Medium caries - clinic, diagnosis, treatment. Chronic caries is a slow but sure path to tooth loss Superficial caries acute and chronic course

Tooth decay is the most common dental problem faced by every person.

Allocate acute and chronic forms of the course of the disease. Chronic - differs from acute by slow development erased by the clinical picture.

Often, the pathology does not cause severe discomfort to patients, but, despite this, the disease is considered very dangerous, since it can lead to serious damage, fraught with loss of teeth. Therefore, chronic caries is necessary detect and eliminate as soon as possible.

Chronic caries: what is it, characteristic manifestations

The danger of chronic caries is that over a long period of time the disease does not manifest itself in any way.

The defeat most often begins with one tooth, gradually moving to neighboring ones. Thus, the patient is found to have multiple carious lesions, which often cover the entire dentition.

Clinical symptoms chronic caries:

Dark areas appear on the enamel, the density and structure of tissues is maintained for a long time.
Gradually the enamel surface changes, it loses its smoothness and glossiness of the coating.
The patient may complain of short-term pain, which occurs as a result of thermal or mechanical effects on the site of carious lesion. With the elimination of the irritating factor, the pain quickly disappears.
Enamel with chronic caries practically does not lose its shape However, the lesion focus covers dentin, therefore, with the visible integrity of the dental crown, the patient often finds destroyed internal tissues of the tooth.
A carious cavity appears, having a narrow entrance and an extended base. At the bottom and walls of the cavity is destroyed, darkened dentin.

Etiology and risk groups

Highlight general and local adverse factors that can lead to to the development of a chronic form of caries.

Common causes include various diseases of the internal organs.

For example, pathologies of the endocrine, respiratory systems, disorders of the digestive system, leading to a decrease in saliva production, a change in its composition and viscosity, as well as to reduce the level of minerals in the enamel.

In addition, it is customary to attribute errors in nutrition to common adverse factors, such as the use of sweets, aggressive foods that destroy enamel, bad habits, and the lack of full oral care.

Attention! Internal provoking factors for the development of chronic caries include an increase in the number of pathogenic microflora in the oral cavity, gum disease, untreated acute form of caries.

In addition, it is important genetic predisposition which determines the innate strength of the enamel, its sensitivity to the action of various stimuli.

At-risk groups:

Stages

Initial chronic caries: tooth enamel is damaged, on the surface of which specific spots of an unnaturally white shade appear. In these areas, the smoothness of the enamel is lost, it becomes rough and dull, the spots resemble chalk, therefore they are usually called chalky.
Superficial stage: the destruction of enamel continues, other tissues remain unaffected. Dark areas appear on the surface of the tooth, a small carious cavity with flat and smooth edges gradually develops.
With the development of the middle stage of chronic caries dentin is damaged- the area of the tooth located under the enamel. The carious cavity deepens, takes the form of a canal. On its bottom and walls there is a dark plaque consisting of food debris, bacteria and their waste products, destroyed dentin, which has a pigmented dark color.

Photo 1. Deep caries on the chewing teeth, the process of destruction extends to dentin and roots.

Deep chronic caries- the terminal stage of the development of the carious process, in which the dentin areas located near the pulp are damaged. Destructive processes often cover the dental root, as well as the pulp itself.

Important! However, severe pain do not always bother the patient, but only when exposed to the affected tooth, in contrast to the acute form of development.

Diagnostic methods

The identification of chronic caries includes a number of important examinations: visual inspection and hardware diagnostics.

Visual dental examination

The doctor examines the patient's oral cavity using special tools(mirrors, dental probes).

This makes it possible to detect damage even in the most inaccessible areas, for example, on the inner areas of the tooth.

The use of probes helps not only to identify the presence of foci of destruction, but also to determine their depth.

Hardware inspection

To obtain a detailed picture of the development and course of pathology, modern dental diagnostic devices:

X-ray, allowing you to get clear pictures, which displays the state of the tissues of the oral cavity. On the X-ray, you can see areas of carious lesions, various neoplasms (cysts, granules) that damage soft tissues.
Electroodontometry using a device that emits an electric current. This diagnostic method allows you to recognize the depth of damage, determine the stage of destruction, and detect damage to the pulp.
Use of UV sources. Under the influence of ultraviolet radiation, the areas affected by caries acquire a pronounced shade, thus becoming more noticeable.

Photo 2. The procedure of electroodontometry of the anterior tooth, allows you to accurately determine the depth of carious lesions.

Treatment regimen

The choice of this or that method of therapy depends on the stage of development of the chronic carious process.

At the initial stages of pathology, remineralizing therapy is used. The oral cavity is thoroughly cleaned of plaque and solid deposits. A diseased tooth is treated with special pastes or gels, which contain a large amount of minerals such as calcium, fluorine, phosphorus.

After that, the patient's oral cavity is exposed to a special UV lamp, the radiation of which enhances the effect of the mineral composition. The duration of the procedure is 15-20 minutes.

The most common dental disease is tooth decay. This disease manifests itself in two forms: chronic caries and, they differ in the clinical picture, but are equally dangerous for the teeth and lead to their extensive damage.

What is it?

If the acute form of the disease is characterized by a high rate of dentin damage, then chronic caries is one of the sluggish pathologies that can proceed for several years. A feature of the chronic form is the possibility of its course throughout a person's life, but under the influence of some factors, a relapse variant is likely. To stop this disease, it is necessary to use complex methods that involve the elimination of not only those tissues that are already affected by the disease, but also those factors that provoke it. Otherwise, the pathology will develop further and gradually capture new areas in the oral cavity.

On a note: Chronic caries is characterized by the absence of acute pain and, in general, manifests itself with mild symptoms.

The stages of the disease can replace each other for a very long time, for months and even years, it all begins with the appearance of a pigmented spot that changes color from light to brown. The chronic form usually causes only some discomfort to the person, stopping at the spot stage.

The symptoms of chronic caries are manifested in the following:

darkening of the enamel and a change in its structure to a denser one;
heterogeneity of the tooth surface, the appearance of roughness, easily detected during probing;
mild painful sensations, which usually act as a reaction to an external stimulus of a mechanical or thermal nature;
the enamel is practically not subject to destruction, dentin is exposed to the main damage.

The causes of chronic caries

The factors causing chronic caries are no different from the acute form of the disease, and the main ones are most often:

poor oral hygiene leading to an increase in bacteria on the tooth surface;
loss of minerals by enamel as a result of the development of pathology, which leads to a decrease in the level of enamel protection;
eating foods that saturate the enamel with essential substances and minerals.

What tissue is affected?

The process of affecting the disease develops gradually, it does not affect the entire tooth at once. Gradually, it affects the enamel, then dentin and finally the pulp, each of these stages has its own characteristics and is manifested in certain symptoms:

Enamel. Chronic caries at this stage is manifested only by a change in the color of the affected area, and gradually the enamel becomes more and more dark and the surface of the tooth changes. With the development of pathology, an affected pigmented cavity appears, which has a smoothed bottom.
Dentine. In the next stage, dentin damage occurs, when the formation of a wide cavity becomes a characteristic feature, which is covered with secondary dentin with a change in color. This stage can last for a very long time, up to several years, without manifesting itself in any way, however, in this case, there will be a gradual damage to the pulp and a change in the thickness of the walls of the dentin.
Pulp. At this stage, a reaction to a change in temperature or exposure to other stimuli may appear, the cavity acquires a color close to black with polished and smoothed edges. If you do not start treatment, then the inflammation of the pulp can be supplemented, and chronic caries will turn into an acute stage.

Features of a sluggish form

The absence of pronounced symptoms of the disease complicates its diagnosis and can lead to the fact that the defeat of one tooth, in the absence of proper treatment, spreads to the rest of the jaw. The transition from one stage of caries to another is gradual and does not manifest itself in any way, this process can take several years. Only a doctor can notice caries after a comprehensive examination. For the patient, the signal will be the appearance of a pigmented spot on the tooth of a whitish color, and if it does not change shade for some time, this serves as a signal for an urgent visit to the dentist, since there is still the possibility of successful treatment without the use of radical measures.

Milk teeth are at risk

Among children, there is no more common dental disease than tooth decay. The problem here is that many parents start paying attention to the condition of their child's teeth too late, considering milk teeth unimportant due to their temporary status. Moreover, even after learning about the defeat of milk teeth disease, many of the parents do nothing to combat the disease, again, due to a misconception about the role and importance of such teeth for the baby's body. Meanwhile, there is a direct relationship between the health status of deciduous and molar teeth; problems with the former will inevitably entail difficulties with the latter.

Development stages

Caries in its course goes through four stages of development:

... It is very difficult to detect a disease at this stage, the appearance of a white spot and a rare reaction to external stimuli can be a signal.
... At this stage, darkening of the enamel is observed, which indicates its defeat by the disease.
... Dentin is damaged.
... At this stage, the cement and the root of the tooth are affected, the degree of damage reaches the greatest extent.

Clinic features and diagnostics

It is very problematic to independently determine whether a patient has chronic or acute caries, this is the responsibility of the doctor. The following symptoms can help him during the examination:

discoloration of the enamel and its compaction;
secondary dentin in the cavity;
at the site of the lesion, the surface becomes more rough;
painful reaction to external stimuli.

Since the chronic form does not affect the entire tooth, but successively enamel, dentin and pulp, only external signs of the disease manifest themselves, and only at the last stage does pain appear. Not only visual inspection can help to identify the problem, but also radiography, which must be resorted to in the absence of pronounced signs of caries.

Chronic caries treatment

The process of treating acute and chronic forms of caries does not have any special differences from each other, except for one serious point: it is necessary to eliminate not only the affected area, but also the factors causing the disease.

The method of treating the disease can be as follows:

Remineralizing therapy. It involves the saturation of the enamel with calcium and phosphorus ions with the help of special preparations, you can use, for example, calcium gluconate or Remodent, which are applied to the surface of the teeth in several layers.
... The procedure is similar to the previous one, allowing to restore the tissues affected by caries at the stage of the stain. The surface is treated with fluorine ions, translucent with ultraviolet light and left for several minutes. Then this composition is washed off and a new one is applied, consisting of phosphorus and calcium, which is also supported by ultraviolet light.
Fissure sealing. This method is effective for treating superficial caries in children. First, the removal of the affected tissues is performed, after which the surface is covered with a composite with a remineralizing complex in the composition.
Filling the cavity. This technique is carried out in situations where the lesion has reached the deep layer of dental tissue. The procedure involves the removal of infected tissues, if the pulp is affected, then it is also necessary to treat it and remove the nerve, after cleaning the cavity and performing the appropriate treatment of the canals, it must be sealed.

The method of treatment is selected based on the degree of damage to the disease, in particular, the initial form does not require, and at the middle and deep stages it is no longer possible to do without it.

Prophylaxis

The main task of preventive measures is to eliminate the key cause of the disease. To this end, it is necessary to take the following measures:

carry out high-quality measures for the care of oral hygiene;
visit the dentist in a timely manner for examinations;
apply toothpicks and dental floss on an ongoing basis;
stick to proper nutrition.

Caries - one of the most common dental diseases that occurs at any age, can occur in chronic and forms.

Sluggish chronic caries eventually affects all tissues of the tooth. As a rule, the development of the disease occurs gradually, over time, affecting all layers of dental tissue. The duration of such a process can be calculated in years and a person does not always suspect about it.

Features of a sluggish form

The chronic form of the disease is much more common than. In the course of the development of the disease, remission can last for several years or worsen after exposure to provoking factors.

Most often, it all starts with the defeat of one tooth and if you do not resort to treatment in time, then the pathology will move to other teeth, gradually affecting the entire jaw.

The difficulty lies in the fact that chronic caries does not give itself out for a long time, and the symptoms are completely absent.

For example, in an acute course, toothaches are observed, which can not be said about the chronic form of the disease. In order to make the correct diagnosis, a comprehensive examination by a doctor is required.

As a rule, the transition from one stage to another occurs gradually and the patient does not notice it. This period lasts from several months to several years.

Initially, a whitish spot appears on the tooth, which later turns brown. If the stain remains white for a long time, then you need to consult a doctor, there is still the possibility of a complete cure without the use of drastic measures.

Provoking factors

Sluggish caries appears for the same reasons as rapidly progressing, the so-called. To the factors provoking the appearance of the disease include the following:

absence, provoking the multiplication of bacteria on the teeth;
unbalanced nutrition, which is based on fast carbohydrates - when choosing food, you need to pay attention to those that contain vitamins and microelements that strengthen tooth enamel;
due to pathologies of a general nature.

Most often, any dental disease develops precisely because of the lack of hygiene. In this regard, bacteria begin to multiply and process acids and carbohydrates. Over time, the enamel gradually collapses and if in this case you do not start treatment, then other parts of the tooth will also start to be affected.

Milk teeth are at risk

As practice shows, chronic is the most common dental disease among babies.

The main reason for this phenomenon can be called the fact that parents do not always start. In order to avoid the development of a lesion, you need to start brushing your teeth after the first incisor appears.

If the doctor suspects the presence, in which the carious area, most often, is located, it is necessary.

From the practice of professionals

It is safe to say that sluggish and acute caries are two forms of the disease that flow from one to the other. For this reason, even an experienced dentist is not always able to distinguish them from each other. To prevent the development of the disease, you need to visit the dentist twice a year.

Oleg Viktorovich, dentist of the highest category

Every second patient of mine deals with the problem of carious lesions of varying degrees of complexity - all this is due to the fact that I do not think about my health in a timely manner. If the patient addresses in a timely manner, then I manage to bring the patient's teeth back to normal.

Chronic caries is a common disease that occurs not only in adults but also in children. In order to predict the disease in time and start treatment, you need to visit your dentist regularly.

Anna Vasilievna, dentist-surgeon

Health care

Treatment of chronic caries is practically the same as therapy. The difference is only in the principles: therapeutic measures should be aimed not only at eliminating the carious area, but also at the reasons that caused the disease. The doctor can offer his patient the following healing methods:

The first two techniques are used to treat primary and. With the type of disease, filling is indicated, and with -.

The choice of the method of therapy remains with the doctor and primarily depends on the depth of the lesion. If, however, the treatment procedure will not be difficult, since it is not associated with tissue preparation. Also, the age of the patient plays an important role.

Preventive measures

Prevention of the disease is to prevent the causes that provoke it. These measures include the following:

If you adhere to all these rules, you will be able to preserve the health of your teeth and the entire oral cavity.

Caries in dentistry is considered the most common pathology with two types of manifestation - compensated (chronic) and decompensated (acute).

Both types lead to extensive damage to the teeth, but only in the chronic form, the destructive process is slow, almost imperceptible to humans.

Without an integrated approach to treatment, accompanied by proper dental care, diet correction and elimination of possible causes of its appearance, chronic caries remains incurable. New foci of it will constantly appear.

Chronic (typical) caries is a sluggish form of common caries, characterized by gradual damage to all layers of dentin.

The disease can progress over several years with minimal or smoothed manifestation of symptoms, and not be accompanied by pain (except for a state when the disease is in its final stage).

For a chronic carious form, the following symptoms are typical:

The appearance of small areas of lesion with dark enamel, but at the same time it still retains a dense unchanged structure.
A little later, when the situation begins to deteriorate, the enamel surface acquires heterogeneity and roughness.
Soreness is almost always absent or manifests itself very weakly (smoothed) and not for long, and only in response to thermal or mechanical action. The reaction to sweets is very active. But the pain quickly goes away if the causative factor is eliminated.
Enamel with a compensated form is almost not affected, but the destructive process quickly damages dentin. That is why dentists are often faced with a situation when, with the integrity of the enamel, a cavity lined with dead tissues is very quickly formed in the tooth.
The resulting cavity is characterized by steep, gently sloping edges and a fairly wide entrance. Its bottom and sides are covered with pigmented and very dense dentin.

This disease is characterized by incomplete remission, those. it can be lifelong or relapse under the influence of a number of factors.

According to medical statistics, typical caries is more common than its decompensated form. The transition of pathology in stages is gradual, and their change can last from a couple of months to several years.

In his opinion, caries is manifested under the action of organic acids, which are produced by pathogens (usually Streptococcus mutans) in the presence of a low molecular weight carbohydrate in the oral cavity.

The causes of chronic caries are identical to those that lead to the acute form. The disease begins to develop as a result of the joint action on the oral cavity of local and general causes.

Common causes include the following conditions:

unbalanced diet, which is based on fast carbohydrates, as well as the absence in it of products that saturate the enamel with vitamins and microelements;
severe pathologies that a person suffered during the formation of hard dental tissues;
insufficient fluoride content in water;
genetic predisposition, when such indicators as the thickness of dentin and enamel, their resistance to the action of pathogenic microorganisms, are only hereditary.

Dentists also noted that compensated caries is more often manifested in people with a history of chronic metabolic and endocrine disorders, with a strongly weakened immune system.

Local causes are:

lack or inadequate oral hygiene, leading to active reproduction of bacteria on the teeth;
pathologies leading to a decrease in saliva production and a change in its composition;
demineralization of enamel;
congenital (acquired) anomalies in the structure of the dentition;
low resistance and changes in the structure of all dental tissues.

Important! Timely elimination of many of these factors will help reduce the possibility of a disease at times.

Babies at risk

From the practice of pediatric dentists, it becomes clear that chronic caries of milk units is one of the most common occurrences among children.

The main cause of the disease, according to doctors, is that some parents start teaching babies too late to take care of their teeth.

Important! In order to prevent the development of pathology, it is necessary for the child to start brushing the teeth as soon as the first incisor appears.

Rare mouth treatment or complete neglect of it leads to the fact that saliva ceases to fully suppress the activity of bacteria and cope with the occurrence of certain diseases of the oral cavity.

Parents are mistaken, believing that caries on milk teeth can not be treated, since the affected units will eventually be replaced by healthy ones, and do not take the child to the dentist.

But this is far from the case. The state of future permanent teeth depends on the health of the children's elements of the dentition, and if treatment is not started in a timely manner, caries can affect the rudiments, and they will erupt already sick.

Stages

In chronic caries, as well as in its acute form, there are four stages of development. The transition of the disease from one stage to another occurs very slowly and almost imperceptibly.

Cretaceous spots

The disease begins with the appearance of an unnatural white small spot on the enamel, which resembles chalk in color. That is why the initial period of the disease in dentistry is called the "chalky spot" stage.

This is a completely reversible stage of pathology, i.e. the development of caries can be quickly stopped.

The appearance of the stain is explained by the washing off of vitamin and mineral compounds from the enamel, the transformation of its entire structure.

Surface

For the second (superficial) stage, further destruction of the enamel is characteristic, when small holes and cavities (depressions) with shallow edges are already formed on it, gradual darkening of whitish spots. They can range in color from light brown to dark gray.

There is no pain symptom, and when examining the affected area, it is noted heterogeneity and looseness of the surface.

Average

The next stage is dentine caries or medium. Differs in the penetration of caries into the surface layer of dentin. It is diagnosed by the following symptoms:

expansion over the area of the spot;
the appearance of causative pain, which disappears almost immediately after the elimination of the irritating factor;
the formation of a narrow cavity.

Deep defeat

The last and most severe of all stages is deep caries. Large dark brown or black cavities are formed, interdental spaces widen.

The tooth edge collapses so that its sharp edges are well felt by the tongue. The carious process, completely destroying the enamel and dentin, spread to the pulp.

There is no constant severe pain, as in the acute form. The symptom is temporary and manifests itself only under the influence of irritating factors.

Diagnostics

Revealing caries, including its chronic form, takes place with several examination methods:

Visual inspection, during which the dentist examines the state of the oral cavity, determines the degree of damage to the teeth.
Treatment of all surfaces of hard tissues with a special dye, which helps to identify the pathological process at the beginning of its development. If, after applying the dye under a fluorescent lamp, against the background of white enamel, darkened areas are visible, you can diagnose the course of the carious process on them.
Electroodontometry- a technique to measure the degree of pulp sensitivity. If the effect of the current causes a short-term painful reaction, then the fragment is affected by caries.
Examination on the device "Diagnodent". Acting on the enamel with light waves, it analyzes the light reflected from its surface. If there are changes in the composition and structure of the enamel (which is typical for caries), the device informs about this.
Radiography. Caries, imperceptible on visual inspection, is easily detected on an X-ray. In the image, not affected (healthy) tissues are light, but destructive areas, even very small ones, are shown in black. X-rays can also determine the depth of penetration of caries into the tissue.

Learn more about the symptoms, types and diagnosis of caries from the video.

Therapies

Therapy for typical caries and acute caries is very similar. The only difference is that in the chronic course of the disease, the entire therapeutic course is aimed both at arresting the carious process and at eliminating the very cause that led to the disease.

Based on the stage in which caries is, how deeply it has affected the tissues, the dentist uses the appropriate treatment methods. The doctor also takes into account the patient's age and general health.

Remineralization

This is the process of saturation of the enamel with potassium and phosphorus. Remineralization allows you to restore the density of the enamel and its mineral composition, to reduce sensitivity.

For this purpose, two concentrated preparations are usually used: a 3% solution of "Remodent" and "Calcium gluconate 10%". Each of these compositions is applied to the previously cleaned tooth surface for 10-15 minutes.

During all this time, to improve the penetration of minerals, a special light is applied to the enamel surface.

Each of the products is applied in several layers, after which it is washed off with a special solution, removed with a swab, and the enamel is well dried.

The number of remineralization sessions is determined by the doctor, based on the initial quality of the enamel and the degree of tissue damage by the disease.

Important! The procedure is effective if only primary damage to the enamel is observed, i.e. caries is in the chalky stage.

Deep fluoridation

In terms of the technique, the method is very similar to remineralization, but with the only difference that preparations with fluorides in the composition are used to cover the teeth.

Their application leads to the formation of crystals that penetrate into all layers, fill in all microcracks of the enamel. To improve penetration, the tooth is exposed to ultraviolet rays for some time.

Fluoridation helps to reduce the rate of spread of caries, to prevent its occurrence on other units, to improve the quality of all tissues in the oral cavity, to increase the density of enamel and its hyperesthesia.

The procedure is indicated for carrying out no more than once a year at the initial stage of caries.

Fissure sealing

It is carried out with superficial carious lesions, when the furrows are sealed on painters.

First, the dentist prepares the fissures to remove the affected tissue from them. Further, he covers the treated clean surface with a special super-strong composite mass, which contains remineralizing compounds.

Sealing takes place quickly, it takes no more than 15 minutes to close the grooves of one element.

Filling

The technique is used if the destructive process has affected the deep layers of dentin. It provides for the complete removal of all destroyed tissue and the creation of a cavity for placing a seal.

If the inflammation has reached the pulp, then it is treated with the extraction of the nerve. Upon completion of cleansing, the cavity is treated with an antiseptic solution, the root canals and the cavity itself are closed with a composite.

Important! The selection of material for the filling takes place depending on the location of the "sick" unit and its functionality.

The filling time is about 40-50 minutes, and if the procedure is carried out without removing the nerve, the total time is reduced by almost half.

Prophylaxis

The prevention of the manifestation of chronic caries is to eliminate the main factor of its development, as well as the implementation of the following recommendations:

Treat those dental diseases in a timely manner provoking the reproduction and spread of pathogenic microflora.
Clean the oral cavity regularly and efficiently with the obligatory use of remineralizing and anti-inflammatory drugs - pastes and rinses.
Complement daily processing teeth using additional hygiene devices - floss, irrigator, dental brush.
Balance your diet by eliminating or greatly reducing the volume of consumption of bakery products and products with simple carbohydrates in the composition.
Give up habits gnaw nuts, snap seeds, remove stuck food from the interdental gaps with a sharp object.
Avoid injury to enamel.
Visit the dentist(at least once every 6 months) for a preventive examination and timely treatment of the problems identified by him.

Important! Compliance with these rules will help preserve the health of the oral cavity and teeth, which will not fully return even a high-quality treatment by a highly qualified specialist.

Issue price

The cost of compensated caries therapy depends on the stage at which it was detected. The earlier the disease was diagnosed, the cheaper its treatment will cost.

This table shows the approximate cost of all methods of treating the disease used in dentistry.

These numbers are not final. To them you will have to add payment for a doctor's consultation, diagnostic methods performed.

With the progression of caries, destruction covers not only the upper, but also the deep layers of the hard tissues of the tooth. When deep caries affects dentin, the chances of restoring a tooth becomes less and less, but complications in the form of inflammation of the pulp or periodontal tissues - more and more.

Clinic for deep caries

The clinical picture of deep caries is short-term pain and a deep relief cavity inside the tooth (with sharp edges, loose dark dentin).

Under the influence of any irritant - temperature, chemical (food debris) or physical (pressure with a medical instrument, chewing) - acute pain occurs, which subsides after the source of irritation is removed.

Symptoms of advanced caries

The first symptom of deep caries is acute but short-term pain while eating.
If the teeth began to react to hot and cold drinks, there are sharp painful "lumbago" when chewing solid food, then it can be assumed that the tooth tissues have lost their density, the dentin layer is catastrophically thinned.
During a visual examination of the teeth, one can see the growth of brown-black spots on the enamel, and when cleaning them, one can detect the breaking off of small particles.

In some cases, deep caries develops outwardly imperceptibly, for example, under a filling. The appearance of pain should be a signal for a visit to the dentist, who will conduct a differential diagnosis.

Methods for the diagnosis of deep caries

To avoid mistakes, the doctor may prescribe differential diagnostics in relation to:

focal pulpitis;
caries of medium form;
fibrous pulpitis.

Tactile methods (probing the bottom of the cavity, tapping the walls of the dental crown) do not always give an accurate idea of the extent and nature of the pathology, therefore they are most often used in combination with an X-ray.

By examining the image, the doctor will be able to measure the thickness of the healthy dentin layer and make an appropriate conclusion.

Why is neglected caries dangerous?

A carious tooth is a focus of infection, which spreads very quickly to adjacent crowns. In the absence of treatment, deep caries gradually covers several teeth, causing not only the destruction of enamel and dentin, but also inflammation of the soft periodontal tissues, acute pulpitis and periodontitis.

People suffering from severe chronic diseases, women during pregnancy and lactation should monitor the vitamin balance of their diet. By including foods that contain calcium, they protect teeth from premature decay. The lack of this element contributes to the softening of dentin, which can cause a relapse, the development of pathology into a chronic form.

Prevention of deep caries in children

In children, the rate of disease progression is several times higher than in adults. Some parents do not consider it necessary to treat milk teeth and go to the doctor only when the infection literally "eats" them.

This behavior can lead to the development of deep caries in permanent teeth, since neglected caries does not go away without a trace. To restore healthy microflora, the child will have to undergo a long course of treatment.

As a preventive measure to prevent the disease, it is necessary from a young age:

accustom the child to daily brushing of teeth;
control the use of acidic, carbonated drinks, sweets;
visit a pediatric dentist regularly.

How is deep caries in an advanced stage treated?

When choosing a course of treatment for deep caries, the doctor relies on the MKB 10 classifier. If the depth of the lesion allows you to determine the degree of pathology as dentin caries, then restorative procedures should begin with cleaning the carious cavity.

Stages of deep caries treatment:

anesthesia;
cavity preparation;
antiseptic treatment;
drying and degreasing the cavity;
installation of a medical and insulating pad.

After medical treatment, the tooth is filled. Pain after treatment is not always associated with a complication. The procedure for treating the tooth cavity is carried out with mechanical instruments, therefore, painful sensations for one to two days are considered the norm.

Increasing pain, swelling of the cheekbones and gums, an increase in temperature indicate a complication - you should immediately consult a doctor.