Dentistry. Treatment of dental caries.
Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disease are that acid produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification.
Today the scientists maximize the heredity, state of dental system during eruption and dents development. For example it was noticed that the sixth teeth are destroyed the first of permanent dents as they come through earlier than other (the enamel are not sated the calcium and fluorine from the saliva) and they are cleaned badly.
The first clinical sign of the caries
The first clinical sign of the caries – “the white spot” caused by calcium and phosphate ions loss. For the first time the demineralization is under-superficial and the superficial enamel layers are not defective. The caries forms at the scurf of dental calculus, namely in holes and fissures directly under the points of contact of adjoining dents, at gym edge. At target area it is possible change of color – “the brown spot”. The lesion focus has conical form with base at surface . If the process progresses the enamel is ruined and the hole is formed. After destruction the tooth need restoration .
Fissure caries
Fissure caries is the caries on the location of spot deposit in other words in the holes and fissures. Often this location is affected first of all .
Dentine caries
Dentine caries develops when the caries process extends to enamel - dentine combination . The caries extends in directions and cones with the base at enamel-dentine combination. Dentine reaction depends on the caries development rate. Dentine reaction shows with reactive and repeated dentine and tooth cavity obliteration.
Latent caries
Latent caries is characterized with vast dentine caries in the presence of minimum or total clinical finding of the enamel destruction. More often it becomes apparent under surface of teeth closure . The disease is much extended at the childhood and youth . The probable cause is enamel firmness to destruction as a result of treatment the dents with fluorides.
Root caries
Appears as a result of gum recession. The color of affected area is from light-yellow to dark-brown. This disease is the most typical for ageing people.
Recurrent caries
Development of caries process after sealing.
Recurrent caries
New caries cavities appear on the edges of tooth filling. Repeated or recurrent caries is evidence of the unsuccessful treatment and quality of operative dentistry.
Denunciation caries
Is characterized with acute progressive process, more often in milk-teeth.
Caries of the nursing
This caries is characterized with extended process on the milk cutting-teeth as a result of long influence of sugar-containing drinks given in the mouth from small bottle or cup.
Stabilized caries.
With the favourable conditions this caries becomes the inert course, affected area obtains black or dark-brown color and solid or semisolid consistence.
Diagnostics of caries
Clinical diagnosis
It demands the careful examination of each tooth with the bright lightening . Drying of tooth surface allow discovering of white spot and other initial affections . Latent caries or caries on adjoining surfaces show as grey or black color.
Radiographic analysis
Intraoral radiographic is applied to diagnosis the caries on adjoining surfaces and also latent caries under the surface of teeth closing. Radiographs are also used to find out the caries process on filled teeth.
Remember that caries is difficultly found with ordinary clinical examination. If there are some doubts it is necessary to apply intraoral radiography.
Fiber-optics transillumination (FOTI)
Using this method the bright light can be directed over the fiber-optic light pipe interproximally. Caries on adjoining surfaces is shown as a dark shade. This method is recommended for epidemiological researches, while the inraoral radiographic is more useful to diagnosis single patient.
Individual approach determines the necessity of caries control, repeated visits to stomatologist, decision concerning need the most advanced methods for restoration and orthodontic treatment.
The various tests were elaborated to determine the risk of caries.
They are based on:
• calculation of bacterium concentration in saliva Lactohacilli (Dentoculf LB]
• Mutant Streptococci (Dentoculi SM) saliva test on buffer capacity (Dentobuff)
• tests on the base of social and economical factors
• tests on the base of exciting image of caries expansion and stomatologist clinical conclusion
In consequence of the fact that teeth caries is caused with the number of factors, all above tests provide only a limited success diagnosing the risks of this disease. Dispersal of senses influences negatively on the precision and order of the estimation of caries liability. The doctor's clinical conclusion and current image of caries are the most reliable indexes of the caries.
Microbiology of tooth caries
It is proved that caries of animals doesn't develop even the animals are hold on cariesgenous diet. The cause of caries is not single types of bacterium but the acidities which are the products of vital functions of some microorganisms (hypothesis about nonspecific bacterium fur).
Dentistry in “ON Clinic”
“Arbatskaya” station, 32, bat. 1 B. Molchanovka, Moscow (behind the Cinema “Oktyabr”)
Tel.: (495) 203-4500, 203-4505
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