One of the most common forms of tooth damage is fissure caries. It is very difficult to diagnose in a timely manner. A neglected pathological process can lead to tooth loss. To avoid this, you need to know the methods of preventing the disease and always follow them.
Disease Description
A tooth consists of a root, neck and crown. On its chewing surface are small indentations called fissures. They are usually divided into two types:
- Open, whose bottom is clearly visible.
- Closed, resembling in its form a groove with almost closing walls.
This type of caries is encountered not only by adults, but also by young children. Their tooth grooves are so deep that they constantly get stuck pieces of food. The result is a plaque. In the process of chewing food, the remains of products under pressure remain in the tubercles. There they decompose, creating a favorable environment for the reproduction of bacteria. Even thorough brushing does not always guarantee protection against disease.
Many underestimate fissure caries, putting off its treatment in a long box. Over time, more and more new areas are involved in the pathological process. Often patients get an appointment with the dentist when caries has captured not only the enamel surface, but also the pulp itself. At this stage of the development of the disease, pulsating pain accompanies a person constantly, even in the absence of external stimuli. Typically, this symptom indicates the occurrence of pulpitis or periodontitis.
The causes of the disease
The main reason for the development of the disease is considered improper oral hygiene. Fissure of the tooth is a vulnerable place where food debris constantly accumulates. Subsequently, they begin to rot and destroy the enamel. Over time, the pathological process leads to caries, which gradually spreads to new areas of the tooth.
Among other factors provoking the appearance of the disease, doctors distinguish the following:
- large size of dental grooves;
- low enamel resistance;
- changes in the composition of saliva against the background of chronic diseases;
- malnutrition with a predominance of carbohydrate foods.
In the presence of these factors, caries is not always manifested, but the likelihood of its occurrence increases several times. People who are at risk should be periodically examined by a dentist. In addition, more attention should be paid to oral hygiene.
How to independently recognize a pathology?
Fissure caries is one of the few dental diseases that can be easily diagnosed independently. It is worth mentioning that we are talking about an open type of grooves. The first manifestation of the pathological process is considered to be a darkening of the enamel. In this case, the tooth surface retains its integrity. This symptom is supplemented by bouts of monotonous or throbbing pain. Gradually, the sensitivity of the tooth in relation to external stimuli increases. Eating too hot or cold food is always accompanied by unpleasant sensations.
Closed tooth fissure is a more complicated case. The disease can develop for a long time without causing concern. External signs of the pathological process are almost always absent. It is not possible to independently recognize the ailment.
Diagnostic Methods
When the first symptoms of the carious process appear, you should seek the help of a dentist. Do not be afraid and postpone a visit to the doctor. The sooner the specialist identifies the pathology and proceeds to its treatment, the less likely the development of complications.
To diagnose fissure caries in modern dentistry, the following manipulations are used:
- Visual inspection with a probe. This method is effective only for open fissures. With its help, you can examine the grooves and consider the condition of the enamel.
- Hardware diagnostics. This modern research technique allows you to identify closed and open fissures. During the procedure, the doctor examines the patient's teeth with a special laser. Any private dental clinic can provide a similar service, which cannot be said about free medical facilities.
- Roentgenography. This method is used to diagnose closed fissures when the main symptoms of the disease are absent. They resort to his help in case of patient complaints of increased tooth sensitivity.
- Fissurotomy. For the procedure, the dentist uses special soft burs, which allow to open the 0.6 mm tooth groove. In most cases, this is enough to detect pathology.
- The use of caries markers.
If caries is suspected, several diagnostic options from the above are usually used simultaneously. However, the most informative is the hardware method. Laser treatment of teeth affected by fissure caries is not used. The device is used solely for diagnostic purposes.
When to start treatment?
The opinions of dentists on this issue differ significantly. Some believe that dark spots on enamel do not require specific treatment. In this case, the patient is given recommendations on the proper care of the oral cavity in order to delay the further development of the pathological process and the destruction of tooth enamel. Only after the disease has moved to a new level can therapy be started.
Other dentists have a different opinion. They believe that the dark spot is a favorable environment for the life of pathogenic bacteria. Lack of timely therapy can lead to the destruction of the entire tooth.
The treatment of the disease is carried out in two ways - by filling and using special tabs. All therapeutic measures are aimed at the removal of caries-affected tissues. They differ only in the choice of material and the technique by which the shape of the tooth is restored.
Sealing with light-polymer materials
Treatment of a problem tooth begins with the removal of carious tissues. To do this, use diamond burs, the rotation frequency of which is about 30 thousand revolutions per second. Such a high speed and the use of water cooling provide a painless procedure. Pathological tissues are removed to the level of healthy structures.
At the next stage, the dentist etches the prepared cavity. This procedure involves the treatment of the bottom and walls of the tooth with phosphoric acid. As a result of etching, micropores are formed on the entire surface of the cavity.
Then the doctor applies a special composition - adhesive. This is an adhesive substance that fills all microcracks on the tooth surface. Also, its use is necessary for better connection of the filling material with hard tissues. At this preparatory stage ends.
The dentist fills the previously dried cavity with filling material. The shape of the tooth and its functions are restored. In modern dentistry, the most popular is light filling, which is also called photopolymer. It is characterized by high resistance to abrasion, the absence of toxic effects on the body.
The final stage of treatment is polishing an established seal. With the help of special brushes and rubber bands, the dentist smooths out all the bumps and roughness.
Recovery Tab Treatment
The procedure for working with a diseased tooth practically does not differ from the treatment regimen using fillings. The doctor first drills carious tissue into the cavity, preparing it for the installation of a kind of microprosthesis - the restoration tab. Then applies an adhesive composition to eliminate microcracks.
After that, a cast of the tooth is made, according to which technicians in a special laboratory will be able to make an exact copy of it from plaster. According to this model, a restoration tab is made. It can be made of ceramics, silver or a medical alloy of semiprecious metals. The resulting micro-prosthesis fills the recesses of the chewing surface of the tooth. At the final stage, the dentist carefully glues it to a special cement.
Which is better: seal or restoration tab?
Most dentists favor the use of repair tabs. They explain their choice very simply. Often caries extends not only to the tooth itself, but also to the filling. As a result, small gaps remain, which can lead to the development of a secondary form of the disease. When using tabs this problem can be avoided.
Microprostheses have a longer service life than fillings. Ceramic inlays have an attractive appearance. Over time, this material will not fade, unlike fillings.
Today, each private dental clinic offers services for the treatment of fissure caries. In most cases, the restoration tabs are used precisely at the restoration stage. To be sure of the quality of the result, you can familiarize yourself with examples of the work of dentists. Almost every medical institution has a stand with photos before or after treatment. In addition, specialists always give a guarantee on the work performed.
How much does dental treatment cost?
It is not possible to unequivocally answer this question. Crucial in the total cost of therapy is the choice of material used. For example, for the treatment of caries with light filling, you will have to spend from 3 to 6 thousand rubles. Additionally, in dentistry they can charge for anesthesia.
How much does dental treatment using a restorative tab cost? In this matter, the choice of material also plays a direct role. A microprosthesis made of a medical alloy will cost much less than its ceramic counterpart. However, the latter is characterized by greater durability and wear resistance. It should also be borne in mind that the cost of treatment will include the work of a technician for making a mold. On average, the final price can vary between 10-20 thousand rubles.
Preventive measures
Fissure caries is a disease that can be avoided by following preventive recommendations. Among them:
- Regular visits to the dentist. At the appointment, the doctor will be able to identify a nascent pathology and painlessly eliminate it.
- Compliance with the basic rules of oral hygiene (the use of dental floss, rinse aid).
- Remineralization of teeth every 6 months.
- Taking drugs with calcium. It is worth noting that only a doctor can prescribe any medication.
For people with a complex fissure structure, when there is no way to clean the grooves qualitatively, dentists recommend a sealing procedure. It means applying a special gel to problem areas of the teeth.