What does dental caries look like in the early stages? Stages of caries from initial to deep. Signs with photos and symptoms of the disease

Caries is a complex slow-flowing pathology, the localization of which is hard tissues tooth. This disease is a consequence of the effect on the tooth various factors both external and internal. Caries begins with focal demineralization (washout mineral components) of the inorganic component of the enamel, followed by the destruction of the organic matrix. When hard tissues are destroyed, decay continues in the dentin that has been exposed to bacteria. If the disease is neglected, then the inflammation affects the pulp and periodontium.

Specialists 3 stages of caries are distinguished (according to the degree of tooth decay): spot stage (initial caries), superficial caries stage, medium caries stage, deep caries stage.

The spot stage differs most mild clinical picture. The appearance of the tooth practically does not differ from a healthy one, and this is dangerous, because the patient may simply not notice the changes, while the pathological process is gaining momentum.

At the first stage of caries, the tooth is insensitive to palpation (palpation), and no external damage is detected on it. The only thing that can be noted with the naked eye is the enamel that differs from the main light small spot of white a.

The initial stage of the disease can be suspected if the enamel becomes loose in appearance, does not shine and loses its brightness. With the development of the disease, the spot becomes larger and acquires a dark shade.

Reasons for the appearance

The trigger factor for the appearance of caries is often non-compliance with hygiene. oral cavity. According to multiple observations, the "spots" of caries are located in places that are difficult to clean, such as the cervical area, the joint or the recess in the crown.

Plaque and food debris become favorable environment habitat for microorganisms. Exactly microbes cause the onset of the disease - demineralization. The loss of minerals occurs due to the leaching of calcium from the enamel. As a result, the tooth becomes fragile and loses its healthy appearance.

Diagnostics

Such caries is often recognized by a specialist when he is contacted for another problem. You can see carious spots at home. If after cleaning and lightly drying the teeth, areas other than enamel are noted, then you should contact your dentist.

With a targeted visit to the doctor, drying the enamel and visual inspection is a common diagnostic method. A demineralized tooth loses its luster and appears comparatively duller than the rest.

An effective and more reliable test is exposure to organic dyes. The most common indicator is methylene blue; also methylene red, carmine, or tropeoline may be used. The dye is applied to the prepared tooth, aged for a while, and then washed off with water. The presence of stained areas indicates the development of the disease.

For a more accurate diagnosis, before any manipulations, the teeth are pre-cleaned and plaque is removed from them. In addition, the enamel is treated with hydrogen peroxide and cleaned of saliva by medical suction using cotton wool and jet air.

One of the ways to determine this disease is the probing method., in which the doctor pays attention to the roughness of the enamel.

Diagnosis is complicated by such factors:

The inaccessibility of the localization of education;
The risk of confusing caries at this stage with a spot of endemic fluorosis (the latter disease is provoked by an excess of fluoride in the body). The clinical manifestations of caries and fluorosis are very similar, but fluorosis is characterized by clusters of spots, and single localizations are characteristic of caries.

Such caries is characterized by the process of destruction of hard tissues. The carious defect is concentrated in the enamel coating. Disease does not yet apply to dentin-enamel bonding. At this stage of caries development, patients may feel discomfort as chemical or mechanical stimuli provoke short-term pain.

Among mechanical and chemical damage can be distinguished:

Sour, salty and sweet food;
Chewing gum;
Too cold or hot dishes;
Brush contact with gums during oral hygiene.

If food remains are not removed from the carious cavity in time, then the process of inflammation may begin, characterized by an increase in body temperature, the appearance of edema and bleeding of the gums in the area of the damaged tooth.

Reasons for development

In the absence of proper treatment of the disease at the first stage, enamel lesion begins from a chalky speck. On the early stages demineralization disease is reversible.

Lack of proper care of the oral cavity exacerbates caries and contributes to its development. In addition, low-resistant (subject to destruction) enamel, insufficient amounts of proteins, minerals and vitamins in the body can become factors in the development of the disease.

Diagnostics

Patients rarely turn to a specialist at the stage of superficial caries, because pain with this disease can be easily confused with hypersensitivity . A specialist can see such caries when visual inspection.

Effective diagnostic measures in the case of a superficial stage are considered probing and transillumination (transillumination method). Rarely used radiography. During the probing procedure, the patient may feel slight discomfort due to a painful reaction at the site of the lesion. When probing, the disease at the superficial stage becomes noticeable due to roughness on the surface of the enamel and the presence of specific cavities.

Transillumination is effective as helper method, which improves the visualization of the disease due to the transillumination of hard-to-reach places.

Average caries - more late stage, for which characterized by the appearance of a pronounced carious cavity(the so-called hollow). The carious cavity looks like a cone, the top of which is located inside the tooth, and the widest part is on the surface of the enamel. In such a cone-shaped hole there are 3 types of affected dentin:

Soft dentin, the structure of which has been completely destroyed;
Transparent dentine covered with lime;
Secondary dentin (it is also called replacement or irregulatory).

The last type of dentin performs the function of stabilizing the process of spreading the lesion. If he does his "work" well, then the patient may not feel pain under the influence of various traumatic factors. However, this makes the process invisible, and the disease becomes neglected.

Affected areas continuously and painfully react to mechanical and chemical stimuli. The patient may complain about the presence.

Reasons for development

Main causes of caries middle stage I can be:

cariogenic microflora, favorable conditions for the development of which are created by non-compliance with hygiene procedures;
Excessive consumption of carbohydrate-containing foods;
Decrease protective functions hard tissues.

The middle phase is the result of the progression of the superficial degree of caries. With the transition of the putrefactive process to the dentin, the tubules expand and various microorganisms freely penetrate there. During the life of microorganisms, odontoblast processes are damaged (dystrophy and necrosis).

Toxic substances secreted by microbes provoke the destruction of dentin, demineralize it and make it soft.

Medium caries can become chronic disease, localized on the contact surface of the tooth and characterized by a latent course. In this case clinical manifestation will be insignificant and the disease will gradually move to a deep stage or acquire a complication in the form.

Diagnostics

The patient can independently detect caries at this stage, because carious cavity becomes clearly visible and characteristic shape"hollow", and painful sensations will be periodically present. During a visual examination, the specialist will find a "hollow" filled with soft and darkened modification of the dentin. The recess is still shallow, it does not extend into the cavity of the tooth.

For accurate diagnosis, the following procedures are carried out:

Electroodontodiagnosis;
Thermal test;
Differential diagnosis.

deep caries It is the most running stage diseases. This stage is characterized by a wide spread of lesions on the hard tissues of the tooth and the capture of deep layers of dentin.

This stage implies the destruction of the crown, the formation of a deep carious "hollow", severe pain upon contact with mechanical or chemical irritants. The tooth is critically demineralized, all tissues, its components, including the peripulpal dentin, succumbed to destruction.

The patient feels a pronounced bad smell from the mouth, pain on palpation; if the process occurs under the seal, then it can loosen, fall off or chip.

Reasons for the appearance

There are 2 types of deep caries stage, depending on the origin:

Primary- with a neglected state of medium caries, the disease passes into a deep stage;
Secondary- in case of chipping or deformation of the seal, installed earlier in the problem area.

Excessive consumption of carbohydrates and retention of residues of carbohydrate-containing food in the oral cavity can accelerate the process of transition of the middle phase to the deep stage of caries. Due to the fermentation of such residues in the mouth, the appearance of organic acids, which "corrode" the enamel and make it easier for bacteria to access the dentinal tubules.

Plaque covering the enamel due to poor oral hygiene also contributes to the spread of damage to the tissues of the teeth. Another important factor that creates a favorable or unfavorable environment for bacteria is the proportional composition and acidity of saliva.

Diagnostics

On examination the doctor reveals the progressive destruction of the tooth crown and a deep carious cavity filled with modified dentin. The probing procedure at this stage is very painful for the patient, or they do not feel it at all (if secondary dentin has formed).

The survey also uses the following methods:

Differential diagnosis;
Thermodiagnostics;
Electrodiagnostics;
X-ray / radiophysiography.

How to determine the stage of caries - video

Learn how quickly caries develops and what are the main stages of the disease from this video.

In the first two stages of development, caries is a reversible process. With timely and competent treatment, the tooth can be restored and saved. aesthetic appearance. If you suspect caries, you should make an appointment with a dentist, because the quality of your life depends largely on the health of your teeth.

All stages of dental caries are mutually consequential processes in which there is a gradual progression of the affected area. Each stage has its own distinctive external signs and symptomatic manifestations. It is impossible to determine the clear boundaries of each level of the carious process, since the division is rather arbitrary and is determined by the type of affected dental tissue: enamel or dentin.

The initial stage of caries

The disease is characterized by the appearance of demineralization zones on the surface of the enamel. At the initial stage of caries, the covering tissue of the tooth does not have visible mechanical defects and tissue loss - the defeat of the carious process is manifested by a change in the color of the enamel.

At the first signs of initial caries, a chalky spot appears - a zone that has a whitish tint and is devoid of shine. The color of demineralized enamel gradually changes from light to dark brown.

Complaints are most often absent, with the exception of a violation of aesthetics. Often the patient does not pay attention to the spot that has appeared on the tooth or takes it for plaque. Caries in the stage of a light spot can be stopped and, having replenished the enamel with the necessary microelements, restore the integrity of the structure.

Superficial caries

The second stage of development of caries is characterized by the appearance of depressions on the surface of the enamel. In this case, the pathological focus is located only within the upper layer of the tooth. The enamel acquires a roughness, which is felt when probing the lesion.

A person may indicate hypersensitivity when taking sour or sweet foods. If caries occurs in the cervical region, where there is a thinner enamel layer, complaints about short term pain from thermal stimuli.

Medium caries

At this stage of caries, tissue loss reaches the dentin, while crossing the enamel-dentin junction. The lesion looks like a pigmented cavity with sharp, undermined edges. Depending on the type of the process, the hardness of the dentin changes.

At acute course During the carious process, the dentin layer has a light color, while the tissues are softened and can be easily removed with manual dental instruments. When the disease develops slowly and long time, then the cavity has a dark color, the dentin is dense.

There are complaints of pain from all kinds of irritants, when food gets in, in the process of brushing your teeth. In the absence of proper treatment, medium caries moves to the next stage.

deep caries

The final stage of the carious process, in which the destruction extends so deep that the cavity almost reaches the pulp chamber. A person points to pain when eating, with mechanical irritation of a diseased tooth, sometimes discomfort occur spontaneously.

Upon detection of caries deep stage there is a possibility that the pulp of the tooth is already infected, and endodontic treatment will be required.

Diagnosis of caries at different stages

In order to spend effective treatment of the affected tooth without the development of complications, the doctor needs to determine at what stage of development the carious process is.

To determine the degree of damage, dentists use following methods :

visual inspection- determined visible changes colors and structures, as well as the amount of destruction of a carious tooth.
sounding- using a thin sharp instrument, the integrity of the enamel is checked. If the probe clings to the edge of the surface or gets stuck in the recess, this indicates the presence of changes in the structure of the tooth. Probing also allows you to determine the soreness of the enamel-dentin junction (a sign of medium caries) or the bottom of the cavity (occurs with a deep process).
Percussion– tapping on the crown helps to detect changes in the apical tissues. In uncomplicated caries, this diagnostic test is negative.
X-ray method– Demineralized areas appear darker in the image. This method is good for detecting caries on contact surfaces, as well as determining the depth of the lesion in medium and deep forms.
Cold test- shows how the tooth reacts to low temperature. pain sensitivity characteristic of medium and deep caries.
Caries marker- the part of the tooth that has demineralization is stained under the action of the pigment. This diagnostic method is good to use to clarify the initial or surface forms caries. In more serious stages, with the help of staining, the doctor determines how much more altered tissues need to be removed.

The main diagnostic manifestations for different stages Tooth decay is fairly easy to identify. The exception is hidden cavities located in deep fissures, on proximal surfaces and in the area under the gum.

Manifestations of caries in stages:

Initial caries - there is no destruction of dental tissue, probing and percussion are painless, the appearance of a white or pigmented spot on the surface is noted.
Superficial caries- the process affects only the enamel layer, tapping on the tooth and diagnostics with a probe are negative, a small carious cavity is found;
Medium caries- the cavity is located within the dentin, filled with dense or loose tissue, changed in color. Probing is sensitive along the enamel-dentine junction. Percussion is painless.
deep caries- deepening is determined large sizes, pigmented. Probing is painful all over the bottom. Tapping on the tooth does not give a positive reaction.

Treatment of various stages of caries

Treatment Method pathological process varies and depends on the stage of the disease. Often patients dental clinics Interested in whether it is possible to cure caries at an early stage? Let us consider in more detail the methods of treating a carious process in the stain stage.

Eliminating white spots on enamel can be done through remineralizing therapy. This method treatment involves the application to the surface of the tooth of certain medical preparations, which are based on ions of fluorine, calcium, phosphorus or magnesium. Due to their entry into solid tissues, the crystal lattice is restored.

However, therapeutic measures should be carried out at the first manifestations of demineralization, only in this case will it be achieved positive result. In order not to miss the emerging pathological process, you should regularly visit the dentist for examinations of the oral cavity.

Remineralization is usually carried out in courses of 10-20 days, depending on the agent used.

There are several methods of treating initial caries.:

Classical fluoridation- a varnish containing fluoride ions is applied to the changed enamel. After drying, a film is formed on the tooth surface, from which the minerals are released. The course is 2 weeks.
Deep fluoridation- the method has similarities with the previous method, the difference is in active substances. Initially, a composition is applied in which fluorine and copper are present. After holding for 10-15 minutes, the tooth is covered with a solution from the second bottle, which contains calcium compounds.
Restoration of the enamel structure using calcium- the preparation "Remodent" or calcium gluconate is applied to the teeth.

Methods for the treatment of subsequent stages of caries involve the mandatory removal of affected tissues, followed by filling:

Classic preparation- softened tissues are removed using a turbine or contra-angle handpiece.
Laser preparation- infected dentin is removed laser beam, while only local removal of caries occurs without affecting healthy tissues.
Air abrasive method- caries is removed from the surface of the tooth using a device that ejects a powerful jet of a finely dispersed substance, which causes grinding of the enamel.
ART-method– atraumatic removal of infected tissues with sharp hand instruments.

After drug treatment and the preparation corresponding to the selected material, the cavity is sealed.

Prevention

It is impossible to avoid caries forever, but by doing preventive measures can reduce the chance of tooth decay.

Basic caries prevention methods:

Regular brushing of teeth. Contact surfaces should be flossed daily during evening oral care to remove food debris and microbial plaque from hard-to-reach areas.
Application of fluoride toothpaste. The prophylactic concentration of this trace element for adults is 1500 ppm, for children under 12 years of age, a dosage of up to 1000 ppm is recommended.
Reducing the amount of sugar-containing foods consumed.
Removal of tartar and professional cleaning oral cavity at least once every six months.
Visiting the dentist for preventive check-ups.

Attentive attitude to the health of the oral cavity consists in timely visits to the dentist and regular care. This helps to reduce the number and growth rate of cavities.

Useful video about the diagnosis of caries

From this article you will learn:

stages of caries
what are the signs of caries,
how to identify caries yourself.

Caries is a process of destruction of hard tissues of the tooth with the active participation in this process of cariogenic microorganisms of the oral cavity, such as streptococci, actinomycetes and lactobacilli. The development of caries is usually divided into stages that correspond to different depths of damage to the hard tissues of the tooth.

Stages of caries -

It is customary to allocate 4 successive stages caries:

Superficial form of caries and (Fig. 2) -
a defect is formed within the enamel layer, without affecting the dentin underlying the enamel. Please note that in Fig. 1, the carious focus in the form of a dark spot does not extend beyond the enamel-dentin border.

Medium caries (Fig. 3) -
the process extends to the upper and middle layers of dentin, without affecting its deep layers directly surrounding the tooth pulp.
Deep form of caries(Fig. 4) -
the process of destruction extends to the deep layers of dentin near the pulp of the tooth. In Figure 3, we can clearly see how caries-affected tissues (dark in color) are close to the pulp chamber, in which the tooth pulp is located.

Complications of caries -

If the deep form of caries is not treated in time, then the infection penetrates into the pulp of the tooth. In this case, inflammation of the nerve in the tooth develops, which is called. If, in turn, pulpitis is not treated in a timely manner, then the inflammation goes beyond the boundaries of the tooth - into the tissues surrounding the tops of the roots of the diseased tooth. In this case, granulomas or cysts (purulent sacs) appear on the tops of the roots. Such a disease is called.

Signs of caries

Typical signs caries is an infrequent occurrence pain attacks under the influence -

thermal stimuli ( cold water or cold air)
chemical irritants (for example, sour, salty or sweet foods).

How Do Dentists Detect Caries?

Most main way is a visual inspection. However, there are places in the oral cavity where it is quite difficult to detect caries. These places include:

interdental spaces,
deep fissures in chewing surfaces teeth,
if you suspect the presence of caries under a filling or under an artificial crown.

To detect caries in these hard-to-reach areas, the following diagnostic methods are used:

x-ray –
identify hard-to-reach caries - an x-ray may well. In this case, caries should not be too small. Tooth tissue affected by caries x-ray will be dark in color, and dense healthy tooth tissues will be lighter. The pulp of the tooth on the x-ray also looks like a blackout. X-ray diagnostics is very useful method, because X-ray may reveal carious lesion, for example, even under a filling and under a crown.

A widespread disease of the teeth is called, characterized by their demineralization and further destruction of hard tissues. In translation, "caries" means "rotting". This destructive process affects people of absolutely any age: from babies to the elderly.

Scientists have achieved impressive success in studying the disease and were able to formulate the main cause of caries. According to research, the development of carious processes is the result of exposure to organic acids that contribute to the dissolution of hard dental tissues and the development of cariogenic organisms.

There are also certain features. The presence of the same microorganisms in the oral cavity various people and eating similar foods does not guarantee identical development and course of caries. This makes the pathology polyetiological and means that the formation of defects in hard tissue needs a simultaneous combination of influence a large number factors.

Why does caries develop?

There are two groups of factors contributing to the development of caries: those that do not depend on us (exogenous) and those that a person can prevent by his own efforts. The latter include:

insufficient hygiene mouth (it is necessary to clean the teeth using the correct technology twice a day - in the morning and before bedtime);
poor immunity, serious infectious diseases(it is necessary to carry out treatment in a timely manner and strengthen the body);
bad habits(abuse of smoking, alcohol);
the presence of plaque (it is necessary to produce 1-2 times a year hygienic cleanings teeth in a dental clinic).

How exogenous factors, you can note:

drinking low quality water;
increased solar radiation;
pregnancy;
lack or imbalance of macro- and microelements in the body;
genetic predisposition;
insufficient maturation of the enamel.

It should be noted that the susceptibility of the body to caries in each person is individual. Someone has never had to visit a dentist in their entire life (although this is a rarity these days), and someone does something that constantly makes an appointment. This may depend on genetic factors, general condition organism, quality of saliva, nutrition, hygiene, saturation of tooth enamel with fluoride, anatomical structure teeth. Doctors around the world tirelessly argue and talk about the causes of caries. And yet, today the destruction of tooth enamel tissues is usually associated with vital activity. pathogenic microorganisms contained in dental plaque.

Stages of development of caries

Different stages of caries differ in signs and symptoms. Its division into separate stages can be called conditional, as a simplification of the understanding of the process. In this regard, the manifestations of caries cannot be distinguished with perfect accuracy from each other at each of the stages of its development. Stages are characterized by a smooth flow from one phase to another and develop from one to another.

The first stage allows reverse process for the restoration of tooth enamel. At other stages, this is not possible. Treatment of caries in such a situation is carried out as a removal of the carious process, followed by the restoration of destroyed tissues with the help of a filling. If in doubt about the presence of caries, it is better not to try to carry out self-diagnosis and contact a specialist.

?Carious disease, like any disease, progresses in stages. Each stage appears gradually.

Deep caries (root, cervical) dentist treats in stages. Usually two visits are required. First of all, the main task of the doctor is to anesthetize the dentin. To do this, he does the following:

eliminates the surface layer;
puts an anesthetic into the cavity;
placing a temporary filling.

A second visit will be required in 2-3 days. If there are no complaints, the dentist performs the following procedures:

cleans the cavity from temporary fillings;
rinses it out with antiseptic preparations;
if necessary (in case of pulpitis) removes the nerve;
puts a special pad with calcium hydroxide in the cavity, which will promote the formation of secondary dentin, then covers it with glass ionomer cement;
places a permanent filling.

Diagnosis of caries at different stages

Detect a carious defect and put correct diagnosis not so difficult, since its symptoms are well known to both patients and doctors. An exception is hard-to-reach, hidden areas of the tooth (for example, subgingival zones or a contact surface with tight interdental contact). For examination, the doctor must use X-ray or dental transillumination with a powerful light source.

The most important symptoms of caries:

White (chalky) spot or the presence of a hard tissue defect with uneven walls made by decay.
With medium or deep caries, this is pain as a result of probing the bottom of the carious cavity, most often at points located near the pulp.
At deep cavities- positive thermal test.

Caries markers ( existing funds, which allow to detect caries) are of practical importance only for the two primary stages of the development of pathology, with the difficulty of visual detection of the defect.

About the types of fillings

Classical treatment caries is a dental filling, which restores the function and aesthetic appearance of the tooth.
Various materials are used to make fillings. The most popular are light composites, which harden with the help of a special blue light and chemically cured composites. Products made of a light-cured composite are not only beautiful, but also durable, allowing you to fully restore the tooth. color scheme tooth.

If there are long-term defects in the dentition, experts recommend using an alternative to classic fillings - dental inlays. They are performed on exact individual casts in dental laboratories. The doctor attaches the tab to the tooth using a special glue. Materials for the manufacture of inlays are common, classic fillings are made from them. But the most popular are ceramic inlays, which serve more reliably and longer than the classics.

Permanent and temporary fillings

Dental practice is familiar with 2 types of fillings.

Temporary fillings. Their establishment is carried out for a certain time period with further replacement with permanent fillings. They are mainly used for therapeutic and diagnostic purposes. For example, the dentist is not sure if the tooth nerve is affected by the disease. If the establishment of a temporary filling provokes aching pain in the tooth, then the nerve is damaged and must be removed. Temporary fillings tend to close different drugs introduced into the tooth, and requiring removal after some time. Such fillings do not fall out on their own after a certain period, but are subject to quick and easy removal dentist. Temporary fillings are covered with arsenic, which destroys the diseased nerve.

Permanent fillings, established for a long period, during which they faithfully serve the owners.

There are three main types of fillings:

Photo seals ( light seals). They harden under the action of the rays of a special lamp. With their help, the dentist can give the tooth the desired shape and the desired shade, similar to natural. After the treatment of the tooth appearance no different from healthy.
Composite filling with chemical curing. Such fillings are durable, not affected by saliva, but the choice of shades is limited.
Amalgam. Metal filling containing mercury. Very strong and reliable, but it has a grayish or even dark tint, so it is installed mainly on distant teeth and it is recommended to immediately put crowns on them, since mercury is unsafe for health.

According to the place of localization, deep caries can also be different:

Cervical. It develops in the basal areas of the teeth.
Hidden. Progresses in the dentin under a layer of healthy or partially destroyed enamel.
Fissure. A carious cavity is formed in the pits and grooves of the molar.
Root. It usually occurs in older people with gum recession.

Dentists recommend everyone not to run such an insidious disease as caries to a deep stage! Only a timely visit to the clinic and daily observance of preventive measures will help keep your teeth strong and healthy throughout your life.

Video: How caries develops.

The video contains a detailed story about the structure of the tooth, its defeat by caries on different stages and what can be done at these stages of the disease.

Video: Tooth filling.

In the treatment of caries, most often everyone was faced with the situation of placing a filling on a tooth. The video tells about the main type of caries treatment and tooth filling.

Statistics confirm the conclusions of dentists that every year the number of people suffering from caries is constantly increasing.

Today, almost 90% of the population has this disease in one of its stages.

root cause given state is poor oral hygiene. It is this circumstance that leads to the concentration pathogenic flora causing caries.

In addition to hygiene, a healthy lifestyle helps to contain the reproduction and spread of microorganisms, strong immunity and proper nutrition. If, for any reason, the action of one of these deterrents is excluded, microbes will intensify their activity and lead to caries.

It is rather difficult to identify the disease on its own at this stage, since it does not manifest itself in any way.. It can only do experienced specialist. But you can suspect its presence by weakening the tooth shine. Gloss in this situation does not disappear from the entire tooth surface, but only in a small area.

It will subsequently form small shapeless white or matte spots. Their appearance indicates the development of demineralization, which quickly covers all units. Over time, the enamel of demineralized teeth begins to thin, and the spots themselves darken and become Brown color. Such a change in many patients causes soreness.

Important: at this stage, the affected unit does not show a reaction to the action of stimuli. There is no discomfort or pain.

The use of a methylene solution will help diagnose caries at the initial stage. He tints problem units in Blue colour. Instrumental diagnostics is powerless, since the enamel is still smooth in the destructive areas, and the probe slides over it.

We will be told about the treatment of caries in the stain stage in the following video:

Treatment of carious teeth excludes the use of preparation and filling. Their therapy consists in enriching the enamel with the necessary ions of calcium, magnesium, potassium (remineralization). The procedure itself is performed in the following sequence:

held local anesthesia(if necessary);
professional cleaning of the oral cavity;
the affected tooth is polished and isolated from saliva access;
one of the remineralizing agents is applied to its dried surface.

Caries at the 1st stage is a reversible process, provided timely access to a specialist and treatment.

Surface

Left without treatment initial stage, shows a trend further development. The stain begins to grow rapidly, changes color, but does not affect the deep layers of the enamel. The greatest intensity of the process is observed on its lateral and internal surfaces.

The superficial stage is characterized by such manifestations:

the structure and structure of enamel changes: it acquires porosity, unevenness, roughness;
the color of the spots themselves changes: from matte (white), it changes to brown or even black;
recesses, cracks, chips become well on the spots;
a short-term aching pain reaction to the action of stimuli develops (especially from hot, sour, sweet, cold food), and with the additional presence of a focus of infection, discomfort from brushing the teeth or pressing on them with a finger is observed;
plaque accumulates in the pre-gingival area;
develops inflammation of the papillae (rarely).

Superficial caries is easily diagnosed by visual inspection or probing.

It is impossible to return the enamel to its original state using remineralization. Dentists at this stage use direct action on the tooth itself, and the sooner it is started, the much less effort will be required to restore it.

Treatment of superficial caries consists of:

problem surface treatment;
grinding of altered enamel;
adhesion-increasing coatings;
filling.

Upon completion of the procedure, the filling is necessarily polished, corrected for bite, fissures (bumps) are formed on its surface.

Average

At this stage, the disease is visible visually, so ignoring its presence is pointless and dangerous. Every day, discomfort and pain will manifest themselves on the rise.

Medium caries is manifested by the following symptoms:

Sharp, but not intense pain that appears under the action of irritants: brushing teeth, food, contrasting air temperature. The pain disappears almost immediately after the exclusion of the irritating factor.
In isolated cases, it may be completely absent due to the fact that the dentin-enamel junction was destroyed and replacement dentin was formed. He then weakened the sensitivity of the pulp to the action of stimuli.
Increased affected area covering most tooth. Caries affects the middle layers of enamel, captures dentin.
Noticeable aesthetic disturbances. A dark carious spot appears on the tooth cavity, the enamel on the affected unit loses its luster and becomes rough.
Hard walls of the appeared cavities.
Bad smell coming from the mouth. Its appearance is associated with decay and decomposition of food debris accumulated in carious cavities. Daily hygiene will not completely clean them out, so the food begins to rot.

For a detailed study of the oral cavity, an x-ray, visual examination (mirror) and instrumental examination are used. Examination reveals a characteristic carious spot, brown (rarely gray and beige colors), a carious cavity of different depths.

Using a probe allows you to determine the degree of coverage of the pathological process of the enamel, the depth of the cavity, the sensitivity on those teeth that are poorly visible visually.

According to the results of the obtained data, appropriate treatment is prescribed. If you do not delay visiting a doctor, caries at this stage can be easily stopped. The scheme of his treatment is as follows:

Anesthesia is given.
Infected tissues are destroyed.
Held aseptic processing with the use of fluorine- and calcium-containing preparations (their use strengthens tissues and prevents the development and spread of caries in the future).
An insulating gasket is applied.
A filling is placed.
The tooth is polished and ground.

Important: usually such caries is treated in one visit. The patient still has a chance to save his tooth, which cannot be done at the next stage.

Deep

Unfortunately, it is this stage of the disease that is most often detected. Fear of the dentist causes many people to put off going to the dentist, which leads to further spread of the disease and worsening of the condition: development secondary diseases, the loss of the tooth itself.

Pathology is characterized by the following features:

voluminous deep carious cavities going to the dentin (but they do not affect the pulp);
sharp, long-lasting pain, which can develop not only from the action of irritants, but also at rest (pain sensations are more often manifested in the evening and at night);
damage to the dental nerve;
the affected areas become black;
the tooth and subgingival area are gradually destroyed.

Caries treatment for this stage – long process and may take more than one visit to the dentist.

It is carried out in the following order:

Local anesthesia is given.
Using a mirror and a probe, the doctor examines the carious cavity, determines its depth, and explains the course of treatment to the patient.
Necrotic, carious soft and hard tissues are removed.
A cavity is formed.
Aseptic processing is carried out.
superimposed medical pad to the bottom of the cavity in order to prevent the development of complications.
Following it, an insulating gasket is laid to secure the first and protect it from the ingress of the composite.
An adhesive material is applied to the walls.
A filling is placed.
The tooth is being restored.

If the treatment takes place in 2 stages, then instead of permanent filling is set to temporary. This is done if the patient complains of pain, the disease turns into pulpitis, the dentin is severely thinned or absent, the pulp chamber is open.

Multiple

The acute stage of the disease, in which immediately subject to destruction of 6 or more units, moreover, several "holes" can be present on one at the same time. It manifests itself in the presence of neuro-somatic, endocrine, infectious and other chronic conditions.

Among the "unfavorable" factors leading to this condition are the lack of vitamins and minerals in the food and water consumed, poor ecology, stress, diet, work in hazardous industries, heredity, etc.

A characteristic sign of pathology is its fast development and distribution. So, in just a year, almost all units can collapse in a person. Simultaneously with the development of the pathological process in humans, ductility and high viscosity saliva, poor salivation, dry mouth.

To others clinical signs caries include:

slight destruction of enamel with extensive damage to dentin;
the appearance of several cavities on one tooth;
rapid appearance of plaque;
simultaneous presence of caries at different stages of development.

Another sign of the disease is the loss of relatively fresh fillings. This is due to the development of a secondary focus of caries under them, as a result of which the enamel becomes soft and the fixation of the composite weakens.

Treatment multiple stage includes:

removal of affected dentin;
formation of cavities;
their treatment with antiseptics;
filling.

The success of treatment directly depends on how successfully the treatment of the underlying disease that caused multiple caries is carried out. In addition, the patient is recommended to take drugs that increase immunity, restoring mineral balance. A diet is being developed that includes foods, saturated with proteins, minerals, vitamins.

A good result is given by physiotherapy: fluoridation, silvering, calcination of teeth with special means or electrophoresis.

recurrent

It arises and develops in a sealed tooth (under the filling itself or at the edge of the sealed cavity). You can recognize the pathology by the darkening of the filling along its edge, the appearance of visible cracks or chips on the enamel.

Several reasons can lead to its development:

wrong transition filling material into the tooth (with a joint);
the outer tooth surface is poorly prepared for the application of the composite;
the carious cavity was not completely cleaned during the first filling.

Important: in order to prevent the development of repeated caries, it is necessary to periodically come to the dentist to check the condition of standing fillings.

If unevenness, roughness of the filling is found, and especially in the place where it connects to the tooth, the doctor, using polishing, will return it original view and protect against caries. In the event of a disease, the treatment consists in replacing the filling.

Carious tooth decay can be stopped at any of these stages.. The main thing is to establish and eliminate the cause of the disease in time.

By location

On this basis, the disease is divided into 4 types:

Fissure (occlusive)

The most common type that affects the natural depressions of chewing tooth surfaces: fissures. It is in these recesses that most deposits accumulate, which are not always completely cleaned out.

Interdental (proximal)

Destroys the contact surfaces of the teeth, and is not visualized for a long time. Its "stealth" is explained by the peculiarity of the development of pathology: affecting chewing units, the disease develops towards their center, while the carious cavity itself remains covered with preserved enamel for some time. An x-ray can reveal its location.

Cervical (cervical)

The focus of the disease is located in the area near the gums (in the neck). It can be covered by a reddened gum area for some time.