Dantų kariesas (ėduonis) – tai lėtinis, infekcinės kilmės kietųjų audinių (emalio, dentino, cemento) pažeidimas, kuriam progresuojant vystosi kietųjų audinių demineralizacija ir irimas. Kitaip sakant, dantų emalyje pradeda mažėti mineralinių medžiagų (kalcio ir fosforo), todėl prasideda jo irimas ir danties struktūrose susiformuoja infekcinė ertmė, buitiškai dažnai vadinama „skyle“.
Causes of dental caries
Svarbu paminėti, kad dantų karieso atsiradimui įtakos turi ir įgimti veiksniai, ir paties žmogaus veikla bei įpročiai. Kadangi įgimtų veiksnių pakeisti veik neįmanoma, labai svarbu koreguoti tai, ką galima – gyvenimo būdą, mitybą, burnos higienos įpročius.
Congenital factors in caries:
- The anatomical shape, structure and chemical composition of the teeth – enamel structure, distribution of fluoride in the tissues, areas of tooth retention – deep furrows, pits, irregularly spaced teeth in the dental arch
- Biological and biochemical factors – plaque composition and accumulation site, rate of plaque formation, activity of micro-organisms, intracellular and extracellular polysaccharide content, fluoride.
- Saliva – release rate, buffering capacity, immunological and antibacterial factors.
- Epidemiological and demographic factors – prevalence and intensity of caries in deciduous and permanent teeth. Localization of incipient and established carious cavities. Prevalence and intensity of caries in different age, socio-economic level and ethnic groups.
- Systemic conditions are generic diseases that directly or indirectly affect oral health.
- Local factors: dental plaque, changes in the composition and properties of saliva (viscosity, pH fluctuations, excretion rate), malocclusion.
- Endogenous factors: weak immunity, genetic predisposition, structure and properties of dental hard tissues.
- Exogenous factors: climatic influences, water influences, living conditions, extreme circumstances.
Acquired caries factors:
- Diet – the quantity and frequency of carbohydrate-rich foods consumed, incomplete diets lacking in essential minerals. Fluoride intake.
- Poor personal oral hygiene habits, little or no professional oral hygiene, carbohydrate residues in the mouth.
A model of the interaction of the main etiological factors.
Carbohydrates are food for oral microorganisms. When they break them down, the micro-organisms release acids that dissolve the hard tissues of the teeth, leading to cavities. Poor oral hygiene, such as inadequate brushing, leads to the accumulation of plaque, which increases the likelihood of cavities, bad breath, and loss of aesthetic appeal. In the initial stage, caries can be seen as a whitish spot on the surface of the enamel or in its pits. This is followed by the formation of a cavity which grows larger and reaches the pulp of the tooth.
Symptoms of dental caries
Pagrindiniai dantų karieso simptomai yra šie:
- Toothache;
- Darkened teeth;
- Softened tooth tissues;
- Crumbling tooth enamel;
- Tooth sensitivity in the neck area.
Treatment of dental caries
The first step in the treatment of dental caries is the cooperation between the patient and the doctor, the identification and prevention of the factors influencing the formation of caries. This is followed by a careful clinical examination and the selection of the most appropriate caries treatment. We describe these steps in more detail:
- Identification of caries factors. During the initial visit, it is necessary to find out the factors that may be linked to the development of dental caries. These include the patient’s attitude towards dental care and treatment; his/her habits. During the interview, complaints and medical history are revealed. The presence, nature, duration and stimuli causing the pain are targeted.
- Clinical examination. The clinical examination includes additional tools such as a mirror, a light source and a dental probe. The carious focus is assessed on the basis of visual and tactile criteria: changes due to tooth demineralization (loss of minerals), color changes, enamel clarity, and the condition of the hard tooth tissue. A prerequisite for the clinical examination is the isolation of the tooth surfaces from saliva and air-drying, particularly in the case of early caries. A light source is directed and all surfaces of each tooth are examined. Particular attention shall be paid to the newly erupted tooth surfaces, the distal surfaces of the molars and, in elderly people, to the tooth areas near the gingival margin. In our clinic, the following factors are taken into account when planning the treatment of dental caries: the extent and localization of the carious lesion; the risk factors for caries; the state of oral hygiene and periodontal health; the quality and condition of any other existing restorations; the functional and aesthetic needs; the patient’s occlusion; the patient’s age; and the need for dental treatment.
CLINIC | DPC uses the following methods of caries treatment:
Conservative treatment is used in the early stages of the disease and requires considerable effort on the part of the doctor and the patient. The aim is to stabilize the progression of the disease by promoting the remineralization of the hard tissues of the tooth; to preserve the integrity of the tooth surface. Measures: topical remineralizing agents: fluoride solutions, varnishes, gels. Sealing agents – silants.
Radical treatment is used in the case of active, progressive caries when conservative measures are not sufficient to stabilize the disease. The aim is to remove the damaged, infected and decayed tooth tissue, apply measures to protect the pulp and restore the tooth surface in order to restore the lost functions and aesthetics. Simply put, this therapeutic treatment is carried out by cleaning the carious, decayed cavity and restoring the tooth surface with a filling. Most often, the carious cavity is cleaned using a dental drill. It is worth mentioning that modern caries removal instruments are modern and highly effective, and cavity cleaning with ultrasonic, ultra-fast vibrating devices and laser is also gaining popularity.
