Most likely, you will not even be able to find a person who would not dream of having a snow-white smile and healthy teeth. How to achieve the desired result? To do this, you will need to regularly visit the dental office for the timely detection of diseases. One of the most common of the huge list of pathologies is caries. According to numerous studies, more than 98% of the inhabitants of European countries suffer from it.
Caries was known to mankind more than one millennium ago. However, pathology was first described only in 1884 in the theory created by Miller. According to this scientist, teeth begin to decay even in infancy, as soon as the very first of them appear.
At first glance, it seems that caries is a harmless disease. Nevertheless, this is one of the most serious problems for dentists. Indeed, the progression of the pathological process can lead to inflammation of periodontal tissues and the dental nerve, which can cause the loss of the tooth itself, as well as the occurrence of diseases of many organs and the musculoskeletal system.
Caries development
Everything is born from the small. At the initial stage of caries, pigmentation and demineralization of enamel occurs. In order to understand how pathology develops, consider the structure of the tooth itself.
The upper and most durable part is called enamel. With poor oral hygiene or with its complete absence, a rapid process of reproduction of pathogenic microorganisms occurs in it. All this leads to the formation of harmful bacterial plaque on the tooth surface.
The structure of enamel consists of several compounds that are bonded together by a protein matrix. With plaque present on the teeth, the microorganisms contained in it begin to produce organic acids. That soft coating, which lingers on enamel for a long time, begins to mineralize over time and hardens. Thus, tartar occurs. And under the surface of this formation acids begin to act freely. They dissolve enamel cells, contributing to the development of the demineralization process. This is the primary cause of caries.
An interesting fact is that simultaneously with demineralization, that is, with destruction, the process of enamel restoration, that is, its remineralization, begins to occur in our body. In the area where pathogenic microorganisms were able to make a dent in the tissues of the tooth, mineral substances in saliva begin to flow intensively. If these two processes are balanced, the enamel will remain intact. Otherwise, with the prevailing force of bacteria, the initial stage of the disease will occur.
The causes of the pathological process
Today, scientists have already managed to explain what are the main factors leading to tooth decay. Among them:
- poor nutrition;
- a small amount of fluoride in the water used for drinking;
- weakening of the body during the period when the laying of dentin and enamel occurs;
- negative impact of environmental factors;
- heredity.
There are also some local factors leading to the onset of caries. Among them:
- tartar or soft plaque on the teeth;
- residues in the oral cavity of food;
- violations in the biochemical composition of dentin, enamel and cement;
- failures in the course of the bookmarking processes and further development, as well as teething;
- not fully formed structure of dental hard tissues.
However, each of us knows that not every person has caries. So, some people constantly monitor their oral cavity, but at the same time they suffer from multiple dental injuries, while others do all the procedures every other time, but they don’t even know what kind of disease it is.
There is an explanation for this phenomenon. The whole thing lies in the degree to which individual caries resistance of a person has, that is, his resistance to pathology. The development of the enamel damage process begins only when the destructive work of pathogenic bacteria is able to overpower the body's resistance.
The manifestation of caries resistance can be carried out at various levels. This process proceeds as follows:
- At the molecular level. In this case, the ability of an organism to resist the negative effects of organic acids is directly related to the degree of mineralization of enamel and the interaction between its constituent elements.
- At the fabric level. Enamel structure sometimes plays a decisive role in the development of the initial stage of caries. If there are a large number of irregularities on its surface, then it is easier to linger on the bacteria destroying it.
- At the level of the teeth. In this case, the important factors are the depth and shape of the fissures, as well as the structure of the protective organic film - pellicles.
- At the level of the general dentition. In this case, the body's resistance to caries will depend on the shape that the facial skeleton and jaw have, as well as on the correct bite.
As already mentioned above, with the onset of the initial stage of dental caries, the body fights using the salivary glands. The secret allocated by them allows you to clean the enamel from plaque, which prevents the accumulation of bacteria. With a decrease in the rate of salivation and an increase in its viscosity, caries forms much faster.
Initial tooth decay is often observed in pregnant women. The fact is that for normal development, the fetus requires a lot of calcium. He takes it from the bones and teeth of the mother, which leads to their weakening.
The development of caries in children
Dentists observe etiological factors not only in adults, but also in small patients. Moreover, at an early age, caries is detected much more often. This fact is explained by the fact that after the tooth has erupted, the enamels for the final maturation will require another two years. During this period, tooth decay most often occurs in children. Caring parents should definitely pay attention to this.
At the age of 2 to 4 years, the so-called bottle caries is often observed - the initial stage of the disease, the cause of which is the habit of drinking milk before bedtime or at night. After that, in the mouth of the baby until the morning continue to be numerous food debris. This is the main reason for the development of the initial stage of decay of deciduous teeth (see photo below).
Medical reference books do not contain the term “bottle caries”. This name is used only in everyday life, because by the nature of the primary causes of development and further course, pathology is a typical caries. Among them:
- The weakened immunity of the child, as well as the still low bactericidal characteristics of his saliva.
- Errors in the preparation of the diet of the baby. When a child eats sweet cereals and juices, flour and confectionery products, their residues will certainly linger in his teeth, and will contribute to the greatest extent to the reproduction and active life of harmful bacteria in his mouth. The enamel condition will also be affected by the absence of rough food in the diet, for example, apples and carrots, which chewing eliminates plaque. In addition, the initial stage of caries in children is observed with a lack of foods that are high in fluoride and calcium, for example, natural milk and fish.
- Regional factor. The initial stage of decay of milk teeth sometimes occurs in cases where there is not enough fluoride in drinking water. In this case, the enamel is weakened, and it begins to be damaged by aggressive acids.
Dentists recommend that parents comply with the rules for the recommended hygienic procedures for their baby's oral cavity. Milk drunk before bedtime will not be so harmful to the baby’s teeth if they are cleaned after feeding. And this is what dentists recommend to parents.
The initial stage of decay of deciduous teeth sometimes occurs due to heredity. But in this case, mothers and fathers need to remember that a healthy nutritious diet and oral hygiene can significantly reduce the likelihood of developing a pathology even with the existing genetic predisposition.
Stages of development of initial caries
A person’s teeth do not deteriorate immediately. Pathology occurs, then passing through certain time periods or stages. As you move from one of them to another, an increase in the degree of tooth damage occurs. As a result, in the absence of treatment, the so-called point of no return occurs. It is characterized by the appearance of extensive voids in the tissues of the tooth. And this will require serious treatment.
What are the stages of the initial stage of dental caries (photo below)?
Among them:
- The stage, which is called the "chalk spot". At this stage, the pathology is determined by the presence of a white area. Such a spot is lighter when compared with the rest of the enamel.
- Stage of the so-called dark spot. This form of the disease is more serious. The pathological process thus penetrates deeper into the enamel. Food coloring is easily delayed in this area. It is because of this that the spots on the teeth become brown or acquire a brown color.
Let us consider in more detail the stages of initial caries, and begin with the first stage.
Classification
"Spotted" caries are divided into:
- Surface. This is a stable area where mineralization is reduced and fluorine content is reduced.
- Superficial. A similar type of pathology is porous areas with a reduced calcium content and characterized by highly permeable enamel.
- Central. This type of initial caries represents a strong degree of enamel change with the development of its porosity and with a maximum decrease in its calcium content.
- Intermediate. In this case, microspaces are formed in the enamel.
- Interior. This type of initial manifestation of caries is characterized by the most prosperous enamel area with a minimum percentage of microspaces.
If in the initial stage of caries (photo below) you do not contact a specialist for appropriate treatment, then the demineralized and porous tissue of the tooth, in the crystal lattice of which failures have already occurred, will be destroyed further.
Pigments will begin to accumulate in the areas of the pathology, transferring the initial caries from the white spot stage to the next stage, when these areas of the pathology turn brown or black. Later, when a cavity is formed in this place, the dentist will have to use aggressive methods of treatment, such as preparation and restoration of the tooth.
Symptoms
What are the signs of the initial stage of dental caries (photo can be seen below)?
The main symptoms of pathology, as a rule, are associated with pain and aesthetic manifestations. What are they at this stage?
At this stage, a person does not feel any discomfort. However, with a careful examination of the tooth enamel, there is a loss of its shine and some roughness of the affected area. That is why at the beginning of the development of pathology, called the “white spot”, only 10-20% of patients come to the dentist for a consultation. The sizes of such zones, as a rule, are 3-5 millimeters.
Is it possible to identify the pathology yourself? To do this, first of all, you need to know what the initial stage of caries looks like. In addition, you will need to brush your teeth and dry them with a cotton swab, and then carefully consider the enamel in good light. Especially noticeable in this case is the initial stage of cervical caries on the front row of teeth. Also visible areas of demineralization, characterized by their dullness.
Another sign of the initial stage of the pathology can be the appearance of increased sensitivity of the teeth to thermal or taste stimuli.
Self diagnosis
Sometimes the initial stage of caries (photo below) is confused by patients with such dental pathologies as:
- spotted form of fluorosis;
- enamel hypoplasia.
However, it should be borne in mind that with caries, the spots on the teeth are chalky or pigmented, with a smooth or matte surface that does not have clear boundaries.
While in case of fluorosis, the affected areas, despite their white color, have a more pronounced color in their central part, which gradually passes to the periphery in a tone normal for enamel. Such zones do not have a luster and are sometimes distinguished by yellow pigmentation. White spots with hypoplasia have a clear boundary, do not lose their luster and do not lose the smoothness of the surface.
To establish an accurate diagnosis at home, ordinary blue can be used. Dentists recommend thoroughly brushing your teeth before using it, and then begin to process the enamel with a 2% aqueous solution of this substance. If, as a result of the performed manipulations, the spot turned blue, then this is a clear evidence of caries. In the dental office for the diagnosis of pathology, dentoscopy is used. The doctor directs ultraviolet rays to the teeth. In their light, healthy enamel looks light green, and the affected areas have a darker tone.
Treatment of the first stage of initial caries
How to eliminate white spots that threaten further destruction of enamel? Treatment of the initial stage of caries does not require tooth drilling so familiar to many. The fact is that caries, which is at the stage of a white spot, manages to damage only the surface layer of enamel, and is most often a reversible process.
In this case, the doctor can be applied remineralization of the teeth, suggesting their saturation with calcium. A similar method allows you to restore the enamel. This is the main dental treatment on which white spots appeared. In this case, medications on the lesions are applied:
- with a brush;
- adding to mouth guards;
- using applications.
Along with such therapy, dentists advise their patients to take mineral complexes containing calcium gluconate, calcium phosphate, as well as fluorine compounds.
The initial stage of caries in children also requires treatment (pictured below).
Otherwise, such inaction can cause multiple tooth defects, up to their breaks and splits. Very often, such processes are accompanied by discomfort during eating or even spontaneous pain. With the loss of function of a significant number of teeth, malocclusion, chewing, digestion are impaired, and the general well-being of the child worsens.
Stains for removing white spots
How to treat the initial stage of caries? To do this, you need to go through the following steps in sequence:
- A soft coating and a formed stone are removed from the enamel by the dentist. For this, abrasive pastes or hydrogen peroxide are used. After that, the surface must be polished.
- Affected teeth are treated with special preparations, the main ingredient of which is calcium.
- The dentist applies applications using 2-3% sodium fluoride.
Treatment of the initial stage of caries consists of 10-14 procedures. After them, the enamel is dried, fixing with varnish with fluorine.
Instead of remineralization, dentists use special mouthguards that are filled with therapeutic agents. Such removable structures are made individually, which is why they are convenient and airtight.
To reminalize, dentists often direct their patient to electrophoresis with drugs necessary to strengthen the enamel.
A recovery period after a course of treatment is not required. The patient should periodically undergo control at the dentist and properly care for your teeth.
Often, cervical caries in the initial stage is found on the enamel of babies. And in this case, it will be necessary to carry out restoration procedures. Remineralization should be done before the formation of the carious cavity. Enamel protection will be especially effective if parents take care of the proper nutrition of their children and the hygiene of their teeth.
White Spot Prevention
Often teeth deteriorate in people for reasons beyond their control. These are genetic prerequisites, a polluted atmosphere, and other similar factors. However, it is also necessary to pay attention to your teeth, recognizing the areas of demineralization on them. Otherwise, going to a specialist will require quite serious treatment.
What to do to prevent initial caries? To do this, you must:
. .
What does the initial stage of caries on teeth look like, past its first stage? Gradually, the pathological process, if it has not been treated, changes the color of the enamel. As it develops after a white spot, it becomes beige, then light brown, then dark brown, and finally black. In this case, the stain increases in size, and the pathological process covers the enamel in its deeper layers.
The most intensive development of caries occurs on the lateral surfaces of the teeth. In the dark spot stage, the enamel continues to decay. It becomes uneven, porous and rough. In the spot zone, sometimes some defects occur. They are minor chips and pinholes. At the same time, a person complains of a sharp painful reaction when exposed to external stimuli.
In those cases where the pathological foci are located in the cervical zone, discomfort occurs even with some mechanical influences, for example, when brushing your teeth or when you press on them with your finger. The pain in this case is aching short-term in nature. Some changes are occurring in the gingival zone. Here, near the teeth, plaque has a yellowish or white color. Sometimes the inflammation covers the gum papillae.
Diagnosis of caries in a similar stage differs in some significant nuances. So, the doctor will definitely begin to check what is the condition of the enamel by picking up a dental probe. In the case when caries is noted at the stage of a white spot, such actions are not carried out. The fact is that at the initial stage the enamel still retains its hardness, and the tip of the probe does not indicate changes, continuing to slide along its surface. Things are completely different with deeper demineralization. This can be understood by seeing what the initial stage of caries looks like (photo - confirmation of this) at the dark spot stage. In this case, sounding reveals a decrease in enamel hardness and its roughness. The patient, during this procedure, feels minor pain.
If dark spots are located in the fissures, that is, in the recesses of the natural relief of the tooth, then it is sometimes difficult for the doctor to identify whether such symptoms are initial caries or is it a more serious form. The most problematic such diagnosis becomes in small patients. The fact is that the enamel of children's teeth in the fissure area is still not mineralized enough. In this regard, pain during probing occurs in babies even on those surfaces that are not involved in the carious process. That is why many pediatric dentists do not use sharp probes at all when diagnosing fissure caries, since in this case enamel damage and the creation of artificial foci of its roughness are possible. To determine the pathology in this case, resort to the use of dyes that are firmly fixed in the pores, which allows you to identify demineralized areas.
Perhaps this will surprise someone, but the stripes and black dots on the enamel in the fissure area do not at all indicate that the tooth has finally decayed and cannot be restored. Yes, he already has problems, but dark spots can only be one of the signs of the initial stage of caries. And in this case, the process is completely reversible.
As with white spots, the dentist can be remineralized. The use of a drill in most cases is not required. However, sometimes reminalization does not lead to the desired result. In such cases, dentists offer the patient surgical treatment. Light brown spots are removed using diamond boron. After that, the adhesive filling method is applied. In the event that the stain has acquired a dark brown color, operational processing of hard tissues will be required. In this case, filling is performed in the same way as with medium caries, that is, with a more serious form of pathology.
Today, dentists successfully use a helium-neon laser. It eliminates the initial forms of caries. The light from this laser activates the enzyme system located in the pulp of the tooth. It also increases the effectiveness of anti-cariosis medicines lured by a doctor, actively affects the permeability of enamel and reduces the solubility of its surface layer. After such treatment, the density of the enamel itself significantly increases, and the activity of all its protective mechanisms also increases.
Signs of successful treatment
Initial caries can be eliminated without much difficulty. Nevertheless, it should be borne in mind that with incomplete or poorly performed treatment, the disease will certainly go to its next stage. Moreover, it will be more serious and subsequently may cause various negative processes.
In what cases is it considered that the elimination of the initial caries led to the desired result? The success of treatment is indicated when:
- the color of tooth enamel became uniform, and the carious stain disappeared;
- during re-diagnosis, traces of enamel demineralization are not detected;
- the patient does not complain of a negative reaction in the presence of temperature and taste stimuli.