What is cervical caries and how much does it cost in dentistry? What is cervical caries Cervical dental caries

Cervical caries is considered the most dangerous type of caries. Often diagnosed in 30-60-year-old people, children, people suffering from endocrine diseases.

Causes

The gum area is a hard-to-reach area for high-quality hygienic care. When brushing, the brush does not completely cover the neck of the tooth, which is why a larger amount of plaque accumulates here and tartar forms more actively.

1. Pathogenic bacteria multiply in plaques Streptococcus mutans that produce lactic acid. It negatively affects the surface and subsurface layers of enamel, washing out calcium, fluorine from it and breaking the mineral crystal lattice of enamel.
2. Non-compliance with the rules of hygiene is not the only reason for the development of cervical caries. Too intensive brushing of teeth can also provoke the development of the disease, during which the already thin enamel in the neck area becomes thinner (for comparison: 0.1 mm in the neck area and 1.7 mm in the area of ​​the tubercles). The state of the enamel is also affected by the use of abrasive products for teeth whitening, the use of certain medications.
3. Damage to cervical caries of several teeth at once is often observed in endocrine diseases (diabetes mellitus and thyroid diseases). The fact is that with diabetes, the number of representatives of pathogenic microflora increases significantly. This leads to accelerated demineralization of dental tissues. A high concentration of glucose in saliva also leads to an increase in the prevalence of tartar and plaques (in diabetes - up to 6.33 mg, normally - up to 3.33 mg)

stages

1. Caries in the stain stage. The color of the enamel in the cervical region varies from white chalky to pigmented spots. Shine is lost in a limited area of ​​​​enamel. From sour and other chemical and temperature irritants, a quickly passing feeling of soreness may occur.
2. Stage of superficial caries. A shallow defect appears within the enamel. Roughness appears in the center of a white or pigmented spot.
3. Medium caries. A shallow carious cavity is filled with softened dentin. Damage is shallow, they do not affect the layers adjacent to the pulp.
4. deep caries. There is a deep carious cavity with overhanging edges of the enamel, filled with softened dentin. A common complication is pulpitis.

Symptoms

How to treat - an overview of effective methods

How is cervical caries treated in a dental clinic

Depending on the stage of caries of the neck of the tooth, various methods of treatment can be used.

In the spot stage

1. ICON technique (treatment of the tooth with an etching gel, filling the damage with a special composite compound).
2. Remineralization. Its purpose is to saturate the enamel with calcium and fluorine.

Remineralizing preparations used in dental clinics:

• Tiefenfluorid - enamel-sealing liquid;
• Gluftored;
• Remodant;
• Belagel Ca/P;
• calcium gluconate solution;
• Sodium fluoride solution;
• Fluorine-containing varnish (fluorine varnish, bifluoride-12).

Treatment in the later stages

In advanced cases, treatment of the carious cavity and filling is required. Deep dentinal involvement may require root canal treatment or nerve removal.

Filling is carried out in stages:

1. Professional cleaning (removal of dental plaque and calculus).
2. Enamel color determination (for material selection).
3. Gingival pushback (required to treat the affected area under the gum).
4. Treatment of the carious cavity with boron, removal of necrotic tissues.
5. Isolation of the tooth from saliva with a rubber dam (it is necessary that the filling does not fall out within 2-3 months).
6. Treatment of dentin and enamel with an adhesive (for reliable adhesion of the filling material to the tissues of the tooth), if necessary, the imposition of an insulating and therapeutic pad.
7. Filling with light polymerization, grinding and polishing with fine-grained discs.

The choice of material depends on the location of the carious cavity - near the edge of the gums or under it. In the presence of subgingival defects, the choice of the dentist falls on a material that hardens in a humid environment (isolation from liquid is almost impossible). These are glass ionomer cements (VITREMER), which have high strength and a triple curing mechanism. In addition, light-curing composites (filtek, enamel, charisma), compomers, ormokers (organically modified ceramics with high biocompatibility) are used.

To restore the aesthetic and functional parameters of the tooth, some dentists combine 2-3 filling materials, thanks to which they cope with complex clinical cases.

Treat or not?

Cervical caries is fraught not only with aesthetic problems and the periodic occurrence of pain. The main danger is the complete destruction of the tooth and its removal.

Other complications:

• Pulpitis with acute pain;
• Gingivitis (inflammation of the gum tissue);
• Periodontitis (inflammation of the periodontal tissues);
• Phlegmon (inflammatory process in the tissues of the head and neck).

Is it painful to treat cervical caries?

Patients who are afraid of a drill are often interested in whether it is painful to remove cervical caries. If dentin is damaged and caries goes beyond the enamel and mechanical treatment of the cavity is required, then anesthesia is mandatory. The fact is that the defect zone is located very close to the gum, and the dentist's manipulations can be really painful.

Can be applied:

• Superficial application anesthesia of hard tissues;
• Regional injection;
• Electroanalgesia;
• Acupuncture analgesia;
• Anesthesia.

What tool is used to remove caries in the cervical area

Treatment at home

At home for treatment, you can use:

• Toothpastes and gels;
• Dental floss impregnated with fluoride;
• Rinsers.

Remineralizing gels and special toothpastes are effective only in the case of cervical caries in the stain stage. It is quite difficult to choose such a tool on your own and there are several reasons for this:

1. In the spot stage, cervical caries is almost always visually invisible, and the detected defect may turn out to be a disease of non-carious origin, pigmented plaque, or cervical caries, but in a superficial or intermediate stage.
2. Treatment with drugs chosen in the pharmacy network may be ineffective, because. it is necessary to take into account the general state of health, the depth of the lesion and the area of ​​cervical caries.
3. The wrong choice of means for home treatment is fraught with harm to dental health. For example, the use of products with a high fluoride content can cause the development of fluorosis.

Fluffy caries of the neck of the tooth can be cured only by removing the softened affected tissues.

Treatment with folk remedies

If a visit to the dentist is impossible due to insurmountable circumstances, then folk methods will help to stop the development of cervical caries and get rid of pain.

sage tincture

1 tbsp herbs pour 1 tbsp. boiling water, after an hour of infusion, strain and use for rinsing. In order to prevent the spread of carious lesions on the enamel, you can apply a cotton swab dipped in tincture.

Propolis

Propolis is rolled into a pea and applied for 30 minutes. per tooth. To prevent propolis from softening, a cotton swab is applied on top.

Onion skin tincture

3 tbsp husks pour 500 ml. boiling water is brought to a boil over medium heat, filtered and kept for 8 hours in a cool place, and then used for rinsing.

Calamus tincture

1/2 cup of calamus root is crushed and poured into 500 ml. vodka, insist a week, after which they rinse the aching tooth with tincture for 1-3 minutes. For filling microcracks, you can add 10-20 g of alcohol tincture of propolis.

Herbal rinses

• Collection 1: St. John's wort, dry chamomile and calendula flowers (1 tbsp each). Pour 2 tbsp. boiling water and insist hour.
• Collection 2: lemon balm, nettle and strawberry leaves, couch grass root and knotweed (in equal proportions). Measure out 2 tbsp. l., fill them with 300 ml. boiling water and simmer in a thermos for 2 hours.
• Collection 3: fennel fruits and mint leaves (25 gr each). Insist in 500 ml. alcohol for 3 months, after which they rinse the mouth, dissolving 1 tsp. tincture in a glass of warm water.

Toothpaste, gels, rinses and ointments for cervical caries

Anti-caries toothpastes

• Strengthen the mineral tissues of the tooth with fluorine and calcium compounds;
• Prevent the formation of plaque;
• Block the growth of bacteria in plaque.

In the stain stage, pastes show good results:

• Lacalut Fluor(strengthens and restores damaged enamel);
• Remodant(from animal bones, its use leads to an improvement in the composition and structure of tooth enamel);
• Colgate Maximum(increases caries resistance due to the restoration of the hydroxyapatite crystal);
• Fallen(contains nano-hydroxypatite, the particles of which fill microcracks in the tooth enamel and enhance the mineral flow of saliva);
• signal(fluorine-containing pastes with a therapeutic and prophylactic effect);
• Blend-a-med(the fluoristat system of the paste retains calcium well in the tooth enamel).

Gels

Therapeutic gel Fluocal

The composition of this relatively new dosage form may include chemically incompatible substances (because the aqueous shell prevents the reaction between them). They are effective in the application of both for the prevention and treatment of cervical caries in the stain stage.

For therapeutic purposes are used:

• Fluocal;
• Fluodent;
• Elmex;
• Gel R.O.C.S. for office use.

Gels are applied to the teeth with a brush or a special application spoon for 3-4 minutes at regular intervals (they are set by the dentist).

Therapeutic and prophylactic rinses

They are an aid in remineralizing therapy in the stain stage. They are used 1-2 times a day according to the instructions, intensively passing between the teeth.

Popular anti-caries rinses:

• Oral B;
• 32 Bionorma;
• Caries Protect;
• Caries Protect;
• Colgate Plax.

Anti-caries creams

Tooth Mousse- water-soluble cream that restores the mineral balance of the oral environment in pathologies of salivation, after curettage, teeth whitening, etc. This cream is suitable for children when other fluoride preparations are not suitable due to age restrictions.

It has been proven that Tooth Mousse "suspends" the development of caries on milk teeth and allows you to postpone the use of anesthesia. Apply the cream to the areas affected by cervical caries with a cotton swab for 2-5 minutes.

Complications

Cervical caries in children

The main reason for the development of cervical caries in children is the insufficient thickness of the enamel on milk teeth. It rarely reaches 1 mm, and due to certain difficulties in maintaining the hygiene of the child's oral cavity, pathogenic microflora actively develops on it.

Cervical caries primarily occurs on the incisors of the upper jaw. During sucking on the nipple of the bottle, the main surfaces of the tooth are cleaned, and the cervical region does not have contact with the nipple. Gradually, microbes surround the entire tooth around the gum and corroded dark spots appear on all sides. The lower teeth are protected by the tongue when eating from a bottle, so caries rarely occurs on them.

Without timely treatment, caries affects the entire tooth, and it must be removed.

Treatment of cervical caries during pregnancy

During pregnancy, there is a high probability of occurrence of cervical defects in the hard tissues of the tooth and the development of caries. Pregnancy is not a contraindication to treatment, however, taking into account the toxic effects of anesthesia, it is worth doing it in the second trimester.

If there is no risk of exacerbation in the third trimester, then it is advisable to transfer the treatment to the postpartum period.

In the first and third trimesters, only emergency interventions are performed.

Cervical caries and wedge-shaped defect

A wedge-shaped defect is a disease of non-carious origin. It differs visually from cervical caries. So, with caries, the damaged surface has an irregular shape and brown color, the enamel is loose and rough, and with a wedge-shaped effect, there is just a deepening of the V-shaped shape, there is no darkening of the enamel.

Prevention

1. Endogenous non-drug. Introduction to the diet of foods rich in amino acids, proteins, vitamins, the use of calcium and fluorine-containing foods.
2. Endogenous medicinal. Reception of calcium and fluorine preparations by children, pregnant women, persons of risk category.
3. Exogenous non-drug. Careful hygiene with the use of therapeutic and prophylactic pastes, professional hygiene, slow drinking of milk and tea, limited carbohydrate intake, replacement of sugar with sweeteners.
4. Exogenous medicinal. Local application of remineralizing agents, rinsing.

Price of treatment

The cost of treatment depends on the stage of the disease, the status of the dental clinic and the filling material used. The average cost of treatment of undeveloped basal caries is 1600-4000 rubles. If the channels are damaged, this figure rises to 6,000 rubles.

If remineralization is indicated, then the price of treatment will be lower. Covering one tooth with enamel-sealing liquid will cost 500 rubles, and TUS MUS complex fluoridation up to 4,000 rubles.

Additional costs: removal of dental plaque (up to 4,000 rubles per jaw).

Frequently asked Questions

Toothache after filling cervical caries

If the pain decreases over time, then this is a normal reaction of the body to the intervention. An increase in pain occurs in the presence of inflammation in the gums and pulp, incomplete removal of necrotic tissues by the dentist, penetration of the filling material into the tooth, violation of the sealing hardening technology, which led to nerve injury.

How much can I drink after treatment of cervical caries

You can not eat after treatment for 2 hours, you can drink, but only warm plain water without impurities. It is also better to abstain for 2 hours.

Why does the tooth react to tapping after cervical caries treatment?

There may be several options - from the natural adaptation of the tooth to a new environment to errors in treatment, for example, the filling is too high, they made a mistake with the diagnosis (cervical caries turned out to be deep) and put a filling without a pad. If symptoms increase, contact your doctor for retreatment.

What vitamins you need to drink with cervical caries

Patients with a rapid form of enamel demineralization require complex therapy that affects the immunological state of the body. So, with cervical caries, dentists recommend taking:

• ascorbic acid (0.1-0.2 g per day);
• vitamins A and E in oil (regulate phosphorus-calcium metabolism, the deficiency of these elements leads to a decrease in the resistance of teeth to caries);
• calcium preparations (glycerophosphate, gluconate, calcium pantothenate, lactate) in courses 2-3 times a year;
• fluorine preparations (sodium fluorate, fluoride) 1 mg twice a day;
• phosphorus preparations (phytin) 3 times a day, 0.25 g.

In addition to the above, for the synthesis of a complete bone structure, teeth need vitamin K1, silicon and manganese (they participate in the synthesis of collagen, an element of the organic matrix of teeth). They are part of many vitamin and mineral complexes designed to strengthen teeth and reduce the risk of developing cervical caries (DentoVitus, Kaltsinova, CalciumOsteoporosis, Forever Kids, Duovit, Centrum).

Caries in the cervical region under the gum

Caries under the gum is root caries in most cases. You need to go for an eye examination.

Is it possible to put braces with cervical caries?

Teeth affected by cervical caries are healed until the installation of braces. Before installation, it is necessary to remove plaque and strengthen the enamel with fluorine- and calcium-containing preparations. If caries occurs while wearing braces, then the arc is removed from the diseased tooth, but this is highly undesirable.

Treatment of cervical caries with nerve removal

Such treatment will be required if cervical caries has become complicated to pulpitis, which has led to an acute inflammatory process in the pulp. In this case, the patient complains of severe pain and the dentist may decide to remove the nerve.

Is it possible to put a crown on a tooth with cervical caries

A crown cannot be placed on a tooth with decaying enamel. caries will eat the tooth anyway. First you need to cure caries.

How to cure cervical caries of a wisdom tooth

The easiest way to treat a wisdom tooth affected by caries is to remove the problematic “eight”.

Caries is a dental disease that is characterized by the destruction of hard tooth tissues (enamel and dentin). At the initial stage, the disease is asymptomatic, but over time, a cavity forms in the dental tissues. This causes severe discomfort, pain and further leads to tooth loss.

Cervical (radical) caries is the most dangerous type of caries, which destroys the tooth at its very base. It is localized in the neck of the tooth (gingival zone). Such a disease progresses rapidly, affects the root canals and can lead to a fracture of the dental crown.

In this regard, it is necessary to treat cervical caries immediately. Timely therapy will avoid tooth loss and the development of such serious diseases as pulpitis, gingivitis, periodontitis.

Causes of cervical caries

The main cause of the disease is plaque, which contains the harmful bacteria Streptococcus mutans. Due to poor brushing of the teeth, it quickly accumulates on the enamel and in the gum pockets. In the process of life, bacteria secrete organic acids that leach calcium from the enamel. As a result - the formation of a carious cavity.

Among the main factors contributing to the development of cervical caries are:

1. Neglect of two-time brushing, as well as insufficient removal of soft plaque- brushing movements should be cleaning - from the gums up, and not rubbing, as many people brush their teeth.
2. Anatomical features of the enamel near the gums. In the basal areas of the teeth, the enamel is very thin, so it is strongly exposed to the harmful effects of cariogenic organisms.
3. genetic predisposition to exfoliation of the gums causes the formation of “gingival pockets”, where food debris accumulates over time. As a result, carious cavities appear and caries develops under the gum.
4. Impaired secretion of the salivary glands. Saliva in the human body performs a protective function. Decrease in the amount of saliva produced leads to a decrease in the level of protection of teeth from the harmful effects of bacteria living in the oral cavity.
5. Refusal of preventive visits to the dentist. Most people from time to time require professional hygiene procedures - the removal of hard tartar, which, like soft plaque, is inhabited by cariogenic microorganisms.
6. Root caries may be indicative of endocrine dysfunction(development of diabetes mellitus or disruption of the thyroid gland).

Cervical caries is the most dangerous among all types of this disease, because it very quickly damages the roots and canals of the tooth. In patients older than 60 years, it is the defeat of the neck of the tooth that becomes the main cause of its loss.

Symptoms

The main symptoms of cervical caries are exactly the same as with the occurrence of other types of caries. At an early stage of the development of cervical caries, a small light spot appears on the tooth enamel, which darkens with time, becomes deeper, affects the dentin and eventually, in the absence of appropriate treatment, leads to the complete destruction of the tooth.

Stages of development of cervical caries:

1. Caries that looks like spots. This stage is expressed by the appearance of a small white spot, which can remain unchanged for a long time.
2. Caries that breaks the surface of the tooth. The upper part of the tooth is affected - enamel, a person feels cold and hot.
3. Caries of the middle stage. Tooth enamel and dentin suffer, a pronounced sensitivity to temperature changes appears. The pain disappears fairly quickly.
4. Deep stage caries. This stage of the disease is characterized by a deep disturbance of the inside of the tooth, which is close to the nerves, the pain is powerful and unbearable, irritation to everything cold and hot.

A feature of cervical caries is that if it is started, the doctor will have to remove the dental nerve and fill the canals of the tooth. This is due to the fact that the neck of the tooth is in close proximity to the dental canals, and if caries is not treated in time, it will quickly penetrate deep into the tooth.

Cervical caries: before and after photos

What this type of caries looks like, we offer detailed photos of the tooth for viewing.

Diagnostics

Cervical caries is diagnosed well, since the affected areas are visible to the naked eye. The patient himself, looking in the mirror, can easily find white chalky areas at the base of the tooth.

In some cases, dentists use special solutions for accurate diagnosis and ask the patient to rinse their mouth with them. The essence of the technique lies in the inability of dyes to penetrate through healthy enamel, while at the same time, in places of demineralization, the pigment easily penetrates through a porous, damaged surface into dentin. The main substance of the tooth easily and quickly takes on a given color and keeps it for several days.

How to treat cervical caries

Depending on the severity of the course and the severity of the symptoms of cervical caries, a treatment regimen is determined. When caries still looks like white chalky spots, and the top layer of enamel is not damaged, conservative treatment is usually performed, namely, remineralization. During remineralization, calcium-deprived tooth enamel is saturated with this mineral using special preparations that also contain other minerals. This procedure strengthens the enamel and prevents caries from developing further.

When a cavity is formed, the process of treating cervical caries should include the following main steps: local anesthesia, removal of dental plaque, preparation of the defect and treatment of the cavity, application of a medical and insulating pad (in the treatment of medium and deep caries), placing a filling with light polymerization, grinding and polishing the filling.

Prevention

The best way to prevent the recurrence of cervical caries is to brush your teeth regularly, making sure to thoroughly clean them down to the neck. In addition, visit the dentist regularly, because if caries is detected at an early stage, it will be quite possible to get by with a simple remineralization.

Cervical caries is the most dangerous type of caries. The carious process manifests itself in the area where the tooth comes into contact with periodontal tissues. The danger of such a pathology is that in the first stages of progression, symptoms may not appear at all. Cervical caries goes unnoticed until the first severe pain occurs. Also, in the area of ​​​​the neck of the tooth, the thickness of the dentin is much less than in all other areas, so this type of caries quickly reaches the pulp chamber and degenerates into a deep process.

If cervical caries has reached the pulp, then absolutely all dental canals are affected, complications can develop, and in most clinical situations it is not possible to save the tooth. Therefore, it is important to timely detect the progression of the pathological process and prevent its further development. As practice shows, cervical caries affects mainly people after 30 years.

The reasons

The main cause of cervical caries is that the dentin in this area is much thinner than in other places. Also, the area of ​​​​the neck of the tooth is very difficult to fully clean. Due to poor oral hygiene, a large amount of soft plaque and stone accumulates in the cervical region. In these structures, pathogenic microorganisms that secrete acids begin to actively multiply. It is these substances that destroy tooth enamel. Also, heredity can be attributed to the causes of the disease.

Predisposing factors to the formation of cervical caries:

• enamel demineralization. This happens as a result of the vital activity of bacteria that are in the mouth, as well as due to changes in the biochemical composition of saliva. As a result of the activity of bacteria, lactic acid is released, which leads to the destruction of enamel (one of the main causes of caries);
• avitaminosis. If there are not enough certain vitamins in the human body, then specific gum pockets can form, into which food debris can fall. As a result, pathogenic microorganisms will begin to multiply in these formations;
• ignoring the appearance of chalky spots on the enamel. This is the first sign that indicates the development of cervical caries. If you start treating it at this stage, then the entire basal part of the tooth is not damaged and the tooth can be completely preserved.

stages

The carious process in the cervical region proceeds in several stages:

• spot stage. A small whitish spot is formed on the surface of the tooth, which may not change at all for a long time. It is best to treat cervical caries at this stage of development, since it is possible to preserve tooth tissues and completely eliminate the pathological process;
• carious process damages the surface of the tooth. It affects the upper part of the tooth - enamel. The tooth begins to react to stimuli;
• average caries. The carious process penetrates deeper and affects both enamel and dentin at the same time. The patient has a strong sensitivity to various stimuli - chemical, mechanical, temperature. Pain, as a rule, passes rather quickly;
• deep caries. The pathological process affects the deep tissues of the tooth, which are located in close proximity to the neurovascular bundle. The pain is unbearable, often occurs at night.

Symptoms

• the appearance of a spot or cavity of various sizes;
• pain while eating;
• the tooth reacts to various stimuli - cold, hot, sour, sweet, etc.;
• headache;
• night pains (with deep cervical caries);
• pain while brushing your teeth.

Treatment

Treatment of cervical caries depends on which stage of the pathological process is observed in the patient. At an early stage of disease progression, when only chalky spots are visible on the enamel, it is advisable to resort to conservative treatment. If a carious cavity of any size has formed, it is indicated to sanitize the cavity and seal it with composite materials.

Treatment of caries in the stain stage

The essence of the treatment of cervical caries at this stage is that the demineralized area of ​​​​enamel must again be saturated with calcium. To this end, dentists use remineralizing agents, which contain active calcium and fluorine. Before applying such drugs, it is indicated to remove plaque and calculus from the surface of the affected tooth.

Treatment of caries in the formation of a carious cavity

It is possible to treat caries, in which the integrity of the tooth enamel is already broken, only with the help of a drill. Other methods in this case are not appropriate. The entire treatment process is divided into the following stages:

• removal of plaque and tartar from the surface of the tooth;
• The second stage is very important - the definition of color. It is important to choose the color of the composite material as accurately as possible so that it matches the color of the patient's enamel as much as possible;
• preparation of an existing carious cavity. It is carried out only under local anesthesia;
• tooth isolation;
• covering the formed cavity with an adhesive;
• filling the cavity and giving the tooth an anatomical shape. At this stage, the functionality and aesthetics of the tooth are restored;
• polishing and grinding.

Prevention

Cervical caries is easier to prevent than to treat later. Prevention includes the following activities:

• regular brushing of teeth;
• for the purpose of prevention, it is recommended to visit a qualified dentist every six months;
• after drinking drinks, coffee, sweets, juices, be sure to rinse your mouth;
• Rational nutrition is also very important for the prevention of cervical caries. A person should consume a sufficient amount of vitamins and minerals;
• strengthening the immune system.

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

Diseases with similar symptoms:

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, a large amount of food remains in the baby’s mouth all night, which is the main reason for the progression of caries.

Caries is a pathological process that leads to the destruction of enamel, a layer of dentin, resulting in a "hole". If you do not start treatment in a timely manner, then this pathological process can lead to complete loss of the tooth.

It is called the neck of the tooth. The name comes from the location of the disease. Cervical caries is the most serious and dangerous type of caries, because it affects the tooth in the most vulnerable place - at the base. If it is not treated, the disease deepens with damage to all canals of the tooth, which inevitably leads to its loss. This type of caries is mainly observed in people over thirty years of age.

Cervical caries

Reasons for the appearance

Causes are cariogenic bacteria that live in plaque and calculus. Microorganisms process leftover food, turning them into organic acids that damage tooth enamel, leaching calcium out of it. Change their composition and become pathogenic, thereby causing disease, microorganisms can with poor oral hygiene and on the basis of the anatomical features of the enamel of the neck of the teeth. Some patients have a predisposition to gingival detachment. Because this area is poorly cleaned of food debris, a large number of pathogenic microorganisms are formed in the gum pockets that cause cervical caries.

So the reasons are as follows:

• insufficient hygienic care;
• anatomical predisposition.

Mechanical damage to the enamel of the neck of the tooth can also contribute to the occurrence of caries, it can be damaged abrasive toothpastes and toothpowders, which, damaging the enamel, open the way for pathogenic bacteria. In this place, the enamel is the thinnest and needs constant care and attention.

Cervical caries can spread with frequent use of acidic foods or drugs that make the enamel porous. The first sign that the enamel has thinned and needs to be taken care of is the reaction of the teeth to sour and cold. This factor increases the risk of the disease.

To strengthen and make more dense enamel in the root zone, you need to apply special preparations to the cervical region, these manipulations performed by a dentist but you can do it yourself.

Symptoms of the disease

Symptoms of cervical caries are different, upon detection of which you need to seek qualified help immediately specialist. They are similar to the symptoms of caries in any other part of the tooth.

The disease in some cases is found in the chair when examining a dentist. The initial stage of cervical caries, its photo is shown below, is easily treated with remineralization, without the use of a drill.

If pain occurs when eating, and upon examination, the doctor notices a dark spot, then this stage already requires more thorough treatment. With this type of caries there is always pain and carious cavities are formed, as thinning of the enamel takes place.

Also, thin enamel reacts to various stimuli, for example, mechanical ones - pain occurs during brushing.

Diagnosis of the disease

Cervical caries is diagnosed well, since the affected areas are visible to the naked eye. The patient himself, looking in the mirror, can easily find white chalky areas at the base of the tooth. But sometimes doctors use special solutions for accurate diagnosis and ask the patient to rinse their mouth with them.

These dyes get only into the demineralized porous enamel, and they cannot penetrate into the healthy, calcium-coated one. The subject rinses his mouth with clean water and you can immediately see where the paint lingered. After a few hours, this color disappears.

Cervical caries or wedge-shaped defect?

Another common dental disease is the wedge-shaped defect. It appears on the outside of the tooth as a V-shaped flaw. This "wedge" is directed up or down towards the jaw. The most commonly affected teeth are those that experience the maximum load during chewing - canines and premolars. Many patients confuse a wedge-shaped defect with cervical caries, since their localization is the same, and require treatment appropriate to caries.

But this cannot be done, because there are differences between these diseases.

1. With a wedge-shaped defect, the color of the tooth enamel remains the same, and the damaged V-shaped area remains dense and polished.
2. Cervical caries has a loose, rough structure, brown color and irregular shape.
3. A wedge-shaped defect has a long period of development, and cervical caries can destroy a tooth in a short period of time of several months.

Cervical caries

How to treat cervical caries?

Modern treatment of cervical caries is similar to the treatment of any other part of the tooth and should be reduced to a series of medical manipulations, which must be carried out by the dentist. However, it is impossible to start treatment without proper diagnosis to determine the stage of the disease.

Stages of cervical caries

As you know, the disease is divided into four stages.

1. At the first stage of the disease in the gum zone, the enamel changes color, becoming dark.
2. During the second stage, a chalky rough spot is formed.
3. The third stage is characterized by the appearance of a "hollow", with it the affected areas are even more visible.
4. In the fourth stage, the channels are affected.

Treatment of cervical caries, which is at the initial stage, in which only a speck is visible, and the enamel is not badly damaged, reduced to drug applications aimed at sealing the enamel in this area.

But in order to finally get rid of the discoloration in this damaged area, you must select one of the options described below.

First option.

In the first option, the doctor applies to the damaged area whitening or etching gel which bleaches the pigments. But because of these manipulations, the tissue becomes even thinner and more permeable for both dyes and the tooth. Then the dentist continues the treatment and applies a special compound to the cervical region of the tooth to strengthen and reduce the permeability of the enamel.

If attempts to discolor the enamel did not end successfully and the color remained the same, then this only means that the caries lasted long enough and has already managed to stain the deeper layers of the enamel. In this case, the dentist should resort to the second treatment option.

Second option

The dentist begins to carefully polish the painted enamel with various polishers, after which he applies the medicinal composition, saturating the enamel.

If caries, more and more deepening, has already affected the dentin, then this treatment will no longer work., since it is porous and requires a deeper color. In this case, the treatment of cervical caries is carried out by traditional methods. The dentist carefully removes all damage and restores the structure of the tooth with filling materials.

Features of treatment

With this disease, caries is located as close as possible to the gum, which interferes with treatment, significantly complicates it and delays the recovery process. In the cervical area, it is quite difficult to keep the working field dry for reliable treatment. In case of moisture ingress, high probability of poor fixation of the seal, because of which it may fall out and the doctor is forced to carry out the procedure again.

Another method of treatment

There is another way to treat this disease is to accurately reproduce the contour and volume of the tooth. The fillings with it are quite thin, and if poor-quality material is used, then there is a high risk of its falling out, which can lead to repeated caries.

It is important to remember that when caries is detected need to see a doctor immediately And the sooner you start treatment, the more effective it will be. By taking care of your teeth, you are making an investment for many years to come.

Parfenov Ivan Anatolievich Updated: 07/12/2018

There are several types of caries, some of them develop quite intensively, leading to serious complications. One of the dangerous diseases is cervical caries. The features of the course of the disease, the causes and methods of treatment are described in this article.

What is cervical caries

Cervical caries- This is a type of manifestation of caries, which is determined by the location of the focal zone. In this case, we are talking about the place where the tooth and gums meet.

The complexity of the situation lies in the fact that it is this area of ​​dentin that has the thinnest layer, which increases the risk of developing deep caries. In the absence of treatment, there is a rapid progression of the focus to the root of the tooth, which is not always possible to save.

The peculiarity of cervical caries is that its development can be associated with various health disorders of the patient. For example, a visit to the dentist for the treatment of caries at the base of the tooth is often accompanied by an examination by an endocrinologist, during which problems with the functioning of the thyroid gland are detected or diabetes is diagnosed.

Symptoms

Cervical caries differs from other types of caries only in location. You can recognize the disease in children and adults by the following signs:

• darkening of the enamel layer in the area of ​​​​the connection of the tooth with the gum;
• the formation of a carious cavity, a recess extending under the gum;
• increased sensitivity during thermal exposure, the use of sweet and salty;
• tangible discomfort when performing chewing movements of the jaw;
• the appearance of causeless headaches;
• pain syndrome in the dentition, felt during sleep.

Stages and photos

The process of progression of cervical caries is conventionally divided in dentistry into 4 stages. Each has its own characteristic signs, for the elimination of which certain methods of treatment are selected.

Diagnostics

At an early stage, the disease is difficult to identify, because it is almost asymptomatic. On closer examination, only small spots are found. These are the beginnings, which are subsequently transformed into a carious cavity.

At the dentist’s appointment, cervical caries is diagnosed using modern equipment and a special test solution that reveals the focal zone (when rinsing the mouth with a remedy, pigmentation of healthy tooth tissues occurs, white spots indicate the initial stage of caries).

Treatment in dentistry

Treatment methods are selected taking into account the stage of development of the disease, as well as the characteristics of the patient's health status and the presence of other dental problems.

In the white spot stage

At the first visit to the clinic, the doctor performs a thorough examination of the mouth, in particular the focal zone, and a treatment plan is outlined. If cervical caries is diagnosed at the stain stage, the patient is offered one of two treatment options:

• the Icon method;
• remineralization.

In the first case, a polymeric material (etching gel) is used, which is used to treat the focal zone. The composite composition fills small cracks, preventing caries from spreading further.

The second option involves a series of procedures, the essence of which is to enrich the enamel layer with fluorine, zinc, calcium and other microelements valuable for dental tissues. The following preparations are used as working compositions:

• Remodant;
• Enamel-sealing liquid;
• Bifluoride-12;
• Fluorine varnish;
• Calcium gluconate solution, etc.

The remineralization procedure includes the following steps:

• cleaning the enamel surface from stone and plaque;
• applying fluorine-containing compounds to the enamel;
• rinsing the mouth with a special solution.

The therapy is complemented by home cleaning of the teeth with special pastes enriched with valuable minerals, the use of fluorine-impregnated floss, rinsing with solutions based on fluorinated salt.

In the process of enamel destruction

In advanced cases, the disease requires more thorough treatment, namely, the treatment of the focal zone and filling. If the carious cavity has reached the roots, then they have to be removed.

Treatment steps include:

• professional oral hygiene (the goal is to remove hard plaque, tartar, microbes);
• selection of material according to the color of enamel;
• separation of gum tissue from teeth, which ensures high-quality processing;
• removal of necrotic tissue with a drill;
• fixation of the rubber dam (isolation of the filling material from saliva);
• treatment of the treated area with an adhesive composition to increase the strength of the seal in the cavity;
• laying of filling material of light polymerization;
• grinding the hardened surface of the filling;
• polishing teeth with discs with fine abrasive.

The filling material is selected individually, taking into account the parameters of the focus and the natural color of the enamel.

Sometimes, in order to achieve high aesthetic performance, it is necessary to combine more than two types of solutions, which makes it possible to ideally cope with severe clinical cases.

The Icon method is painless. This is an innovative approach in the treatment of caries that does not require drilling.

The essence of the procedure is to apply a special agent made on a polymer basis to damaged enamel tissues, as a result of which the development of the carious process is suspended. The color of the causative tooth is restored, the stains disappear. The material used in the work is also called a liquid filling.

Features of the Icon method:

• gentle way of treatment;
• ensures the safety of living tissues;
• does not require the use of anesthesia;
• suitable for pregnant women.

Differences from the treatment of conventional caries

Treatment of caries on the neck of a tooth type is carried out mainly according to the general principles of combating the disease. However, there are still a few differences.

• The cervical type is known for being difficult to access, so the opening process requires more precise work and effort.
• At the initial stage of development, when performing medical procedures, anesthesia is not used.
• It is possible to use a laser and special formulations that do not affect healthy tooth tissues.

Treatment of cervical caries at home - myth or reality?

Children's fears or ordinary cowardice sometimes prevent the patient from seeking medical help in a timely manner. Treatment of cervical caries is possible at home, but only at the stage of spots.

To solve the problem, you will need to purchase special products that contain an increased concentration of fluorine, zinc, calcium, phosphorus and other components.

Regular treatment of teeth with a therapeutic composition will help enrich the enamel tissues with valuable minerals and restore damaged areas. The products are available in a convenient form for use: paste, gel, rinse, dental floss impregnated with fluoride. Each product is accompanied by instructions, the rules of which must be followed to achieve the desired result.

Folk methods

Along with traditional treatment, the use of folk methods for the treatment of cervical caries is allowed. Healing herbs effectively relieve the inflammatory process, relieve pain, and eliminate swelling. Tinctures, decoctions, creams and other products are prepared from them according to old recipes that were used by our ancestors. Recipes:

• Propolis applications. From the bee product you need to roll a small ball and attach it to the causative tooth. It is better to put a piece of cotton wool on top of propolis so that the product is not washed off with saliva. Keep 20-30 minutes. The tool fills microcracks, preventing the spread of caries.
• Decoction for rinsing the mouth based on wormwood. Pour 5 g of dry branches of wormwood into a glass container, add a teaspoon of dried valerian and the same amount of calendula. Pour 200 ml of boiling water and let it brew under the lid for 20-23 minutes. With a cooled and filtered liquid, make applications or rinse your mouth 3-5 times a day. The tool perfectly deals with pathogenic microflora, inhibits the development of the inflammatory process.
• Sage tincture. The plant has extensive medicinal properties. Decoctions and infusions of sage quickly relieve pain, relieve inflammation, and eliminate harmful microorganisms. The infusion is prepared on the basis of a tablespoon of dried flowers and 200 ml of boiling water. It will take a day to infuse the liquid. After straining, rinsing can be carried out 3-5 times a day.
• Herbal decoction. Pour dry plants into the container in equal proportions: lemon balm, nettle, chamomile and calendula flowers. Pour them with boiling water (500 ml) and let it brew under the lid for about 10-12 hours. Rinse your mouth with filtered liquid 3-4 times a day. The tool quickly relieves aching pain, inhibits the development of inflammation, listens to swelling.

What to do if a tooth hurts after treatment of cervical caries?

If the intensity of the pain syndrome after the installation of the filling decreases, then this is considered a normal reaction of the body. With increasing pain sensation, inflammation may develop in the pulp or gums.

A complication can be caused by poor-quality cleaning of the carious cavity, nerve injury, the installation of a seal contrary to technology, and other medical errors.

Preventive measures

To prevent the occurrence and development of cervical caries will help the observance of simple rules of prevention:

• Daily hygiene oral cavity with the use of high-quality paste and a brush suitable for tooth enamel.
• Regular preventive check-up at the dentist (1 time per six months).
• Dental care includes gum massage, which promotes blood flow to the dental tissues.
• Diet is developed taking into account a sufficient amount of products enriched with fluorine and calcium. This will help restore the mineral balance of the enamel, restore the damaged structure.
• After eating any food it is recommended to rinse the mouth with balm or clean water to remove food particles. It is they, stuck in the cracks, that provoke the development of pathogenic microflora.
• Once every 6 months professional oral hygiene is required. This will help to remove tartar and plaque in a timely manner.
• Dentists recommend periodically take a vitamin complex to restore the mineral balance of the enamel layer and strengthen the gums.

Popular questions

A selection of common questions expands information about the treatment of cervical caries:

• Should cervical caries be treated?

Cervical caries is characterized by intensive progression, which, without timely treatment, leads to tooth loss and the development of other dental diseases. Ignoring the problem can lead to an abscess or cellulitis.

• How is cervical caries treated in front teeth? On fangs?

If the disease was diagnosed at the initial stage, then the enamel mineralization procedure is offered to the patient as a treatment. As means, special formulations are used, enriched with fluorine, calcium and other minerals important for tooth tissues. Dairy units are treated with fluoride-containing pastes or gel. A combination of fluorine and silver gives good results.

In the presence of a carious cavity, it is cleaned and sealed. Removal of affected tissues is carried out using a drill, laser, air-abrasive treatment. In case of loss of a visible fragment of the tooth, the patient is offered restoration (veneers, crown, implantation).

• Is it painful to treat cervical caries?

Cervical caries affects the sensitive area of ​​the tooth, so the treatment is carried out using a local anesthetic (Lidocaine, Melivacaine, Ultracaine).

• What toothpaste is needed for cervical caries?

At the stain stage with cervical caries, dentists recommend the use of a paste with a high content of fluoride, calcium and other minerals, a remineralizing gel. The following products are popular: R.O.C.S., Fluorodent, Enamel-sealing liquid, Gluftored, etc.

Cervical caries progresses rapidly, so you should not hope for an independent cure. Folk remedies are effective only in combination with traditional therapy. Following the recommendations of a specialist, it will be possible to maintain a beautiful smile.