Cervical caries treatment

When cervical caries occurs, many people, instead of running to the clinic to treat a tooth as soon as possible, all delay this undesirable moment. This is partly due to various conflicting information on the network about the possibility of cervical caries treatment even at home (with its initial forms), about the possibility of using remineralizing toothpastes and other available means that supposedly help to effectively restore tooth enamel and thereby save a person from Problems.

About where the truth is, and where is the myth, what methods of treating cervical caries are really effective and what can be done at home, we will talk further. And also consider the mechanism of development of pathology and features associated with the localization of caries in the cervical zone of the tooth.

 

Features of cervical caries and a characteristic clinical picture

Cervical caries appears, generally speaking, in many respects for the same reasons as any other caries, and is associated with the vital activity of microorganisms that convert carbohydrates into organic acids. As a rule, pathology is formed against unsatisfactory oral hygiene and progresses rapidly without treatment

The lack of brushing skills formed since childhood and the neglect of dental floss (starting from adolescence) lead to the fact that the most carious-sensitive surfaces of teeth are affected, where plaque accumulates abundantly.

On a note

The microbial factor in the development of caries on the background of the use of products containing easily fermentable carbohydrates (mainly sucrose) was proved back in 1884 by Miller. This chemical-parasitic theory of the development of caries with minor amendments has survived to the present day. Focal demineralization of the subsurface layers of enamel begins under plaque as a result of fermentation of carbohydrates by bacteria of the species Streptococcus mutans with the formation of various organic acids that “corrode” the enamel structure. At the same time, the mineral composition of the crystal lattice of enamel prisms is violated with the formation of so-called “micropores”, and visually this is manifested by the formation, for example, of cervical caries in the spot stage.

Most dentists are inclined to believe that cervical caries is a rather aggressive form of dental disease, due to several factors.

1. The area of ​​damage by cervical caries has a small thickness of protective tissues, and often the enamel is not sufficiently mineralized. A tooth consists of a crown, a neck and a root. The neck of the tooth is normally located under the edge of the gum, and the entire area near the border of the neck is called the “cervical”. Selective caries of this particular weak zone often involves the active destruction of enamel and dentin, up to the pulp (“nerve”), with the rapid onset of painful sensations characteristic of each stage of the disorder. It is for this reason that cervical caries without timely treatment can start in a short period of its complications: pulpitis, periodontitis, etc.
2. Combined defects. The specificity of the localization and spread of the lesion is that often cervical defects “spread” throughout the cervical region, reaching the middle of the tooth crown, deepening under the gum or capturing contact surfaces with the transition to the so-called circular caries. In such cases, the tooth is covered in caries in a circle, which without treatment often leads to breaking off part or the entire crown.

The photo below shows an example of circular decay of deciduous teeth:

A peculiarity of cervical caries is also the fact that defects often appear to be located in the “smile zone”. If the areas of destruction are located on the lateral group of teeth, or on surfaces inaccessible to the gaze, then most often this does not cause serious aesthetic consequences and experiences, however, short-term pain from various irritants and the risks of caries in its complications without treatment being started are possible.

When the cervical decay on the front teeth (especially in the "smile zone"), serious psychological problems often arise, up to a nervous breakdown. This is especially true for people whose work is associated with constant business contacts or public activities (journalists, artists, managers, teachers, doctors, etc.).

Symptoms of cervical caries can be very diverse, but they all fit into the general rule: pains are always short-term and quickly disappear after removal of the irritant. It is this aspect that allows you to make the correct preliminary diagnosis and not to confuse with the complications of caries.

Cervical caries in the spot stage, as a rule, manifests itself only visually: by changing the color of the enamel in the cervical region: from a white spot to a pigmented one, depending on the activity of caries and the options for staining it with dyes from food. Sometimes there is a passing feeling of soreness from chemical irritants (especially sour). At this stage, treatment is possible with conservative methods, without the preparation of a tooth with a drill.

Superficial cervical caries without timely treatment can cause a more diverse clinical picture with the development of pain from cold, hot and sweet, although sometimes it also develops asymptomatically.

If you do not start treatment, then further cervical caries from the superficial form goes into the middle, and then deep. In this case, pain most often occurs from chemical (sweet salty), temperature (cold and hot) and mechanical (if solid food gets into) irritants. It is worth emphasizing once again that all pains are short-term in nature and pass quickly when the causative factor that causes them is eliminated.

Feedback

When there were pains in the front tooth from cold water - at first I did not understand what was the matter. He looked in the mirror and was horrified: near the gum near the upper tooth there was a barely noticeable dark spot extending under the gum. I went to a familiar dentist for treatment. He told me that this is cervical caries. The treatment took about 40 minutes, put a seal similar to the color of my tooth, now I drink cold water, as much as you like ...

Valery, Tambov

 

Treatment of cervical caries at home: reality or myth?

For many people, the very fact of the possibility of cervical caries treatment at home allows not to go to a dentist for professional help for a long time (for example, because of children's fears of terrible toothache during treatment with a drill). Well, the good news for such people is that certain home-based therapies really are not without meaning.

Cervical caries in the spot stage can be cured at home for a long time using hygiene products and preparations with increased concentrations of fluorides and calcium to saturate the weakened enamel crystal lattice in the zone of its color change (contraindications are possible). You can, for example, use remineralizing gels, as well as special toothpastes from cervical caries.

However, with such treatment, some important points should be considered:

1. Cervical caries and its characteristics are individual for each person: location, depth of damage, area, enamel structure, etc.Moreover, the carious process in the cervical region (regions) often proceeds against a background of various aggravating factors, which may include poor oral hygiene, age, the presence of other problems with teeth, and general health. There is no guarantee that independent choice caries treatment at home, it will take into account all the nuances of not only the oral cavity, but also general no less important characteristics, on which the success of therapy directly or indirectly depends.
2. The range of products (preparations) for professional and home treatment and prevention of cervical caries is too diverse and wide. Again, there is no guarantee that the independent choice of one or another remedy will be so successful that it will not only solve the problem of cervical caries treatment in the spot stage in a short time, but also will not harm the general health and dental health of high concentrations, for example, fluorides (which can be dangerous if used improperly).
3. Cervical caries can be treated with conservative methods only at the spot stage. And with what probability you can assume that your cervical defect is caries in the spot stage, and not superficial, medium or deep (or a disease of non-carious origin in general - enamel hypoplasia, fluorosis, wedge-shaped defect; or commonplace dental deposits - pigmented plaque or stone)?

From the experience of the dentist

Even a dentist at a professional appointment to clarify the diagnosis conducts not only clinical diagnostics (interrogation, examination, sounding), but also special research methods (staining with dyes, X-rays, EOM, transillumination, etc.). Sometimes it takes from 10-15 to 60 minutes. Indeed, the correct tactics for the further treatment of cervical caries depends on the correct diagnosis.

Often, under the cervical caries, in the spot stage, defects of deep-lying tissues (deep layers of enamel and dentin) are masked, as well as common complications of caries - pulpitis and periodontitis. When pulpitis (or periodontitis) is detected, the treatment tactics comes down to the treatment of the tooth canal with the elimination of the infectious process in it. The placement of a filling in the cervical region without processing and filling the canal (s) would soon lead to even more serious complications, including tooth loss.

 

Popular folk remedies for the treatment of cervical caries

Cervical caries is often accompanied by painful sensations that may not last long until the cause causing them is eliminated: sweet, cold, hot - all this can cause pain of varying degrees of intensity. Sometimes it can cause very severe pain during meals, which is already characteristic of deep cervical caries.

In folk medicine, there are many ways to temporarily get rid of pain, if the appointment with the doctor for insurmountable circumstances is postponed for some time.

Among the popular methods of treating caries with folk remedies, there are:

• Infusions for rinsing the mouth: from sage, lemon balm, blueberries, blackberry leaves, mallow grass, knotweed grass, oregano;
• Decoctions for rinsing the mouth: from the bark of oak, aspen, tricolor violets, flowering branches of wormwood, valerian;
• Roots for chewing: angelica vulgaris, calamus;
• Propolis tincture for rinsing, previously diluted with water.

Folk recipe for pain in caries

One of the simplest folk remedies for getting rid of pains during caries is sage infusion. It is necessary to fill in 2 tablespoons of dry grass with half a liter of boiling water, and then insist for about 30 minutes in a closed container. The resulting product must be filtered and rinsed with a warm solution 4-5 times a day, mainly after eating. This will not restore your teeth, but it will make it possible to hold out for a while before going to the dentist for normal treatment.

The relief of pain in cervical caries after the use of folk remedies is temporary and may even mask serious problems, for example, the transition of cervical caries to pulpitis. Therefore, be careful and try to contact a specialist as soon as possible.

 

Features of filling a gingival defect at the dentist

Cervical caries is one of the most complicated caries lesions in the clinic.

The easiest way is to treat cervical caries in the spot stage with a conservative method, that is, without the traumatic use of a drill and filling. The most common remedies are preparations for remineralizing therapy and deep fluoridation.

• Glufthored;
• Enamel-sealing liquid;
• Remineralizing gel R.O.C.S. for office use;
• Belagel Ca / P, Belagel F;
• Remodent;
• "Fluorodent";
• "GC Tooth Mouss."

And etc.

The treatment of cervical caries in the spot stage with the method of remineralizing therapy includes the following steps:

• Professional oral hygiene with dental cleansing from dental plaque (plaque, stone).
• Application of remineralizing gels or application of fluorine-containing preparations in 2-3 visits with the intervals required by the instructions.
• Home use of dentist-prescribed preparations and hygiene products to further strengthen the enamel.

Despite the often good overview of the carious cavity for the doctor and the convenience of the approach to it, the gingival location presents many problems in the treatment of superficial, middle and deep cervical caries using mechanical treatment of the cavity, namely:

• inconvenient location of the cavity of the cervical defect for filling (especially when combined with subgingival caries);
• moisture on the working field;
• penetration of blood from the inflamed or injured edge of the gums into the working field.

We list the basic principles of cervical caries treatment using the methods of mechanical cleaning of the carious cavity and subsequent filling:

1. Cleansing tooth surfaces from dental plaque;
2. Isolation of the working field with cofferdam (rabberdam) with good clinic equipment;
3. Dissection of the cavity with air-air cooling with excision of carious and pigmented tissues;
4. The formation of a cavity for the selected material for the seal;
5. Installation of filling material in compliance with the filling technique;
6. Seal correction: grinding, polishing.

Among the main modern materials for the treatment of cervical caries with filling, glass ionomer cements (SIC), light-cured composites, compomers and ormocers (organically modified ceramics) can be noted.

It is interesting

A prominent representative of the ormokers is Admira. Ormoker is a group of restoration light-cured materials, or organically modified ceramics. They have high biocompatibility, are easier to model and give lower shrinkage than the classic "light fillings", are resistant to abrasion. They are used for filling defects of all classes, including with cervical caries.

Currently, combined technologies using 2-3 different materials are used to fill the cervical caries to maximize the extraction of the positive properties of each and minimize the negative effects. This makes it possible not only to cope with complex clinical situations associated with subgingival or subgingival localization of cavities, but also allows you to restore the aesthetic and functional parameters of the tooth, in other words, to preserve a beautiful tooth for many years.

The photo shows how the teeth look after treatment of deep cervical caries:

 

Prevention is the best protection against cervical caries

Prevention of cervical caries is many times better and more profitable than any treatment.However, most people either do not know its basics, or neglect the elementary rules that can protect teeth from cervical caries, even for those who are prone to the development of this pathology.

If the mechanism of caries development has been known for more than a hundred years, then it’s enough to simply break the links leading to it, namely:

1. Limit the use of easily fermentable carbohydrates with high culinary processing (sweets, flour products). This will not only help to adjust the diet in a useful way, but will also reduce the risks of tooth decay.
2. To observe the culture of carbohydrate intake, if it is not possible to completely refuse them: in no case should they be eaten in the intervals between main meals, in large quantities, and even more so at night without oral hygiene.
3. Increase the consumption of rough (solid) food, especially at the end of the meal. The alternation of hard fruits (apples) and vegetables (carrots) creates a self-cleaning procedure for the surfaces of the teeth, which is not an innovation, but was a food culture even of the ancient Slavs.
4. After a meal, teeth should be brushed as a mandatory procedure. Brushing your teeth before breakfast is an almost useless procedure, since plaque after eating begins to form during the first hours.
5. As soon as possible, adjust your brushing skills either at the dentist (hygienist) or with the help of a training video. The level of hygiene and the protection of teeth from cervical and any other caries depends on the proper observance of the cleaning technique for surfaces accessible to the brush.
6. It is imperative to include dental flosses (flosses) in the list of hygienic procedures due to their high effectiveness against cervical caries that occurs on contact surfaces between the teeth, which are not fully accessible for a toothbrush.

Special tools caries protectionthat can be used at home:

• Toothpastes from cervical caries with a concentration of fluoride from 1000 to 1500 ppm;
• Dental floss soaked in fluorides;
• Rinses with fluoride.

Most hygiene products for protecting the teeth from cervical and other types of caries that are available on the market (for example, toothpastes) are safe for the teeth and general human health, but there are always risks. In each age group, depending on the cariogenic situation in the oral cavity, the structure of tooth enamel, the level of hygiene, the number of fillings and removed teeth, the concentration of fluoride in drinking water in a particular area, general health and the presence of concomitant pathologies, etc., an individual is selected a set of tools for professional and home tooth strengthening and protection against cervical and other types of caries. It can be pastes, and gels, and solutions.

This is the competent systematic approach in relation to the dentist's health of his patient. Therefore, if you are not sure of the correctness of your actions regarding prevention, you should contact a specialist for professional advice.

 

An interesting video about the features of cervical caries

 

Causes of caries and effective methods of protection against it