Bottle caries in children: causes, symptoms, treatment. What is it and why is it called that? Causes of caries at an early age

Bottle caries is a dental disease that occurs in young children between the ages of 1 and 3 years. The peculiar name is due to the main cause of this disease - drinking mixtures from a bottle at night. favorite teeth for bottle caries- these are the central and lateral incisors, a little less often - canines. Usually, caries of milk teeth in children is located on the vestibular surfaces or covers the teeth circularly from all sides. It spreads more often along the plane, and not deep into, without a tendency to limit. The susceptibility of the frontal teeth to this type of carious process is due to the fact that these teeth erupt first during the period when the child is on the chest or artificial feeding.

Like any other type of carious lesion, bottle caries in children appears under the influence of cariogenic microflora, which secretes harmful acids and toxins. In an infant, these bacteria appear primarily due to such habits of adults as licking the baby's pacifiers and spoons, kissing. Feeding your baby formulas or juices at night without proper hygiene creates an excellent environment for bacteria to grow. Mother's milk also contains sugar, so after the appearance of the first teeth, it is necessary Special attention devote to hygiene. More prone to caries are children with weakened immune systems or children whose mothers had toxicosis during pregnancy.

Bottle caries most often attracts attention only at the stage when the dentin is already damaged, however, it goes through all the same stages as caries in adults.

Stages of bottle caries and symptoms

Initial caries looks like white spots on milk teeth closer to the neck. The neck of the tooth is the most vulnerable area. In this zone, the enamel has the smallest thickness. Also in this zone is the border between the enamel, which was formed during the prenatal period and after birth. The disease at this stage most often does not manifest itself symptomatically. Parents usually mistake these spots for plaque.

Superficial children's caries of milk teeth develops soon after the appearance of spots. Against the background of white areas of enamel, roughness begins to appear - places where the enamel begins to come off in the form of layers. This stage also does not attract the attention of parents due to the fact that the teeth do not bother the child in any way.

Average caries of milk teeth can be determined when an area of exposed softened dentin appears on their surface, surrounded by a border of white non-viable enamel. The rate of destruction of dentin will be higher. Hypersensitivity will be present because the lesion has affected the dentin-enamel junction, which is the site most susceptible to pain. The child may refuse to eat and not allow touching damaged teeth. As a rule, in this situation, the parents of the baby and the question arises: “is it necessary to treat milk teeth in children?”.

With deep caries, teeth can completely lose enamel, dentin is destroyed almost to the pulp. Pain syndrome even more pronounced than with a lesion of medium depth.

The next stage in the development of caries is pulp inflammation. Pulpitis of milk teeth is a complication. AT early age it will most likely lead to tooth loss. Since bottle caries affects milk teeth at the stage of their development, when the vascular-nerve bundle of the tooth is not yet fully formed, pulpitis has a chronic course. The tooth may not bother, slowly collapsing to the very roots.

Treatment of caries of milk teeth

Is it necessary to treat milk teeth in children? This question is often asked by parents. Many of them are sure that if a tooth falls out, then there is no point in following it. Milk incisors fall out only after 6-7 years. If caries is started at an early age, the infection will penetrate into the rudiments of permanent teeth, which can either die or develop incorrectly. Extraction of teeth for for a long time before their physiological change will lead to disruption of the growth and development of the jaws. The result will be no room for permanent teeth to erupt. The main difference in the approach to the treatment of children and adults is that the goal of treating milk teeth is to keep the tooth as long as possible until the permanent eruption.

The treatment of bottle caries has its own characteristics, since, as a rule, the age of young patients is 2-3 years. Depending on the depth of the carious lesion, the following methods are used: remineralizing therapy, coating of teeth with silver nitrate (silvering), filling.

IT'S IMPORTANT TO KNOW:

Remineralizing therapy is effective when caries of milk teeth in children is treated at the initial stage, it is used a little less often when superficial caries. The most popular method of remtherapy is deep fluoridation. The meaning of this procedure is to strengthen the remaining enamel by saturating it with fluorine. Fluoride preparations are sold in a variety of photocurable varnishes, suspensions, and liquids.

Stages of teeth fluoridation using fluorine-containing suspensions

Silvering

Treatment of milk teeth in children with the help of silvering does not restore the structure of the tooth. The purpose of this method is to stop the development of caries due to a pronounced bactericidal effect. In modern dentistry, silver is used less and less due to the fact that teeth become black after the procedure.

Removal of plaque from teeth.
Isolation of teeth from saliva
Application of silver solution. The drug consists of two liquids. First of all, the tooth is covered with a silver-containing liquid without color, and then a restorer is applied, after which the carious area becomes black.

The teeth are under the supervision of a dentist to control the course of caries.

Tooth filling

A feature of such a procedure as the treatment of bottle caries with the help of filling is the use of gentle preparation techniques. It is important not to scare the child on the first visit. It is best to do nothing at all except for the examination and acquaintance with the dental office. On the second visit, if the child is in a normal psychological state, teeth can be filled. The preparation of teeth under the age of three years can be carried out without the use of a drill, but with the help of sharp hand tools. Glass ionomer cement is used as a filling material. light mechanism curing. These cements have the ability to saturate tooth tissues with fluoride, have good adhesion to the teeth, and do not require a long time to work with them.

To prevent infection, there are simple preventive measures, under which you can stop not only milk caries, but avoid complications such as pulpitis on milk teeth and periodontitis.

Toddler dental care tips

Brushing teeth from the moment they erupt. At first, you can use special cleaning wipes or silicone brushes that are put on your finger. Then you can switch to other brushes according to age.
Limit sugary drinks, remove the bottle from the baby's crib. After nightly feedings, it is advisable to wipe your teeth with a napkin or give some water.
If the child is in the completion stage breastfeeding, it is desirable to refuse night feedings as soon as possible.
Do not lick pacifiers, nipples, spoons of a child to prevent the ingress of cariogenic bacteria.
The use of gels with anti-caries action after consultation with a dentist.

Of course, there is no 100% guarantee that, subject to all the rules, the question “should caries be treated on milk teeth?” will never arise. However, these rules can significantly reduce all risks, and if the disease develops, its course will not be aggressive.

Caries in children, caries of milk teeth is a very common problem. It is complicated by the fact that the treatment of children aged 2-3 years requires special conditions. Firstly, it is necessary that the pediatric dentist is engaged in the treatment, and secondly, a specially equipped children's dentist is needed. dental office and the availability of quality materials for milk teeth.

- group carious lesions of milk teeth in young children, due to improper diet and poor hygiene child's oral cavity. Bottle caries affects the cervical areas of the upper incisors and canines and goes through several stages: the stage of demineralization, enamel destruction, destruction of the enamel-dentin junction, deep damage to the hard tissues of the tooth. Diagnosis of bottle caries is carried out by a pediatric dentist based on the results of examining the child's oral cavity and the presence of characteristic lesions. In the early stages, the treatment of bottle caries may include remineralizing therapy, silvering of teeth; in advanced cases- treatment and filling of carious cavities.

General information

Bottle caries - early childhood caries, detected in children aged 1-3 years. Other names for early childhood caries - “nursery”, “bottle”, “kefir”, “feeding caries”, “circular”, etc. to one degree or another reflect the age at which the disease occurs, the path of its occurrence and the nature of the damage to the teeth. The risk of developing bottle caries is directly proportional to the duration of breast or bottle feeding of a child: for example, in children who sucked a breast or a bottle up to 1 year, caries is detected in 6% of cases; up to 1.5 years - in 25%; up to 2 years - in 38-40% of cases. Problem early detection and the treatment of bottle caries deserves the closest attention from pediatric dentistry and pediatrics in general, since complicated forms of pathology can cause damage and death of the rudiments of permanent teeth.

Causes of bottle caries

At the heart of bottle caries, like any other type of caries, are focal accumulations of bacterial flora, which contribute to the fermentation of carbohydrates with the formation organic acids and shift acid-base balance to the sour side. These processes lead to damage to the enamel and facilitate the penetration of bacteria into the dentinal tubules, which leads to softening and destruction of the hard tissues of the tooth.

Except common causes, in the development of bottle caries important role belongs to private factors, namely, a violation of the diet of a young child, low level oral hygiene, changes in saliva composition, decreased defensive forces organism, the presence chronic diseases the parents of the baby.

It is known that the development of bottle caries is more susceptible to children receiving natural or artificial feeding "on demand" for more than one year. At the same time, night feedings of a child (breast, formula or sweetened drinks from a bottle) are especially negative for the condition of milk teeth, which contribute to the accumulation of food debris on the teeth. After a night feeding, the child immediately falls asleep, and for obvious reasons, no one brushes his teeth. A small amount of saliva released during sleep is not able to wash off food residues, neutralize bacteria and acids, and replenish the mineral composition of the enamel. Thus, the incorrect feeding regimen of the child, combined with the lack of adequate oral hygiene and saliva hyposecretion during sleep, play a triggering role in the development of bottle caries.

In addition to local causes, a weakening of general immunity associated with infectious diseases (ARVI, intestinal infection, enterovirus infection, etc.), general somatic diseases (diabetes mellitus, etc.) contributes to the formation of bottle caries. Changes in general immunity are always accompanied by a decrease in the concentration of immunoglobulins in saliva - specific local protective factors that prevent the growth of bacteria in the oral cavity. In turn, the unhindered development of pathogenic microorganisms, their release of toxins and acidic waste products cause an increase in viscosity and a decrease in the pH of saliva. AT acidic environment saliva does not fulfill its remineralizing function; along with this, calcium is easily released from mineral component tooth enamel, which again triggers the development of bottle caries.

Dental, gastrointestinal and ENT diseases of the parents, who, in close contact with the child, “share” their microflora with him, also contribute to the defeat of the teeth of a young child with bottle caries. The presence of dental plaque, caries, periodontitis, gingivitis, tonsillitis, chronic gastritis, etc. in parents leads to the fact that the child's body from the first days of life is faced with a highly virulent pathogenic microflora, which he is unable to resist. That's why expectant mother it is extremely important to eliminate all foci in the body even before conception or as part of a pregnancy management program chronic infection.

Classification of bottle caries

Depending on the depth and lesion on the age of the child, 4 stages of bottle caries are distinguished:

initial stage(10-20 months) - characterized by the appearance of chalk spots on the vestibular and palatal surface of the upper incisors - foci of enamel demineralization. In the cervical region, a whitish line is clearly defined. Pain missing. On the this stage bottle caries can be diagnosed by a pediatric dentist only after the surface of the affected tooth has dried, so parents often do not notice the emerging changes. When carrying out appropriate therapeutic and preventive measures further development bottle caries at the initial stage can be suspended.

Stage of superficial caries(16-24 months) - characterized by the formation of a defect within the tooth enamel and exposure of the dentin. Superficial caries affects not only the cervical region of the incisors and canines, but also the proximal and occlusal surfaces. upper molars. Carious foci have a light yellow or brownish color, there is hyperesthesia of the teeth. Superficial bottle caries requires preparation and filling of the cavity.

Symptoms of bottle caries

With bottle caries in a child, the upper incisors and canines are primarily affected, which is associated with the sucking mechanism: when the breast or nipple is captured, the child's tongue covers the teeth mandible, while the upper front teeth are in direct contact with food. It is here that plaque and food residues accumulate to a greater extent. For bottle caries pathological process spreads circularly, i.e., along the circumference of the crown part of the tooth, mainly in the region of the neck, which has the weakest mineralization.

The progression of bottle caries is accompanied by the formation of yellow-brown and brown-black spots on the teeth, hypersensitivity teeth to cold, hot, sour, sweet food, toothache. An unsightly appearance of the anterior teeth spoils the charming smile of a child, and a persistent infection can affect the rudiments of permanent teeth. Due to the anatomical and physiological features, the carious process quickly spreads not only over the entire surface of the tooth, but also on adjacent teeth(multiple caries), as well as deep into the tissues with the development of pulpitis and periodontitis. In advanced cases, bottle caries leads to premature loss of the first teeth.

Diagnosis of bottle caries

Bottle caries is recognized on the basis of a thorough examination of the child's oral cavity by a pediatric dentist using a mirror and a probe. To improve the results of the examination, methods of drying the surface of the tooth, stomatoscopy in ultraviolet light, vital staining of the teeth, which makes the spots brighter and more noticeable, are used, often - general anesthesia.

At the initial stage of bottle caries, the silvering method is used - applying a solution containing silver ions to the affected tooth surface. This is a temporary measure to stop the progression of bottle caries. However side effect One such preventive measure is persistent black staining of the teeth, leading to an unacceptable aesthetic result. Therefore, at present, pediatric dentists at this stage of bottle caries, after preliminary professional dental hygiene, perform remineralizing therapy - local applications of fluoride-containing preparations.

In the stages of superficial, medium and deep lesions, complex treatment of caries is indicated. With significant destruction of milk teeth, it may be necessary to remove them or restore them using special metal-composite or zirconium children's crowns.

Forecast and prevention of bottle caries

Untreated bottle caries can lead to a deterioration in the quality of life of a child, serious problems With permanent teeth. Teeth affected by bottle caries cannot perform their physiological functions in full, which is accompanied by a violation of the chewing process, diseases of the gastrointestinal tract, speech defects, impaired eruption of permanent teeth, etc.

Measures to prevent bottle caries are proper hygienic care of the first teeth of the child, restriction of feeding with mixtures and milk at night, timely transfer of the child to solid food, the use of therapeutic and prophylactic toothpastes, regular visits pediatric dentist starting from the moment of eruption of the first teeth.

Bottle caries is a disease that affects young children between the ages of two and four. Its name is quite original and is due to one of the reasons for the development of this pathological condition- bottle caries in children often develops due to the habit of drinking milk mixtures from a bottle at night. As a result of this, in the baby's mouth all night long remains a large number of food, which is the main cause of the progression of caries.

Also this disease called "milk", "kefir" or "nursery". AT medical reference books it is impossible to meet these terms, since by the nature of the course and the causes of the onset, the disease is a common caries. "Bottle" is also called it in everyday life.

The reasons

The causes of bottle caries are the same as those of others. carious lesions. Main etiological factor is damage and destruction of the structures of the teeth under negative impact acids produced by microorganisms present in oral cavity child. The food for them is carbohydrates that are left on the teeth after feeding the child.

Most doctors are sure that the main reason for the progression of bottle caries in children at this age is frequent night feedings. And it doesn’t matter at all how the child eats - from a bottle, or sucks at the breast. Lactose is found in varying amounts in mother's milk, mixtures and more. But in itself, this reason does not in all cases lead to the development of a pathological process.

Factors that provoke the progression of bottle caries:

weakening immune system child;
insufficient bactericidal properties of saliva. Often this leads to the presence in the body of other diseases, such as, and so on;
improperly formulated child's diet. Sweets, juices, flour products, the remains of which remain on the teeth, contribute to the reproduction of pathogenic microorganisms. The condition of the teeth is also affected by the lack of roughage in the diet - apples and carrots;
regional factor. If the water that the baby uses does not contain enough fluorine, then his tooth enamel will weaken and quickly succumb to the destructive effects of organic acids;
heredity.

Stages of development

Doctors distinguish four stages in the development of bottle caries in children:

initial. The age of the child is from 10 to 20 months. This is an early stage in the development of the pathological process. Chalk foci are noted on the surface of the teeth, and a whitish line can be noted in the cervical zone. Sometimes these changes are difficult to notice, as this will require completely drying the surface of the tooth. The development of pathological foci at this stage is reversible. Treatment consists in covering the pathological area with a sealant;
second stage. Child from 16 months to 2 years old. Pathological foci grow, and the destruction of enamel structures occurs. At this stage of the development of the pathology, dentin is exposed. At the same time, the first symptoms appear. Baby's teeth react to temperature stimuli. In some cases, there is a change in the shade of the tooth surface;
third stage. Child from 20 months to 3 years. The lesions are large and deep. At this stage, the carious process can irritate the pulp. The symptoms get worse. It is painful for children to chew food, brush their teeth. Night pains appear;
fourth stage. Age limit - from 30 months to 4 years. Destruction of the enamel-dentine junction occurs. On the molars of the upper jaw, necrosis and stage 3 of the lesion are noted. On the molars of the lower jaw, signs of the second stage are noted. The child is restless, refuses to eat any food, does not sleep well. The reason for this behavior is strong toothache. With severe tooth decay, only one type of treatment is indicated - extraction.

Symptoms

With the progression of bottle caries in children, the upper incisors and canines are primarily affected. This is due to the sucking mechanism. On these teeth, plaque and food residues (mixtures) accumulate in large quantities. Bottle caries has a characteristic feature for it - the pathological process affects the tooth circularly. This means that the tooth is destroyed along the circumference of the coronal part (more often in the neck area).

If the pathological process develops, then spots of various colors appear on the surface of the teeth (from yellow-brown to brown-black). The sensitivity of the teeth increases several times. Unpleasant sensations causes the intake of sweet, cold, hot, sour foods. Pain can also occur while brushing your teeth. The danger of bottle caries is also that it can spread to other teeth. In medicine, this phenomenon is called multiple caries. It can also affect deeper dental structures, as a result of which the baby may develop periodontitis or pulpitis. Therefore, treatment should be started as early as possible to prevent the development of complications.

Diagnostics

At the first suspicion of the progression of bottle caries, parents are recommended to immediately visit a pediatric dentist for diagnosis and treatment of pathology. You can determine the presence of an ailment during a thorough examination of the child's oral cavity. In order to increase the effectiveness of the examination, the doctor can use the following advanced techniques:

stomatoscopy in the light of UV rays;
vital staining;
dental radiography.

Treatment

A complete treatment of bottle caries in young children is very difficult, as the kids simply do not allow the doctor to do everything. necessary procedures. Therefore, sometimes they resort to sedation - carrying out all the necessary medical procedures under general anesthesia.

If the baby has only the initial stage of caries, then it can still be stopped without dissection. Doctors simply close or seal the pores formed in the spots. This method of treatment is called remineralizing. Its main goal is to replenish the mineral composition of the affected area. Of course, the enamel structure is not restored, but the tooth is no longer vulnerable to disease. It is possible to treat bottle caries in this way, since the procedure is painless and does not frighten the child.

Medium and advanced caries should already be treated by known methods - sanitation of existing carious cavities with their subsequent filling. But not all children allow this to be done, so most often dentists resort to the procedure of teeth silvering.

This technique does not eliminate the carious process in the teeth and does not return their aesthetic appearance, but on the contrary, the teeth become even more unattractive (blacken). But this method of treatment makes it possible to stop the destructive process. We can say that the teeth are "preserved" in this state. As a rule, after this, all symptoms of the disease disappear in children. The silver film should be replaced once every 3 months. This will make it possible to keep milk teeth until they fall out naturally. This technique treatment is highly effective.

In some cases, the above methods of treatment will not be effective. If the tooth decay is very strong, then neither sealing nor silvering will help - it is only necessary to carry out the extraction of teeth. This must be done, as destroyed teeth can cause defective formation of the rudiments of permanent teeth.

Many mothers use folk recipes. But you should never do it on your own. Not only can prescriptions not help, but they uncontrolled use may worsen the general condition of the child. Only a qualified dentist should treat bottle caries.

Prevention

In order not to treat bottle caries in children, you should take care of prevention in a timely manner. this disease. It is important to constantly monitor the condition of the child's teeth, and this task falls entirely on the shoulders of the parents. To this species caries has not developed, you should follow simple recommendations:

baby teeth need to be taken care of. It is recommended to remove plaque and food debris with a gauze swab or silicone nozzle, which is put on the mother's finger;
it is better to refuse night feedings if possible;
children should be taught to brush their own teeth from 8 months;
do not dip nipples in sugar or honey. If you do this, then early caries will be provided and it will have to be treated;
be sure to show the child to the dentist. If the doctor has determined that he has a tendency to caries, then he will prescribe a therapy that should be followed in order to prevent the progression of the pathological process.

Parents always worry about the appearance of any problems with the teeth of their children, but in the case when the disease is observed in the first year of life, they begin to panic. Bottle caries usually occurs in formula-fed babies. Carious process develops very quickly, therefore, at the first manifestations of the disease, you should consult a dentist for treatment.

The concept of bottle caries

Bottle caries in children is the destruction of the delicate enamel of milk teeth and the harder tooth tissue - dentin. The development of the disease occurs rapidly, and it quickly passes to neighboring teeth (see photo). This is due to the special structure of milk teeth. They have thinner enamel and softer dentin than permanent teeth. With bottle caries, even only erupted teeth can be affected.

Localization of the disease

This type of caries, like bottle caries, is localized on the front teeth, namely, the incisors and canines. It begins to develop in the neck of the tooth and gradually affects the entire tooth enamel at the points of contact with the gums. Then the disease affects the bottom of the tooth, and over time it becomes covered with dark spots. If the pathology is not cured at this stage, it is possible complete defeat tooth. As a result, the so-called "stump" will remain in its place, which will have to be removed.

What age children are at risk?

Popular names for this type of caries (bottle, milk, kefir, nursery, circular) speak of age category patients with this disease. The risk group includes children under 2-4 years old who are fully or partially fed through a bottle. Especially if it happens at night. The fact is that after eating food remains on the teeth, which contribute to the reproduction of the pathogenic environment.

Diagnostics

At the first sign of bottle caries, parents should consult a dentist as soon as possible. During the initial examination of the oral cavity, a probe and a mirror are used. This takes into account the age of the child and the affected teeth (we recommend reading:). The following methods can be used to confirm the diagnosis:

drying of the surface of the teeth;
stomatoscopy with ultraviolet light (transillumination);
special staining of teeth, which makes carious spots more noticeable;
x-ray (to determine the consequences of tooth damage).

Causes

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If the dentist has confirmed the diagnosis, then in addition to treatment, it is necessary to identify and eliminate the causes of its appearance, since not all children of this age suffer from such a disease. It's caused various factors associated both directly with general condition child, as well as with others external causes. It is worth noting that the "bottle" disease rarely occurs for any one reason, usually there is a combination of them.

Weak immunity

Immunity is reliable protection organism. It helps to overcome various diseases. Decreased immunity occurs mainly due to colds, various infections(including intestinal), diabetes mellitus, etc. As a result of the implementation protective functions body, there is a decrease in the amount of immunoglobulin in saliva. It is he who fights against harmful bacteria and does not give them the opportunity to multiply. As a result, the volume of toxins produced in saliva increases. pathogenic microorganisms, its viscosity increases, the chemical composition changes. All these changes lead to the release of calcium from mineral composition tooth enamel, which also contributes to tooth decay.

Poor oral hygiene

It is necessary to take care of the oral cavity from the moment the first tooth appears. During brushing, food debris and plaque are removed from the surface of the enamel. The food left after eating helps create an environment conducive to the growth of harmful bacteria. That is why children need to observe oral hygiene in the same way as adults. First, parents do it, and then the children themselves do it on their own. It is worth noting that improper oral hygiene favors the development of the disease only in combination with a weakened immune system and a change in the composition of saliva.

Diet

plays an important role in the development of caries malnutrition. A large number of bakery products, sweets, sugar contributes to the development of pathogenic microflora.

Juices contribute to the erosion of thin enamel without this. Not getting enough calcium and fluoride makes teeth weaker. A small amount of solid food (apples, carrots) also affects, since it naturally cleans teeth from plaque.

Night feeding

Normal night feeding, at first glance, absolutely safe, significantly affects the development of bottle caries, especially in children under 2 years of age. The fact is that during sleep, the secretion of saliva decreases, and it becomes insufficient to protect the oral cavity, and naturally no one will wake the child up to brush his teeth. It is at this time that bacteria begin to multiply intensively.

Dental diseases in parents

Dentists advise all parents to spend complete reorganization oral cavity. Otherwise, all pathogenic microflora when kissing, licking a fallen nipple and other things is transmitted to the child and quickly spreads not only in the mouth, but also in the gastrointestinal tract. The child's body, which is not yet strong, cannot cope with so many bacteria.

4 stages of bottle caries and their symptoms

There are 4 stages of the development of the disease: initial, stage superficial lesion tooth, middle stage and stage deep damage. This classification is based on the degree of damage to the teeth and the age of the patient. Each stage has its own symptoms and signs. The photo shows advanced stage diseases.

The initial stage occurs in children aged 10-20 months. During this period, chalky (whitish) spots appear on the front teeth - places of enamel demineralization. Near the gum on the neck of the tooth can be seen white stripe. The child does not experience any pain at this stage. It is almost impossible to determine the onset of caries development on your own. To diagnose the disease, the surface of the teeth is dried and carefully examined. Carrying out rehabilitation measures at this stage prevents the further development of the disease.

At the second stage, the destruction of enamel and exposure of dentin is observed. It occurs in children aged 16-24 months. With superficial caries, yellow and light brown spots are clearly visible. The disease can affect not only incisors and canines, but also begin to spread to nearby molars. Appear pain but they are short lived. Treatment at this stage is carried out with the help of preparation and filling of the affected areas.

Medium bottle caries is common in children aged 20-36 months. At this time, enamel and partially dentin continue to collapse. Upon contact with irritants (cold, hot, sweet) appears sharp pain which disappears after rinsing the mouth. During this period, the child becomes more capricious. Deep lesions are carefully processed and sealed.

The stage of deep bottle caries occurs in children 30-48 months old. At this stage, the enamel is completely destroyed and the dentin is deeply damaged. The pain becomes prolonged, as a result, the child may refuse to eat, sleep poorly, be capricious. Special crowns are placed on teeth that can still be saved. All other affected teeth are removed and a removable denture is put in their place. If this is not done, the child will have malocclusion and work problems gastrointestinal tract.

What is the danger of bottle caries?

The danger of caries primarily lies in its rapid development and distribution (more details in the article:). Lack of treatment can lead to the death of the pulp and infection of the soft tissues of the gums, and in the future bone tissue jaws. As a result, there are problems with healthy teeth, there is a violation of the bone tissue of permanent teeth in the future.

After the removal of a diseased tooth, there are often problems with bite, jaw structure, correct growth permanent teeth. All this leads to a violation of speech, a change in the shape of the face and mental disorders. Children with bottle caries are more likely to suffer from infectious diseases, slightly lag behind in physical development from their peers.

Treatment

Treatment of bottle caries in children depends on the degree of damage to the teeth. In the early stages, this process is much easier and easier for the child to bear. Deep bottle caries in most cases involves the intervention of a surgeon. To ensure the psychological comfort of the child, you can use a service such as sedation (drug sleep).

At an early stage

Treatment of bottle caries at the "spot" stage is the most gentle and gentle. At this stage, it is possible to stop the development of the disease with the help of remineralization therapy, deep fluoridation enamels. The drill can be replaced by a laser and special gels.

At an early stage, all tooth tissues can be saved, complex treatment at once. That is why dentists recommend that parents bring their children to the examination of the oral cavity every six months. Solving any dental problem early stages passes easier, faster and does not injure the child's psyche so much.

Silvering

This method has been known for a long time. It consists in applying a solution of silver nitrate to the enamel of the teeth. Silver particles penetrate deep into the enamel, strengthening it, and do not allow to multiply. harmful bacteria. This method is used at the initial and superficial stages. The disadvantages include:

the need to update the silver coating;
teeth become black, which not only looks unaesthetic, but can also lead to the development of complexes in a child.

Remineralization

Remineralization is advisable to carry out at the initial stage of caries, when the destruction of the enamel is just beginning. With a deeper lesion, a filling is necessary. This method consists in strengthening the enamel with gels and varnishes based on fluorine and calcium. In addition, the dentist prescribes special mineral-containing toothpastes. In the course of treatment, it is necessary to visit a doctor regularly to confirm its effectiveness.

Classic preparation

If a tooth filling is necessary, parents should prepare the child so as not to cause him fear of further visits to the dentist. Currently, more gentle preparation methods are used. Up to three years, teeth are sealed manually without the use of a drill using special tools. The filling material is glass ionomer cement. It holds firmly and at the same time saturates the tooth with fluoride, strengthening it from the inside.

Modern ICON method

It's relative new method. It was developed in Germany in 2009. It is based on the use of a special gel that seals the affected area, strengthens the enamel from the inside and prevents caries from developing further. This method allows you to cure all diseased teeth without a drill in one visit to the doctor. This does not harm the unaffected tooth tissue. This method has revolutionized dentistry and is successfully used in almost all European countries.

Removal of a tooth

Dentists try to treat all the affected teeth to the last, but this is not always possible. Tooth extraction is last resort caries treatment. In their place are special removable dentures. Otherwise, there may be problems with the bite, the location of the teeth, and even with speech. This process is carried out under anesthesia or with the help of deep sedation.

Folk remedies

Bottle caries is one of the few diseases in which ethnoscience powerless. Not a single remedy can clean and protect damaged areas of dentin, but you can stop the development of the disease:

in the diet of the child, it is necessary to increase the amount fermented milk products, fish, raw vegetables and fruits;
brush your teeth regularly with a gauze pad soaked in soda solution, decoction of chamomile, lemon balm, sage;
children over two years old can be given a nibble on the skin of a lemon.

Prevention of bottle caries

To prevent bottle caries, the following preventive measures must be observed:

However, the main preventive measure will be a visit to the dentist. Early detection illness will allow quality treatment sparing methods and relieve such consequences as tooth extraction, inflammatory processes, changes in bite, etc. It is equally important to teach a child to proper oral hygiene. This will prevent the appearance of not only bottle caries, but also a number of other diseases.

Caries is one of the most common diseases modern man. Both adults and children can get sick of them, equally. There are several forms, one of which is bottle caries.

it the disease occurs at an early age, even at the stage of formation of milk occlusion and causes rapid and severe tooth decay.

What does it represent?

Bottle or caries feeding(as well as nursery, milk, kefir) - dangerous form this disease, which can lead to near-total decay of milk teeth in toddlers around 2–4 years of age.

For many reasons, the disease develops rapidly, rapidly covering a large amount of tooth tissue. This is facilitated by some features of the structure of milk teeth, for example, enamel, which is thinner and less durable than that of permanent teeth.

The main reason for this form of caries is the accumulation of bacteria that break down carbohydrates in the course of life, after which organic acids are formed in the oral cavity.

The process provokes change acid-base balance to the side hyperacidity, which becomes the main factor in enamel damage. Bacteria then easily penetrate into the next layer - dentin - through special tubules and destroy the hard tissue of the tooth.

Who is at risk

To successfully combat this disease, it was determined risk group, which includes:

children who are often ill infectious diseases – enteroviral infections, SARS, etc.;
patients with diabetes and others general somatic diseases;
kids with reduced immunity;
children who are on artificial feeding;
babies who have disrupted normal diet and there is no control over hygiene procedures.

Symptoms

Enamel damage begins with several teeth at the same time. Most often, this is the upper frontal group. Fangs and incisors are damaged, but the lack of treatment provokes further spread.

If in adults caries is manifested by darkening, in most cases, on chewing surfaces, then in the case of baby bottle caries, the picture is different:

The appearance of white spots on the outer surface of the central upper teeth. At this stage, it is important to differential diagnosis with incipient fluorosis.
An increase in white spots, their darkening and spread to neighboring areas.
External "looseness" of enamel.
Sensitivity enhancement damaged teeth, the appearance of soreness during eating.
Further spread appears as a darkening (brownish color) of the entire coronal part.

Bottle caries begins, as a rule, from the cervical region, in order to later spread throughout the tooth.

One of the most common forms of this disease is circular, when the affected area covers the tooth from all sides in a circle.

Among the symptoms, more late stages diseases can be called restlessness and capriciousness of the baby, as well as poor sleep, which are caused by pain not only when chewing, but also when pressing on the aching tooth and most of the chemical, thermal and mechanical effects on it.

The reasons

The main reason has already been named - this is the rapid spread of cariogenic bacteria that easily damage the thin enamel of milk teeth.

Therefore, the factors that cause such development can be classified as causes of bottle caries:

Poor oral hygiene.
Artificial feeding(hence the name "bottle"). When receiving mixtures from the horn, part of the food falls on the teeth. These mixtures contain a large amount of carbohydrates, which are a breeding ground for bacteria.
Meals on demand over one year. It does not matter whether it is artificial nutrition or natural breastfeeding.
Night feedings, after which the baby immediately falls asleep. During sleep, there is no natural cleansing of the oral cavity due to insufficient saliva production.
Dental and ENT diseases of parents that are not treated immediately. From parents who try the baby's food (for temperature, etc.), pathogenic bacteria can easily get to him.
Frequent consumption of certain carbohydrate-rich foods- cookies, lollipops, sweet drinks, cakes and more.

Not all doctors agree that night feedings are the main cause of bottle caries. Observations in medical practice, equally show cases of caries in those children who eat at any time, and in those who are fed on a schedule, with brushing their teeth before bedtime.

This happens because some children have a strong immune system, while others have a weak one. Saliva healthy child has a bactericidal effect, which should be sufficient to destroy bacteria in the oral cavity. Therefore, many children eat at night, do not observe hygiene, and at the same time have excellent health of milk teeth.

Children with serious illnesses, such as diabetes or intestinal problems, have weak immunity. But even the common flu can become undermined health.

What is dangerous?

The danger of bottle caries mainly lies in its rapid development and spread.

Photo: consequences of bottle caries in children

However, in order to fully understand this danger, it is necessary to be aware of the consequences that the lack of treatment of bottle caries can lead to. Wherein serious violations can manifest itself not only at the local, but also at the systemic level.

Rapid spread provokes pulp necrosis, after which the infection will spread further, passing already to soft tissues periodontal.

Manifested by the main two forms - acute and chronic:

In the acute form, there is an inflammatory process in the connective tissues, tooth mobility in the affected area, as well as adenopathy.
The chronic form is more common. It involves the defeat of the interalveolar septa, which is accompanied by an abscess.

When reduced immunity in a baby, the spread of infection can proceed uncontrollably, provoking the occurrence of complications not directly related to the teeth.

The consequences of childhood caries affect not only the oral cavity and dental system . First of all, the loss of teeth, which is sometimes inevitable, can lead not only to orthodontic problems, but also to speech disorders - incorrect pronunciation, changes in diction, and so on.

The whole body of the baby as a whole also suffers - it is not for nothing that in children diagnosed with bottle caries, weight and height are somewhat behind the same physical indicators of their healthy peers. This is due to malfunctions in the gastrointestinal tract, bad dream, frequent infections.

Diagnostics

Diagnosis of caries in children is slightly different from that carried out by adults. Children are not x-rayed, but diagnosed at visual inspection and according to the results of dental tests, harmless to the child.

Methods for diagnosing the degree of carious lesions in children:

visual inspection. First of all, the doctor examines the baby's teeth using a dental mirror, in this way it is determined overall picture condition of the teeth and the presence of single defects. Further tests and differential diagnostics are carried out.
Sounding. A special tool is used - a probe, which gently probes the alleged carious cavity. The method allows you to establish the presence of caries in places that cannot be examined. The child feels pain when the probe enters the cavity.
And caries in the stain stage is examined by scraping off the affected area: it should have a loose structure.

If obvious deep caries, actions during probing must be accurate, because strong pressure will perforate the pulp chamber and cause acute pain.

Exclusion of other diseases

Differential diagnosis is carried out in order to exclude other diseases:

pulpitis;

The following techniques are used:

Percussion. Tapping a tooth in order to exclude the presence of an inflammatory process (pulpitis), it should not be painful.
Thermometry. Excludes pulpitis with the help of temperature tests: exposure to the lesion with cold or heat. For example, a swab cooled with ether or water is placed on the tooth, normal reaction the occurrence of pain during the period when the stimulus is on the tooth is considered.
After removing the tampon, the pain should immediately go away. Pulp hyperemia is diagnosed if pain persists for 15 seconds or more after the swab is removed.
Vital staining with early forms caries. Excludes fluorosis and enamel hypoplasia. It reveals the degree of enamel damage and focal demineralization.
Substance for evaluating the reaction - 2% aqueous solution methylene blue. A dye is applied to the prepared surface, aged for 3 minutes, washed off.

With non-carious lesions, staining does not occur. At a positive result, according to a 10-point scale, the degree of damage is judged: from low to high.

Therapy Methods

As for others dental diseases, there are certain techniques that allow you to maintain healthy teeth and stop the rapid process of their destruction.

Is it necessary to treat

According to the famous pediatrician Yevgeny Komarovsky, it is necessary to treat this disease in order to avoid many unpleasant and serious consequences that it can entail.

And since bottle caries is characterized by a rapid course, delay can be dangerous.

Independently, without consulting a specialist, as in the case of adult caries, it is impossible to cope with this disease, since the hard tissues of the teeth are damaged.

If no measures are taken when symptoms of bottle caries are detected and diagnosed by a specialist, then progressive the disease can damage and even destroy all milk teeth, usually except for the lower incisors.

What stages are curable

bottle caries has four stages of development.

The medical measures taken on each of them are different and depend on many factors, including the age of the patient himself:

Initial (initial) stage. The age of the child is about 10-20 months. The most suitable stage for treatment is when the development of the disease can be stopped completely, preventing destruction.
At this time, a white thin strip appears in the cervical region of the upper incisors, and small whitish spots appear weakly on the smooth surfaces of the same teeth - foci of demineralization.
Second stage. Usually observed at 16-24 months. Here there is a darkening of white spots, caused by the destruction of enamel and exposure of dentin, which is not white, but yellowish color. There is also treatment.
Third stage. At the age of 20 months to 3 years. At this stage, the lesions deepen and spread, already coming close to the pulp or affecting it.
At the same time, the lower teeth are also involved in the process - the symptoms of the initial stage of the disease are clearly visible here. Modern dentistry allows treatment at this stage.
Fourth stage. 30 to 48 months. At this stage, there is necrosis of the teeth, which were the first to be involved in the lesion process. For such teeth, surgical and even orthopedic methods of treatment are most often used.

Therapy Methods

The treatment of babies is associated with serious difficulties, since not all children happily go to the dentist and allow procedures to be carried out.

On the initial stages use remineralizing therapy to restore the structure of the enamel.
Sometimes silver plating is also used, an effective surface coating procedure. special composition, however, it has a negative aesthetic effect - blackening of the treated surfaces.
At all stages and at any age shown conducting professional hygiene oral cavity.
If the dentin is affected, then it is necessary remove affected tissue and carry out filling. Depending on the age and the presence of psychological contact with the child, this can be done using local anesthesia or even general anesthesia.
ICON method. A new direction in dental treatment that does not require the use of a drill. The cavity is sealed with a special gel, it strengthens it from the inside and stops the destruction process. In this way, all teeth can be treated in one session.
Rubberdam plates- conservation of diseased teeth. The tooth is covered with an insulating substance and dried with a lamp. Thus, it is separated from neighboring ones, in order to prevent the spread of caries.

When unable to save baby tooth, it is removed. Then you may need to install special orthodontic crowns for children (). This procedure requires a special approach and the use of painkillers. Read more about the removal of milk teeth in children in the article.

On the methods of treatment and prevention of bottle caries, see the video:

How to avoid the appearance?

To prevent bottle caries in babies, parents should be aware of preventive and protective measures.

Systemic prevention

Timely treatment of any infectious diseases the baby and the parents.
Improving the immunity and defenses of the child's body.
Complete nutrition.
Lack of "snacks" and feedings "on demand".
Limit feedings at night with mixtures, sugary drinks and milk.
Timely visits to the dentist.
Strict adherence to the rules of oral hygiene.

Local protection measures

The use of toothpastes that contain fluoride or other therapeutic and prophylactic complex.
Choosing the right toothbrush for your child's age
Refusal to "taste" food from a spoon or bottle of a child, in order to avoid infection with "adult" bacteria.
Timely introduction of solid foods in the diet. Vegetables and fruits contribute natural cleansing oral cavity.
Use of remineralizing gels and fluoridation preparations (eg, gluftored) that can be used at home. Or holding an office.
Replacing sugary drinks with pure water.

A prerequisite healthy teeth the baby has regular visits to the dentist and timely treatment all comorbidities.

To prevent bottle caries in children, Dr. Komarovsky gives parents the following advice:

teach a child to drink clean water. This will help to wash out the remnants of food from the teeth in a timely manner;
start monitoring the cleanliness of the baby's oral cavity even before the first teeth appear;
do not give the child juices bought in the store, they can be replaced with home-made drinks;
when the first symptoms of caries appear, immediately visit the dentist.

In the following video, Dr. Komarovsky tells a lot of interesting things about children's teeth:

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