Complications after treatment of dental caries. Treatment of superficial, medium and deep caries. What is caries and what are its complications?

Many people think that they carry out the prevention of dental diseases at home. But they are surprised by the fact that caries, after all, appears. Dental care at home is not a guarantee of caries prevention. To prevent complications, the help of a dentist is necessary.
Everyone has heard of people who are afraid of dentists. Checking their teeth with a doctor becomes torture for them. When pain and caries arise, people often endure to the last. And this - Right way to complications and serious dental disease. The aggravation of the situation and complications can quickly become chronic.

infectious process striking dental tissue is caries. The causes of the disease are the following factors:

• hypovitaminosis;
• decrease in local immunity, provoking active reproduction of cariogenic microflora;
• violation chemical structure saliva;
• insufficient content in food of such microelements as calcium and fluorine;
• body sensitization;
• systemic diseases;
• radiation sickness;
• pathology in the building dental system etc.

The photo shows the examination of the teeth using a dental mirror with initial stages caries.

Complications of caries

Launched caries is fraught with serious consequences that can lead to total loss of the dentition. The advanced stage of the disease is characterized by severe pain, since the destructive process extends not only to the dentin, but also to the pulp and periodontal tissue.

The picture shows the stages of development internal caries.

Very often, patients drown out a sharp toothache various painkillers, as a result of which the nerve of the affected tooth dies off completely, the process of tissue decomposition begins and in carious cavity pus accumulates.

The purulent process can lead to the development of strong allergic reactions and intoxication of the body. In addition, the patient's immunity begins to independently fight the complication of the disease, resulting in the formation of a granuloma, which can develop into a cyst.

Ignoring or delaying the visit to the doctor is a guarantee of the onset of dental disease. Caries formed on the tooth can also occur on adjacent teeth. And this is a dangerous possibility of losing the dentition. Therefore, it is urgent to resort to the treatment of a damaged tooth.

Otherwise, caries will develop into acute diseases:

• pulpitis;
• periodontitis;
• granuloma;
• cyst.

Consider the advanced forms of caries disease in more detail.

The photo shows the stages of tooth cleaning from purulent pulpitis: before and after.

Pulpitis occurs when infectious bacteria enter the teeth hard tissues. The infection enters the dental nerve (pulp) and inflames it. Bacteria multiply inside the tooth. This causes squeezing of the veins and swelling. Edema compresses the nerve endings, which causes severe pain.

The picture shows the stages of development of caries into pulpitis.

Signs of pulpitis:

1. When consuming cold, hot, sour food, there is a sharp pain impulse. It lasts less than five minutes.
2. Pain also appears when biting on an aching tooth. It also causes pain at night.
3. Regardless of the use of food, pain occurs, covering the entire dentition. Also, the pain impulse is given to the ear cavity. Often, it is even difficult to determine which tooth is causing the pain.
4. Headache in a certain part of the head from the side of the painful tooth.

There are two ways to treat pulpitis: biological and surgical. With biological (conservative), the affected nerve is preserved. In the case of surgical intervention, the pulp is removed, and the empty cavity is sealed.

A complication of caries is characterized by toothache, which is acute. Pulpitis occurs as a result of damage to the pulp by cariogenic microorganisms and their metabolic products. Toothache occurs spontaneously and is paroxysmal in nature. Pain sensations are felt not only in the area of ​​the affected tooth, as they radiate along all branches trigeminal nerve, give to the jaw, temple and ear. It is possible to distinguish pulpitis from neuralgia by increasing toothache at night, as well as with horizontal position sick.

If the pulpitis is not acute, but chronic, then pain can occur under the influence of chemical, mechanical and thermal stimuli. At the same time, the pain does not fade for a long time even after the elimination of irritants. When probing the carious cavity, the patient feels a sharp shooting pain.

If an acute form of purulent pulpitis develops, then the patient feels a continuous throbbing toothache, which is aggravated by thermal exposure. Attacks are long, and painkillers stop pain for a short period of time.

Pulpitis requires urgent dental treatment, which does not exclude surgical intervention.

Periodontitis

Inflammation of the tissues surrounding the root of a tooth is called periodontitis. As a rule, the disease proceeds acutely, toothache increases with mechanical irritation of the affected tooth, gum edema occurs, and an abscess may form in the area of ​​the diseased tooth. The disease is accompanied by severe intoxication of the body, which is manifested by nausea, fever, headaches, weakness, and vomiting. Treatment of a purulent form of periodontitis requires urgent surgical intervention, which consists in the outflow of pus and the relief of the inflammatory process. Very often to avoid possible complications resort to the extraction of the affected tooth.

The occurrence of periodontitis can be caused by several reasons:

• periodontitis. Inflammation of the gums can be one of the reasons for the development of periodontitis;
• dental trauma of a mechanical nature;
• lack of vitamins, macro- and microelements in the body;
• diseases chronic form (diabetes, diseases of cardio-vascular system);
• bad habits.

The first warning sign of periodontitis is bleeding gums. Also, the appearance bad smell from mouth.

The photo shows a severe form of periodontitis with bleeding gums.

There are two types of periodontitis - chronic and acute. At acute periodontitis the tooth is in pain. When you press it, the pain intensifies. Also, the pain impulse appears from the reception hot food. When eating cold food, on the contrary, it subsides. There is swelling of the gums around the affected tooth. Also, there may be purulent formation near him. Periodontitis is accompanied elevated temperature feeling of nausea, vomiting. Periodontitis is characterized by a feeling of weakness and intoxication of the body as a whole.

Periodontitis in purulent form requires urgent surgical intervention. In the case of a non-purulent form of periodontitis, the diseased tooth can still be cured. At the same time, without resorting to its elimination. There is an option classical treatment. If you do not see a doctor in time, the tooth will have to be removed. It is possible to improve the condition of the tooth and reduce the symptomatic picture. But after 1-1.5 weeks, periodontitis will become chronic. This will lead to high mobility of the dentition, the formation of gaps between the teeth. If the problem is not eliminated, the bacteria will lead to diseases of the joints, heart, kidneys. Periodontitis can develop into a granuloma.

Dentist's opinion.

The non-purulent form of periodontitis proceeds with less severe symptoms, and it can be treated with conservative methods (expansion and filling of the dental canal).

The photograph shows severe periodontitis with severe bone and gum recession.

Granuloma is called advanced periodontitis. It is characterized by the presence of a purulent formation at the base of the tooth. It can only be diagnosed with x-rays. A granuloma may not show any signs, but one day it may become inflamed. There is a strong throbbing pain. Tooth enamel darkens and appears purulent discharge. Treatment of a granuloma with a conservative method does not always allow saving a damaged tooth. If the granuloma has grown into a cyst, surgery is the only treatment option. At its core, a granuloma is a focus of infection. It can cause disease internal organs.

The photograph shows an x-ray of a tooth with a granuloma along the root of a molar.

It is possible to diagnose a granuloma with the help of an X-ray examination, it occurs gradually and is a consequence of such carious complication like periodontitis. Gradually increasing, the granuloma manifests itself in the form of swelling of the gums and its pain on palpation. If a purulent process flutters in the granuloma, then the patient feels a throbbing toothache, tooth enamel darkens, purulent discharge appears.

chronic course the disease can be asymptomatic, and in the process of disease progression, the granuloma transforms into a cyst. The granuloma is the focus chronic infection in the body and in addition to tooth loss can give serious complications on the organs of the respiratory tract and the cardiovascular system.

conservative methods granuloma therapy does not always allow saving a tooth; when it is transformed into a cyst, they most often resort to surgical intervention.

The image shows the location of the granuloma at the root of the tooth.

Prevention of caries complications

Preventive measures for complications of caries include early diagnosis and timely treatment caries, holding professional cleaning oral cavity, orthopedic treatment allowing to evenly distribute the load and restore the dentition.

Complicated caries is a defect in which not only the teeth are destroyed, but also the periodontium. Treatment in professional dentistry makes it possible to get rid of the problem, to restore damaged tissues and oral health. Use of modern equipment and materials, effective methods therapy allows you to achieve best results without pain and discomfort.

What is complicated caries

Any problem of the oral cavity, unresolved in time, leads to diseases that require emergency treatment. is not the result timely treatment to the dentist. It is much easier to eliminate such a defect at an early stage of development, therefore, when symptoms of the disease are detected, it is necessary to undergo a diagnosis and begin treatment.

Classification of the most common types of disease for patients of any age:

1. Pulpitis, which is characterized by the destruction of the pulp - the nerve or neurovascular bundle. May be fibrous, hypertrophic, calculus or gangrenous chronic.
2. Periodontitis when the tissues surrounding the cementum of the tooth root are affected.
3. Multiple caries, which captures several teeth at once. Each of them can form several cavities. This type of caries appears most often due to reduced immunity, hormonal disruptions, infections and other serious illnesses. Requires complex treatment.
4. Cervical, or cervical caries- a defect that occurs at the border of the tooth and gums, near the neck of the tooth. It affects not only the health of the oral cavity, but also the aesthetics of the smile. It appears most often on the front teeth.

The initial stage of the disease is usually fissure caries - a type of disease in which fissures- natural cracks and depressions on the enamel surface of the tooth. This form is most often manifested in children on temporary or new, molars. Characterized by darkening of the enamel.

The final chord of development complicated caries is pulpitis and / or periodontitis:

• pulpitis- a complication in which the carious process has affected the pulp ("nerve" of the tooth, or neurovascular bundle);
• periodontitis- a complication in which there was a lesion of the tissues surrounding the tooth (periodontium).

AT advanced cases The described problems can occur simultaneously, causing discomfort, pain and inflammatory processes oral cavity, often leading to the need for tooth extraction.

Diagnostic methods

Diagnose complicated caries simple enough. The first symptom is pain in the area of ​​the tooth. If for the superficial or even for deep caries pain may be uncharacteristic, then with a neglected, acute problem, pain and sensitivity are the main signal that requires immediate medical attention. For a more reliable and accurate diagnosis a single image is taken, or an orthopantomogram, thermodiagnostics, examination of surfaces using special tools.

Features of treatment. Prevention

The method of treatment of complicated caries is as follows:

1. Filling of carious cavity. The algorithm of actions is as follows:

• occlusal points are determined;
• for anesthesia, anesthesia of the tooth is performed (treatment can also be carried out under anesthesia);
• the surface is cleaned of food plaque;
• an insulating system is applied;
• preparation or grinding of teeth is performed using a drill, which is used for drilling;
• treatment of the carious cavity with antiseptics and other drugs;
• applying a dental adhesive;
• closing the treated area with a filling or installing a composite material;
  grinding, polishing surfaces.

In the treatment of pulpitis, the sequence of actions also includes work to remove the nerve (depulpation).

2. laser treatment complicated caries– therapy using a diode laser radiation with high bactericidal properties. Provides elimination of bacteria, careful processing of a dentin by the laser. main feature of this technique is minimum quantity pain for the patient.

In order to prevent the development of complicated caries, preventive measures should be taken:

• regular oral care;
• minimum sugar intake;
• cleaning tooth enamel with fluoride toothpaste;
• compliance with the technology of cleaning the oral cavity;
• use of dental floss for minimal cleaning of the gaps between the teeth;
• rinsing with 0.1 - 0.2% chlorhexidine solution and special rinses;
• usage chewing gums containing xylitol;
• fluorination.

We perform treatment, restoration, prosthetics, implantation, sedation, removal and other procedures that result in healthy teeth and a white smile.

Obviously, neglected caries will not disappear on its own. Moreover, the decay affects the nerve, moving towards the top of the root. Therefore, the topic of timely seeking help is always relevant.

The reasons

Initially, the disease occurs due to damage to the enamel by bacteria streptococci. In the absence of proper oral hygiene, the waste products of microorganisms destroy the protective layer of the tooth. Carious foci tend to spread to neighboring tissues. And now, when the process of decay reaches the pulp, various complications begin.

The second main cause of complicated dental caries is wrong treatment. Violation of the rules of the procedure, inattention or inexperience of the doctor sometimes leads to the fact that the pathological process continues to develop in the sealed unit.

Endodontic treatment in half of the cases ends with complications. After all, the processing of channels and their filling is carried out almost blindly.

Why is it dangerous?

Complicated caries in dental practice- Not unusual. Often it gives a person severe torment:

• Danger untimely treatment caries is that there is a gradual death of the nerve. An inanimate tooth becomes more fragile, darker.
• The infection penetrates deep into the root, provoking new problems. At its top appear pathological formations filled with purulent contents.
• The infectious focus is a threat not only to the oral cavity, but also to the whole organism. Bacteria can multiply rapidly, causing gum disease, mucous membrane disease, or multiple caries. All this is accompanied by oppression. immune system. After all, every minute the body fights infection in the tooth.

Types of caries complications

Consider the diseases that arise as a result of the progression of the disease:

• Pulpitis is last stage caries when the patient starts it. The tissue that fills the cavity of the tooth is affected. The pulp is a bundle, woven from many fibers, penetrated blood vessels and nerve endings. That is why the symptoms of pulpitis are expressed in acute pain.
• Periodontitis - this is dangerous pathology. The disease is expressed by an inflammatory process, covering the stabilization system of the tooth and adjacent tissues. Caries complicated by periodontitis leads to the destruction of the ligament holding the unit in the hole. She is losing her stability. Acute course illness quickly turns into chronic stage, often occurring without obvious symptoms. Meanwhile, the disease progresses.
• Granuloma is a limited inflammation of periodontal tissues. Represents education round shape lined with dense connective tissue. Inside the cavity is filled with purulent contents. Most often localized at the top of the roots. The danger of the disease lies in the fact that it can develop for years without obvious symptoms. The formation begins to disturb the patient only when it reaches 1.5–2 cm in diameter.
• Flux popularly called inflammation of the periosteum of the jaw. In dentistry, the term "periostitis" is used. The pathological phenomenon is expressed as the formation of a tumor on the gum near the causative tooth, filled with pus. It occurs due to the inflammatory process in the root. Primarily pus is formed in it. Subsequently, the fluid breaks its way out through the bone tissue of the periosteum and gums.
• Phlegmon - this is purulent inflammation. Only unlike a granuloma or cyst, it is not limited to a sac connective tissue. Pus spills over the tissues, freely passing into various facial sections. Pathology is expressed by a small swelling, which increases in size over time. It is important with phlegmon to do everything in a timely manner medical measures. Otherwise, the disease can lead to serious consequences.
• Osteomyelitis rank among purulent diseases infectious and inflammatory nature. The pathological process covers all layers of the jaw, destroying them. The disease is severe, expressed in the form of local signs and general symptoms. In addition to chills, a person experiences pain. Abscesses constantly form on the surface, transforming into fistulous passages.
• Multiple caries - this is acute illness, leading to the simultaneous destruction of 6–20 units. At the same time, several spots or cavities can be immediately detected on one tooth. Multiple caries appears against the background of severely weakened immunity, infectious, endocrine diseases.

Complications of caries in children

Dentists warn that children's body all processes proceed rapidly. A small damage to the enamel quickly transforms into acute caries. If it is not eliminated in a timely manner, then complications will have to be treated.

The milk set has the same structure as permanent units. Accordingly, the complications of caries are similar to pathological processes in adult patients.

The only caveat is the fact that the nerve in milk tooth less sensitive. Therefore, during pulpitis, the child may not experience severe pain. Meanwhile, the pathology progresses, transforming into periodontitis, flux and other diseases. AT similar situations required immediate help. Some purulent processes can even cause death.

It is important to treat complicated caries in a timely manner. Otherwise, the infection will quickly spread along the root and go beyond it, rendering Negative influence throughout the baby's body.

The most important step in the prevention of caries complications is regular hygiene, timely treatment and constant examinations of the oral cavity by a dentist. In order to detect the disease at the very beginning of its development, it is enough to visit a doctor every six months. And in childhood It is advisable to go to the dentist more often.

Useful video about caries complications

Caries is insidious in that at first it does not cause serious concern on the part of a person. At an early stage, it does not cause concern, and the patient gets the impression that the disease is not serious. And only when the affected tooth begins to hurt, most turn to the dentist for help. And treat the consequences advanced stage much more difficult than curing the initial caries.

The disease is characterized total absence symptoms that warn of its development. The patient may be completely sincerely unaware of the presence of the disease. Detect caries on early stages can only experienced doctor. Therefore, it is important to follow the recommendations of dentists and visit a doctor at least 1-2 times a year.

So, to what backfire can lead to cavities if left untreated:

1. There is a danger of such formidable complications like pulpitis and periodontitis. Pulpitis is acute inflammation pulp, in which the pain becomes simply unbearable. Periodontitis is an inflammatory tissue disease and is also difficult and long to treat. Sharp forms caries cause inflammatory processes in soft tissues gums, and sometimes the face, and the patient may swell not only the gums, but also the cheek.
2. A serious consequence of caries, especially if it is not treated at all, is presence of a constant source of infection in human body, and this is already fraught with more serious consequences - such as the development of diseases of the cardiovascular system, as well as inflammatory diseases joints. Agree that all this looks pretty intimidating, and it is much easier to seek help from a dentist in time.
3. The presence of a constant source of infection in the mouth can lead to the development of a variety of chronic allergic reactions. Sometimes the patient himself cannot understand what he is allergic to, as it seems that the body reacts to literally everything. And what is the surprise of the patient when it turns out that the cause of allergies is banal caries!
4. Without proper treatment, caries gradually completely destroys the tooth.. The absence of a tooth affects the quality of chewing food. And if food is not chewed properly, then this adversely affects the condition. gastrointestinal tract, and if not one, but several teeth are lost at once, and this situation lasts for years, there may be serious illness stomach.
5. The aesthetic side of the issue also plays an important role. A smile looks beautiful if a person has healthy and strong teeth. If they are affected by caries, darkened, collapsed or fell out, oh beautiful smile there can be no talk. You begin to be ashamed of your teeth, avoid communication with friends, feel uncomfortable in the company. All this negatively affects the quality of life, inevitably leading to depression. So isn't it easier to seek help and treat your teeth in time than to suffer and suffer for many years?

In this article, we did not set ourselves the goal of intimidating you. possible consequences caries. We were just trying to warn you and explain how dangerous caries really is. We hope our article has helped you the right decision and see a dentist, even if you this moment nothing worries.

Most common complication caries - pulpitis - inflammation of the nerve of the tooth. It makes itself felt with strong pain sensations. Which arise from cold or hot, when biting. And last more than five minutes. Often there are spontaneous pains - for no reason. A sure sign of a complication of caries in pulpitis is night pain.

The reason for this complication of caries is the involvement of the nerve of the tooth. Which is inflamed and reacts to everything very sharply. Complicated caries takes a long time to get to the nerve. It may cause discomfort or be asymptomatic - not manifesting itself in any way. But when there is a complication of caries - pulpitis, then most often it very violently and unambiguously declares itself.

So from the banal small dark dot on the tooth there are such complications of caries as pulpitis and periodontitis. Which require a deeper, longer and more expensive treatment compared to the treatment of caries.