Causes of cervical caries. Cervical caries: an insidious and invisible destroyer of teeth. Cervical caries and wedge-shaped defect

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

Causes

The gingival area is a hard-to-reach area for quality hygiene 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 whitening teeth, taking some medicines.
3. Damage to cervical caries of several teeth at once is often observed in endocrine diseases (diabetes mellitus and diseases thyroid gland). The fact is that in diabetes, the number of representatives pathogenic microflora increases significantly. This leads to accelerated demineralization of dental tissues. It also leads to an increase in the prevalence of dental calculus and plaques. high concentration glucose in saliva (with 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 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. Frequent complication- 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, the neck of the tooth can be used various methods treatment.

In the spot stage

1. ICON technique (treatment of the tooth with an etching gel, filling the damage with a special composite composition).
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

AT advanced cases treatment of the carious cavity and filling is required. At deep defeat dentin 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 adhesive (for reliable adhesion filling material with tooth tissues), if necessary, the imposition of an insulating and therapeutic pad.
7. Filling light curing, 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). It's about about 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. Main danger- complete destruction of the tooth and its extraction.

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 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 still cervical caries, but in superficial or middle stage.
2. Treatment chosen in pharmacy network means 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. Wrong choice of funds for home treatment poses a risk to dental health. For example, the use of funds high content fluoride 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 carious lesion 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. alcohol tincture 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);
• Remodent(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

This relatively new dosage form may be included chemically incompatible substances(since the water 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.

FROM therapeutic purpose 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

Are auxiliary means with 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 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 gums and corroded teeth appear on all its sides. dark spots. lower teeth while eating from a bottle, they are protected by the tongue, 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 depression V-shape, darkening of the enamel does not occur.

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, replacing sugar with sweeteners.
4. Exogenous medicinal. Local application remineralizing agents, rinsing.

Price of treatment

The cost of treatment depends on the stage of the disease, the status dental clinic and the filling material used. average cost treatment of unstarted basal caries - 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 it is normal reaction body for 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’t 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 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 gasket. 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 need complex therapy affecting the immunological state of the organism. 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 treatment of a caries-affected wisdom tooth is the easiest - remove the problematic "eight".

Cervical caries is a dangerous disease that affects the very base of the tooth. It must be treated strictly. We will talk about the features of this dental disease and methods of treatment below.

Cervical caries is a severe form of dental disease. An aggressive state occurs due to a number of factors.

First factor

If we consider, then this is the root, crown and, in fact, the neck. The neck itself is located under the edge of the gum. The area where the neck is located is called cervical. The cervical area has a small protection in the form of tissue. In this zone, tooth enamel is poorly mineralized. Caries affects this weakened area. The disease actively destroys the dentin and the enamel itself. The inflammatory process reaches the pulp itself. Depending on the stage of the disease, a person feels a different degree of pain. If you do not treat cervical caries in a timely manner, then it will soon turn into more dangerous diseases such as periodontitis and pulpitis.

Second factor

Cervical caries has the specifics of a circular distribution. Defects in the form of caries quickly spread throughout the area. They quickly move to the middle of the crown. Further, the defects begin to deepen under the gum itself and, over time, cover the entire tooth in a circle. Without treatment, such caries can lead to the breakage of part of the tooth. Often the disease turns into circular caries.

Third factor

Another feature of cervical caries is that the defects of the disease can be located in the zone open mouth while smiling. Cervical caries of the front teeth greatly affects the human psyche. It can even lead to nervous breakdown. This psychological problem often touches public people who are busy with business contacts and are constantly in public.

If the areas affected by caries are located on the side of the lateral teeth, which are not visible to the eye, then they do not cause such strong feelings. But another problem arises: sick people usually do not seek to heal such invisible caries. Over time, cervical lesions of the lateral teeth begin to cause pain and sensations of sensitivity from various irritants. If you delay with treatment, then cervical caries will turn into a more complex form.

How does cervical caries develop?

Cervical caries develops in several stages. At each stage, it has its own clinical picture.

• First stage:. Formed on the surface of the tooth small spot. It may not change in shape or size. long time. With this form, pain is absent. But sometimes a soreness may appear, especially from taking sour or other irritants. The color of the spot may be white or pigmented. The shade depends on the speed of development of caries and its staining with food dyes. The enamel itself becomes thinner and acquires a matte finish. But it still feels smooth to the touch. The first stage of the disease is treated conservatively; drill preparation is not used here.
• Second stage: superficial cervical caries. The stain becomes rough. The process of destruction of the enamel begins. Painful sensations that appear from various irritants begin to disturb: sour, sweet, spicy food and drinks. There were cases when the stage of superficial caries was asymptomatic. This stage is characterized by a fairly rapid progression of the disease.
• Third stage: average cervical caries. This is where a carious cavity forms. At the same time, dentin and enamel are affected. The defect is highly visible visually. The pain becomes much more intense.
• Fourth stage: deep cervical caries. The disease makes its way into the most deep tissue, which are located next to the neurovascular bundle. Caries affects the pulp and dental canals. The patient begins to suffer from unbearable pain, which intensifies at night. Also, a person begins to feel pain when inhaling cold air.

Determining the stage of the disease can be difficult. It is not visually clear to what stage cervical caries has reached. There is a fairly smooth transition between stages of development.

Symptoms

Having described the mechanism of development of cervical caries, we list the generalized symptoms:

• The appearance of a visible stain on the surface of the tooth.
• Formation of a carrosion cavity.
• Headache.
• Night toothache.
• Pain while chewing food.
• Feeling sore teeth (reaction to stimuli).
• Soreness of the mouth during brushing and toothpaste.

The reasons

Some causes of cervical caries are similar to those of ordinary caries. Let's consider them.

1. Features of the structure of the cervical region. The gingival zone collects plaque very quickly. It is difficult to remove plaque with a brush without injury. As a result soft tissues always get hurt. If you do not make an effort when cleaning, then the plaque near the neck of the tooth always remains in place for quite a long time. in large numbers. The plaque contains cariogenic microorganisms that destroy the neck of the tooth. In addition, the thickness of the cervical enamel is only 0.1 mm. Compared to other parts of the teeth, this is a very small value. A thin layer of enamel is also easily damaged by a hard bristled brush or aggressive cleaning pastes. The enamel layer wears off even more. As a result, the tooth becomes available for damage. pathogenic bacteria.
2. Finding leftover food oral cavity. Food is collected in a kind of pockets, which are located near the gums and teeth. At the time of decomposition of food residues, lactic acid is released, which leads to demineralization of tooth enamel.
3. Excessive consumption of food that contains rapidly fermentable carbohydrates. For example, this applies to sucrose. Fermentation of carbohydrates results in organic acid, which begins to rapidly corrode the enamel.
4. Frequent consumption of acidic foods.
5. A significant lack of vitamins, especially vitamin B1.
6. Treatment with drugs that significantly increase the porosity of the enamel.
7. The presence of endocrine diseases, hormonal disorders.
8. Pregnancy period.
9. Insufficient or incorrect hygiene resulting in soft plaque and hard stone.

In most cases, cervical caries begins to develop in elderly and senile people.

Diagnosis of the disease

Radical damage to the tooth is very easy to diagnose, even at home. It can be seen by carefully examining the teeth with a mirror and good lighting. Near the neck of the tooth, there is usually a whitish spot that resembles chalk in color. The discovery of a defect should prompt a person to visit a dentist. The doctor will treat cervical caries initial stage.

The doctor can also confirm the diagnosis with a specific test. The patient is allowed to rinse his mouth with a dye solution. After rinsing, the white area indicating the disease turns dark. Other surfaces of the teeth remain unstained. This happens due to the fact that the affected area has a porous structure, into which the dye used easily enters. The patient does not have to worry about the fact that his teeth will now be darker. The color will fade after a few hours.

The doctor also diagnoses diseases by the following signs:

• The presence of a poor spot: the first stage.
• The enamel is destroyed, the dentin layer is not affected: the second stage.
• Deep damage to the enamel, layers (superficial and middle) of the dentin are also damaged: the third stage.
• Strongly destroyed enamel and deep layers of dentin: the fourth stage.

When diagnosing, the doctor may use other methods. For example, transillumination, radiography, radiovisiographic examination, EOM and more.

Treatment Options

The method of treatment depends on the stage of the disease. Treatment, except for the first stage, is carried out under the action of painkillers. The fact is that the neck of the fur coat is a very sensitive area. Therefore, any aggressive impact causes unbearable pain to the patient. Patients may not be afraid for the pain of treatment. Since if the dentist understands that he will cause pain to the patient, he will definitely do anesthesia.

Spot stage

The stain can be "removed" with the help of remineralizing therapy. This therapy program includes:

• Cleansing of tooth enamel from formed plaque and calculus.
• Carrying out the application with the help of fluorine-containing compounds. Such formulations are sometimes replaced with special gels. As these drugs, Ca / P, Fluoroden Glufluored or Belagel F are used. The listed drugs allow you to achieve good results in just a few applications. visible result. Under their action, the enamel layers are regenerated and the development of caries is stopped.
• Carrying out rinsing with special solutions at home.
• Use of fluoride dentifrice (concentration active substance should be 1000-1500 ppm).
• Use with fluorine content.
• Application of fluoridated water and salt.

It should be remembered that before applying special gels or pastes, plaque and stone must be removed.

Stage of superficial caries

At this stage, the affected carious area is polished. Diseased tissues are removed. In addition, it is recommended to carry out remineralizing therapy.

Medium caries stage

At the stage of medium caries, the damaged tissue is first removed, then the resulting cavity is treated with special preparations. On the last step seal is installed.

Stage of deep caries

This stage is the most difficult to treat. The dentist is forced to remove the pulp, thoroughly clean root canals and carry out a filling.

The doctor can easily get to the oral cavity and carry out treatment. The difficulty lies only in the machining of this zone, because:

• The cervical region is extremely inconvenient in filling. If the patient still has subgingival caries, then this significantly aggravates the situation.
• Moisture (saliva) constantly gets on the treatment area.
• The work interferes with the blood that accompanies the process.

The whole process of getting rid of deep caries takes place in several stages:

1. Conducting anesthesia. The gum is a very sensitive organ. Therefore, any manipulation of a doctor causes pain to a person. You can't do without painkillers here.
2. Carrying out professional cleaning. Deposits are removed from the tooth, as a result, the likelihood of infection is significantly reduced.
3. Establishing the color of the filling material. The composite material used should be as close as possible to the native color of the enamel. This is quite an important step.
4. Retraction of the gums. The procedure is necessary in order to treat the area under the gum.
5. Implementation of the preparation of a carious defect. Here, using a drill, tissue that has been affected by caries is removed.
6. Tooth isolation.
7. Carrying out the formation of a cavity for the further installation of a permanent seal.
8. Implementation of the treatment of the cavity made with an adhesive. The material helps the filling adhere well to the surface of the tooth.
9. . This is a structural stage at which the structure and functionality of the tooth is restored. The filling material is applied in layers. Each layer is treated with a photopolymerization lamp.
10. Carrying out polishing and grinding. Here the doctor creates the correct natural form. This is a corrective stage in which the tooth returns to its aesthetics.

Dentists often use glass ionomer cements in fillings. They are very stable in a humid environment, have a triple cure, strength and enough large spectrum colors. Physicians also continue to use composite materials which are much more aesthetically pleasing.

Treatment at home

Many people ask themselves: how to help yourself with cervical caries on your own, is it possible to cure the disease at home. It is possible, but only at the spot stage, that is, at the first stage. Among the drugs that are used in the treatment, PresidentUnique, Fluorodent, Blend-a-med Anticaries, or Ikon are often used. In addition, it is recommended to rinse the mouth with sodium fluoride and drink additional calcium tablets.

1. Sage. A table boat of grass is poured with one glass of boiling water and insisted for 1 hour. After cooling, the treatment is carried out by rinsing.
2. Onion peel. Three teaspoons of husks are poured into half a liter of boiling water and put on fire to boil. After the infusion is filtered and allowed to brew for 8 hours. Treat the tooth by rinsing.
3. Fir oil. For treatment, lotions are made from the named remedy.
4. Common angelica. Hold for 20 minutes in your mouth and spit it out.
5. Calamus tincture. Calamus root is insisted on vodka (0.5 l) and kept for one week. Rinse is carried out for several minutes. It is undesirable to use infused calamus inside.

Prevention

The appearance of cervical caries is desirable to prevent. This requires constant hygiene. When cleaning, you need to use only a good brush, in which the bristles have medium hardness. AT daily care better to use only quality pastes. The advice of a dentist will help with this.

It is imperative to use dental floss. They clean the interdental space well.

After the main meals and snacks, you need to rinse your teeth. The irrigator helps a lot in care. It makes care more complete.

Twice a year, in addition to treatment, you need to visit a dentist who will assess the condition of the teeth, restore them, whiten and remineralize.

It is necessary to carry out procedures at home that regenerate and restore tooth enamel. These include gum massage, application preventive formulations, rinsing with decoctions of herbs.

You also need to consume enough calcium and reduce the consumption of sweets to a minimum.

Cervical caries is a type of caries, in which there is destruction of the hard tissues of the tooth at the border of the tooth root and crown. With cervical caries, the labial, lingual, buccal surfaces of the anterior and lateral teeth can be affected. The disease most often occurs in childhood and in people aged 30–60 years and is one of the most dangerous types of caries, since pathological process occurs in the most vulnerable part of the tooth, which contributes to its rapid destruction.

The tooth consists of hard tissues (enamel, dentin, cement) and soft tissues - the neurovascular bundle, the so-called pulp, which nourishes the hard tissues and is located inside the tooth.

Anatomically, the tooth is divided into the coronal part (the visible part of the tooth), the neck (transitional area) and the root (the part of the tooth that is located in the jaw). With the development of cervical caries, the pathological process can occur on the gingival area of ​​the tooth or spread to the entire root region of the tooth. Due to the thinness of the enamel in this area, the disease is prone to rapid progression: initial caries quickly turns into deep stage.

Causes of cervical caries and risk factors

The causes of cervical caries include the same factors that cause the occurrence of caries of other localizations, and in addition, the specific conditions that occur in the root region of the tooth. These, first of all, include the inaccessibility of this area for hygienic care. For this reason, soft plaque often accumulates in this area, and the formation of tartar is often noted. Cervical caries often develops against the background of inflammation of the gums (gingivitis). The formation and development of cervical caries is facilitated by the thickness of the enamel in this area, which is approximately 0.1 mm (at the same time, in the area of ​​​​natural furrows on chewing surface teeth enamel thickness - 0.7 mm, and in the area of ​​the tubercles - 1.7 mm). The thin layer of enamel is easily damaged during brushing, especially when using hard brushes and abrasive toothpastes, which also increases the risk of damage by pathogenic bacteria with the subsequent development of caries.

Other risk factors for cervical caries include:

• some diseases that reduce the density of dental tissue (thyroid pathologies, diabetes mellitus, rickets, scurvy, osteoporosis);
• genetic predisposition;
• the use of drugs that increase the porosity of tooth enamel;
• period of pregnancy;
• frequent consumption of acidic foods, easily fermentable carbohydrates;
• lack of vitamins in the body (especially vitamin B 1).

In addition, the risk of cervical caries increases with age.

Forms of the disease

Depending on the number of affected teeth, cervical caries can be single, multiple and generalized.

Based on the state of the pulp, cervical caries can be simple and complicated (in the latter case, they often talk about the transition of deep caries to the stage of pulpitis).

Cervical caries can be acute (more common in children or immunocompromised patients) or chronic (typical of adults).

Cervical caries most often occurs in childhood and in persons aged 30–60 years and is one of the most dangerous types of caries, since the pathological process occurs in the most vulnerable part of the tooth, which contributes to its rapid destruction.

Stages of the disease

AT clinical picture cervical caries distinguish the following stages:

According to the depth of the lesion, cervical caries is distinguished:

• initial (chalk spot stage) - due to anatomical features cervical caries at this stage is extremely rare in this area;
• superficial (within the enamel);
• medium (destruction goes beyond the enamel, dentin is also affected);
• deep (almost the entire enamel-dentin layer is affected while maintaining the integrity of the pulp chamber, i.e., a narrow layer of dentin remains, protecting the pulp chamber from destruction).

Symptoms

The clinical picture of cervical caries varies depending on the stage of the disease. At the stain stage, the enamel in the neck of the tooth loses its luster and becomes matte. A small white (chalky) or pigmented spot forms on the surface of the affected tooth, which can retain its shape and size for a long time. Pain or any other discomfort at this stage are absent.

At the stage of superficial cervical caries, the surface of the spot becomes rough, which indicates the beginning of the destruction of the enamel. Pain sensations may be absent, or observed when sweet and / or cold drinks and foods are consumed, the pain in response to such stimuli is short-term, disappears almost immediately after the stimulus stops.

At the stage of medium caries, a carious cavity is formed in the affected tooth. Outwardly, this may not be noticeable, but food begins to get stuck in the affected area, causing discomfort after eating - usually this is the symptom that becomes the first manifestation of cervical caries. Pain, as in the previous stage, may be absent, but it may also take on a more pronounced character, also manifesting itself in response to chemical (sweet) and thermal (cold) stimuli. Often, pain accompanies brushing the teeth, especially if the patient rinses his mouth with cold water during brushing.

With deep cervical caries, food gets stuck in the cavity, and the pain can become very intense. It still appears in response to stimuli, however, it does not pass as quickly as in the previous stages, lingering for some time after the cessation of the stimulus. Often the pain appears when inhaling cold air.

Don't expect the visible cosmetic defect. The cavity can be relatively shallow - due to the thinness of the enamel in this area, even a slight depth of the lesion can be a sign of a deep stage of caries. In addition, the cavity may go unnoticed due to its location on the lingual or lateral surfaces of the tooth. At acute caries often there is a slight defeat of the enamel, under which, during the preparation, extensive destruction of the dentin is found.

Cervical caries is characterized by a circular distribution. The pathological process quickly moves to the middle part of the crown, can go deep under the gum and cover the entire affected tooth in a circle.

Diagnostics

When carrying out planned medical examinations cervical caries can be diagnosed at the stain stage. To do this, it is enough to examine the oral cavity, probing, assessing the hygienic state of the oral cavity.

From additional methods diagnostics, dental radiography, radiovisiography of the tooth, transillumination, electroodontodiagnostics, thermal test are used. In addition, vital staining of the teeth can be performed, in which the patient is asked to rinse the mouth with a dye solution. In this case, the coloring matter cannot penetrate the enamel. healthy teeth, however, penetrates into the demineralized areas of the enamel of the affected teeth. The previous staining returns to the teeth a few hours after the vital staining.

Differential diagnosis is carried out with fluorosis, enamel erosion, wedge-shaped defect. If cervical caries is found on several teeth, an endocrinologist should be consulted.

With the development of cervical caries, the pathological process can occur on the gingival area of ​​the tooth or spread to the entire root region of the tooth.

Treatment of cervical caries

The choice of treatment regimen for cervical caries depends on the stage of the disease.

At the stain stage, professional oral hygiene is carried out, as well as remineralizing therapy, which is aimed at normalizing the mineral composition of the enamel and strengthening it. The patient is given recommendations regarding oral hygiene, since with improper care, relapse is almost inevitable.

When a carious cavity is formed, the treatment of cervical caries includes surgical treatment of the carious cavity and tooth filling.

The cervical region of the tooth is different high sensitivity, therefore, before starting the preparation, the tooth is usually anesthetized with a guide or infiltration anesthesia. With the help of a drill, a carious cavity is prepared, and all tooth tissues that are affected by caries are removed. After that, the tooth is isolated from saliva, the cavity is first treated with an antiseptic, then with an adhesive for strong adhesion of the filling to the tooth tissues. In cases where the bottom of the cavity is close to the pulp, therapeutic and insulating pads are placed on the bottom; at the stage of medium caries, only an insulating pad is sufficient.

Then the tooth is sealed, with the help of filling material the crown is given its physiological shape, which is corrected by grinding and polishing. When the carious cavity is located on the vestibular surface of the tooth, the treatment can be supplemented by the installation of a veneer - a ceramic plate that protects the tooth and provides a high cosmetic effect.

Possible complications and consequences

Launched cervical caries leads to the development of pulpitis, then periodontitis, and, as a result, tooth loss. In addition, caries can be complicated by gingivitis and periodontitis.

Forecast

With timely and properly selected treatment, the prognosis is favorable.

Prevention of cervical caries

Prevention of cervical caries includes:

• thorough and regular oral care with the help of individually selected products;
• regular (at least once every six months) preventive examinations at the dentist with professional hygiene oral cavity;
• avoiding snacking between main meals, especially without subsequent oral hygiene;
• rejection of bad habits.

Video from YouTube on the topic of the article:

The tooth can be damaged in the most different places. And cervical caries, the causes and treatment of which we will describe in more detail, is the most difficult option.

This disease is often confused with some other problems, but it is much more dangerous.

Causes of cervical caries

From what happens cervical, or as it is also called basal, caries. To answer the question why such a disease appeared, you need to reconsider all possible reasons. Doctors distinguish the following:

• Malnutrition, in which the body lacks calcium and vitamins. As well as the use of large quantities flour, sweet, carbonated drinks, etc. The absence of dairy and fermented milk products, fish, vegetables and fruits will lead to complications general condition health, and teeth in particular.
• Bad habits - alcohol, smoking, etc.
• Hereditary factors affect the tendency to certain diseases, which include caries.
• Wrong. And this is the wrong choice of toothpaste (gels clean worse), too soft brush, horizontal movements. Lack of rinsing after eating.
• Poor quality drinking water which you are using.
• Pregnancy and lactation as a time of hormonal surges. And they, in turn, greatly affect the overall health.
• Taking medications that can destroy the structure of the enamel.
• Acidity gastrointestinal tract and contributes to saliva itself frequent illnesses oral cavity.
• The work of the endocrine glands can also affect the health of the teeth. Therefore, endocrinology is one of the important factors in the defeat of teeth by caries.
• Too thin enamel from birth.
• Disturbed metabolism.
• Age changes. It was found that after 30 years of age, the teeth are affected by cervical caries in most patients.

Symptoms and stages

Diagnosis of the disease is carried out at the dentist's office. He will immediately notice the changes or apply a special coloring gel that will reveal the destruction of the enamel that has begun. In some cases, the observation of the patient himself will indicate the appearance of cervical caries at the first stage, when everything can still be quickly corrected. At various stages of the disease, the following symptoms are observed:

1. At the first stage, the changes are almost imperceptible. May appear White spot at the root of the tooth, the enamel will fade, and the sensitivity will increase.
2. The second stage is characterized superficial manifestations caries, in which the stain becomes larger and lighter. It will be hard to miss him. In this case, the structure of the enamel becomes rough, it begins to gradually collapse.
3. The third stage refers to the average intensity of the disease, in which the upper layers of the dental tissue are affected.
4. But last stage characterized by deep destruction of the tooth, in which both roots and nerve endings are already affected. If this chewing teeth that are heavily loaded, they may even break. This process is always accompanied by painful sensations, sometimes so acute that it is impossible to endure.

Since cervical caries is often similar to other diseases, and a hard-to-reach place does not always make it possible to examine a tooth for the presence of initial symptoms it is better to visit the dentist in time. The doctor will be able to detect the problem at an early stage, knowing how to identify it, and distinguish it from similar ailments that are treated in a fundamentally different way.

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Cervical caries and methods of its treatment

How to diagnose and prescribe treatment of cervical caries can only professional dentist. And the sooner the disease is detected, the easier, faster and cheaper it will be produced, so you should not delay going to the clinic.

What exactly is the treatment depends strictly on the severity of the disease.

• At the stage of the appearance of a spot and the practical absence of most other symptoms, it is enough to prescribe a remineralizing toothpaste. It is rich in fluorine, calcium and other minerals important for enamel health. As a result, the tissue is strengthened, and caries does not damage its deep layers.
• At the second and third stages, with more noticeable destruction, the doctor may prescribe a filling of the affected surface, while not affecting the nerve endings.
• treated only with complete removal nerve, seal the canal and dental cavity. AT this case use an injection with painkillers, as the procedure is quite painful.

If the doctor decides that filling is indispensable, he must additionally carry out a number of preparatory procedures:

1. Clean tartar and plaque.
2. If possible, neutralize the cause of caries.
3. It is good to dry the work area, since with the smallest amount of saliva, the filling will not hold and it is possible.

Treatment of cervical caries is complicated by its location. When the gums are close, it is quite difficult to dry the desired area. If chewing teeth are affected, then it is physically difficult to reach them. At the same time, the sensitivity of the patient is increased, since the place is rather painful.

The fillings themselves are used the same as in the treatment of other types of caries. The differences are only in the location and complexity of the work of the dentist. When filling the front teeth, the doctor must carefully select the color of the material so that it does not differ from the natural one.

AT modern dentistry there are painless ways to treat caries. For example, the use of ozone laser therapy All of these technologies are already available.

In children

Cervical caries is more common in adult patients after 30 years of age. But there are cases when the teeth are affected in childhood. In this situation, it is important to use painkillers, as the procedure will give the child a lot of discomfort.

The cause of cervical and any other caries in very young children is most often bottle-feeding before bedtime. The child keeps formula in his mouth for too long, sometimes falling asleep with it. From this, bacteria begin to actively multiply on milk teeth that are not yet strong, rapidly destroying them.

First aid

If you have made an appointment with the dentist, but you feel that there are unpleasant sensations, and the appointment is still far away, then you can do something yourself. That's it folk remedies, which are used at home to relieve pain and reduce negative impact bacteria.

• Infusion of sage - 2 tablespoons of dry grass pour half a liter of boiling water and leave to brew for half an hour. Further, it is enough to strain it and rinse up to five times a day.
• Valerian decoction - also take 2 tablespoons of the root, but pour a glass of boiling water. Boil in a water bath for no longer than ten minutes and filter. Rinse the affected area three times a day.
• Melissa infusion - the ratio of dry grass and boiling water will be as follows - 2 tablespoons per 100 - 150 ml of water. Need to insist it whole hour and rinse every time after eating.
• Propolis tincture - perfectly helps to cope with most ailments and reduce the action of bacteria. To do this, dilute 2 tablespoons of the finished tincture in a glass of warm water. Rinse your mouth periodically up to four times a day.
• The onion is rubbed and wrapped in several layers of gauze. Apply e to the affected area until they get rid of pain.
• Ordinary saline solution- three tablespoons per glass of warm water edible salt. You can rinse as often as pain occurs.
• Camphor oil compress - a small piece of cotton is soaked with camphor and applied to a sore spot.

Prevention

If you have never had cervical caries, or if this problem has not bothered you for a long time, it is advisable to engage in the prevention of the disease. The sooner you start taking action, the less likely you are to get cavities. Doctors recommend:

• Brush your teeth with toothpastes that contain a high concentration of minerals. It can be Lacalut (Lacalut Extra sensitive), President sensitive, Silca Complete Sensitive, 32 bionorm and others.
• Daily oral hygiene. At the same time, choose toothpaste, not gel, as it cleans plaque and tartar better. The brush should be of sufficient rigidity, and the movements should be vertical or circular. should be twice a day, and rinse your mouth after each meal.
• Soft tissue massage is desirable, as blood vessels feeding teeth.
• The use of foods rich in vitamins, calcium, fluorine and other minerals. Refusal from flour, confectionery and other harmful products. Periodically it is desirable to take vitamin complexes with high content calcium.
• Once every six months, a visit to the dental clinic for a general examination is mandatory. This will help to detect the problem in time and prevent deterioration.
• Every year, professional cleaning of the oral cavity is desirable, which includes the removal of tartar, cleansing of strong plaque, strengthening of enamel and other wellness procedures.
• Must be avoided mechanical damage and injuries.
• Quitting bad habits will help improve overall health.

Video: what is cervical caries and how is it treated?

Additional questions

How much does the treatment cost?

The cost of the procedure will depend on the specific clinic and region, but most prices form the neglect of the problem. When installing a simple filling, you can spend 1500-2000 rubles, and if necessary, the cost will increase to 4000. In Ukraine, prices vary between 350-650 hryvnia.

Can a filling fall out due to cervical caries and a tooth hurt?

If the lesion occurs on a tooth that was previously filled, then such a filling may fly out. After all, the disease has penetrated from the other side and destroys dental tissue. Pain appears at the stage when caries reaches the nerve endings.

Toothache after treatment - is it normal?

If the pulp was not removed, then it may have become infected and inflamed. In the case of tolerable pain, in the absence of deterioration in the general condition, redness or swelling of the gums, this is probably just a reaction of the tooth to the intervention, it will pass with time. At acute pain, especially at night, you should definitely consult a doctor.