Caries is a common dental disease. It leads to deformation of the structure of the teeth. In the advanced stage, the disease provokes a complete loss of teeth. For this reason, it is so important to diagnose the lesion in time and begin its comprehensive treatment. Unfortunately, many people with such a problem try not to pay attention to it until the last, when they can’t do without the help of a dentist. In the acute stage, the treatment of cement caries will already be radical, in some cases the doctor will amputate the damaged tooth.
Description of defeat
Caries of tooth cement is its partial defeat, in which the disease is spread mainly in the cement part. The problem progresses against the background of exposure of the root of the tooth and the development of the pocket, which is attributed to the anomaly. Most often, the lesion is diagnosed as caries of cement root .
With the disease, harmful pathogens and bacteria spread along the inside of the tooth without affecting the enamel and dentin.
Classification of caries in cement in ICD-10 - KO2.2. This condition is most often diagnosed in older people, in whom, due to age and physiological processes, atrophy of the gum bone tissue begins, which provokes an incomplete exposure of the tooth root.
Causes of caries
The main cause of tooth root cement caries is the negative effect of bacteria and microorganisms such as Lactobacillus and Streptococcus mutans on the tooth tissue .
Such pathogenic microorganisms in the oral cavity arise and are actively spreading due to the influence of the following factors:
- Xerostomia is an abnormal decrease in the amount of saliva secreted, which washes the mucous membranes and dentitions, as well as problems with its qualitative composition. Such processes provoke demineralization of enamel on the teeth. Enamel with prolonged exposure to such a process simply cannot preserve the condition of the teeth and protect them from the effects of pathogens. It should be noted that xerostomia may appear as a result of the use of certain drugs of the antihistamine group, sedative medications and diuretics.
- Poor oral care - improper oral care or its complete absence leads to the fact that the root part of the teeth remains contaminated, plaque and stony deposits accumulate on it over time.
- Cervical caries - an unrepaired lesion quickly transfers to the root area and affects other nearby tissues.
- Incorrect prosthetics - the artificial crown in this case does not fit well to the gum surface, and a large number of pathogenic microorganisms accumulate in the opening that appears.
- Improperly prepared diet - a systematic shortage of minerals and vitamins provokes the process of demineralization of hard tissues, and due to the large amount of carbohydrates in the oral cavity, the rapid spread of bacteria begins. It is these pathogens that provoke the onset of caries.
- The development of periodontitis.
- Oncological formations in the brain during radiation treatment.
The risk of cement caries does not depend on the age category of a person. Most often, the lesion appears with periodontal tissue disease or after radiation therapy.
Main symptoms
Depending on the place of development of caries, each patient will have their own symptoms of the disease. In this case, signs of damage can be mild and hardly attract the attention of the patient if caries is hidden in the gingival pocket.
In this case, cement decay is diagnosed already at a late stage of its development, when acute and severe pulpitis has already begun.
With an advanced stage of development of a lesion, a person has the following symptoms:
- aesthetic defects of a smile - this is especially noticeable on the front of the jaw, when noticeable deformation and destructive processes occur at the base of the tooth;
- unpleasant sensations and pain when chewing food - when pieces of food get in or under the influence of cold and hot temperature of a dish, a person develops pain of varying intensity.
Diagnostic measures
For the diagnosis and treatment of cement caries in the clinic, it is important to visit the appropriate doctor. Professional methods for diagnosing lesions include a set of techniques with the use of various equipment and dental instruments.
Diagnosis of cement caries in the clinic is carried out through the following procedures:
- Thorough brushing of teeth from plaque and stones, since it is they in most cases that provoke the appearance of the disease. When cleaning use specialized curettes, scalers, ultrasonic caps, as well as devices for hardware cleaning.
- Separation of a diseased tooth base from salivary mass. For this, experts use rubber dam.
- Direct sounding of a tooth root. At the same time, a specialized pointed probe is fixed on the affected area along the rough surface of the tissue.
- X-ray. Pictures will help determine if there are pockets in the diagnosed crown. X-ray root caries will appear darkened compared to nearby tissues. To identify the hidden type of the disease, the dentist uses a visograph - the procedure helps to carefully examine the affected area of the oral cavity in various projections.
- Thermal diagnostics is the most accurate and effective method that helps to determine the degree of caries of cement in the root of the tooth. In this case, the affected tooth is exposed to hot or, conversely, cold water - if the pain does not last long and it is not very pronounced, then this is the initial degree of development of the lesion, if the syndrome is strong and not passing, then this is a clear symptom of the presence of pulpitis.
- Electrometry - a point effect on a pulp site by electric pulses of various strengths. The stronger the burning sensation in a sore area of the body, the more advanced the stage of the disease and the more dangerous the syndrome.
Therapeutic measures
The treatment of cement caries will be prescribed by a doctor after diagnostic measures, depending on the severity of the disease. There are two methods to eliminate the disease:
- conservative technique;
- surgical intervention.
Treatment with drugs and physiological procedures is best used when tooth decay processes have not yet started. Surgery is used in the development of pockets when filling is the only possible way to eliminate caries.
Conservative treatment
When treating root cement caries, specialists carry out the following procedures:
- professional cleaning of the dentition - cleaning of stratifications and stone deposits;
- elimination of the root cause of the development of the disease and dangerous factors - correction of improperly selected prostheses, elimination of periodontitis and other inflammatory lesions in the oral cavity;
- impact on the crown through remineralizing components - this method includes the use of fluorine-containing agents and antiseptic components. In order to achieve a better effect and quickly restore the state of the oral cavity, calcium crystals and copper ions are additionally used.
Surgical intervention
With this method of treatment, the doctor surgically eliminates the pathology from diseased tissues and the crown of the tooth. The procedure includes a set of the following activities:
- Local anesthesia, in which drugs directly affect the affected area, depriving it of sensitivity. The injection site is pre-treated with an antiseptic and a special gel or spray, which helps to eliminate the pain syndrome.
- Since it is rather difficult to isolate the affected area by means of a rubber dam, a specialist performs a partial dissection of the gums by means of diathermocoagulation.
- Next, the doctor conducts corrective contraction of the edge surface of the affected gum tissue with special hemostatic threads.
- After the doctor removes the diseased dentin, treating nearby tissue. When carrying out diagnostic measures, a special composition is used - a caries marker.
- If necessary, the dentist eliminates the nerve and performs canal filling.
- At the end of surgical treatment, the patient's oral cavity is disinfected comprehensively with an antiseptic.
The filling materials used during the procedure will be selected depending on the condition of the patient’s oral cavity, the main symptoms of the disease, the place of spread of caries, its severity and general condition of the gum tissues.
In this case, the following components are used to seal the canals:
- Amalgams - are used in rare cases, since when using them, it is necessary to create conditions of complete dryness in the oral cavity, and to achieve such a state is extremely difficult. In addition, the material contains mercury, and for its mixing, individual protection is needed.
- Compomers - help create a strong and reliable seal, which can easily withstand the load of any force. Such a tool is recommended for the treatment of a small cavity. The main disadvantage of the material is considered too strong fixation.
- Glass ionomer - the best option that will help restore the affected areas, improve the condition of tissues and teeth. The product is well fixed, and also not affected by moisture, it contains remineralizing substances that help restore the structure of the organ.
Price per procedure
The cost of complex surgical treatment will depend on many factors, namely: the severity of the disease, the treatment used, filling materials and the clinic itself.
Treatment of surface caries will cost from 2,000 to 3,000 rubles; for complex cases, you will have to pay a lot more. Given the price for filling material, the cost will vary from 3,500 to 6,000 rubles.
Negative consequences
If you do not start timely treatment of dental caries, the following complications may occur in the oral cavity:
- Pulpitis is an inflammatory process, the focus of which is located in the pulp of the organ. Complication is distinguished by its chronic and acute form. Treatment of the disease is carried out through a comprehensive cleaning of the roots and their subsequent filling with good material.
- Periodontitis is a lesion of the internal tissues of the apical periodontitis, in which a person develops severe acute pain.
- Maxillary periostitis is a disease that appears as a result of a complication of the stage of development of periodontitis. It is characterized by an inflammatory process in the tissues of the periosteum. In this condition, the patient has an increased body temperature, pain, a feeling of malaise and general weakness.
- Osteomyelitis is a lesion in which the patient has purulent foci. In this case, the clinical picture includes pain in the jaws, swelling of the cheeks, general fatigue, and poor health.
- Abscesses are complicated inflammatory processes with a complex course and severe symptoms. It is characterized by its odontogenic appearance. With untimely treatment, it goes into the acute stage and becomes a serious threat not only to health, but also to human life.
Preventive actions
Dentists advise each patient to perform daily actions that will help reduce the risk of tooth decay:
- several times a day to clean the oral cavity with special professional pastes;
- use dental floss regularly;
- reduce the amount of sweets, confectionery;
- use fluoride products;
- include as many fresh vegetables and fruits on the menu as possible.
Danger of defeat
Like other diseases of the oral cavity, caries of cement provokes various complications. Timely initiation of treatment for the disease will help prevent the following conditions:
- the spread of the infectious process to the root site, which often leads to periodontitis;
- prevent severe tissue damage, since such a process can affect the pulp and lead to pulpitis;
- if the disease has reached the nerve, then the tooth dies and in some cases it even has to be removed.
A regular visit to a doctor will help to timely identify the lesion and quickly get rid of it even at the initial stages of development.
Symptoms and stages of the lesion
With the appearance of caries in a patient, the following symptoms of damage appear:
- pain syndrome to any external factors: mechanical, chemical, thermal;
- discomfort in the neck;
- the diseased area darkens over time.
With the progression of the disease in a person, other symptoms of the lesion begin to appear, which are characteristic of a particular stage:
- The initial stage of caries. This condition is characterized by extensive demineralization of tooth tissues. The affected area in the oral cavity changes its color from white to brown. At this stage of development of the lesion, the cement-dentin border continues to persist.
- Superficial damage to the root. In this condition, the process of destruction of dentin and cement begins, followed by the appearance of a small pigmented gap. The hole depth reaches 0.5 mm. Borders are made up of raincoat dentin.
- Deep defeat. Caries in this case extends to deep tissues, the cavity exceeds 0.5 mm. Most often, the free space is separated from the pulp only with a thin layer of dentin. The bottom and borders of the sore spot begin to turn dark.
Timely diagnosis and proper treatment of cement caries are the main factors that help to keep the tooth intact and to avoid its removal. The laser procedure will help to cure the affected area quickly and painlessly. Do not self-medicate during the development of caries, since in this case you can only spend time. The health of your teeth is best entrusted to a professional doctor.