About neglected caries: what to do if there are signs of decay on almost all teeth

Author: Yashin Svyatoslav Gennadevich | Last update: 2019

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Launched caries is a complex pathology of tooth damage resulting from the intense demineralization of tooth enamel. This disease has other names: the term “multiple caries” is most often used in medical practice, but others are also applicable - “blooming”, “generalized”, “acute”, “systemic”.

In this form of the disease, damage from 5 to 20 teeth is characteristic, and in one tooth there are often several carious cavities at once. An unambiguous assessment of the number of affected teeth for the diagnosis of multiple forms of caries does not exist. As a rule, the diagnosis corresponding to generalized caries is made for children with a CPU of 5 teeth or more and adults with a CPU of 6 teeth or more.

On a note

The KPU index is defined as the sum of tooth surfaces that have carious formations that are sealed and removed.

Generalized caries is an acute disease characterized by intensive development. It can provoke severe infectious diseases, chronic respiratory diseases and weakened immunity.

Today, due to the popularity of oral care and the availability of dental services, the disease has become less common, but the problem is still relevant in rural areas and in school-age children, when almost all the teeth in a child are affected by caries (see the example in the photo), and parents don’t know what to do in such a situation.

It is important to keep in mind that this problem requires the most careful attitude, since advanced caries can cause the loss of the entire dentition.

Symptoms and clinical manifestations of generalized caries

Generalized caries is dangerous because it develops extremely fast. Sometimes most of the teeth are affected within one year.

Symptoms of the disease are obvious and can be detected by patients on their own. A visual examination of the oral cavity caries is found on almost all teeth, and often there are several lesions in each tooth. In addition, the disease is accompanied by pain, there is bad breath.

Clinical manifestations characteristic of multiple caries:

simultaneous damage to a large number of teeth;
slight damage to the enamel along with extensive destruction of dentin;
the formation of cavities on different surfaces of one tooth;
the appearance of lesions even in the immune zones and teeth that are most resistant to carious damage - incisors and fangs;
pain during contact with acidic and sweet foods;
the presence of a reaction to temperature stimuli;
rapid plaque formation;
increased saliva viscosity;
decreased secretory IgA;
painful sounding due to lack of replacement dentin;
the presence of lesions at different stages of development - from the initial "white" caries to advanced periodontitis.

In patients with multiple caries, saliva is sparse and very viscous. She does not clean her teeth well, which further aggravates the situation.

Important:

Oral fluid (saliva) acts as a natural cleaner for the oral cavity. In addition, it is also called “liquid enamel”, since the return of the lost trace elements necessary for the formation of the enamel structure occurs precisely due to saliva. Sufficient salivation with a high-quality mineral composition allows you to return to the maximum amount of lost minerals (fluorine, calcium, phosphorus, etc.).This is just one explanation for the fact that some people may not fully care for their teeth, and those, oddly enough, do not collapse, or collapse very slowly and slightly.

In case of generalized caries, fillings quickly fall out of the cured teeth, often this occurs 1-2 months after their installation. This situation is explained by the fact that caries progresses under fillings, causing softening of tissues and weakening of fixation of fillings.

It is also useful to read: How to protect your teeth from tooth decay: a review of effective methods

In addition to the fact that caries is dangerous for health, causes pain and limits the choice of food, it is also a serious aesthetic problem. The photo below shows an example of generalized caries:

A disease can lead to the development of complexes: a person begins to smile less often, feels constant insecurity and discomfort, ceases to feel attractive and closes. This is especially dangerous if it becomes the norm in childhood.

Why does this disease develop?

Graphically, the causes of tooth decay are often depicted in the form of a “Casey trefoil” - a symbol consisting of three circles mutually overlapping in the center. This image provides an understanding that tooth decay appears when three conditions coincide:

on the surface of the teeth, cariogenic microflora develops, the acid secretion of which destroys the tooth tissue;
in the oral cavity, most of the time there are digestible carbohydrates that serve as food for bacteria;
for various reasons - from genetic to pathological - low enamel resistance develops.

All these factors actively contribute to the development of multiple caries.

Recently, the trefoil is often supplemented with a fourth circle, symbolizing the duration of the interaction.

Common factors affecting the development of caries are:

chemical composition of drinking water;
diet;
ecological situation;
heredity;
somatic diseases;
inadequate oral hygiene (violation of hygiene rules).

The cause of the development of multiple caries in most cases is the general unsatisfactory state of the patient's body. It is worth noting that quite often this disease occurs in children.

The photo below is another example of running decay of deciduous teeth The child has:

Most often, this situation is observed in children who have had acute infectious diseases, suffer from various chronic diseases and have congenital heart defects.

High prevalence of generalized caries is observed in children with tonsillitis, scarlet fever, suffering from chronic rheumatism, glomerulonephritis, Little's disease, Down's syndrome, and marble disease.

Severe caries is also characteristic of children with tuberculosis and having generally weak immunity. It is almost always found in people infected with HIV. Endocrine disorders and diabetes mellitus are also often the causes of acute caries.

Adolescents are also at risk, since during hormonal changes, this disease often progresses.

Survey Results:

Surveys of students in schools in Russia show that the more a child suffers from infectious diseases, the more teeth he has that are affected by caries. Often in children with blooming caries chronic tonsillitis and adenoids are detected. Many examined patients have depressed antitoxic liver function. Almost always, the disease is associated with diseases of the central nervous system or endocrine system.

What if all teeth are in caries? First of all, you need to contact the dentist and pediatrician, you may also need the help of an endocrinologist and immunologist. Multiple caries is a serious and dangerous disease, therefore, it is necessary to approach the treatment responsibly and not start the pathology to irreversible consequences.

Not only children suffer from blooming caries, the disease can also develop in an adult. Often this occurs due to the cessation of the functioning of the salivary glands, for example, as a result of radiation therapy of cancer. The disease is so destructive that it sometimes leads to the destruction of the crown of individual teeth within a few weeks after the onset of development.

There is a risk of damage in people suffering from gastroduodenal diseases, chronic neuro-somatic diseases, as well as those who have suffered acute infections.

Treatment of multiple caries

The earliest possible treatment of multiple caries is absolutely necessary, regardless of whether the baby’s baby teeth or permanent ones are affected by an adult. Also, do not think that the teeth will fall out and the problem will disappear by itself.

It is also useful to read: About deep caries: photos, symptoms and diagnosis

What should parents do? First of all, you need to go to the dental clinic, whose specialists will treat the affected teeth and refer the patient for an additional examination by other doctors.

Local treatment involves:

conducting preparation with anesthesia;
removal of damaged dentin;
the formation of cavities and their treatment with an antiseptic;
silvering of individual teeth;
the use of drugs that stimulate the production of replacement dentin in the tooth.

In especially advanced cases, depulpation, installation of crowns or even tooth extraction with subsequent prosthetics is required.

To effectively eliminate advanced caries, you will also need to identify and cure the disease that caused its development. Often a medical examination of the patient is carried out, during which he is prescribed general strengthening therapy, physiotherapy, vitamins and a specialized diet.

To restore the phosphorus-calcium balance and strengthen the immune system, the patient is prescribed calcium, phosphorus, fluorine and iron preparations, as well as vitamins A, B, C, D. Usually, the treatment lasts several months, due to the slow normalization of mineral metabolism.

The diet is developed individually for each patient, taking into account the causes and nature of the course of the disease. It necessarily includes foods rich in proteins, vitamins and mineral salts.

Physiotherapeutic procedures are very effective in case of generalized caries: calcination and fluoridation of teeth with the help of special preparations and (or) electrophoresis.

On a note

Children who have had or are currently having foci of multiple caries are necessarily registered in the dispensary and under supervision. Remediation (complex treatment) carious tooth damage accompanied by the implementation of therapeutic and preventive measures:

Professional oral hygiene (cleansing of tartar and plaque).

Training in oral hygiene of the parents of the child, the child himself with controlled brushing, control of brushing during the period prescribed by the pediatric dentist.

Mineralization of the teeth in the dentist’s chair with calcium and fluoride preparations with possible options for combining techniques to achieve the best results in each case (for example, the “Fluftored” drug for deep fluoridation).

Treatment of inflammatory processes in the gum surrounding the teeth. Unfortunately, with an unsatisfactory condition of the oral cavity, there are local or generalized lesions of periodontal tissues (for example, gingivitis). If the inflammatory process in the gum is left unattended, a multiple infection in the tissues will provoke tooth decay. It’s easy to understand: if the gum is swollen and painful, bleeds easily when touched, then neither the parents nor the child will be able to follow the dentist’s instructions to perform the correct techniques for cleaning the surfaces of the teeth, in particular in the cervical region,where the highest risk of caries formation or progression due to the presence of soft plaque.

Basic preventive measures

Prevention of generalized caries is aimed at improving the overall health of the patient and increasing the resistance of the teeth to the development of this disease.

Important preventative measures are:

a balanced diet, without fail, containing dairy products and dishes rich in vitamins;
the use of easily digestible carbohydrates in limited quantities;
timely treatment of somatic diseases;
thorough oral hygiene at least twice a day;
the use of pastes specially designed to combat tooth decay;
regular toothbrush replacement.

This is the minimum, the implementation of which will help to maintain health and a beautiful smile for a long time. It is also important to undergo a regular examination in the dental office, and even if the teeth look completely healthy.