
Let's sort it out in order.
The first step is pain relief . Anesthesia for the treatment of teeth in the upper jaw occurs quickly and quite well, it takes about
5 minutes (application anesthesia, the so-called “jam”, occurs within 1-2 minutes, then direct infiltration anesthesia, in which the administration of the anesthetic takes 1 minute and waits for the onset of the anesthesia effect for about 2-3 minutes).
And when treating lower jaw teeth, difficulties with pain relief may arise, which is due to anatomical features.
Often, infiltration anesthesia alone is not enough, and it is necessary to resort to conduction anesthesia.
Its effect develops on average within 5-7 minutes, but there are cases (rather rarely) when you have to wait up to 30 minutes. This depends on the individual characteristics of the patient.
Degree of mouth opening and access to tooth.
This is the next factor that influences the duration of treatment. There are a number of patients with limited mouth opening and pathology of the temporomandibular joint. Also, molars (the very last teeth) have a complex arrangement. All of this can increase the time required for treatment.
The fundamental factor is the degree of tooth decay .
This refers to the depth of the carious process (caries can be superficial, medium and deep), as well as the number of affected tooth walls.
The deeper the cavity, the longer it takes to remove the entire carious process and preserve the tooth tissue as much as possible.
If the contact surfaces are affected or, for example, caries is located under the gum, this also increases the duration of treatment, since it is necessary to install a matrix system and restore the physiological contact point.
The time of preparation of the carious cavity and its restoration depend on these factors. Preparation time can take from 5 to 20 minutes, and the restoration itself can take from 10-40 minutes.
Creating a high-quality restoration takes a sufficient amount of time, which is associated with performing certain manipulations:
- high-quality insulation (use of rubber dam),
- use of optics (microscope or binoculars),
- installation of a matrix system and its adaptation to recreate a dense physiological contact point;
- stage of conditioning with a special gel to create micro-spaces,
- compliance with the technique of introducing the adhesive system (adhesive is a kind of “glue” that firmly connects the filling material to the tooth tissues),
- layer-by-layer application of filling material, its adaptation and polymerization, formation of anatomical formations (tubercles, fissures),
- polishing the restoration.
Compliance with all stages affects the quality and service life of the restoration.
To summarize, we can say that on average, caries treatment time can take from 30 minutes to 1.5 hours.
At Belaya Medvetsa, we pay great attention to the quality of the treatment, which requires a certain time to perform all the necessary manipulations according to the treatment protocol, and as a result, obtain a functional restoration that will repeat the anatomical shape of a natural tooth.
And finally, let's look at a few clinical cases.
Clinical case 1:
Objectively: on the chewing surface of the 17th tooth there is a carious cavity of medium depth.
The treatment of this tooth took 30 minutes.
Clinical case 2:
Objectively: on the chewing surface of the 36th tooth there is a filling with a defect in the marginal fit, on the contact surfaces there are carious cavities of medium depth. There is also a carious cavity on the distal surface of the 35th tooth.
In this case, the treatment time was 1.5 hours.
Average caries
If the pathological process has reached this stage, it is already difficult for a person to ignore its symptoms. A carious tooth reacts more often and more sharply to cold and hot, and may hurt when in contact with sweet foods and drinks. But, as soon as the irritant disappears, the pain goes away quite quickly.
Visual symptoms also change. The carious spot darkens. A small cavity may also form on it. If a cavity has formed on the front wall of the tooth, you can see it; if on the back, you can feel it with your tongue. Food debris gets clogged into the cavity, and this provokes a new sign of caries - an unpleasant odor in the mouth and “stuffy” breath.
Treatment of caries at this stage is more complex and often requires pain relief, since the pathological process has affected the internal tissues of the tooth. The doctor uses a drill to remove all affected dentin and fill the cavity with filling material.
Middle caries is the last stage at which pathology can be eliminated without serious long-term therapy. If you do not see a doctor, tooth decay will continue and move to the next stage - deep caries.
Methods for diagnosing caries
In order to develop a program for the correct treatment of a patient with caries, it is very important for the doctor to make a correct diagnosis and find out what caused the damage to the tooth tissue.
The work uses two main methods:
- Visual inspection. The doctor uses a special instrument to check the condition of the tooth and whether there are signs of damage. A detailed examination helps to understand which tooth is affected, even if there are no clear external signs.
- Radiography. X-rays in our clinic are performed using high-quality modern equipment. This allows you to get a clear picture of the condition of the deep parts of the tooth, its roots. In this way, it is possible to understand exactly how severe the lesion has developed.
Also, at the first appointment, the doctor collects a general picture of the person’s condition and finds out what the cause of the disease may be. A good dentist always tries to eliminate not only the tissue damage itself, but also the factors leading to its appearance.
How is caries treated using the ICON method?
When dental caries in adults is in the staining stage, it can be treated with a non-invasive infiltration method. This technology allows you to stop the spread of carious lesions deep into the tooth without the use of a drill.
Caries is treated according to the following scheme:
- The dentist removes plaque and other deposits from the surface of the tooth enamel.
- A special etching gel with hydrochloric acid is applied to the affected area.
- Within two minutes the surface layer is removed;
- After two minutes, the gel is washed off with an air-water jet, the surface is dried and washed with an ethanol solution to remove residual moisture from the porous areas of the tooth. At the final stage, the tooth is covered with a composite material that seals the pores of the tooth enamel.
The main advantages of the method: it is possible to treat both caries of permanent teeth and baby teeth for children.
The treatment is absolutely painless, so no anesthesia is needed. Healthy areas of dental tissue are preserved during treatment. You can quickly and easily treat carious lesions on several teeth in one visit. The procedure takes no more than 15 minutes.
Superficial caries
If the carious process is not stopped at the stain stage, it progresses and enters the next stage - superficial caries. Pathological changes at this stage do not yet go beyond the enamel layer and do not affect the internal tissues of the tooth. Since the dentin is not damaged, the tooth does not hurt, but discomfort may occur when a person eats or drinks something hot or cold. Discomfort may occur while brushing your teeth. Most people ignore the clinical signs of superficial caries or consider them to be symptoms of tooth sensitivity.
Externally, the carious process at this stage appears in the form of a rough whitish spot. But you can see it yourself only if the pathology is localized on the front side of the front teeth. If caries develops on the inner or lateral surface, it is difficult to detect it on your own. It will no longer be possible to cure superficial caries without a drill, but the treatment itself will be quick and painless for the patient.
