Cervical caries. Dangerous cervical caries: treatment or how to avoid complete tooth decay How is cervical caries treated

Date: 19.10.2019

Cervical caries is damage to the tooth at its base. This is the most dangerous and difficult type of caries today, because it destroys the tooth in the most vulnerable place - at the root, affecting all the canals of the tooth. Most often, this type of caries affects the teeth of people after thirty years.

Modern dentistry is very concerned about the reasons for the appearance of this type of caries, because it is always easier to prevent a disease than to cure it.

The main causes of occurrence are cariogenic microorganisms present in the composition of soft dental plaque and hard dental calculus.

These microbes recycle food debris in the mouth into organic acids, which wash out calcium from the enamel, destroying it. These microorganisms can develop into a disease due to insufficient oral hygiene and the anatomical features of the enamel of the tooth neck.

Photo: Cariogenic microorganisms under a microscope

Poor oral hygiene

Cervical caries is located at the very gums, on the neck of the tooth.

These places are the most difficult to access during normal hygiene procedures, so you need to brush your teeth as thoroughly as possible and be sure to twice a day.

Video: oral hygiene

Features of the enamel of the neck of the tooth

Due to the anatomical features, the enamel of the tooth neck is very thin, therefore, its condition must be carefully monitored. If, at the very first hints of caries, you consult a doctor, you can restore the enamel near the cervix with the help of revitalization, without resorting to using a drill.

Symptoms at different stages

The first symptom of such caries is the darkening of the tooth enamel, followed by the appearance on it white spot... This stain begins to change its color and deepen, which can ultimately lead to a complete loss of the tooth, if not treated.

The final symptom of cervical caries is the formation of a hole, the so-called "hollow" in the tooth.

It is important to pay attention to a symptom such as an unpleasant sensation while eating, a painful reaction to a hot or cold temperature as well as constant aching pain in the tooth.

This kind caries has several stages of development, during which a small spot develops into deep caries, each of which has its own symptoms.

First stage- a demineralized small area on the tooth enamel, dullness of the smooth surface of the tooth;
Stage of superficial caries- degeneration of the stain, the gradual destruction of tooth enamel, the appearance of a reaction to temperature conditions;
Moderate caries stage- the appearance of deep damage to the tooth;
Deep caries- "hollow" reaching the nerve endings of the tooth.

Diagnostics

It is easily diagnosed because carious defects are located on well-visible parts of the tooth. The patient may even notice white chalky spots on the tooth enamel on his own, looking in the mirror.

But sometimes doctors, in addition to a visual examination of the teeth, use special solutions with dyes, which they ask the patient to rinse the mouth with.

The fact is that the dyes that make up these solutions cannot penetrate into healthy, calcium-saturated tooth enamel, but they penetrate well into demineralized, diseased areas of the enamel, because it has a porous character.

The patient rinses his mouth with clean water, and it becomes clearly visible where the dye lingered on the teeth. A few hours after the procedure, the teeth acquire their usual color.

Difference from wedge-shaped defect

Another common dental disease is a wedge-shaped defect, which manifests itself as a V-shaped defect on the outside of the tooth. The edge of such a "wedge" is directed into the dental cavity.

Most often, the wedge-shaped defect affects the teeth, which bear the greatest load during chewing - premolars and canines.

Sometimes patients confuse this defect with cervical caries, because it is also located at the root neck of the tooth, and require dentists to treat the caries according to it.

But this is wrong, as there are differences between the two dental diseases.

In the case of a wedge-shaped defect, the affected surface in the form of a V-shaped depression remains dense and polished, and the color of the tooth enamel does not change;
With caries, the affected surface will be loose, rough and irregular in shape, have a brown color;
A wedge-shaped defect develops for a very long time, literally for years, and cervical caries can destroy a tooth in a few months.

Treatment

It is treated in the same way as ordinary caries, it lends itself perfectly standard treatment, but depending on the stage of development of the disease, the stages of treatment also differ.

In addition, it is possible to stop pain with the help of traditional medicine.

Treatment is carried out with the obligatory use of local anesthesia, because the neck of the tooth is a very sensitive area.

This is the main difficulty of treatment - the doctor's actions must be as accurate and confident as possible, so as not to touch the most sensitive areas of the tooth once again.

How to relieve pain at home

If it is not possible to quickly visit the dentist when pain from cervical caries appears, folk remedies can help as a temporary measure.

The most popular way to get rid of a toothache in alternative medicine- infusion of sage, for the preparation of which 2 tablespoons of dry sage are poured with 0.5 liters of boiling water, and then infused in a sealed container for 30 minutes. The resulting infusion must be filtered and rinsed with it 4-5 times a day.

A decoction of valerian also has an analgesic effect - pour 20 grams of root with a glass of boiling water, warm it up in a water bath for 10 minutes, let it cool, strain and rinse your mouth three times a day.

Also, to reduce toothache in folk medicine, lemon balm infusion is used - 4 tablespoons of raw materials are poured with a glass of boiling water, and infused for an hour. Rinse your mouth with lemon balm after each meal.

A good effect is given by alcohol tincture of propolis - dilute 2 tablespoons of the finished tincture in a glass of warm boiled water and use it for rinsing 3 times a day.

Chopped onions wrapped in gauze can be applied to a sore tooth for 5-10 minutes.

However, despite the apparent feeling of relief, one must remember that folk remedies can only relieve pain, caries itself, including the cervical, they cannot cure.

Remineralization in the early stages

At the earliest stage, when cervical caries is white chalky spots, and the top layer of enamel is not destroyed, dentists usually carry out conservative treatment, that is, remineralization.

The essence of this therapy is to saturate the tooth enamel deprived of calcium with calcium. To do this, use special remineralizing drugs that contain highly active calcium and fluorine.

Before applying these preparations to the teeth, soft plaque and hard deposits are removed from them.

Remineralization is carried out in several sessions.

How to treat later stages

At later stages, the procedure for treating cervical caries is carried out as follows:

The tooth is cleaned of plaque and tartar, as a rule, this is done with an abrasive paste and polishing brushes;
A carious defect is prepared, for which a drill is used or more modern methods - a laser, a scaler, a special agent;
The tooth is isolated from saliva and treated with adhesive - this is necessary for the filling to reliably adhere to the tooth tissues;
The defect is filled - the treated carious cavity is filled with filling material, the tooth is given its anatomical shape;
The tooth is ground and filled with special discs and burs.

Prophylaxis

As with any other type of caries, the prevention of its cervical variety is, first of all, high-quality oral hygiene.

Thoroughly brushing twice a day is necessary not only for the teeth themselves, but also for the gums adjacent to them, thus the neck of the tooth will also be cleaned. You can reduce the risk of cervical caries by using dental floss after every meal.

Photo: Cleaning the gaps between teeth with floss

Since most often such caries occurs in people after thirty, then at this age you need to periodically undergo professional teeth cleaning at the dentist.

The most important thing in this case is not to delay the visit to the dentist if the first signs of dental problems appear. Cervical caries develops faster than all others, and any delay can lead to complete tooth decay.

A tooth can be damaged in many different places. And cervical caries, the causes and treatment of which we will describe in more detail, is the most difficult option.

This disease is often confused with some other problems, but it is much more dangerous.

Causes of cervical caries

From what is the cervical, or as it is also called basal, caries. To answer the question of why such a disease appeared, you need to reconsider all possible reasons... Doctors distinguish the following:

Malnutrition, in which the body lacks calcium and vitamins. And also use in large quantities flour, sweet, carbonated drinks, etc. Lack of dairy and fermented milk products, fish, vegetables and fruits will lead to complications in general health, and teeth in particular.
Bad habits - alcohol, smoking, etc.
Hereditary factors affect the propensity for certain diseases, which include caries.
Wrong. And this is the wrong choice of toothpaste (gels cleanse worse), too soft a brush, horizontal movements. No rinsing after eating.
Poor quality of the drinking water you are using.
Pregnancy and breastfeeding as a time of hormonal surges. And they, in turn, greatly affect overall health.
Taking medications that can destroy the structure of the enamel.
The increased acidity of the gastrointestinal tract and saliva itself contributes to frequent illnesses oral cavity.
The functioning of the endocrine glands can also affect the health of the teeth. That is why endocrinology is one of the important factors in tooth decay.
Too thin enamel from birth.
Disrupted metabolism.
Age-related changes. It was found that after the age of 30, the teeth are affected by cervical caries in most patients.

Even after undergoing treatment, it is advisable to eliminate the very cause due to which the problem arose so that it does not come back again and again. Otherwise, you will have to constantly deal with root caries.

Symptoms and stages

Diagnosis of the disease is carried out at the dentist's office. He will immediately notice the changes or apply a special coloring gel, which will reveal the beginning of the destruction of the enamel. In some cases, the observation of the patient himself will indicate the appearance of cervical caries at the first stage, when everything can still be quickly corrected. On different stages diseases are observed following symptoms:

At the first stage, the changes are almost imperceptible. A white spot may appear at the root of the tooth, the enamel will tarnish and the sensitivity will increase.
The second stage is characterized by superficial manifestations of caries, in which the stain becomes larger and lighter. It will be hard not to notice him. In this case, the structure of the enamel becomes rough, it begins to gradually deteriorate.
The third stage refers to the average intensity of the disease, in which the upper layers of the dental tissue are affected.
But the last stage is characterized by deep destruction of the tooth, in which both the roots and nerve endings are already affected. If this chewing teeth, which are heavily loaded, they may even break. This process is always accompanied by painful sensations, sometimes so sharp that it is impossible to endure.

Since cervical caries is often similar to other diseases, and a hard-to-reach place does not always make it possible to examine a tooth for the presence initial symptoms, it is better to visit the dentist on time. The doctor will be able to detect the problem at an early stage, knowing how to define it, and distinguish it from similar ailments, which are treated in a fundamentally different way.

Photo

Cervical caries and methods of its treatment

Only a professional dentist can diagnose and prescribe treatment for cervical caries. And the sooner the disease is detected, the easier, faster and cheaper it will be produced, so you shouldn't delay going to the clinic.

What exactly is the treatment depends strictly on the severity of the disease.

At the stage of the appearance of the spot and the practical absence of most of the other symptoms, it is enough to prescribe a remineralizing toothpaste. It is rich in fluoride, calcium and other minerals important for enamel health. As a result, the tissue is strengthened, and caries does not damage its deep layers.
At the second and third stages, with more noticeable destruction, the doctor can prescribe a filling of the affected surface, while the nerve endings are not affected.
they are treated only with the complete removal of the nerve, the canal and the dental cavity are filled. In this case, an injection with an anesthetic is used, since the procedure is quite painful.

If the doctor has decided that filling is indispensable, he must additionally carry out a number of preparatory procedures:

Clean tartar and plaque.
If possible, neutralize the cause of tooth decay.
It is good to dry the working area, since with the least amount of saliva, the seal will not hold and it is possible.

Treatment of cervical caries is complicated by its location. When the gums are close together, it can be difficult to dry the desired area. If the chewing teeth are affected, then it is physically difficult to get to them. At the same time, the patient's sensitivity is increased, since the place is rather painful.

The fillings themselves are used the same as in the treatment of other types of caries. The only differences are in the location and complexity of the dentist's work. When filling the front teeth, the doctor must carefully select the color of the material so that it does not differ from the natural one.

In modern dentistry, painless methods of caries treatment appear. For example, the use of ozone, laser therapy - all these are already available technologies.

In children

Cervical caries is more common in adult patients after 30 years of age. But there are times when the teeth are affected in childhood... In this situation, it is important to use an anesthetic, as the procedure will give the child a lot of unpleasant sensations.

The cause of cervical and any other caries in very young children is most often bottle feeding before bedtime. The child holds the formula in his mouth for too long, sometimes falling asleep with it. From this, bacteria begin to actively multiply on the still not strong milk teeth, rapidly destroying them.

First aid

If you made an appointment with the dentist, but you feel that unpleasant sensations appear, and you are still far from the appointment, then you can do something yourself. So, there are folk remedies that are used at home to relieve pain and reduce the negative effects of bacteria.

Sage infusion - 2 tablespoons of dry herbs are poured with half a liter of boiling water and left to brew for half an hour. Further, it is enough to strain it and rinse it up to five times a day.
Valerian decoction - also take 2 tablespoons of the root, but pour a glass of boiling water over it. Boil in a water bath for no longer than ten minutes and filter. It is necessary to rinse the affected area three times a day.
Lemon balm infusion - the ratio of dry herb and boiling water will be as follows - 2 tablespoons per 100 - 150 ml of water. You need to insist it for an hour, and rinse it every time after a meal.
Propolis tincture - excellently helps to cope with most ailments and reduce the action of bacteria. To do this, dilute 2 tablespoons of the finished tincture in a glass of warm water. Rinse the mouth periodically up to four times a day.
Rub the onion and wrap it in several layers of gauze. Apply it to the affected area until the pain is relieved.
Regular saline solution - give three tablespoons of table salt to a glass of warm water. You can rinse as often as pain occurs.
Camphor oil compress - a small piece of cotton wool is impregnated with camphor and applied to the sore spot.

It is important to understand that such remedies will not cure the underlying disease, but will only help to relieve pain and wait for the prescribed appointment, therefore, it is necessary to make an appointment with a doctor in any case.

Prophylaxis

If you have never had cervical caries or this problem has not bothered you for a long time, it is advisable to engage in disease prevention. The sooner you start taking action, the less likely you are to get tooth decay. Doctors recommend:

Brush your teeth with pastes with a high concentration of minerals. It can be Lacalut Extra sensitive, President sensitive, Silca Complete Sensitive, 32 bionorms and others.
Daily oral hygiene. When doing this, choose a toothpaste over a gel, as it cleans plaque and calculus better. The brush should be of sufficient rigidity, and the movements should be vertical or circular. should be twice a day, and rinse your mouth after each meal.
Massage of soft tissues is desirable, since under the gum they pass blood vessels feeding the teeth.
Eating foods rich in vitamins, calcium, fluoride and other minerals. Refusal from flour, confectionery and other harmful products... Periodically, it is advisable to take vitamin complexes with a high calcium content.
Must visit once every six months dental clinic for general inspection. This will help to detect the problem in time and prevent the deterioration of the condition.
Every year desirable professional cleaning of the oral cavity, which includes the removal of tartar, cleansing of strong plaque, strengthening the enamel and other wellness procedures.
Mechanical damage and injury must be avoided.
Refusal from bad habits will help to improve overall health.

Video: what is cervical caries and how is it treated?

Additional questions

How much does the treatment cost?

The cost of the procedure will depend on the specific clinic and region, but most of the price is formed by the neglect of the problem. When installing a simple seal, you can spend 1500-2000 rubles, and if necessary, the cost will increase to 4000. In Ukraine, prices vary between 350-650 hryvnia.

Can a filling fall out and a tooth ache due to cervical caries?

If the lesion occurs on a tooth that was previously filled, then such a filling can fly out. After all, the disease has penetrated from the other side and destroys dental tissue. Pain appears at the stage when caries reaches the nerve endings.

Is it normal to have a toothache after treatment?

If the pulp was not removed, then, perhaps, its infection and inflammation began. In the case of tolerable pain, in the absence of a deterioration in the general condition, redness or swelling of the gums, it is probably just a reaction of the tooth to the intervention, with time it will pass. At acute pain, especially at night, it is imperative to see a doctor.

It is customary to distinguish several parts in a tooth: a tooth root, a neck and a crown. V normal condition the crown is located above the gum, and the rest of the tooth is hidden behind it. Caries that occurs on the border of the gum and the neck of the tooth is called cervical, or in other words, cervical.

Not taking the factors that cause cervical caries seriously, people visit the doctor only when the problem begins to bother them seriously, since the appearance of the front teeth becomes unaesthetic (a similar ailment very often spreads in the smile zone).

The reasons for its occurrence can be different. Not all people go to the dentist on time. After all, the appearance of such an ailment is not immediately possible to notice, especially on early stages... And sometimes people try to eliminate the disease on their own using special pastes or resorting to treatment with folk remedies.

Let's consider the main reasons due to which there is a cervical caries. First of all, they are associated with the following factors:

Diet, as well as the frequency and amount of carbohydrate foods that are easily fermented.
The presence of microbes, that is, the activity of bacteria under plaque. This is especially true for Streptococcus mutans. In this state, bacteria begin to ferment and organic acids are formed. They have a detrimental effect on the layers of tooth enamel. In this regard, areas of demineralization may arise. As a result, calcium, phosphorus, fluorine is washed out, the mineral crystal lattice of the enamel is disturbed, and a caries stain gradually appears.

In general, the causes of decay in the neck of a tooth are similar to those that cause normal decay. With improper or irregular oral care, root caries can begin to develop.

Dmitry Sidorov
Dentist-orthopedist
With cervical caries, the transition from initial stage diseases to its deep development.
Cervical caries begins to develop, which goes through the following stages:
the formation of carious areas in the form of small spots;
transition to superficial caries;
the middle stage of development of basal caries;
deep stage of the disease.

It is often difficult to recognize the extent of the lesion. Stages or dentin are difficult to identify. It is difficult for an uninitiated person to see the differences between newly emerging caries in the spot stage and superficial, as well as between medium and deep tooth damage. Take a look at the picture below:
Circled is the initial stage of cervical caries. Very noticeable?
This is because in the border area, where there is a transition to the neck from the coronal part of the tooth, there is a thin enamel, which is slightly mineralized. Improper brushing of teeth or improper care of the oral cavity erases it. Therefore, you should not apply too much pressure to the toothbrush.
The video below shows the technology for proper teeth cleaning:
Thus, the enamel in this place becomes thinner and thinner over the years. And if this area is not properly cleaned, then the bacteria will not be long in coming. It is then that the disease begins to develop in the area of the neck of the tooth.
Many people, already in the initial stage of the root type of lesion, may begin to experience discomfort. These are discomfort, soreness and hypersensitivity of the teeth. They are especially pronounced when eating cold or hot food or getting sweets on a problem area. However, such sensations pass quickly.
Dmitry Sidorov
Dentist-orthopedist
If a person develops cervical caries, treatment of the disease should be started as soon as possible!
But sometimes, cervical caries can develop without any symptoms. Then it can only be recognized visually. At first, it appears as a light spot. When the lesion becomes superficial, pain appears when eating sweet, spicy, cold or hot.
If you visit a dentist, then when examined with a special probe, you can reveal irregularities and roughness in the middle of the spot itself.
What are the symptoms of the disease
When basal caries progresses to later stages, other symptoms of the disease are already added here. It can be pain from chemical exposure or painful sensations from getting pieces of solid food under the edge of the gums. When cold air gets on them, pain may appear.
Self-diagnosis of cervical caries at home is very difficult. In any case, only a dentist can make an accurate diagnosis.
It is possible to determine the root caries in oneself only at a late stage of the disease.
If there are any formations, spots, defects in the area of the tooth neck, then this can mean pathologies such as:
caries under the gum;
other dental diseases - erosion, hypoplasia, etc.;
a type of pigmented plaque.

However, the first option is the most common. And this is the main problem with which people go to the dentist.
Then the doctor can make an accurate diagnosis. And to confirm it, the dentist stains the tooth surface with a special solution. If the stain does not change color, then it is enamel hypoplasia, and not a symptom of cervical caries in the form of a white spot.
Dmitry Sidorov
Dentist-orthopedist
The cervical form of caries usually develops in the form of a single spot.
How to treat cervical caries
If a person has symptoms of cervical caries, how to treat such an ailment? Different methods treatment of such a disease has been used in dental practice for quite a long time.
Treatment of cervical caries does not differ from the treatment of the usual form of the disease. But if you contact a doctor late, you may have to fill and clean the canals.
How is cervical caries treated? Therapy is prescribed by a dentist based on the stage of development of the disease. How used to be a man turned to a doctor, the easier it will be to fix this problem.
Treating cervical caries at home can be used as adjunctive therapy in the spot stage. In such cases, you can apply:
medicinal toothpastes or gels that contain fluorides and compounds of phosphorus and calcium;
dental floss, which is impregnated with fluoride;
rinses with fluorides (these elements very effectively affect the mineralization of tooth enamel).

However, it is worth noting that one should refrain from the independent use of drugs containing fluorides. You should not use them without a doctor's recommendation. All treatment is prescribed by a doctor based on the results of the examination, the stage of development of the disease, the area of enamel damage and possible risks.
Caries treatment can be carried out without resorting to the use of a drill. But in some situations, difficulties can arise here. For example, due to the proximity to the gum tissue, constant leakage of gingival fluid into the working area, or thinning of the enamel. But you should not delay with the treatment of root caries. Therefore, such new technique, like icon, is not used in such cases, since the substances used here are harmful to the tooth enamel.
Caries treatment will be as follows:
It is necessary to carry out anesthesia so that unpleasant painful sensations do not arise.
The affected area of the tooth is cleaned of deposits to reduce the infectious load.
Preparation is carried out - a type of mechanical processing. With its help, carious areas and pigmented tissues are treated.
It is necessary to treat the oral cavity with medicinal antiseptic agents.
Formation of a cavity (in accordance with the selected material) for a permanent filling.
Installation of a seal.

The material for the filling is selected based on the localization of caries. The closer it is to the gum, the stronger the material will be needed so that the filling cannot fly when it is loaded.
The video below will help clarify some points of this article:
Can subgingival caries be cured? Doctors consider such an ailment one of the most dangerous, so it requires an immediate visit to a specialist. This type of caries is detrimental to the tooth, because it can penetrate deeply and affect all canals. Treat gingival caries as soon as possible.

Caries is a serious damage to the teeth, which can be localized in completely different parts of the dentition. An especially serious and severe form of this pathology is tooth decay, which is also called cervical caries. The thing is that this form of lesion is located in the most vulnerable part of the tooth, in which the main parts of the tooth are located. For this reason, the treatment process is rather complicated and may not always be effective. But in any case, when the first signs of this form of carious lesions appear, you should immediately contact your dentist.

The main factors in the appearance of this form of caries are bacteria of the cariogenic species, which are found in dental plaque and in calculus. Bacteria recycle food leftovers, while they convert these components into organic acids. Organic acids cause severe damage to the structure of tooth enamel and cause increased leaching of calcium from its structure.
In fact, each of us has a large number of microorganisms in the oral cavity, but they do not harm until certain conditions are created. Bacteria can change their composition and become pathogenic as a result of poor oral hygiene. Also, this process can be affected by the anatomical features of the enamel of the neck of the teeth.
Some patients may have a predisposition to gum detachment. With poor-quality cleaning of the oral cavity and dentition, all food debris can fall into the pockets, which are formed when the gums are detached at the base of the teeth. Further in these places there is an increased accumulation of pathogenic bacteria, which cause the appearance of cervical carious lesions.

As a result, there are two main reasons for the occurrence of cervical caries:

Poor hygiene procedures;
The presence of an anatomical predisposition.

But in addition to these reasons, there are other concomitant factors that also contribute to the appearance of cervical carious lesions:

Various mechanical damage to the enamel structure. This damage can occur as a result of the use of toothbrushes with a rigid base, as well as abrasive pastes and tooth powders;
Increased consumption of acidic foods;
Use a large number products containing easily fermentable carbohydrates, namely sucrose. During the fermentation process, organic acids are formed, which corrode the enamel;
Lack of vitamins that cause the process of vitamin deficiency, namely B vitamins;
Medicines that increase the porosity of the enamel;
The presence of endocrine dysfunctions. Often, with various endocrine diseases, cervical caries can affect 2-3 teeth;
Pregnancy period.

Symptoms

The main symptoms of the presence of cervical caries are the following factors:

Development features

As well as other types, carious lesion of the neck of the teeth proceeds in several stages. Each stage is accompanied by certain characteristic symptoms.

initial stage

The initial stage or form of a white spot is usually asymptomatic. This type of lesion is difficult to independently determine. When viewed on the tooth, you can not see spots and other defects. In addition, this form is rarely accompanied by unpleasant sensations... True, some sometimes note a slight discomfort, a sore feeling.

Attention! In the period of the initial carious lesion, the enamel becomes thinner, it becomes dull, but at the same time it continues to remain smooth. A small white or pigmented spot appears on the surface, which has no roughness.

Surface form

During this form, the formation of roughness is observed in the places where the spots appear. In these places, the process of destruction of enamel begins. This process may be accompanied by unpleasant sensations, pains that may appear as a result of exposure to any irritating factors. Unpleasant feelings can occur when exposed to cold or hot food or drinks, and they can also appear when eating sour, sweet, salty food or drinks.

Average

The process of damage goes to the dental tissue. As a result, a carious cavity appears. On visual inspection, caries becomes pronounced. With this type of lesion, an increase in unpleasant sensations is observed.

This figure shows the stages of development of cervical caries: initial, superficial, middle, deep and circular caries.

Deep form

Attention! During deep caries, a process of destruction occurs, which penetrates deeply into the dental tissue. In this form, lesions often spread to a large part of the tooth and can affect the canal and pulp of the tooth.

The painful sensations become strong and simply unbearable. Pain can be caused not only by thermal, mechanical and chemical irritants, but it can occur as a result of inhalation of cold air.

Circular

Cervical caries usually affects the buccal (vestibular) and palatal (lingual) surfaces of the gingival areas of the anterior and lateral teeth. In rare cases, a wisdom tooth can be affected.
After a certain period, the pathological process of carious lesions can spread further, while it captures the entire cervical area of the crown in a circle. During this process, a circular carious lesion is formed, which is usually called a complicated form of cervical carious lesion.
This type of caries is considered the most aggressive. In contrast to the cervical type of lesion, it has pronounced clinical signs. This form is dangerous in that during it often there is a breakage or fracture of the crown of the tooth.

Survey methods

At home, it is quite difficult to find out what reason caused the appearance of painful sensations or various defects on the surface of the tooth in the area near the root. This is due to the fact that these symptoms can indicate the presence of various lesions. Dentists say that the appearance of spots, streaks, deformations in the root part of the tooth indicates the presence of various pathological processes:

The occurrence of cervical caries;
Pathologies with a non-carious nature of origin, for example, it can be a wedge-shaped defect, fluorosis and others;
The presence of pigmented plaque, which can appear for various reasons.

Therefore, the dentist can use to determine different methods diagnostics that provide an accurate definition of the diagnosis. Other diagnostic methods are used in conjunction with the clinical examination:

It is important to make a correct diagnosis, because further treatment will depend on this. Also, do not forget that under the cervical caries other pathologies of the deep layers can be masked or the most common complications of carious lesions - periodontitis or pulp.

The difference between cervical caries and wedge-shaped defect

In dentistry, another common disease is distinguished, which is called a wedge-shaped defect. This defect usually occurs on the outside of the tooth and looks like a "V" This wedge can be directed up or down towards the jaw. This defect most often affects the teeth, which, when chewing, experience an increased load - canines and premolars. Many patients confuse cervical caries with a wedge-shaped defect, because these pathologies have the same localization. Therefore, unknowingly, patients may require the same treatment.

This figure shows a wedge-shaped defect of teeth and cervical caries, these lesions can be very similar in appearance, but you should not confuse them, because solving these problems requires a different approach.

In these cases, it is necessary to know the important differences between cervical caries and wedge-shaped defect:

During a wedge-shaped defect, the color of the tooth enamel remains the same, and the place of damage to the V-shaped area acquires a dense and polished structure;
During cervical caries, the damaged area becomes loose, rough. He usually has irregular shape and takes on a dark shade;
The wedge-shaped defect can take years to develop, and cervical caries usually develops rapidly. This type of carious lesion can destroy a tooth in a few months.

Treatment

All types of carious lesions have the same treatment characteristics. However, therapeutic therapy for cervical caries has a characteristic difference - the whole procedure is carried out under the influence of an anesthetic. The thing is that the root area has an increased degree of sensitivity, any effect on it can cause severe pain.

Features of treatment of the initial stage

At the initial stage, when the carious lesion has the form of a white spot, conservative therapeutic therapy can be applied without the use of drilling and preparation. In these cases, remineralization is usually applied. During this therapy, the following actions are carried out:

Cleansing the surface of the teeth from plaque and tartar;
After cleaning, the entire surface is thoroughly polished;
Further, remineralization is carried out using special preparations in the form of a gel. An application with fluoride agents or gels are applied to the surface of the teeth.

In order to consolidate the entire result of restoration of dental tissue, hygiene procedures are additionally prescribed using various means:

Use of rinse aids with a high fluoride content;
It is imperative to use toothpastes that contain fluorides (the average content is from 1000 to 5000 ppm);
It is recommended to use floss containing fluorine;
Additionally, you need to use fluoridated water and salt.

Treatment of cervical caries at the stage of a white spot consists in professional teeth cleaning, polishing, remineralization with a special gel that strengthens tooth enamel.

Superficial stage treatment

During curative therapy In this form, grinding is additionally used, during which the surface layers of caries, namely the affected tissues, are removed. After that, remineralization is done as in the treatment of the first form.

Medical therapy in the last stages of carious lesions

At the stage of the average form of carious lesions, the removal of damaged tissues is performed. After removing the affected areas, the cavities are treated with special disinfectants that kill all pathogenic bacteria. At the end, the cavity is completely filled with special materials.

Important! Deep form carious lesion is the most difficult, and its treatment takes a long time. During therapeutic therapy, the doctor has to remove the pulp, clean the cavity and canals. After cleaning, everything is necessarily treated with special antiseptic preparations. Only after all these procedures, filling of the carious cavity is carried out.

Usually, with a deep carious lesion, the carious area is quite clearly visible, and the doctor has full access to it. But in case of caries in the area of the tooth neck, this access is not always completely open. Often, when mechanical processing of cervical caries, certain difficulties arise, which may arise due to the following factors:

The cavity of this type of carious lesion has an inconvenient location for filling. In addition, the presence of subgingival carious lesions can greatly aggravate this process;
The working area does not have the necessary protection against moisture ingress;
Blood can enter the carious area in the root part, which can drain from the area of the injured gum.

Treatment of deep cervical caries includes several stages: anesthesia - removal of the affected tissue - preparation - cavity formation - filling - grinding of fillings.

Usually, the treatment of a deep stage of cervical caries proceeds according to the following scheme:

First of all, anesthesia is performed. For this, various strong pain relievers can be used. It is important that the pain relief is strong, because this area has an increased degree of sensitivity and small mechanical influences can cause strong painful sensations;
The next step is to cleanse the carious area from various deposits on the surface of the tooth. The main goal of this procedure is to reduce the infectious burden. Also at this stage, the dentist must decide on the filling material;
Next, the preparation procedure is performed. This stage consists in cleansing the affected area and treating it with special antiseptic preparations;
The cavity is being formed. When performing this process, it is imperative to take into account the type of material for filling;
Then the cavity must be treated with a special adhesive. This drug increases the adhesion of the filling to the surface of the tooth tissue;
After that, filling of the cavity is performed. The filling material is applied in layers. Each layer is translucent with a photopolymerization lamp, this is necessary in order for the base to quickly solidify;
At the end, the filling is corrected. At this stage, the filling is grinded and polished. Due to this, it is possible to give the most suitable shape to the filling so that it does not cause inconvenience during the clenching of the jaw.

Features of treatment of an advanced stage

Many dentists recommend starting caries treatment at an early stage, when it is in the form of a spot. But it's not in vain, this form is easiest to cure and eliminate, while not disturbing the structure of dental tissue. If treatment at this stage is not provided, then the pathological process moves on. First, it goes into superficial caries, and then the progression occurs according to the following scheme:

Active destruction of enamel and dentin is observed. During this process, pulp lesions are observed;
Carious lesion becomes a complicated form;
As a result, the development of pulpitis, periodontitis and other complicated forms is observed.

If the entire process of destruction cannot be stopped and taken on time necessary measures in order for caries to stop spreading to other units of the dentition, then ultimately the likelihood of tooth loss increases. For example, if periodontitis is observed, then in these cases the tooth is removed immediately, during pulpitis, the erv is removed, and if the tooth is dead, then, as a rule, it does not last long.

Features of home treatment

But those who are afraid to visit the dentist's office are interested in the main question - is it possible to treat this form of caries at home? Home treatment is possible, but only at the stage when the lesion has the form of a white spot, in other cases, you should definitely consult a doctor for the necessary examination and treatment.
During home treatment the initial stage, you can use special gels and pastes, which contain an increased content of calcium and fluorine. During these procedures, the tooth enamel is saturated with the necessary components, and it is quickly restored. In this case, the development of cariogenic microorganisms completely stops.
For home treatment, you can use the following types of pastes and gels:

PresidentUnique;
Ftorodent;
Blend-a-med Anti-caries.

PresidentUnique is Toothpaste with a high calcium content, is excellent hygienic means, as well as prevention of tooth demineralization and the development of caries.

Also, in addition to pastes and gels, you can use special preparations, for example, Fluorolac or Ikon. Additionally, you need to rinse the mouth with a solution of sodium fluoride and be sure to take drugs with a high calcium content.

Traditional methods of treatment

Cervical caries can be treated with folk methods... Traditional methods can only help at the initial stage of the lesion. As effective means you can use the following herbal tinctures, solutions, lotions:

Gargle with sage tincture. Pour 1 large spoonful of dry sage collection into a glass and pour hot water... Everything is infused for an hour. This solution should be used to rinse the mouth after each meal;
Rinsing with a solution of onion peel... Tediously pour 3 small spoons of onion husks into a container and pour everything with two glasses of water. Everything needs to be boiled, filtered and cooled. The solution should be rinsed out after each meal;
Lotions with fir oil. A cotton or gauze swab should be moistened with fir oil and applied to the affected area for several minutes.

At the initial stage, cervical caries can be treated with the help of folk methods, compresses from oils and solutions, the oral cavity is disinfected and the foci of bacterial development on the tooth enamel are reduced.

Prophylaxis

In order to prevent the formation of cervical caries, several important preventive rules should be remembered:

Regular oral hygiene. Every day you need to brush your teeth with a medium-hard brush and high-quality toothpaste. Cleaning should be done in the morning and evening. You also need to use additional cleaning products - dental floss, brushes;
Proper nutrition, high in calcium, fluoride, phosphorus and other important vitamins and minerals;
It is imperative to rinse your mouth every day with special herbal decoctions and antiseptic agents;
You need to visit the dentist's office twice a year.

Cervical caries is a serious lesion that often causes severe complications. It is extremely important to determine the presence of this form at the very first stage of its appearance. Therefore, you need to visit the dentist once every six months, the doctor will be able to find the initial forms of this lesion and promptly eliminate all its signs.

When cervical caries occurs, many people, instead of running to the clinic as soon as possible to treat a tooth, all delay this undesirable moment. In part, this is due to various conflicting information on the network about the possibility of treating cervical caries even at home (with its initial forms), about the possibility of using remineralizing toothpastes and others. available funds, which supposedly will help to effectively restore tooth enamel and thereby save a person from the problem.

We will talk about where the truth is, and where the myth is, what methods of treating cervical caries are really effective and what can be done at home. And also we will 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 typical 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, the pathology is formed against the background of unsatisfactory oral hygiene and, without timely initiation of treatment, progresses very quickly.

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

On a note

Most dentists are inclined to believe that cervical caries is a rather aggressive form of dental disease, which is caused by a number of factors.

The area affected by cervical caries has an insignificant thickness of protective tissues, and often the enamel is insufficiently mineralized. A tooth consists of a crown, neck and 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 lesion of this particular weak zone often presupposes active destruction of enamel and dentin, up to the pulp (“nerve”) with the rapid appearance of painful sensations characteristic of each stage of disturbance. It is for this reason that cervical caries without timely treatment can turn into complications in a short period of time: pulpitis, periodontitis, etc.

Combined defects. The specificity of the localization and spread of the lesion lies in the fact that often cervical defects "spread" throughout the cervical region, reaching the middle of the tooth crown, going deep under the gum or capturing the contact surfaces with the transition to the so-called circular caries. In such cases, the tooth is covered with caries in a circle, which, without treatment, often leads to a breakage of part or all of the crown.

The photo below shows an example of circular caries of primary teeth:

A feature of cervical caries is also the fact that often the defects are located in the "smile zone". If the sites of destruction are located on the lateral group of teeth, or on surfaces inaccessible to the eye, then most often this does not cause serious aesthetic consequences and experiences, however, short-term pain from various irritants and the risk of caries turning into its complications without treatment is possible.

With the appearance of the cervical (especially in the "smile zone"), serious psychological problems, 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.).

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

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

Superficial cervical caries without timely treatment may cause more varied 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 the cervical caries from the superficial form goes into the medium, and then deep. In this case, pains most often appear from chemical (sweet salty), temperature (cold and hot) and mechanical (when solid food is ingested) stimuli. It is worth emphasizing once again that all pains are of a short-term nature and quickly disappear when the causative factor that causes them is eliminated.

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

Valery, Tambov

Home treatment of cervical caries: reality or myth?

For many people, the very fact of the possibility of treating cervical caries at home makes it possible for a long time not to go to the dentist for professional help (for example, because of children's fears of a terrible toothache during treatment with a drill). Well, the good news for these people is that certain home therapies do make sense.

Cervical caries in the stain stage can be cured at home by long-term use of hygiene products and preparations with increased concentrations of fluorides and calcium to saturate the weakened crystal lattice of the enamel in the area of its discoloration (contraindications are possible). You can, for example, use remineralizing gels, as well as special toothpastes for cervical caries.

However, with such treatment, there are some important points to keep in mind:

Cervical caries and its characteristics are individual for each person: location, depth of lesion, area, enamel structure, etc. Moreover, the carious process in the cervical region (areas) often proceeds against the background of various aggravating factors, which may include poor hygiene oral cavity, age, presence of other dental problems, general health. There is no guarantee that an independent choice at home will take into account all the nuances of not only the oral cavity, but also general, equally important characteristics, on which the success of therapy directly or indirectly depends.

The range of products (drugs) 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 this or that remedy will be so successful that it will not only solve the problem of treating cervical caries in the spot stage in a short time, but also will not cause harm general condition dental health and health with high concentrations of, for example, fluoride (which can be dangerous if used incorrectly).

It is possible to treat cervical caries with conservative methods only in the spot stage. And with what degree of probability can you assume that your cervical defect is caries in the stain stage, and not superficial, medium or deep (or, in general, a disease of non-carious origin - enamel hypoplasia, fluorosis, wedge-shaped defect; or banal dental deposits - pigmented plaque or stone)?

From the experience of a dentist

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

Often, under 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, treatment tactics are reduced to therapy of the tooth canal with the elimination of the infectious process in it. Placing a seal in the cervical region without processing and filling the canal (s) would soon lead to even more serious complications, up to the loss of a tooth.

Popular folk remedies for the treatment of cervical caries

Cervical caries is often accompanied by painful sensations that may not go away for a long time until the cause that causes 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 traditional medicine, there are many ways to temporarily get rid of pain if an appointment with a doctor is postponed for some time due to irresistible circumstances.

Among the popular ways of treating caries with folk remedies are:

Mouthwash infusions: from sage, lemon balm, blueberries, blackberry leaves, mallow herb, knotweed herb, oregano;

Decoctions for mouthwash: from the bark of oak, aspen, tricolor violet, flowering branches of wormwood, valerian;

Roots for chewing: angelica, calamus;

Propolis tincture for gargling, previously diluted with water.

Folk recipe for caries pain

One of the simplest folk remedies for getting rid of caries pain is sage infusion. It is necessary to pour 2 tablespoons of dry grass with half a liter of boiling water, and then insist for about 30 minutes in a sealed container. The resulting product must be drained and rinsed with a warm solution 4-5 times a day, mainly after meals. This will not restore your teeth, but it will give you the opportunity to hold out for some time before going to the dentist for normal treatment.

Relief of pain in cervical caries after using folk remedies is temporary and can even mask serious problems, for example, the transition of cervical caries to pulpitis. Therefore, be careful and try to see a specialist as soon as possible.

Features of filling of gingival defects at the dentist

Cervical caries is one of the most difficult treatment of carious lesions in the clinic.

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

Gluftored;

Enamel-sealing liquid;

Remineralizing gel R.O.C.S. for office use;

Belagel Ca / P, Belagel F;

Remodent;

"Fluorodent";

GC Tooth Mouss.

Treatment of cervical caries in the spot stage by remineralizing therapy includes the following steps:

Professional oral hygiene with cleaning teeth from dental deposits (plaque, calculus).

Application of remineralizing gels or application of fluoride preparations in 2-3 visits at intervals required by the instructions.

Home use of drugs and hygiene products prescribed by the dentist for additional enamel strengthening.

Despite often good overview carious cavity for the doctor and the convenience of approaching it, the gingival location causes many problems in the treatment of superficial, medium 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 ingress into the working field;

the penetration of blood from the inflamed or injured edge of the gums into the working field.

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

Cleansing tooth surfaces from dental plaque;

Isolation of the working field with a rubber dam (rubber dam) if the clinic is well equipped;

Dissection of the cavity with water-air cooling with excision of carious and pigmented tissues;

Formation of a cavity for the selected filling material;

Installation of filling material in compliance with the filling technique;

Filling correction: grinding, polishing.

Among the main modern materials for the treatment of cervical caries with filling are glass ionomer cements (GIC), light-cured composites, compomers and ormokers (organically modified ceramics).

It is interesting

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

Currently, combined technologies are used for filling cervical caries using 2-3 various materials to maximize the positive properties of each and minimize the negative effects. This makes it possible not only to cope with complex clinical situations associated with gingival or subgingival localizations of cavities, but also allows you to return 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 deep cervical caries treatment:

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 they neglect the elementary rules that allow protecting teeth from cervical caries even in those who are prone to developing this pathology.

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

Limit consumption of highly processed, easily fermented carbohydrates (sweets, flour products). This will not only allow you to make healthy adjustments to your diet, but also reduce the risk of tooth decay.

Observe the culture of carbohydrate intake, if it is not possible to completely abandon 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.

Increase the intake of coarse (solid) foods, 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 the nutritional culture of even the ancient Slavs.

As a mandatory procedure, you should brush your teeth after eating. Brushing your teeth before breakfast is practically useless, as plaque begins to form after eating within the first few hours.

Adjust your brushing skills as quickly as possible, either from a dentist (hygienist) or using a training video. The level of hygiene and protection of teeth from cervical and any other caries depends on the correct observance of the cleaning technique for the surfaces accessible to the brush.

Be sure to include dental floss (floss) in the list of hygiene procedures due to their high efficiency against cervical caries that occurs on contact surfaces in the spaces between teeth that are not fully accessible to a toothbrush.

Special remedies that can be used at home:

Toothpastes for cervical caries with fluoride concentration from 1000 to 1500 ppm;

Dental floss soaked in fluoride;

Rinses with fluoride.

Most hygiene products available on the market for protecting teeth from cervical and other types of caries (for example, toothpastes) are safe for the teeth and general health person, 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 extracted teeth, the concentration of fluorides in drinking water in a particular area, general health and the presence of concomitant pathologies, etc., an individual set of tools is selected for a professional and home strengthening teeth and protection against cervical and other types of caries. It can be pastes, gels, and solutions.

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

An interesting video about the features of cervical caries

Causes of tooth decay and effective methods of protection against it