Dental caries from A to Z
Dental caries is one of the most common diseases of the dento-maxillary system, affecting about 80-98% of the population and which is manifested by the gradual and localized loss of dental hard tissue, under the action of several factors, among which we mention:
- non-compliance with oral hygiene;
- increased consumption of foods rich in sugar;
- stress and many other causes that we will detail in the following.
Before the appearance of the actual caries, however, there is a process of accumulation of bacteria that, together with food debris and saliva, forms a thin biofilm known as dental plaque. When you consume foods or drinks with high concentrations of carbohydrates, the bacteria in the dental plaque transform these carbohydrates into energy for their survival and thus acids are produced, which over time destroy the dental layers and thus give rise to caries.
The recommendation of the specialists is to treat dental plaque in the earliest possible stages, because if it is left untreated it increases the risk of caries and serious damage to the tooth structure, which can be manifested by intense pain and the treatment can turn out to be quite a complicated and expensive process. Although the incidence of dental caries is extremely high, this condition can be very easily prevented, provided that oral hygiene is respected and regular visits to the dentist are made.
The structure of the tooth has 4 components, respectively:
- enamel (the hardest part of the outside of the tooth),
- dentin (the less hard part, of bone consistency, below the enamel and cementum),
- the cementum (the part with which the tooth is fixed in the alveolar bone),
- the dental pulp (the soft part of the tooth inside, which contains the nerves and blood vessels).
Dental caries is caused by a number of factors (the most incriminated being bacteria from the oral cavity, poor hygiene, low fluoride intake, diet and smoking) and generally occurs in the back teeth which, due to their flattened shape, are used in chewing food and thus favoring the deposition of food residues in the interdental spaces, which increase the number of harmful bacteria in the absence of proper oral hygiene.
Bacteria in the oral cavity develop rapidly and favor the appearance of acids that destroy the stratuldent. They often arise as a result of improper brushing (it is recommended not to brush the teeth at least 2 times a day).
Also, another possible culprit for the appearance of cavities is gastroesophageal reflux, a gastric disorder in which stomach acids reach the oral cavity and erode the enamel on the inside of the teeth, especially the upper teeth.
Diet is again a major risk factor in the occurrence of dental caries. Foods that stick to the teeth and those with a high carbohydrate content are the most dangerous for dental health. Among them we mention: sugar, honey, jam, chocolate, soft drinks with sugar, ice cream, candies, chips and even bread.
Smokers are also much more exposed to the risk of tooth decay because cigarette smoke decreases saliva production and thus the protection against acids that attack the tooth is decreased. There are studies that also correlate passive smoking with the increased incidence of caries in children.
Saliva secretion is also a problem among people who follow certain medical treatments, such as those based on antihistamines, anti-epileptic drugs, beta-blockers, antipsychotics or in the treatment of radiotherapy. This category of people is much more exposed to the risk of low production of salivary secretion, therefore they must hydrate intensely and have very good oral hygiene.
Although most cases are only treated at an advanced stage, you should know that the dentist can establish a diagnosis of dental caries at an early stage, when the symptoms are not obvious to the naked eye.
It examines both the visible dental surfaces and the less accessible ones by means of dental radiography and thus a more precise diagnosis can be established, so that the treatment is applied as quickly as possible and the results are optimal.
Symptoms of caries
As a rule, caries makes its presence felt quite discreetly, and the symptoms are long awaited, until the moment when it is already in a fairly advanced stage of evolution. Precisely for this reason, it is advisable to periodically go to the doctor's office for a dental consultation.
However, most people reach the dentist only at an advanced stage, when they appear: toothaches, sensitivity to cold, hot or sweet, the breath becomes foul-smelling, the teeth show black, brown or gray colors on certain surfaces, etc.
Such symptoms must alert the patient, who must follow, as quickly as possible, an appropriate treatment. Ignoring them irremediably leads to the advancement of the disease and even the loss of the tooth.
Types of caries
Depending on the stage of development, there are several types of caries, namely:
Caries in grooves and pits (which form on the surface of the tooth with which we chew food);
Caries on smooth surfaces (they form on the lateral surfaces of the teeth);
Caries on the root of the tooth (appear especially in elderly people or those with active periodontal disease, where the gum recedes and leaves the tooth root exposed in the oral cavity);
Secondary or marginal caries (formed between the tooth and filling);
Recurrent or recurrent caries (appear under fillings and are discovered through dental radiology);
The treatment of dental caries differs a lot depending on the stage of development of the dental condition. Thus, a cavity in its early form, so without forming a cavity, can be simply treated by the dentist by applying a fluoride solution that has the role of stopping the tooth decay process, provided that the patient strictly complies the elementary rules of oral hygiene.
If the stage of caries already reaches the lack of substance, that is, the appearance of that so-called hole in the dental layer, the doctor will resort to cleaning the altered and infected dental tissue and will fill this cavity with an obturation, popularly called a filling.
Serious cases of caries, with advanced evolution and deep damage in the dental layer, most likely require a root canal treatment, which first of all involves removing the nerve and sealing the tooth (in order to prevent the transmission of bacteria to the rest of the body), after which we proceed to the procedure to cover the tooth with a covering crown or restore the affected tooth with a simple or reinforced filling.
The filling (obturation) has the purpose of replacing the missing dental tissue and for its realization different types of dental material are used, such as: amalgam (gray-black, metallic), dental cements (the color of the tooth) and composite materials (which are the closest to the properties of the natural tooth).
However, it often happens that the obturation is only a temporary solution, which does not always have its effect, so in these situations it is recommended to restore the dental tissue by inlaying - an obturation made in the dental laboratory (ceramic, composite, gold), which is later cemented to the tooth.
Cases of advanced tooth decay that are left untreated can lead to serious infections of the gums and the underlying bone, both of which support the tooth. These infections can produce, through exacerbation, a dental abscess, which is manifested by intense pain, swelling of the respective area, fever and general malaise, and at this stage the tooth cannot be recovered and there is no other solution than extraction.
Also, the accumulation of excess bacterial plaque can favor the appearance of gingivitis, a condition in which the gums take on a red color, are inflamed, bleed when brushing and are painful.
Some cases of advanced caries can lead to the collection of pus at the base of the tooth root and thus erode the bone that supports the tooth but also spread the infection, which will be treated surgically, by means of a drainage, or rather an incision of the skin or mucosa for to eliminate the collection of pus.
Prevention of dental caries
The first and most effective method of preventing dental caries consists in observing the appropriate oral hygiene, by brushing at least 2 times a day (morning and evening), its correct execution (the brush will be placed at an angle of 45 degrees at the gum level and use movements from the gum down for the upper teeth, from the gum up for the lower teeth and circular movements for the chewing surfaces, without exerting much pressure on the toothbrush).
The second rule of dental caries prevention consists in the use of dental floss and mouthwash, which have the role of eliminating food debris left in the interdental spaces and bacteria left in the oral cavity.
Another golden rule of caries prevention is the diet, which should not be rich in carbohydrate-rich products, such as: whole grains, bread, vegetables, fruits, potatoes, rice or eggs.
And, for the end, I kept what is most difficult to avoid, namely giving up vices, especially smoking, but also excessive alcohol consumption, which affects not only the teeth, but also other vital organs, such as the lungs, liver, kidneys or the heart.
All the measures mentioned above, to which is added the regular consultation with the dentist, can help prevent and successfully treat tooth decay.
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