Caries is a pathological process that is characterized by the resolution of enamel and dentin, followed by the formation of a cavity. This is the most common disease among the entire population, it occurs in children and adults. Prevention of caries is one of the top priorities in dentistry.
For the oral cavity, caries is dangerous due to its complications — pulpitis, periodontitis, which can cause tooth loss, its premature removal, therefore, it can cause malocclusion that will require long and expensive treatment. In addition, pulpitis and periodontitis can cause the process to turn into purulent forms, and such conditions can threaten the health of children.
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The cause of caries is bacteria, some representatives of the genus of streptococci, which, as a result of their vital activity, secrete a number of acids. Enamel is an inorganic substance that begins to break down under the action of these acids.
Minerals come out of the crystal lattice of enamel, this process is called demineralization. It literally melts, the process continues, hitting deeper layers, gradually switching to dentin, which is also an inorganic substance, but softer and more malleable in comparison with enamel. This is how caries develops.
The bacteria that provoke it are among the conditionally pathogenic flora, that is, they can live in the oral cavity without causing any harm if the body’s defenses work fully. But with the formation of favorable conditions, pathology develops.
The fight against caries and prevention are aimed at restoring demineralized areas and strengthening the protective forces of the oral cavity and teeth in particular. Recall that in the initial stages, caries is a reversible pathology, it is enough only to add minerals to the enamel, i.e. to restore its crystal lattice.
Features of teeth in children
Children are unique patients with their own anatomical and physiological characteristics. If we talk about the dental status, then children’s teeth are always in danger: the enamel is thinner, continues to mineralize, therefore, it cannot fully resist the aggressive action of acids and other factors.
The imperfect immune defense, which is just learning to work, often does not cope with the suppression of the growth and reproduction of pathogenic bacteria. In addition, children do not always brush their teeth with zeal and desire and try to skip this daily procedure.
Diseases of childhood, including banal colds, also increase the chances of developing caries, let alone diseases of internal organs, which are more often acquired in childhood.
Parents should understand that children’s teeth are in danger, and these risks are typical for all children, even healthy ones. But they can be resisted, and a dentist will provide significant assistance in this matter.
Indications and contraindications to treatment
• pigmentation or discoloration of tooth enamel;
• darkening of tissues in the near-gingival zone;
• destruction of enamel;
• pronounced limited dark areas on the enamel;
• the presence of a carious cavity.
One of the first signs is a reaction to eating cold or hot food, as well as salty or sweet.
The presence of the disease in some cases can be detected by the person himself without assistance. The first sign is the darkening of the enamel on certain areas of the dental surface. You should also consult a dentist if you have the following symptoms:
• bad breath has appeared from the mouth;
• dark dots appeared on the chewing surface;
• while eating or drinking, unpleasant sensations occur, especially the nerves react strongly to cold, hot, sour and sweet;
• the enamel has become rough;
• there are unpleasant sensations when biting food;
• a recess is felt in the tooth (with a tongue, a toothpick or a match).
Caries is a slow but complex pathological process that occurs in the hard tissue of the tooth. It develops under the influence of a complex of negative internal and external factors that provoke the dissolution of mineral trace elements in the tissues.
It is believed that caries occurs with poor oral hygiene, however, insufficient dental care is a secondary factor, since the appearance of an infection causing a carious lesion requires the influence of other factors.
The factors provoking caries include internal processes, the violation of which leads to a decrease in the resistance of hard tissues to infection:
• weakening of general and local immunity;
• lack of calcium, vitamins and other minerals;
• inflammatory processes not only of the oral cavity, but also of the whole body.
Also, caries is classified into the following types:
• cervical (periarticular tissues);
• fissure (indentations on tooth enamel);
• interdental (between teeth).
Classification of caries
Depending on the stage of development of the disease:
• Superficial, characterized by the appearance of a depression in place of the demineralized area. The study may show the presence of a small cavity, to eliminate which the destroyed enamel is excised and a seal is applied.
• Medium, at the stage of which dentin begins to break down and painful sensations appear. The process is quite fast.
• Deep, during which stimuli (temperature, chemical, mechanical) cause short-term pain. The examination reveals a carious cavity, quite deep. In the absence of treatment, the onset of pulpitis or periodontitis is likely, as well as tooth loss.
Fissures are grooves on the surface of chewing teeth. The problem is that food residues get into them, which are quite difficult to completely remove at home. As a result, the pits and grooves expand, which leads to the formation of a special type of caries – fissure.
To avoid such problems, you can perform “sealing” or sealing of fissures. This procedure serves as an effective method of caries prevention, especially in children. For more information, make an appointment with our specialists.
Prevention of caries by sealing fissures
Sealing of fissures is one of the most effective and widespread measures of caries prevention. Evidence of the effectiveness of the method has been presented by numerous studies and scientific papers.
Stages of fissure sealing
At the moment, the “sealing” of furrows is carried out in 2 ways:
1. Non–invasive – performed mainly on baby teeth, as well as in the presence of shallow furrows. It is recommended only if the doctor can visually fully assess the depth of the fissure. It does not require anesthesia, as the sealing takes place without the use of a drill.
2. Invasive – before applying a sealed material, the fissure is expanded using a dental instrument. This method is used for deep formations when the bottom is not visible. Before sealing, the dentist must make sure that there are no carious formations. It is more often used in adults.
The process consists of the following steps:
1. Visual examination by a dentist.
2. Cleaning the tooth surface from plaque, tartar and food residues. Cleaning can be carried out using a soft special brush or an ultrasonic device.
3. Disinfection of the dental surface and furrow with a special gel.
4. If required, the fissure is expanded using a drill (with an invasive method).
5. Filling the pit with a liquid sealant and its uniform distribution.
6. Strengthening of the composition with the help of a light-polymerization lamp.
7. Polishing and grinding.
Some authors cite figures of 98%, which is how the prevalence of caries decreases in each age group of children. So what is this method, and what is its uniqueness?
Caries has the most favorite places of occurrence, as a rule, these are the fissures of the chewing teeth — natural depressions on the chewing surface of the teeth, in which bacteria like to accumulate so much, therefore, cause caries.
Preliminary filling of the fissure will help significantly reduce the prevalence of caries. With the help of special liquid filling materials, the fissure is simply sealed, the bacteria are deprived of their favorite place of accumulation and formation of plaque.
The method itself can be performed with preliminary stitching, that is, opening the fissure or without it. Everything will depend on her condition. Doctors evaluate the condition according to several parameters. Whatever technique is chosen, fissure embroidery is just work within the enamel, therefore, children do not experience any pain.
Advantages and disadvantages of fissure sealing
This procedure allows you to maintain dental health without the use of a drill. Additional advantages include:
1. Provides additional protection of the tooth surface.
2. Helps to strengthen the enamel, which is important in case of poor heredity.
3. Stops caries at the stage of the chalk spot.
4. The sealant perfectly fixes the existing seals, which increases their service life.
5. Prevents the appearance of secondary caries.
Effective method of prevention: fluoridation of teeth
Deep fluoridation of teeth is the artificial saturation of tooth enamel with minerals, and not only fluoride, we are talking about calcium and phosphorus. At the first reception, children’s teeth are covered with a solution of calcium and phosphorus — this is necessary to fill the crystal lattice with minerals. As a result, a full—fledged hydroxyapatite is restored in the enamel – the main substance of enamel and dentin.
An important condition for strengthening teeth with fluoride is pre-cleaning from plaque. Then simple or deep fluoridation is carried out:
• teeth are covered with a fluoride-containing solution, which is applied with a special brush;
• the preparation is dried with a special lamp or warm air.
To achieve maximum effect, it is recommended to repeat the procedure of fluoridation of teeth once a year. If you do not fight diseases of baby teeth, then their early loss can lead to problems with the bite and the need for orthodontic treatment.
The final stage will be the saturation of the enamel with fluorine, as a result, fluorine hydroxyapatite is formed, which is more resistant to acids that secrete caries-forming bacteria. The effectiveness of the method has shown high results. According to A.F. Kasibina (Volgograd), the use of fluoride varnish locally reduced the prevalence of caries by 60% in the age group of children 5-6 years old.
Sources of fluoride intake into the body:
Drinking water is the main source;
- Food products: sea fish, mineral water, walnuts, cocoa powder, liver, poultry meat, lamb, soy, barley, as well as black and green tea are relatively rich in fluorides;
- Some medicines, pesticides;
- Air (if there are industrial enterprises in the field for the production of phosphoric acid, superphosphate, aluminum, glass, sulfuric acid, plastics and hydrocarbons) [1, 3].
The effect of fluoride on plaque:
Inhibition of glucose transport into the cells of cariesogenic bacteria;
Violation of the formation of extracellular polysaccharides forming the plaque matrix;
Reduction of the number of enzymes involved in the formation of organic acids.
In conclusion, I would like to emphasize that a huge number of people do not even think about how sometimes it is extremely important to visit a dentist every six months. Many consider preventive hygiene a waste of time and money. It is necessary to explain from a young age that teeth are an important part of our body and turning a blind eye to their depressing condition, we make it worse for all systems of our body. My recommendations: visit the dentist as often as possible (at least once every six months), conduct professional hygiene, also using “skyler” to remove hard dental deposits. Teach children from an early age to brush their teeth in the morning and evening. Infections in the oral cavity entail a number of problems with other organs: the heart, joints, stomach. Joint inflammation is particularly dangerous, as a result of which patients experience constant aching pain and stiffness of movements. Untimely treatment not only entails the loss of units and many diseases of a dental nature, but also the development of complications from other organs. Most often, caries causes complications in the form of cardiovascular pathologies, inflammation of articular tissues, allergic reactions of chronic course, dysfunction of reproductive organs.