It is useless to fill cervical caries on baby teeth. What is cervical caries and how much does it cost to treat it in dentistry? Treatment at the initial stage

From this article you will learn:

• favorite places for caries localization on human teeth,
• why does dental caries occur?
• main stages of treatment of cervical caries.

Cervical caries is a carious lesion of tooth enamel localized in the neck of the tooth. Patients often call this pathology the term “root caries.” It should be noted that tooth enamel in the area of ​​the necks of teeth is one of the most common areas of development of the carious process, along with fissures on the chewing surface of large molars. This is due to the fact that it is primarily in these areas that food debris and bacterial plaque accumulate.

In dentistry, therapy for cervical dental caries, despite the apparent simplicity of localization, often ends in secondary caries next to the filling. On the part of the patient, this is usually associated with still irregular oral hygiene, but also often the cause of relapse can be the dentist’s errors during treatment (for example, poor isolation of the carious cavity from saliva, and, no less important, gingival fluid , which is released from the gingival groove around the neck of the tooth).

Cervical caries: photo

In addition to the problem of secondary caries at the filling/tooth interface, the patient may encounter another important problem that arises during the treatment of cervical caries in the area of ​​the anterior teeth. We are talking about a mismatch between the filling (in color and transparency) and the tooth tissue. The fact is that the color and transparency of the teeth change, starting from the cutting edge to its neck. And not every dentist can use a combination of filling materials of several colors and transparency to create a filling that is invisible against the background of the tooth’s own tissues.

In addition, if you are an ordinary patient, then you need to distinguish cervical caries from caries, which are also located in the area of ​​​​the necks of the teeth. The difference is that a wedge-shaped defect is a lesion of tooth enamel of non-carious origin, and the surface of such a defect will always have a smooth, shiny surface. You can read more about this pathology at the link above.

Cervical caries: causes

Let us remember that caries is caused by cariogenic microorganisms in the composition of soft plaque and hard tartar. These microbes “digest” food debris in the mouth into organic acids, which in turn leach calcium from the enamel and destroy it. Poor oral hygiene (Fig. 4-5) leads to the development of caries. You can read more about the development of caries in our review at the link below.

In the process of development, cervical caries goes through several stages: from a white spot to deep caries. So, at the very beginning, cervical caries looks like white chalky spots on the surface of the enamel in the area of ​​​​the necks of the teeth (Fig. 6). At this stage, there is no actual carious defect (carious cavity) yet. These areas range in color from slightly matte to bright white.

If negative factors(soft microbial plaque and food debris) continue to act, then caries in the form of white spots transforms into a superficial, then medium and deep carious cavity.

Cervical caries: diagnosis

Diagnosis of cervical caries is not difficult, since carious defects are located on clearly visible surfaces of the teeth. White chalky spots can also be seen in the mirror even on your own, especially if you dry the surface of the teeth.

In addition to visual inspection, special dye solutions are used. The patient is asked to rinse his mouth with this solution. At the same time, the dye from this solution cannot penetrate the enamel saturated with calcium. healthy teeth, but at the same time the dye penetrates perfectly into demineralized (deprived of calcium) areas of the enamel. Demineralized enamel is very porous. After the mouth is rinsed with running water, the dye is retained only in areas of the enamel that are subject to demineralization. A few hours after rinsing with this dye, the teeth gradually acquire their previous color.

Cervical caries: how to treat...

Depending on the stage of cervical caries, different treatment methods can be used. At a very early stage, when caries consists only of white chalky spots without destruction of the surface layer of enamel, it is advisable to try conservative treatment. If a carious defect has already formed, then it is definitely necessary to fill such defects.

1. Treatment of cervical caries in the white spot stage -

The essence of caries therapy in the white spot stage is that the enamel deprived of calcium must be saturated with calcium again. For this purpose, special remineralizing preparations containing highly active calcium and fluorine are used. One of the best drugs for remineralization of enamel is “Enamel-sealing liquid Tiefenfluorid” (made in Germany). Also, for the treatment of caries in the white spot stage, dentists widely advertise the drug ICON (developed by the German company DMG).

The disadvantage of this drug is that it does not actually heal, but rather preserves the enamel with a special polymer composition (like plastic). In any case, before applying and applying these drugs, soft dental plaque and hard dental deposits must be removed from the teeth. It is also necessary to educate the patient proper hygiene oral cavity, since if hygiene remains at the same level, then the success of such therapy will not be expected.

Enamel-sealing liquid “Tiefenfluorid” –

2. Treatment of cervical caries with destruction of enamel -

Treatment of root caries consists of the following steps:

1. Cleaning teeth from plaque and tartar(Fig.7) –
   Soft plaque and hard dental deposits must be removed. This is usually done using polishing brushes and abrasive paste.
2. Determining the color of the enamel of filling teeth(Fig.8) –
   it is necessary to choose the right color of the filling material so that it matches the color of your own tooth enamel
3. Preparation of a carious defect –
   those. At this stage, all dental tissue affected by caries is removed using a drill.
4. Isolating a tooth from saliva(Fig.9) –
   Qualified dentists use a rubber dam for this, which allows you to completely isolate the tooth (being treated) from saliva and wet breath. This is important if you want the filling not to fall out in a few months to a year.

   A rubber dam is a thin band of latex in which holes are made for a group of teeth and then pulled over those teeth. After tensioning the scarf, a special metal fixing clasp is installed. It is needed to hold the rubber dam close to the gums. You can see how teeth are isolated using the power of a rubber dam in Fig. 9.

5. Treatment of the cavity with adhesive –
   enamel and dentin must be treated with adhesive before adding filling material.
6. Filling a defect –
   
   Filling material is introduced into the treated carious cavity to fill the lost part of the tooth. The tooth is given its physiological shape. During the layer-by-layer application of filling material, each layer is illuminated with a special photo-polymerization lamp, which leads to hardening of the filling material (Fig. 10).
7. Sanding and polishing –
   It is performed using special fine-grained discs and burs in order to give the tooth its final shape, as well as to create a smooth and shiny surface.

Stages of treatment of cervical caries using a specific example -

In Fig. 11 you can see the initial situation: with many carious defects, treatment of the upper central and lateral incisors is planned. In Fig. 12 we can see that all tissues affected by caries have already been removed, and a rubber dam has been applied to the teeth to isolate them from saliva. Figure 13 shows a view of the finished work.

Prevention: cervical caries

As follows from the causes of caries, methods for its prevention are as follows:

• Regular oral hygiene –
  with a toothbrush and toothpaste, and also (after each meal). If you can’t brush your teeth, the minimum you should do is floss and then chew gum for 5 minutes.
• Avoid snacking between meals –
  consumption of sweets, chips, flour, etc. without subsequent brushing of teeth for 5 minutes is one of the reasons for the development of caries. Having a snack means you need to brush your teeth. Laziness? - so keep walking with rotten teeth and bad breath.
• Professional hygiene –
  1-2 times a year (depending on the quality of oral hygiene), remove dental deposits and pigment plaque, and also treat teeth with special fluorine- and calcium-containing products to strengthen the enamel. We hope that our article was useful to you!

The appearance of carious lesions in the hard tissues of the tooth is a problem familiar to almost every person. If the pathology develops in the cervical region, then caries is accompanied by severe, sometimes unbearable pain and, with a high degree of probability, leads to the loss of a tooth (or even several). It is important to identify the first symptoms of the development of cervical caries, fully and effectively treat the disease and take preventive measures.

The concept of cervical (root) caries

Cervical caries is one of the most dangerous types of diseases of hard dental tissues. When basal caries develops (as this pathology is otherwise called), the tooth is destroyed at the root (as the name suggests). In this case, absolutely all dental canals are affected. Risk group for this disease is very extensive - it includes people of any gender over 30 years old.

Cervical circular caries often develops on the front teeth or canines (we recommend reading: photos of the upper front teeth before and after caries treatment on them). Many dentists view it as a more aggressive version of the disease or even a complication of it. Cervical circular caries leads to the fact that the crown of the diseased tooth is completely destroyed or partially broken off. The signs of cervical caries can be found in the photo accompanying the article (we recommend reading: caries: symptoms with photos).

Reasons for the development of the disease

In the vast majority of cases, the occurrence of cervical caries is the result of the activity of cariogenic microorganisms. The ideal environment for them is deposits on the surface of tooth enamel. Tartar and plaque tend to accumulate at the base of the tooth, near the gums. At the same time, thoroughly clean the cervical area during daily hygiene procedures difficult - there is a danger of damage soft fabrics, if you use your toothbrush too intensively.

Another factor that makes the gingival area of ​​the tooth especially vulnerable is the small thickness of the enamel. The root part of the tooth is covered with enamel, the size of which usually does not exceed 0.1 mm, while in upper areas this figure is 6–17 times higher. The main reasons for the development of cervical caries are the inaccessible location of the root region of the tooth and the natural thickness of the protective layer.

The reasons that usually provoke the development of carious lesions include the following:

• pathology endocrine system(cervical caries can affect several teeth at once);
• vitamin deficiency;
• food residues – the appearance of lactic acid due to their decomposition leads to demineralization of the enamel;
• use large quantity acidic foods or food that contains easily fermentable carbohydrates;
• reception medical supplies leading to an increase in the level of porosity of tooth enamel;
• pregnancy.

Symptoms with photos before and after occurrence

The fact that a carious lesion is developing in the cervical area may be indicated by symptoms such as the appearance of a hole (right near the gum, from the inside or outside) on the neck of the tooth.

There is also an increase in sensitivity to irritants of any nature (a short-term pain syndrome occurs upon contact with them), the enamel in the affected area noticeably darkens. You can see what teeth look like before and after the development of the disease in the photo accompanying the article.

The development of root caries does not occur overnight. This is a rather lengthy process, which is divided into several stages. Each of them is characterized by a specific clinical picture, which will be useful to familiarize yourself with in order to be able to detect the onset of the disease in the early stages.

Stage	Symptoms	Note
Initial	Usually there is no pain. Sometimes there is minor discomfort.	A pigmented or white spot appears on the surface of the tooth enamel near the neck. The protective coating on the tooth has a smooth surface but appears matte.
Superficial	Short-term pain syndrome when exposed to sudden changes in temperature or consumption of salty, sour or sweet foods, dishes and drinks.	The destruction of the enamel begins. The pathology progresses very quickly.
Average	Gain pain syndrome. Formation of a carious cavity (hole).	The pathology is clearly visible even to the naked eye. Most often, cervical caries is diagnosed at this stage.
Deep	The unbearable ones appear sharp pains with any impact on the affected tooth (even when inhaling cool air).	The lesion penetrates into deep tissues, affecting the pulp and canals of the tooth.

Diagnosis of root caries

Diagnosing cervical caries on your own is potentially problematic. The patient experiences symptoms such as the appearance of a carious cavity and severe pain, characteristic of many dental diseases. Caries of the tooth neck is characterized by a specific location of the affected areas, however, a person who is not a specialist may confuse the symptoms with signs of fluorosis, pigmented plaque or a wedge-shaped defect (we recommend reading: wedge-shaped dental defect: causes and methods of treatment).

If any of these signs appear, it is recommended to immediately contact your dentist. The specialist will conduct a clinical diagnosis of the disease of the gingival part, in addition, will perform a number of specific research that cannot be organized at home:

• transillumination;
• X-ray;
• electrical odontometry (see also: electrical odontometry in dentistry: what is it and why is it done?);
• radiovisiography;
• stain staining method.

How to cure caries?

Treatment of cervical caries, like any other pathology, should begin as early as possible. If the problem was found on initial stage, then the chances of saving the tooth and using conservative methods increase many times.

When a patient neglects to visit the dentist, not only tooth loss is possible. There is a possibility of complications or multiple caries cervical region.

Treatment at the dentist

The dentist determines effective treatment strategies for cervical caries, based on the stage and severity of the disease and the individual characteristics of the patient’s body. In most cases they are used standard methods treatment of carious lesions. If in the cervical area of ​​the tooth there is carious cavity, then the stages of treatment of cervical caries will be as follows:

1. pain relief (local anesthesia);
2. insertion of a retraction thread into the gap between the tooth and gum;
3. preparation (formation of an oval cavity);
4. filling (in most cases photopolymers are used);
5. grinding the filling surface;
6. polishing a ground filling.

If the filling falls out (such a complication is considered typical for this dental disease), then the patient will have to go through all the filling procedures again (we recommend reading: what to do if the filling falls out?). The reason for this phenomenon may be a violation of installation technology, poor-quality materials, or too big size fillings. In the latter case, installing a crown will help solve the problem.

If the destruction of the enamel has not begun, and the patient seeks help at the stage of formation of a carious spot, then one of conservative methods: remineralization of tooth enamel, deep fluoridation, Icon method. All of them contribute to the restoration of tooth tissue and prevent further development diseases.

You can begin cervical dental restoration only after the disease has been treated. The restoration process differs from filling in that it aims not only to restore the damaged element of the dentition, but also to make it aesthetic, indistinguishable from its natural “neighbors.” If a significant part of the tooth tissue has been lost, then the installation of a pin will be required for restoration. It should be remembered that the restoration procedure is contraindicated if it is impossible to isolate from moisture oral cavity or the tooth itself, with individual intolerance to the components used, as well as for people who have pacemakers.

Remineralizing therapy: pastes, creams and gels

In the first stages of the development of the disease, the patient will be helped by remineralizing therapy. Its essence is to strengthen and restore the structure of the enamel until the protective coating of the tooth begins to deteriorate. In the dental office, the procedure is carried out as follows:

1. the tooth surface is cleaned of deposits using ultrasound;
2. using a rubber dam system or cotton swabs, the tooth is isolated from oral fluid and salivary secretions (we recommend reading: what is a rubber dam system in dentistry and what is it used for?);
3. the surface of the tooth enamel, which is infected with caries, is dried;
4. a cotton swab is moistened in a medicinal solution and applied to the prepared area (15 – 20 minutes);
5. apply sodium fluoride (5 minutes);
6. The oral cavity is washed with clean warm water.

There are a number of toothpastes, creams and gels that can be used for remineralization at home. They can be used on the recommendation of a doctor in the first stages of the development of root caries. The method of application is simple - apply after daily brushing of teeth. medicinal composition on diseased areas. In order to achieve a noticeable effect, procedures must be carried out daily for 3 to 4 months. The most popular means are:

Folk remedies and home recipes

With the development of cervical caries, you can use traditional medicine and treat it with home recipes. They can be used to relieve pain and eliminate discomfort at the initial stage, but do not replace conservative treatment. Before starting self-medication, it is recommended to visit a dentist to clarify the diagnosis and determine the stage of development of cervical caries.

The transition from the initial stage to the superficial stage occurs smoothly and almost imperceptibly. At the superficial stage ethnoscience It will only do harm, since it will not cure the pathology, but will only mask the development of changes.

Means	Recipe	Mode of application
Tincture of calamus rhizomes	Grind 0.5 cups of the plant's rhizomes and pour in 500 ml of vodka. Leave for 7 days.	Rinse your mouth daily before going to bed.
Onion solution	Remove the husks from the onion and place in an enamel pan (3-4 teaspoons are enough). Pour 500 ml of filtered water. Boil. Remove from heat and cool. Strain through cheesecloth. Leave for 8 hours.	Rinse your mouth every time after eating.
Sage tincture	Pour 1 tbsp into a glass of boiling water. sage Leave for 1 hour.	Rinse your mouth or make lotions for a sore tooth.
Fir lotion	Buy fir oil at the pharmacy.	Soak a cotton sponge in oil. Apply to the affected areas and to the side of the tooth for 3 – 5 minutes.
Angelica root	Take a small piece of root.	Chew and hold in the mouth for at least 20 minutes, then throw away.

Preventive measures

The process of treating root caries is difficult, long, painful and expensive. Cervical caries is better to prevent than to treat. For this reason, it is recommended to pay attention to simple preventive measures, which will reduce the likelihood of developing pathology and prevent relapse if the disease has already been successfully treated by a dentist.

Prevention measures:

• Proper nutrition. Limit your consumption of sweets and confectionery. Regularly consume foods with coarse fibers and foods with high content calcium.
• Procedures for restoration and regeneration of tooth enamel. Rinse your mouth herbal decoctions, massage the gums. As prescribed by the attending physician, apply special compounds to the teeth.
• Regular visits dental office. The specialist will conduct a preventive examination and professionally remove all deposits from the surface of the teeth. Remineralization and whitening procedures should also be carried out as needed.
• Complete oral care. Use toothbrush with medium-hard bristles, choose high-quality toothpastes. Clean the space between teeth using dental floss. Use an irrigator.

A tooth consists of a crown (outer) part, a neck and a root. If you notice White spot or darkening of the enamel near the gums, this is probably cervical caries. It is treated with local fluoride medications. And on late stage you need to put a filling, and you can’t delay this moment.

This form of caries is considered one of the most dangerous because it destroys the tooth at the base. The enamel in the cervical area is very thin and quickly deteriorates. Therefore, you risk developing complications in the form of pulpitis, periodontitis and other inflammatory diseases.

Causes of cervical caries

The basis of any form of caries is the activity of pathogenic bacteria Streptococcus. Microbes accumulate in plaque and feed on carbohydrate food particles that remain in the mouth after eating. As a result, the fermentation process starts and acids are released that destroy the enamel.

However, specific causes are also characteristic of cervical caries:

Incorrect teeth brushing technique.

You should brush your teeth using “sweeping” movements from the gum to the cutting edge. If you use a brush with horizontal movements, plaque quickly accumulates in the cervical area and gum pockets.

Peculiarities anatomical structure teeth.

The enamel in the root area of ​​the tooth is thinner than in other areas. Dental tissues under the gum margin have a low degree of mineralization. This is a weak area where the carious process develops quickly.

Recession (sinking) of the gums.

Due to age-related changes organism or chronic diseases of the endocrine system, the gums lose elasticity and recede. The neck of the tooth becomes exposed and becomes susceptible to external influence. Bacteria quickly attack the enamel, destroying it.

Stress, depression, lack of vitamins, addiction to alcohol and smoking are factors in the rapid development of basal caries. After 40 years, the risk of the disease increases.

Symptoms of caries in the cervical area

initial stage

The defect occurs on the front teeth in the “smile zone.” At first, an imperceptible chalky spot forms, but there is no discomfort. A person does not even suspect that he has caries.

Middle stage

After a few months, the spot becomes pigmented, acquiring a yellow or brown tint. The enamel layer of the tooth neck is destroyed. Short-term pain occurs when exposed to cold, hot or sour food, which is attributed to the sensitivity of the enamel.

Deep stage

At a late stage of the disease, the tooth begins to “ache” even when exposed to cold air flow or temperature changes. Deep dental tissues located near the nerve endings are damaged. It is painful for a person to brush his teeth and bite into hard food. Ultimately, a “carious” hollow is formed, into which food particles constantly fall, causing severe discomfort. Arises high risk fracture of the dental crown.

Treatment of cervical caries with the Sandman Futura device

Treatment methods

Icon method

Conservative method without drilling with a drill, relevant for treatment initial form caries. The tooth surface is cleaned of plaque and etched with a gel based on sodium hypochloride.

Then a liquid polymer is applied, which penetrates the rough surface of the enamel, compacting it. The tooth is illuminated with a polymerization lamp for a fixing effect. The procedure lasts 15-20 minutes and is comfortable for the patient.

Sealing

If a carious hole has formed, you need to hermetically close it, that is, seal it.

The procedure includes:

1. Preparation of a carious defect with a drill.
2. Removal of softened (disintegrated) dentin.
3. Isolation of the working field using an elastic rubber dam cloth.
4. Washing the cavity weak solution antiseptic - chlorhexidine, hydrogen peroxide.
5. Filling the defect with a filling material - glass ionomer cement or photopolymer composite.
6. Final correction of the filling, grinding and polishing of the surface.

Is it painful to treat cervical caries? The carious defect is localized on the neck of the tooth, and this is a very sensitive area. Therefore, treatment of cervical caries must be carried out under local anesthesia- injection of Lidocaine, Ultracaine or Mepivacaine.

Treatment at home

Caries can be cured at home only with early stage(chalk spot stage). To do this, the dentist prescribes remineralizing gels and pastes, for example, R.O.C.S., Tooth Mouss, Emofluor, etc.

For an additional bactericidal effect, it is recommended to use sage infusion and oak bark decoction as a rinse ( room temperature) or solution alcohol tincture propolis - 20 drops/1 glass of water.

Prevention at the dentist

Caries prevention services are available in any dentistry. Basic methods:

• Ultrasonic cleaning is the removal of tartar and soft bacterial plaque that accumulates near the neck of the tooth. Ultrasonic waves crush deposits into small particles and also sterilize enamel and gum pockets. The method is painless, non-contact and takes 20 minutes. It is recommended to clean once every 6 months.
• Deep fluoridation is the strengthening and remineralization (restoration) of enamel by saturating it with fluoride ions. Teeth are dried with a jet warm air, then treat the surface with a special solution containing fluorides. The final step is shading with a calcium hydroxide-based liquid. The effect of the procedure lasts for 4-6 months.

Prices

• The Icon procedure will cost approximately 1,600 rubles.
• Filling a tooth in the middle or late stages of caries costs from 1,500 to 4,000 rubles.

Cervical caries is a type of caries in which destruction of hard tooth tissues is noted at the border of the tooth root and crown. With cervical caries, the labial, lingual, and buccal surfaces of the frontal 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 varieties caries, since the pathological process occurs in the most vulnerable area of ​​the tooth, which contributes to its rapid destruction.

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

Anatomically, a tooth has a coronal part ( visible part tooth), neck (transitional area) and root (part of the tooth that is located in the jaw). With the development of cervical caries, the pathological process can occur in 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 moves into a deep stage.

Causes of cervical caries and risk factors

The causes of cervical caries include the same factors that determine the occurrence of caries in other localizations, and in addition, specific conditions that occur in the root region of the tooth. These include, first of all, the inaccessibility of this area for hygiene care. For this reason, soft plaque often accumulates in this area, and the formation of tartar is often observed. Cervical caries often develops against the background of gum inflammation (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 (while in the area of ​​natural grooves on the chewing surface of the teeth, the thickness of the enamel is 0.7 mm, and in the area of ​​the tubercles – 1.7 mm). A thin layer of enamel is easily damaged when brushing your teeth, 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 the development of cervical caries include:

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

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

Forms of the disease

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

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

Caries of the cervical region can be acute (more often observed in children or in patients with reduced immunity) 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 area of ​​the tooth, which contributes to its rapid destruction.

Stages of the disease

IN clinical picture Cervical caries is divided into the following stages:

Based on the depth of the lesion, cervical caries is distinguished:

• initial (chalk spot stage) – due to anatomical features in this area, cervical caries at this stage is found extremely rarely;
• superficial (within the enamel);
• medium (destruction extends 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 area of ​​the tooth neck loses its shine 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. There is no pain or any other discomfort at this stage.

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

At the stage of intermediate caries, a carious cavity forms 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 sign becomes the first manifestation of cervical caries. Pain, as in the previous stage, may be absent, but it can also become more pronounced, also appearing in response to chemical (sweet) and thermal (cold) stimuli. Pain often accompanies brushing teeth, especially if the patient rinses his mouth with cold water while 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, but does not pass as quickly as in the previous stages, lingering for some time after the cessation of the stimulus. Pain often occurs when inhaling cold air.

Don't expect what's visible cosmetic defect. The cavity may be relatively shallow - due to the thinness of the enamel in this area, even a slight depth of the lesion may be a sign deep stage 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 small lesion of the enamel, under which, upon preparation, extensive destruction of dentin is discovered.

Cervical caries is characterized by a circular distribution. The pathological process quickly progresses to middle part crowns, 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 spot stage. To do this, it is enough to examine the oral cavity, probe, and assess the hygienic condition of the oral cavity.

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

Held differential diagnosis with fluorosis, enamel erosion, wedge-shaped defect. If cervical caries is detected on several teeth, consultation with an endocrinologist is necessary.

With the development of cervical caries, the pathological process can occur in 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 mineral composition enamel and its strengthening. The patient is given recommendations regarding oral hygiene, since improper care relapse is almost inevitable.

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

The cervical area of ​​the tooth is highly sensitive, therefore, before starting preparation, the tooth is usually anesthetized using a guide or infiltration anesthesia. Using a drill, a carious cavity is prepared, and all tooth tissue affected by caries is removed. After this, the tooth is isolated from saliva, the cavity is first treated with an antiseptic, then with an adhesive to ensure strong adhesion of the filling to the tooth tissue. 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 filled, using filling material the crown is given its physiological shape, which is corrected by grinding and polishing. If the carious cavity is located on the vestibular surface of the tooth, treatment can be supplemented by installing a veneer - a ceramic plate that protects the tooth and provides a high cosmetic effect.

Possible complications and consequences

Advanced cervical caries leads to the development of pulpitis, then periodontitis, and, as a consequence, 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 using 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:

IN modern world There is not a single person who has not encountered caries. In general, caries is tooth damage. Moreover, caries can occur on various areas tooth This article will discuss one of the types of caries. Cervical caries is damage to the neck of one or more teeth.

First you need to figure out where the neck is.

• crown,
• neck,
• root.

The crown is located under the gum. The root and neck of the tooth are protected by tissue. Hence the name cervical.

Symptoms of the disease

Most often, people start visiting a dentist when severe symptoms which are given below.

1. Pain during various contacts with teeth (brushing, eating, etc.).
2. Pain in the head.
3. Strong sensitivity of teeth to temperature changes, especially with cold or hot food.
4. With severe complications, night pain may occur.
5. Stains on the affected tooth.

There may be cases when there is simply no pronounced pain. This is explained by the fact that they begin to synthesize reserve dentin, the function of which is protection.

Causes

The causes of any type of caries themselves differ little from each other. Therefore, an unknowing patient can often confuse cervical caries with another type of caries. The reasons why such dental damage develops:

• poor or insufficient oral hygiene. When maintaining dental hygiene, it is very important to maintain consistency in this matter;

  

• microbial activity. Due to their metabolic products, teeth begin to be damaged;

  

• nutrition. Incorrect and unbalanced food intake also affects the occurrence of caries. Thus, frequent consumption of carbohydrates and acidic foods increases the risk of the onset of carious processes;

  

• lack of vitamins (in particular B1);

  

• problems with hormones.

  

Stages of problem development

Each stage is replaced by its own “picture”. Therefore, it is important to distinguish between each of them. The stages are given below.

1. Spot. May not change for a long time. There is no pain. But there may be a feeling of acidity and viscosity in the mouth, especially when consuming fermented milk and other acidic foods. The enamel becomes thinner and begins to turn matte.
2. Superficial stage. A feeling of roughness appears when you feel the spot. At this stage, pain already appears because the enamel begins to deteriorate. Eating sour, sweet and spicy foods can also cause painful sensations. There are often cases when this stage occurs without any symptoms.
3. Average cervical caries. A carious cavity appears and it is impossible not to notice it. There is an increase in pain. Enamel and dentin continue to suffer.
4. Deep caries. The disease spreads to the nerve nodes that are located deep in the tooth. Increased pain at night.

Many doctors cannot accurately determine the stage of the disease. Because the transitions between each stage are very smooth. A feature of the flow is individual development. That is, the manifestation of each stage will occur differently for everyone.

Peculiarities

This severe form of dental damage is characterized by the following signs:

• it affects the cervical area of ​​the tooth, as it is poorly protected. This is where inflammation begins;
• the distribution is circular. Often inflammation can reach the central part of the crown. In rare cases, the entire tooth and a small radius from it become inflamed;
• It can also be on the front teeth. Due to such cervical caries there are nervous breakdowns(especially often with various speakers and artists).

This disease can lead to the breakage of parts of the tooth.

Diagnosis of carious lesions

It is extremely difficult to determine the onset of caries yourself. It's better to play it safe and go to dental clinic and undergo inspection. Diagnosis is carried out in several ways:

• electrical odontometry;
• staining spots (for example, two percent methylene blue);
• radiography method and other methods.

But before using one of these methods, the dentist will examine for:

• presence of a stain;
• enamel condition. If it is destroyed, then this is the second stage. If the initial layers of dentin are also damaged, then the third. If the deep layers of dentin are also destroyed, then the fourth stage.

Treatment

Each disease has its own degree of severity. The more advanced the disease, the more intensive treatment. Therefore, each stage of caries has its own therapy.

The filling process will be more complicated depending on the location of the caries. If distant lateral teeth, it will be more difficult to reach them. The pain will also increase.

Video - Treatment of cervical caries

First aid at home

In order for the patient’s pain to subside a little, you can resort to folk remedies. The list is presented in the table.

Means	How to use
	2 tablespoons per half liter of boiled water. You can rinse your mouth up to five times a day.
	Soak cotton wool and apply to the location of pain.
	One glass of boiled water per two tablespoons. It is advisable to rinse three times a day.
	Three tablespoons per glass of boiled water. Rinse as soon as pain occurs.
	Two tablespoons per glass of boiled water. Rinse four times a day.
	Leave for an hour. Use two tablespoons per glass of boiled water. Rinse every time after eating.
	Cut the onion into small pieces. Wrap in gauze napkin. Apply to the painful area until the pain subsides.

Treatment at home

For lovers of self-medication there will now be very good news. If the patient has only the initial stages of caries, then home treatment is allowed. It will be relevant only if the disease is not late stages. For treatment, special fluoride and calcium-containing toothpastes, gels, and so on are usually used. This way the enamel will be saturated, especially where the color has already changed. But during treatment you need to know a few points:

• It is worth taking into account the individuality of each person. That is, one paste or gel can help one person, but not another;
• you need to know that the product that will be chosen must be selected correctly. The success of therapy depends on this. Therefore, responsibility falls only on the patient. No one has any guarantee that the choice will be successful;
• Treatment at home can only be done at the very first stage. And, as you know, it is very difficult to determine the stage. It will be especially difficult to an ordinary person without a dental education.

Prevention measures

In any pathological process there is a chain of disease. Therefore, in order to avoid getting sick, it is important to break the chain at only one link. Therefore, the following measures can be used for preventive measures:

• reduce the number taken fast carbohydrates(candy, cookies, etc.). This will also have a good effect on your figure. If you can’t adjust your diet, you can eat little. But under no circumstances should you eat such food between main meals;

  

• rinse your mouth after eating;

  

• brush your teeth in the morning and before bed. Special attention need to devote the morning. You can’t brush your teeth before breakfast because it puts stress on the enamel. Therefore, you need to clean after breakfast;

  

• As a preventative measure, you can use various dental flosses, since they can penetrate into areas where a toothbrush cannot reach;

  

• eat more solid and rough foods (vegetables and fruits). They promote self-cleaning of the oral cavity.

  

Any prevention will be better and cheaper than treatment. This principle is used throughout medicine. You should never neglect your oral cavity. This could amount to a tidy sum.

Video - Vitamins and minerals for dental health