Caries is a painful disease of the teeth. Its timely treatment allows you to prevent complications. Sometimes tooth root decay occurs, which is difficult to diagnose because it is difficult to recognize visually on your own and at a doctor’s appointment. The symptoms and treatment of such caries are described in the article.
Localization
What is tooth root caries? This is a pathology that occurs in the deep part of the unit. Dentists divide these carious lesions depending on their location into groups:
- on the crown - touches enamel or dentin;
- cervical - a site located near the gums is affected;
- in the root part - this causes the destruction of cement.
The last variant of the disease is more often detected in people after 60 years, less often this happens in other groups of patients. According to ICD-10, this pathology belongs to the class K02.2. It is necessary to distinguish cervical caries from root caries, since in the first case enamel and dentin tissues are affected, but the cavity appears near the mucosa. In the second case, pathology is observed under the gum and is imperceptible during visual examination.
Why does such caries appear?
The causes of caries are various. This should be determined by the doctor. Often this phenomenon occurs due to:
- The presence of a periodontal pocket when food particles get stuck in the gap between the gums and teeth. Since it is almost impossible to clean them from there, the bacteria quickly multiply.
- In cases of cervical damage to the crown of the tooth, when without appropriate treatment, microorganisms spread in the internal deep tissues.
- Errors during prosthetics. Often, due to a poorly installed crown, residues of food penetrate into the resulting gap and quickly lead to tooth decay under artificial material.
- The expiration date of this product, which leads to a gap or infection of tissues under the product.
- Inadequate hygiene of the oral cavity, leading to dental diseases and tooth decay. Therefore, cleanliness of teeth and gums is important. You need to use high-quality brushes, pastes, dental floss, rinses and other devices that remove food debris and pathogenic bacteria even in hard-to-reach areas.
- Lesions of deep tissues and other diseases - inflammation in the gums, purulent infections of the mucous membrane or bones. Diseases are such ailments as gingivitis, periodontitis, periodontitis, periostitis, osteomyelitis.
With age-related changes in the body, a gum recession appears , due to which bacteria quickly penetrate the root of the tooth. It is little protected from aggressive factors, since it is not covered with a layer of enamel. Therefore, more often the disease is observed in older people. But there are other causes of caries. The risk of pathology increases with:
- smoking;
- frequent use of coffee and alcohol;
- chronic stress;
- sudden changes in temperature;
- mechanical damage.
With the use of certain drugs, a violation of the viscosity and composition of saliva is observed. Its protective effect is noticeably reduced, due to which pathological processes are accelerated in the oral cavity. Carious teeth are not only unpleasant in appearance, but also lead to painful sensations.
How is it manifested?
A carious formation of this type cannot be detected at the examination, even dental. Independently all the more it is impossible to determine the pathology. But still there are symptoms of tooth root caries , by which it can be determined:
- There is a reaction of enamel to a change in temperature when eating or drinking drinks.
- Chemical factors in the form of sweet or sour also lead to unpleasant sensations.
- Soft tissue loosens and a periodontal pocket appears when food is stuck between the gums and the dentition.
- There is inflammation.
- There is pain during chewing, because due to the destroyed root, a tooth displacement appears, therefore, an uncomfortable sensation appears.
Caries can be dangerous for the gingival pocket. This should be considered by the doctor in order to prescribe appropriate therapy. The difficulty in detecting tooth root caries is that it usually does not appear for a long time. And only with large tissue lesions and the destruction of the crown can you detect the symptoms of this ailment.
Danger of disease
The ailment is dangerous in that it does not appear for a long time. Pain occurs when the pulp is affected. According to statistics, caries rarely appears at the root. Usually the disease spreads from the painful site of the crown.
It is also known that such a serious ailment as periosteum osteomyelitis is usually a complication of root caries. Therefore, timely diagnosis and treatment of pathology is required.
Diagnostics
For any patient complaints, when symptoms may indicate carious teeth, the doctor needs to be examined. It is necessary to identify the localization of the affected area. For this, the following diagnostic methods are used:
- Visual inspection Correlation of complaints with noticeable changes in the oral cavity is performed. Based on this, other procedures are identified to identify the ailment.
- Sounding. A special thin instrument examines the area of the tooth under the gum. If the probe reveals a rough surface, various violations of the smoothness of the root part and other violations, then an appropriate diagnosis is made.
- X-ray In this picture, everything is visible, even small destroyed areas of hard tissues, and their localization is also determined.
- Visiography. This method of diagnosing dentoalveolar changes allows you to show the problems of the entire series on the screen.
- Thermal diagnostics. A stream of water supplied to the teeth and having a different temperature sets painful places. And with increased sensitivity, an assumption about the presence of pathology appears.
- Electrodontometry. With the help of insignificant pulses of electric current, which are supplied to the tooth with different intensities, problem areas and the stage of destruction are determined.
During the diagnosis, it is revealed whether there is a risk for the gingival pocket. This is the notch between the gum and the tooth. If the neck of the tooth is exposed, then these procedures are required to detect diseases of the oral cavity. This will eliminate the method of therapy. Treatment for superficial caries is usually easier, while deep caries will require more time and more radical methods.
Treatment or removal?
Diagnosis and treatment of superficial caries is considered simple. If caries is at its root, then getting rid of it is more difficult. Many are interested in tooth decay to treat or remove? According to experts, this requires a comparison:
- localization and intensity of destruction;
- volume and depth of the lesion;
- the general condition of the tissues of the oral cavity, the presence of concomitant ailments;
- manifestation of symptoms and condition of the tooth root.
In the presence of caries of the root of the anterior tooth or distant, surface cleaning from plaque and stone is required. For this, a professional procedure is performed to prevent the spread of microorganisms in the tissue. If it is revealed that the cause of tooth root caries is associated with the presence of orthodontic structures, then after therapeutic treatment it is necessary to replace them with new ones to prevent relapse.
Filling
This method is also called operative, since various devices are used to affect the deep tissues of the oral cavity. This method of therapy will allow you to get rid of the places affected by bacteria and fill the cavity that has appeared.
But with a tooth root disease, the procedure is complicated, since there is a risk of damage to the soft tissues. To protect them, apply:
- Diathermocoagulation - the removal of extra periodontal areas with a special hot device.
- Retraction, which is the use of thin filaments with a solution that stops bleeding.
With the filling of deep caries there is a difficulty - the abundant release of saliva and moisture, due to which there is a departure of artificial material. Therefore, you need to choose a quality one:
- Glass ionomer cement. This is the best material for root filling, as it has excellent adhesion to dental tissues and in the presence of moisture. Also fluorides are added to it, which strengthen the units.
- Amalgam. It is rarely used, since there are mercury components in the base. The difficulty lies in protecting the doctor while working with her and the dangers to the patient.
- Compomer filling. This is an artificial compound with glass ionomers and a composite. But its quality of fixation is slightly inferior to previous types.
If the neck of the tooth is exposed, then the filling method is often chosen. What material is better to use, it is advisable to consult a doctor.
Filling
Treatment of tooth root caries with filling is performed as follows:
- Tartar is removed in a professional manner.
- An anesthetic is administered.
- Damaged tissue is repaired.
- A special indicator checks whether there are root pathological processes.
- A cavity with even walls is formed.
- The working part is isolated from saliva and moisture.
- A suitable filling material is selected.
- Damaged and treated area is restored.
Therapy
If microorganisms began to perform destructive work and caries is small, then simple methods of treatment are needed - coating with fluorine-containing agents. But this method is ideal in the treatment of superficial caries in a prominent area of the tooth. Remineralizing treatment for the roots is chosen very rarely.
Root restoration
In some cases, it is possible to completely restore the root section even with large damage. Doctors use special tabs. They are considered the same crowns, but with a core that needs to be laid in the remaining natural root and fixed with a special terminal or cement. They are made of ceramic or metal.
A protective cap can also be installed on the tooth, which protects against damage, infection and root fracture from mechanical factors. A tab and a cap based on individual casts are performed. It is necessary to do everything correctly, and then the life of the tooth is significantly increased.
When will it fail to save a tooth?
Modern treatment methods are aimed at preserving the unit. But sometimes this cannot be done, and therefore extraction is performed. Tooth extraction is necessary in the following cases:
- When the pathology began in the coronal part and passed to the entire root.
- With significant damage and damage to the walls.
- If there are neoplasms at the top of the stabilization system - cysts, granulomas.
- With a fracture of the root.
The removal procedure is performed by the dentist under anesthesia. Further treatment actions should also be chosen by the doctor in order to prevent the occurrence of negative consequences.
Complications
With an untimely relief of this pathology, its progression appears. Damage to large areas occurs, the disease is complicated. The negative consequences include the appearance of:
- inflammation in the periodontium;
- gingival pockets;
- infectious processes at the apex of the root;
- flux;
- root fracture.
You also need to consider that untreated caries is a constant load on the immune system. And timely therapy eliminates these manifestations.
Prevention
To keep your teeth healthy, you need to follow the simple recommendations of the dentist:
- you need to observe oral hygiene;
- balanced nutrition is required;
- a healthy lifestyle is important.
It is important to undergo preventive examinations at the dentist. You need to go to the doctor at least 1 time every six months. This must be done even then, then nothing bothers. Some illnesses at the initial stage go away without symptoms. And routine examinations help identify and cure pathology at the beginning.