Treatment of deep cervical caries. Learn more about cervical caries and the reasons for its development. Cervical caries: how to treat...

IN modern world There is not a single person who has not encountered caries. In general, caries is tooth damage. Moreover, caries can occur in different parts of the 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.

Pain during various contacts with teeth (brushing, eating, etc.).
Pain in the head.
Strong sensitivity of teeth to temperature changes, especially with cold or hot food.
With severe complications, night pain may occur.
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.

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.
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.
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.
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 a dental clinic and get examined. 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

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, because pathological process flows 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 (thyroid pathologies, 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 teeth affected cervical caries can be single, multiple and generalized.

Based on the condition of the pulp, cervical caries can be simple or complicated (in the latter case they often talk about transition 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 the clinical picture of cervical caries, the following stages are distinguished:

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 spreads to the middle part of the crown, can go deeper 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.

Additional diagnostic methods include dental radiography, dental radiovisiography, transillumination, electroodontodiagnostics, and thermal testing. 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 healthy teeth, however, penetrates into the demineralized areas of the enamel of the 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 spot stage it is carried out professional hygiene oral cavity, 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.

During education carious cavity 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 oral hygiene;
avoiding snacking between main meals, especially without subsequent oral hygiene;
rejection of bad habits.

Video from YouTube on the topic of the article:

It is customary to distinguish several parts in a tooth: tooth root, neck and crown. IN in good condition the crown is located above the gum, and the rest of the tooth is hidden behind it. Caries that occurs at the border of the gum and neck of the tooth is called cervical, or in other words, cervical.

Not taking the factors that cause cervical caries seriously, people visit the doctor only when the problem begins to seriously bother them, since the appearance of the front teeth becomes unaesthetic (a similar disease very often spreads in the smile area).

The reasons for its occurrence may be different. Not all people go to the dentist on time. After all, the appearance of such a disease is not immediately noticeable, especially in early stages. And sometimes people try to eliminate the disease on their own by using special pastes or resorting to treatment with folk remedies.

Let's look at the main reasons why cervical caries appears. First of all, they are associated with the following factors:

Diet, as well as the frequency and amount of consumption of carbohydrate-containing foods that are easily fermented.
The presence of microbes, that is, the activity of bacteria under dental plaque. This is especially true for Streptococcus mutans. In this state, bacteria begin to ferment and organic acids are formed. They have a detrimental effect on the layers of tooth enamel. As a result, areas of demineralization may occur. As a result, calcium, phosphorus, and fluorine are washed out, the mineral crystal lattice of the enamel is disrupted, and a caries stain gradually appears.

In general, the reasons that cause caries of the tooth neck are similar to those factors that cause ordinary caries. In case of improper or irregular care oral cavity basal caries may begin to develop.

Dmitry Sidorov
Orthopedic dentist
With cervical caries, the transition from initial stage diseases to its deep development.
Cervical caries begins to develop, which goes through the following stages:
formation of carious areas in the form of small spots;
transition to the superficial type of caries;
middle stage of development of root caries;
deep stage of the disease.

It is often quite difficult to recognize the extent of damage. The stages or dentin are difficult to determine. It is difficult for an uninitiated person to see the differences between caries that have just appeared in the spot stage and superficial ones, as well as between medium and deep damage to the tooth. Look at the picture below:
The initial stage of cervical caries is circled. Very noticeable?
This happens because in the border area, where there is a transition to the neck from the coronal part of the tooth, there is thin enamel that is weakly mineralized. If you brush your teeth incorrectly or take care of your mouth incorrectly, it wears off. Therefore, you should not put too much pressure on your toothbrush.
The video below shows the technology proper cleaning teeth:
Thus, the enamel in this place becomes thinner and thinner over the years. And if this area is not properly cleaned, then bacteria will not take long to appear. It is then that the disease begins to develop in the area of the neck of the tooth.
Many people, already in the initial stage of the basal type of lesion, may begin to experience discomfort. This is discomfort, a feeling of teeth on edge and hypersensitivity of teeth. They are especially pronounced when eating cold or hot food or getting into contact with problem area sweet. However, such sensations quickly pass.
Dmitry Sidorov
Orthopedic dentist
If a person has cervical caries, treatment of the disease should begin as soon as possible!
But sometimes cervical caries can develop without any symptoms. Then you can recognize it only visually. It first appears as a light spot. When the lesion becomes superficial, pain appears when eating sweet, spicy, cold or hot.
If you visit a dentist, then when examined with a special probe, you can identify irregularities and roughness in the middle of the spot itself.
What are the symptoms of the disease
When root caries progresses to later stages, then other symptoms of the disease are added. This could be pain from chemical exposure or painful sensations from pieces of hard food getting under the edge of the gum. Pain may occur when cold air hits them.
Self-diagnosis of cervical caries at home is very difficult. Anyway accurate diagnosis Only a dentist can diagnose it.
You can determine whether you have root caries only by late stage diseases.
If there are any formations, stains, or defects in the neck of the tooth, this may mean pathologies such as:
caries under the gum;
other dental diseases - erosion, hypoplasia, etc.;
a type of pigmented dental plaque.

However, the first option is the most common. And this is the main problem with which people turn to the dentist.
Then the doctor can make an accurate diagnosis. And to confirm it, the dentist stains the surface of the tooth with a special solution. If the spot does not change color, then this is enamel hypoplasia, and not a symptom of cervical caries in the form of a white spot.
Dmitry Sidorov
Orthopedic dentist
The cervical form of caries usually develops in the form of a single spot.
How to treat cervical caries
If a person exhibits symptoms of cervical caries, how to treat such a disease? Various methods of treating this disease are used in dental practice for quite some time now.
Treatment of cervical caries does not differ from the treatment of the usual form of the disease. But if you contact a doctor late, you may have to fill the canals and clean the canals.
How is cervical caries treated? Therapy is prescribed by a dentist based on the stage of development of the disease. The sooner a person consults a doctor, the easier it will be to eliminate this problem.
Treatment of cervical caries at home can be used as additional therapy at the spot stage. In such cases you can use:
medicated toothpastes or gels that contain fluorides and phosphorus and calcium compounds;
dental floss, which is impregnated with fluoride;
rinses with fluoride (these elements very effectively affect the mineralization of tooth enamel).

However, it is worth noting that from self-use medications containing fluorides should be avoided. They should not be used without a doctor's recommendation. All treatment is prescribed by the doctor based on the results of the examination, the stage of development of the disease, the area of enamel damage and possible risks.
Caries treatment can be carried out without resorting to the use of a drill. But in some situations, difficulties may arise here. For example, due to its close location to the gum tissue, constant leakage of gingival fluid into the working area, or thinning of the enamel. But you should not delay the treatment of root caries. Therefore this new technique, like icon, is not used in such cases, since the substances used here are harmful to tooth enamel.
Treatment of caries will be as follows:
Anesthesia is necessary to avoid any unpleasant painful sensations.
The affected area of the tooth is cleaned of deposits to reduce the infectious load.
Preparation is carried out - a type of mechanical processing. It is used to treat carious areas and pigmented tissues.
It is necessary to treat the oral cavity with medicinal antiseptic agents.
Formation of a cavity (in accordance with the selected material) for a permanent filling.
Installation of a seal.

The filling material is selected based on the location of the caries. The closer it is to the gum, the stronger the material will be needed so that the filling cannot fly when there is a load on it.
The video below will help clarify some points in this article:
Is it possible to cure subgingival caries? Doctors consider this disease to be one of the most dangerous, so it requires immediate attention to a specialist. This type of caries is destructive to the tooth because it can penetrate deeply and affect all canals. Gingival caries should be treated as quickly as possible.

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

Causes

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

Pathogenic bacteria multiply in plaque plaques Streptococcus mutans that produce lactic acid. It negatively affects the surface and subsurface layers of enamel, leaching calcium and fluorine from it and disrupting the mineral crystal lattice of the enamel.
Failure to comply with hygiene rules is not the only reason for the development of cervical caries. The development of the disease can also be provoked by too intensive brushing of teeth, 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 cusp area). The condition of the enamel is also affected by the use of abrasive agents for teeth whitening and the use of certain medications.
Damage to several teeth at once by cervical caries is often observed when endocrine diseases (diabetes mellitus and thyroid diseases). The fact is that with diabetes, the number of representatives of pathogenic microflora increases significantly. This leads to accelerated demineralization of dental tissues. Also leads to an increase in the prevalence of tartar and plaque high concentration glucose in saliva (in diabetes - up to 6.33 mg, normally - up to 3.33 mg)

Stages

Caries in the spot stage. The color of the enamel in the cervical area varies from white chalky to pigmented spots. In a limited area of enamel, shine is lost. From sour and other chemical and temperature irritants, a quickly passing feeling of soreness may occur.
Stage superficial caries . A shallow defect appears within the enamel. Roughness appears in the center of the white or pigmented spot.
Average caries. The shallow carious cavity is filled with softened dentin. The damage is shallow and does not affect the layers adjacent to the pulp.
Deep caries. A deep carious cavity appears with overhanging edges of the enamel, filled with softened dentin. Frequent complication- pulpitis.

Symptoms

Stage	Symptoms
In the spot stage	Lack of response to temperature stimuli
Surface	The appearance of short-term pain from sweet, salty, sour. Short-term pain at the neck of the tooth when exposed to temperature stimuli. Pain when brushing your teeth with a hard brush (in areas with a thin layer of enamel).
Average	Pain when exposed to chemical, temperature, mechanical irritants, which quickly passes after the irritant is eliminated
Deep	Pain when exposed to chemical, temperature, mechanical stimuli. The occurrence of long-term pain when food debris enters and gets stuck in the carious cavity. Pain when chewing. Painful sensations when inhaling cold air.

How to treat - a review of effective methods

How to treat cervical caries in a dental clinic

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

In the spot stage

ICON technique (treating the tooth with an etching gel, filling the damage with a special composite composition).
Remineralization. Its goal is to saturate the enamel with calcium and fluoride.

Remineralizing drugs used in dental clinics:

Tiefenfluorid - enamel-sealing liquid;
Gluflutored;
Remodent;
Belagel Ca/P;
Calcium gluconate solution;
Sodium fluoride solution;
Fluorine-containing varnish (fluorine varnish, bifluoride-12).

Treatment in later stages

In advanced cases, treatment of the carious cavity and filling are required. If the dentin is deeply damaged, root canal treatment or nerve removal may be required.

Filling is performed in stages:

Professional cleaning (removal of dental plaque and tartar).
Determination of enamel color (for selection of material).
Gum pushback (necessary to treat the affected area under the gum).
Treatment of the carious cavity with a boron, removal of necrotic tissue.
Isolation of the tooth from saliva with a rubber dam (it is necessary that the filling does not fall out within 2-3 months).
Treatment of dentin and enamel with adhesive (for reliable adhesion of the filling material to the tooth tissues), if necessary, application of an insulating and therapeutic lining.
Installation of a light polymerization filling, grinding and polishing with fine-grained discs.

The choice of material depends on the location of the carious cavity - near the edge of the gum or under it. In the presence of subgingival defects, the dentist's choice falls on a material that hardens in a humid environment (isolation from liquid is practically impossible). We are talking 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 return the tooth to its aesthetic and functional parameters, some dentists combine 2-3 filling materials, which allows them to cope with complex clinical cases.

To treat or not?

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

Other complications:

Pulpitis with acute pain;
Gingivitis (inflammation of gum tissue);
Periodontitis (inflammation of 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 the drill are often interested in whether it hurts to remove cervical caries. If dentin is damaged and caries has gone beyond the enamel and mechanical treatment of the cavity is required, then anesthesia is required. The fact is that the defect area is located very close to the gum, and the dentist’s manipulations can be really painful.

Can be used:

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

What instrument is used to remove caries in the cervical area?

Treatment at home

For treatment at home you can use:

Toothpastes and gels;
Dental floss impregnated with fluoride;
Rinse aids.

Remineralizing gels and special toothpastes are effective only in the case of cervical caries in the spot stage. Choosing such a product on your own is quite difficult and there are several reasons for this:

At 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 the superficial or middle stage.
Treatment with drugs chosen in the pharmacy network may be ineffective, because... it is necessary to take into account the general state of health, the depth of the lesion and the area of cervical caries.
Wrong choice of funds for home treatment may cause harm to dental health. For example, the use of funds with high content fluoride can cause the development of fluorosis.

Advanced caries of the tooth neck can be cured only by removing the softened affected tissue.

Treatment with folk remedies

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

Sage tincture

1 tbsp. herbs pour 1 tbsp. boiling water, after an hour of infusion, strain and use for rinsing. In order to prevent the spread of carious lesions, a cotton wool soaked in the tincture can be applied to the enamel.

Propolis

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

Onion peel tincture

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

Calamus tincture

1/2 cup of calamus root is crushed and poured into 500 ml. vodka, leave for a week, then rinse the aching tooth with the tincture for 1-3 minutes. To fill microcracks, you can add 10-20 g. alcohol tincture propolis.

Herbal rinse

Collection 1: St. John's wort, dried chamomile and calendula flowers (1 tbsp each). Pour 2 tbsp. boiling water and leave for an hour.
Collection 2: lemon balm, nettle and strawberry leaves, wheatgrass and knotweed root (in equal parts). 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 g each). Infuse in 500 ml. alcohol for 3 months, after which rinse the mouth, dissolving 1 tsp. tinctures 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;
Prevents the formation of dental plaque;
Blocks the growth of bacteria in plaque.

In the spot stage good results show pastes:

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 by restoring the hydroxyapatite crystal);
Apadent(contains nano-hydroxypatite, particles of which fill microcracks in tooth enamel and enhance the mineral flow of saliva);
Signal(fluoride-containing pastes with therapeutic and prophylactic effects);
Blend-a-med(the fluoristat system of the paste retains calcium well in tooth enamel).

Gels

Therapeutic gel Fluocal

This relatively new dosage form Chemically incompatible substances may be included (since the aqueous shell prevents the reaction between them). They are effective when used as an application for both prevention and treatment of cervical caries in the spot stage.

WITH 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 certain intervals (they are installed by the dentist).

Therapeutic and prophylactic rinses

Are auxiliary with remineralizing therapy in the spot 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 Bionorm;
Caries Protect;
Caries Protect;
Colgate Plax.

Anti-caries creams

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

Tooth Mousse has been proven to “suspend” the development of caries on primary teeth and allow the use of anesthesia to be delayed. Apply the cream to the areas affected by cervical caries with a cotton swab for 2-5 minutes.

Complications

Complication	What to do
Pain in the gums after treatment. Inflammation of the gums can occur due to poor-quality root canal filling, filling material getting under and on the gum, unsuccessful administration of anesthesia, or trauma received during treatment.	Repeated filling of the canals, rinsing the gums with chlorhexidine, Miramistin, Stomatophyte, Rotokan
Secondary caries. Relapse occurs when necrotic masses are not completely removed or when an insulating pad is applied incorrectly. In this case, a person is bothered by unpleasant sensations when exposed to temperature and chemical stimuli, and sweets.	Filling removal and re-treatment
Pain when biting. Occurs after the installation of a filling that prevents the teeth from completely closing.	Correction of the filling surface
Filling falling out. Possibly due to violation of the technology for installing the filling, unreliable isolation of the tooth from saliva when installing the gasket and filling, or the use of low-quality filling material. A filling that is too large may also fall out. This happens when a doctor recommends installing a crown, but the patient insists on filling.	Contact your dentist as soon as possible to correct the filling error.
Sensitivity of teeth after treatment. Pain may occur when pressing or eating hot/cold food.	Treatment of the canals, if after 2-4 weeks excessive sensitivity does not decrease

Cervical caries in children

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

Cervical caries primarily occurs on the incisors upper jaw. While sucking on the nipple of the bottle, the main surfaces of the tooth are cleaned, but the cervical area does not have contact with the nipple. Gradually, microbes surround the entire tooth around the gum and corroded areas appear on all sides. dark spots. Lower teeth When 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 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 postpone treatment to the postpartum period.

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

Cervical caries and wedge-shaped defect

Wedge-shaped defect is a disease of non-carious origin. It differs visually from cervical caries. Thus, 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 simply a depression V-shape, darkening of the enamel does not occur.

Prevention

Endogenous drug-free. Introduction to the diet of foods rich in amino acids, proteins, vitamins, consumption of calcium and fluorine-containing products.
Endogenous medicinal. Taking calcium and fluoride supplements by children, pregnant women, and people at risk.
Exogenous drug-free. Careful hygiene with the use of therapeutic and prophylactic pastes, professional hygiene, slow drinking of milk and tea, limited use carbohydrates, replacing sugar with sweeteners.
Exogenous medicinal. Local application remineralizing agents, rinsing.

Treatment price

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

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

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

FAQ

Tooth hurts after filling cervical caries

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

How soon can you drink after treatment of cervical caries?

After treatment you cannot eat 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 treatment of cervical caries?

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

What vitamins should you take for cervical caries?

Patients with a rapid form of enamel demineralization need complex therapy, affecting the immunological state of the body. So, for cervical caries, dentists recommend taking:

ascorbic acid (0.1-0.2 g per day);
vitamins A and E in oil (regulate phosphorus-calcium metabolism, a 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;
fluoride 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 the complete bone structure, teeth need vitamin K1, silicon and manganese (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, Caltsinova, CalciumOsteoporosis, Forever Kids, Duovit, Centrum).

Caries in the cervical area under the gum

Subgingival caries is root caries in most cases. It is necessary to apply for an in-person examination.

Is it possible to put braces on 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 fluoride and calcium containing preparations. If caries occurs while wearing braces, then the arch is removed from the diseased tooth, but this is extremely undesirable.

Treatment of cervical caries with nerve removal

Such treatment will be required if cervical caries has complicated to pulpitis, which has led to acute inflammatory process in the pulp. In this case, the patient complains of sharp 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, because... caries will eat the tooth anyway. First you need to cure tooth decay.

How to cure cervical caries of a wisdom tooth

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

Cervical dental caries is caused by the activity of the bacteria Streptococcus mutans, so there is no need to talk about any fundamental differences from other types of caries. Visually, the lesion differs only in location and is observed, as a rule, among people over thirty years of age. However, cervical caries of primary teeth also occurs. In children, the disease often develops into circular caries, like a tooth encircling the neck. The disease should not be confused with enamel erosion and wedge-shaped defect.

Why is cervical caries considered the most dangerous?

The enamel in the neck of the tooth is the thinnest and most vulnerable, and the same can be said about dentin. Caries in the cervical region very quickly affects deep tissues.
When teeth are affected by cervical caries, the patient detects the disease only when pain occurs.
Treatment is complicated due to the proximity of the lesion to the gum line (especially molars). The most difficult case is considered to be cervical caries on a wisdom tooth.
It is caries in the cervical area that most often causes complications and is the reason for tooth extraction.

Causes of cervical caries

Insufficient mineralization of enamel. Considering the fact that in the cervical region it is thinner by definition, this factor is one of the determining ones.
Poor hygiene. Plaque and tartar are most often localized on inside teeth in the area of contact with the gum.
Vitamin deficiency and gum disease. In both the first and second cases, deep gum pockets are formed in which food debris accumulates, which is why there is a high concentration of pathogenic bacteria.
Heredity. If one of the parents suffered from cervical or circular caries, then there is a high probability that the child will also develop this disease.

Otherwise, the causes of cervical caries are the same as classical ones. Diet has a great influence: foods high in carbohydrates have a negative impact on dental health, regardless of the quality of hygiene and hereditary predisposition.

Many people confuse cervical caries and wedge-shaped defect. However, these two diseases have completely different natures and are similar only in the affected area.

How to treat cervical caries?

Most patients are interested in the question of how to treat cervical caries, taking into account the characteristics of the disease? Although this type caries is considered the most aggressive and quickly spreading; with timely contact with dentistry for the treatment of cervical caries, many unpleasant consequences can be avoided.

Speaking directly about treatment methods, you need to understand at what stage the disease is. Below is a table showing methods of treating cervical caries on different stages its development.

Stages of cervical caries	Description	Treatment
Initial (in the form of a spot)	A whitish spot forms on the surface of the enamel in the cervical area. Subsequently, the stain becomes more noticeable, the structure of the enamel is disrupted, and pain appears, for example, a reaction to cold and hot.	At this stage, treatment without therapeutic intervention is possible. Fluoridation and remineralization of enamel at the initial stage, as well as selection special means hygiene (toothpastes for cervical caries) and diet correction. At superficial lesions enamel, it is possible to treat caries without a drill (using Icon technology or using laser therapy).
Average	Caries affects the enamel and dentin, but the pulp and nerve endings are not affected. At this stage, the carious lesion becomes noticeable, and pain increases.	Treatment of the affected area and filling of cervical caries. If the patient is diagnosed with cervical caries of the anterior teeth, after therapeutic treatment Microprosthetics may be required to restore aesthetics.
Heavy	The deep tissues of the tooth are damaged, the patient suffers from severe throbbing pain. Deep cervical caries significantly deforms the cervical area of the tooth.	The nerve is removed and the canals are filled. In case of extensive lesions, it is not always possible to install a stump or crown. Often in advanced stages of cervical caries (especially if it turns into circular) tooth extraction is required.

With therapeutic intervention, pain after treatment of cervical caries can last up to two to three days. If the pain does not go away for a long time or is severe, we advise you to immediately consult a dentist.

Treatment of cervical caries of anterior teeth

Treatment of cervical caries of anterior teeth includes not only restoration anatomical shape tooth, but also aesthetics, so it is important to find an experienced specialist who will select the optimal material and color for the filling. The most commonly used are glass ionomer and light fillings, which are quite strong and durable.

Features of treatment of cervical caries at home

It is impossible to cure cervical caries at home when the enamel is already damaged. Conservative treatment perhaps at the stain stage, when the doctor prescribes agents for remineralization of enamel and prophylactic agents hygiene products that can be used at home. Some experts advise using folk remedies, in particular, rinse with infusions of sage, lemon balm or propolis. However, such measures are only useful for the prevention of cervical caries and in no case can cure the disease in an advanced state.

How much does it cost to cure dental caries?

The average cost of treatment for cervical caries in Moscow is on average higher than the classical one. Light and glass ionomer fillings cost from 3,000 rubles. If the disease has affected the pulp, then filling the canals is necessary. In this case, the total amount for the treatment of cervical dental caries often exceeds 10,000 rubles.