Like many people, I was afraid of dentists and rarely visited dental offices. But one day such a thing happened to me that now every six months I run to the doctor myself, and my wife doesn’t have to persuade me.
The first time, when I was planning to go on vacation abroad with my son and grandchildren, I didn’t pay attention to the pain in my tooth. In general, my teeth often bothered me, but I managed to relieve the pain with tablets and various rinses. During my vacation, several times my cheek even swollen next to a bad tooth. That is, gumboil appeared, but I still made do with my rinses. During that vacation, the tooth began to hurt so badly that it radiated into the ear and neck. What didn’t I do! But the pills only helped for a short time. When we returned home, swelling appeared on the lymph node near the ear, on the sore side. And all because of fear of the doctor! When the temperature rose, I had to go to the clinic against my will.
As I suspected, it was already useless to treat the aching tooth. Moreover, the infection from the flux caused complications in the ear and lymph nodes, which became severely inflamed. They wanted to put me in the hospital. They thought that they would have to have surgery on the jaw. Thank God, everything worked out. But I had to take antibiotics and undergo serious treatment. It happened that the very next day after the tooth was pulled out, almost nothing hurt. And then the pain after the removal kept me from closing my eyes at night for a long time. My bones ached so much that I climbed onto the wall. I'll tell you how I saved myself.
First, I bought a good toothbrush. Secondly, from the fourth to the seventh days after the tooth extraction, I kept a strong infusion of St. John's wort in my mouth. It relieves inflammation, relieves pain a little and has a wound healing effect. Rinse only sore spot it was impossible. After such an operation, a blood clot forms in the socket, which protects the gums from infection and bleeding. Therefore, any rinsing is strictly contraindicated. All liquid rinses should simply be kept in the mouth, close to the place where the tooth was.
Gradually everything went away, but for another month I took bifid drugs after antibiotics. I had to restore the microflora because the medications upset the balance in the intestines.
That’s how I experienced a lot of grief because I didn’t want to get treatment on time. Now I go and slowly treat all the remaining problem teeth. I am sure that I will no longer bring myself to such a state where the infection spreads from the teeth to other organs.
Anton Dmitrievich
rezeptik.ru
Neglected diseased tooth with fatal outcome
There was such a case: one woman had a severe toothache, but she still could not bring herself to go to the dentist. As a result, she came to him on Friday at the end of the day, that is, having endured until the last. On upper jaw They discovered inflammation, but they were able to hospitalize her only on Monday, that is, 2 days later. But it was too late... The woman died in the hospital. The tooth was so neglected that the infection spread further...
A man died due to a bad tooth. And this happened in the center of St. Petersburg, and not somewhere in the wilderness, where it’s a hundred miles to get to the dentist. You have to bring yourself to such a state! But this is an out of the ordinary case, you say. Nothing like this! The city clinic on duty in one night hospitalizes the same number of patients with the same inflammation as they operate throughout Finland throughout the year.
Teeth are very close to vital organs
Just imagine how close your teeth are to other vital organs: the brain is nearby, the heart, and your mouth is also directly connected to the stomach and intestines... You understand where all the infection from the mouth goes straight...
Bad tooth... What not to do when you have a bad tooth
Too often events develop approximately according to this scenario: a person has a toothache, he walks around, sighs, puts garlic on the side that hurts, takes a pill, rinses his mouth - nothing helps... I suffered for a couple of days and the pain went away. The tooth collapsed, broke, and God bless him. And the fact that the roots remain in the gum will come out on its own.
And he thinks that he has outwitted everyone, but you can’t outwit your body. Where a diseased or broken tooth is a constant source of infection. And the body fights with it and waits for the owner to help, but the owner doesn’t care.
Consequences of an undertreated tooth - unpredictable complications
The body throws all the reserves accumulated to protect against any illness into the fight against this unfortunate tooth. Then a person catches a common cold, flu or something more serious, and a new infection instantly knocks him down and gives terrible complications, because the exhausted body is not able to fight on two fronts.
A sick tooth should be treated, not pulled out.
“The teeth are not in order” means not only that they are sick, but also the absence of some teeth. Very often, having suffered to the point of insanity, people run at night to the on-duty clinic to pull out a hated tooth, and if it is not one of the front ones, and the hole is not visible, they part with it without regret. Generally speaking, this is barbarism.
The Lord God gave us 32 teeth for a reason. Let's say your finger starts to hurt, you don't want to cut it off! But you have as many as 20 fingers, a little less than teeth.
You must understand that tooth extraction is the same tragedy, the ultimate measure. Do not bring the matter to the dentist on duty. Now there are ways to cure and preserve teeth that were previously unconditionally subject to removal. And if you have had teeth removed before, it doesn’t matter whether they are visible when you smile or not, do not rest until you have restored the entire dentition. Consult your doctor, calculate your budget, solve this problem step by step, but remember, until you do this, you will not be completely healthy.
Bad teeth should be treated as early as possible
Those traditions are still alive when teeth are put in order for a vacation, holiday, or wedding. Shakespeare was truly right - “The world is a stage, and the people in it are actors.” How we love to work for the public! But you live and chew every day, and it would be nice to be healthy and full of strength every day in order to achieve success and please yourself and your loved ones.
Healthy teeth for the birth of a child
I remember one amazing incident. I once treated a woman, she really had a lot of problems, she needed to restore her teeth, put crowns, and so on, and when everything was ready, she looked at herself in the mirror, smiled and said: “Now I can have children.”
I was dumbfounded and asked: “What is the connection here?” She replied: “Well, don’t you understand, I will be able to smile at the child when he is born, the first thing he will see will be his beautiful mother.”
I later learned that before the birth of her son, she destroyed all her old photographs and videos. As you can see, the matter can also concern such matters as fate and happiness.
How to evaluate and check the work of a dentist?
center-vita.ru
Many people feel fear when meeting a dentist, and try in every possible way to postpone dental treatment “for later.” They drink painkillers, prescribe themselves anti-inflammatory therapy and are happy that the measures taken are producing results - the tooth ceases to remind itself of acute pain. But, believe me, this is a temporary result.
Only a dentist can cure teeth, and no herbs, pills, spells, pieces of lard applied to the tooth will help. Teeth are an integral part unified system, entitled human body. If a person has problems with teeth, he cannot be called healthy. Even if a person pays attention to his health in general, but excludes dental prophylaxis. The key to health is healthy teeth! Throw away your fear of dental treatment, because modern dentistry means dental treatment without pain!
We have already said more than once that, for example, neglected caries can cause gastritis, stomach ulcers, etc. A huge “army” of bacteria accumulates in a tooth affected by caries, which gradually poison the entire body with their toxins, undermine immune system. These facts should not be forgotten when it comes, first of all, to children.
Dental treatment for children at the Lavater dental clinic is absolutely comfortable and painless. However, not all patients consult a dentist at the stage of dental caries. 70% of our patients come for an appointment already when they require root canal treatment. 10% percent of patients come to initial stage caries and, unfortunately, only 10% regularly, every six months, undergo a medical examination and have professional dental hygiene done by a dentist. Even more regrettable are those patients (but fortunately there are very few of them) for whom it is no longer possible to save the tooth and only removal is indicated. Such patients just put off visiting the dentist for a very long time “for later.” The most dangerous thing about an unjustified fear of a dentist is that if the infection covers a significant area of tooth tissue, purulent inflammation occurs, a cyst can form, and even blood poisoning is possible.
If you do not treat your teeth until they are destroyed, then due to the absence of one tooth or several teeth in the dentition, thinning will occur over time bone tissue. And if the patient subsequently decides to undergo dental implantation, then such a problem as lack of bone to install the implant will significantly complicate the installation procedure, and the cost of the implantation operation will accordingly increase.
If children’s milk teeth are not treated, then the milk teeth will be replaced by the same “problematic” permanent teeth. And even if the child does not complain about his teeth, and you yourself do not see any problems with the teeth during examination, you still definitely need to visit pediatric dentist. Only a doctor will be able to “catch” caries in the very early stages, identify orthodontic problems and send for consultation to related specialists.
Draw your own conclusions: the financial costs of regular preventive care and timely dental treatment at the Moscow dental clinic “Lavater” are significantly lower than the cost of treatment, implantation and dental prosthetics.
www.lafater.ru
Causes of tooth decay. How to stop him?
To spend adequate treatment, the doctor must first determine the cause of the disease. Otherwise, the measures may turn out to be useless, the process will continue to develop. The causes of tooth decay are external and internal factors. Despite the fact that enamel is considered one of the most durable materials in the body, under unfavorable conditions it quickly deteriorates. As a result, microbes gain unhindered access to the inner, less protected part of the tooth.
To cope with this problem at the initial stage, one visit to the dentist is usually enough. He clears the cavity of affected tissue and closes it with a filling. However, banal neglect of one’s health, fear of dental office causing people to postpone their visit. The result is deterioration of the teeth and their loss.
When is a person to blame for having bad teeth?
Experts identify a number of causes of tooth decay, for which the patient himself is to blame. Knowing them, you can take timely measures to prevent the development of the disease. These reasons include:
- Smoking. Components released from tobacco disrupt metabolic processes in the tissues of teeth. Due to this, their ability to resist adverse effects is sharply reduced.
- Alcohol, drugs. They negatively affect the functioning of the entire body, worsen it protective functions, ability to recover.
- Poor nutrition. Lack of minerals and vitamins in food leads to weakening of the enamel. An excess of sweets, sour fruits, and berries contributes to the destruction of enamel.
- Unhealthy Lifestyle. Absence physical activity, constant presence in dusty rooms, abuse of fatty, fried foods reduces the body's protective functions.
In addition, lack of or improper oral hygiene contributes to the formation of plaque. It becomes a source of food for microorganisms that gradually destroy teeth.
Negative factors beyond the patient's control
If a person does not smoke, engages in debate, and watches his diet, why do his teeth begin to rot? There may be several reasons for this:
- Bad ecology. Polluted air, poor quality water, an excess of some and a lack of other important components. Fluoride deficiency is often cited as the cause of dental problems.
- Heredity. If the parents had bad teeth or the mother did not visit the dentist during pregnancy, children often experience similar problems.
- Physiological features. Hormonal imbalance in adolescents during the growth period, in pregnant and lactating mothers.
Tooth decay is often a consequence of other diseases. Problems with periodontal tissues - gingivitis, periodontitis, periodontal disease - lead to the development of caries and cause tooth loss. If a purulent cyst forms near the root, the infection quickly spreads to the tooth. Often the deterioration of the condition of teeth is caused by diseases of the stomach, intestines, and thyroid gland.
Characteristic symptoms and stages of disease development
Dental problems manifest themselves in different ways. It depends on the degree of damage, the sensitivity of the body, and the number of problem areas. Tooth decay does not occur in just one day.
Dentists distinguish several characteristic stages, which are characterized by certain symptoms:
- Unpleasant smell. At first it is not too noticeable. Gradually, even during a conversation, the interlocutor feels a putrid “aroma”. Its source is pathogenic bacteria. They inhabit plaque that forms at the point of contact between the gum and tooth.
- Stains on the enamel. This is the next stage of the disease, when the damage spreads deeper and damages the enamel.
- Black areas. If they are located on the root, it is very difficult to notice them. To clarify the extent of the damage, an x-ray is taken.
- Formation of the cavity. A cavity forms in place of the black spot. Through it, food debris gets to the inside of the tooth. The tooth actively “signals” about the problem with painful sensations, reaction to hot and cold.
- Pulpitis develops. By not consulting a doctor in time, the patient allows inflammation to reach the pulp. Soft tissues containing blood vessels and nerves undergo rotting. It is accompanied by sharp, unbearable pain.
The decay process ends in different ways. If it starts from the top of the tooth, it gradually spreads to the root. After the nerve dies, the pain intensity decreases. If decay affects the root first, the tooth may fall out or have to be removed.
Why do teeth rot at the gums?
Caries near the gums and on visible parts of the tooth are no different. The reasons for its occurrence are the same, but near the gums it is more difficult to identify and treat the disease. Therefore, patients usually consult a doctor at the stage of progressive pulpitis.
Timely detection helps prevent the development of caries in the gingival region. To do this, you need to periodically visit the dentist, who will correctly assess the condition of the enamel and detect the development of caries in time. Common cause Experts call its occurrence gum disease. Food debris that accumulates in the gum pocket promotes the development of bacteria. In addition, the disease can be caused by an incorrectly installed crown, poor hygiene, or changes in the composition of saliva.
What to do with a tooth that has rotted to the root?
If the root has rotted and therapeutic measures do not give results, the tooth has to be removed. Loss of the upper part leads to the development of pathologies:
- the appearance of a cyst at the root apex;
- fracture or dislocation of the root;
- injury to the gums from a splinter;
- periodontal diseases.
A rotten root becomes a source of infection, which spreads to nearby tissues.
In any case, the doctor chooses the treatment. If there is a high probability negative consequences, will be deleted. To avoid this, it is recommended not to skip periodic dental checkups.
A child’s teeth are rotting: to treat or not to treat?
Rotten teeth are in most cases a problem for adults. However, this process can affect baby teeth. Moreover, the path from the appearance of a small spot to a severe stage passes very quickly. The reasons for this phenomenon are the same as in adults. At the same time, we can identify characteristic factors that have a negative impact on children’s teeth:
- excessive love for sweets;
- insufficient oral hygiene;
- mother's dental problems during pregnancy.
It is impossible to stop rotting at home. You must contact your dentist immediately.
Caries on baby teeth
As a result of long-term research, scientists were able to identify the main cause of caries in baby teeth. It becomes: microorganisms transmitted to the child from the mother. Streptococcus gets to the baby through a kiss, through a pacifier licked by the mother, or shared cutlery. Microbes come from other people through these same routes. When teething, babies are especially vulnerable to streptococcus. In addition, lack of oral hygiene, poor diet, and the composition of saliva have a negative impact.
Dentists note that regular use of baby formulas from a bottle with a high carbohydrate content creates ideal conditions for the development of bacteria. Reduce them negative influence Getting your baby used to a cup and rinsing his mouth after eating helps.
zubz.ru
What can happen to teeth if they are not treated?
Caries
The most common dental disease is caries and many consider it not very dangerous. Therefore, even with characteristic damage to bone tissue, a visit to the dentist is postponed in the hope that the development of caries will stop and the pain will disappear. Meanwhile, any disease, if left untreated, tends to harm the entire body and lead to the development of other diseases.
advanced caries The causes of caries are not fully understood, however, it has been established that due to insufficient oral care, a soft plaque appears on the enamel, which is a favorable environment for the development of various pathogenic microorganisms.
The waste products of harmful bacteria soften and corrode the enamel, which is the beginning of the carious process.
Toxins released by bacteria actively multiplying in the affected tooth gradually poison the entire body, which leads to many associated painful conditions, such as gastritis, runny nose, and sore throat.
Symptoms of caries development are:
- The appearance of a whitish coating on the enamel, which gradually darkens.
- The enamel becomes a little rough.
- Emergence pain when eating sweets, cold and hot foods.
Caries itself develops in stages, gradually leading to tooth loss:
- Fissure stage, during which the enamel is slowly damaged (fissures are natural depressions in the enamel). At this stage, caries is quite difficult to diagnose; a special dye is used to identify it. With timely diagnosis, remineralizing therapy is prescribed to prevent enamel destruction.
- Superficial caries. Brown or black spots appear on the outer shell, and a yellowish coating is actively formed. Penetration into the internal tissues has not yet occurred, however, corresponding pain sensations are already arising.
- Average caries, characterized by an increase in dark spots, an increase in the intensity of pain symptoms.
- Deep caries. The disease penetrates the hard tissue, dentin, causing danger of nerve damage. Treatment requires installation of a filling.
The consequence of advanced caries in last stage may become pulpitis, i.e. inflammation connective tissue tooth cavity.
Pulpitis
From the surface layers of the tooth damaged by caries, microorganisms and their metabolic products begin to get inside and cause inflammatory processes in the pulp, tissues with a large number of lymphatic and blood vessels, nerve endings. This inflammation of internal tissues is called pulpitis.
acute pulpitis on the left and chronic on the right The disease has several varieties:
- Acute forms a, characterized by the occurrence of acute pain under the influence of any irritant: hot and cold drinks, sweets, etc. When the action ends irritating factor, the pain disappears.
- Purulent pulpitis, is caused by the formation of a focus of infection directly in internal cavity. The pain is extremely intense and intensifies at night. Lack of treatment can lead to connective tissue necrosis.
- Chronic form, replaces acute manifestations of the disease, pain lasts longer than with acute pulpitis and occur much more often.
- Pulp necrosis, complementing untreated pulpitis, provokes the penetration of pathogenic organisms into the internal canal, and from there into the jaw tissue. The resulting inflammation is called periodontitis.
Periodontitis
As a result of pathology, the integrity of the tissues that support the tooth is compromised.
traumatic periodontitis Symptoms of periodontitis are:
- Pain when pressing on the tooth while chewing; painful pulsation may occur, covering the entire face.
- Fatigue, fever.
- Soreness of the chin and submandibular lymph nodes, swelling of the gums.
- The appearance of pus from the dental canal.
- Swelling of the face.
Granuloma
This disease is characterized by the appearance of purulent nodules near the root of the tooth. Such nodules are a serious source of infection and often catalyze various inflammatory processes. At first, the granuloma is almost invisible.
Later, pain occurs, the gums swell and the enamel takes on a darkish tint.
In addition to a permanent focus of infection, granuloma causes a complication in the form of the formation of a root cyst.
Cyst
The root cyst consists of purulent contents and is located in the bone tissue. The development of the disease occurs slowly and rather inconspicuously. A cyst can be visually identified only when it grows strongly, leading to protrusion of the bone.
Enlargement of the cyst makes it likely that it will grow into lower cavity nose or maxillary sinuses. In the absence of treatment or the dentist's dishonesty, periodontitis, pulpitis and root cysts can cause inflammation of the periosteum - periostitis.
Periostitis
Inflammation of the periosteum occurs due to infection due to dental diseases and physical damage to the jaw tissue. Periostitis can also begin due to infection through the lymphatic and circulatory system body.
Symptoms:
- Swelling and swelling of the gums, constant severe pain.
- General malaise, fever.
- The appearance of an abscess causing swelling of the cheeks, lips, infraorbital or submandibular area.
Distinguish different types periostitis:
- Simple, characterized by moderate pain and easy to treat, can develop into chronic form– ossifying periostitis;
- Fibrous, which occurs with prolonged irritation of the periosteal tissue. Appears gradually, causing moderate swelling;
- Ossifying, a fairly common form caused by prolonged irritation. Characterized by the proliferation of bone tissue in the area of inflammation.
- Purulent, with acute manifestation, rapid swelling and pain. The periosteum can quickly swell and disintegrate, causing the appearance of pus on the soft tissues, which can trigger the appearance of phlegmon.
Abscess
The accumulation of pus in a confined space, which can destroy bone tissue in the affected area. Characterized by severe and very painful swelling. If the abscess does not open for a long time, the abscess can spread to the mucous membrane and periosteal tissue.
One of the most dangerous forms An abscess is a phlegmon characterized by infection entering the body.
Phlegmon
Unlike an abscess, phlegmon has no boundaries of distribution. From the affected area, pus begins to spread throughout the surrounding tissues and can reach other internal organs.
Signs of phlegmon are:
- swelling of the gums, pain in the affected area;
- difficulty swallowing;
- headache;
- decreased performance, sleep disturbances, decreased appetite;
- elevated temperature;
Cellulitis is very dangerous due to its widespread distribution purulent inflammation. May cause sepsis and lead to significant complications.
Sinusitis
Various infectious diseases oral cavity can cause sinusitis - inflammation paranasal sinuses nose
Symptoms of this disease are:
- discomfort in the nose or above the eyes, headaches;
- difficulty breathing through the nose;
- nasal congestion;
- temperature increase;
- sore throat, frequent sneezing;
- pain when bending the body forward;
- fatigue, loss of appetite, sleep disturbances;
To treat sinusitis, antibacterial and antiseptics, as well as vasoconstrictor drugs.
Tooth loss
Absence timely treatment, failure to comply with oral hygiene rules often leads to tooth loss.
This has a number of negative consequences:
- Imbalance of the entire dentition.
- The efficiency of chewing food deteriorates, which affects the digestion process.
- Gradually, curvature of adjacent teeth and changes in bite may occur.
- It is possible to change the shape of the face.
- The possibility of developing diseases of the periodontal tissues increases.
Due to this, dentists are reluctant to remove a tooth, even if it does not feel anything due to the destruction of the nerve. To restore the dentition, dental prosthetics are widely practiced.
The absence of teeth leads to the onset of atrophic changes in the maxillofacial area.
Bone atrophy
Tissue reduction begins after tooth loss and atrophy is most active in the first 6 months after removal. This can complicate the installation of the prosthesis, so do not delay the restoration of the dentition.
To restore bone tissue, appropriate procedures are used to build it up.
If this is neglected, a number of undesirable consequences may occur:
- change in speech;
- violation of chewing function;
- loss of other teeth;
- the occurrence of cosmetic changes in the structure of the face, the appearance of wrinkles, hollow cheeks, changes in bite, sunken lips, etc.
Prevention
Do not exhaust yourself with toothaches and oral diseases.
To prevent dental disease, you should adhere to several rules:
- Be sure to visit the dentist once every six months for preventive examination and hygienic cleaning.
- If pain or damage to the integrity of the enamel occurs, immediately consult a doctor to localize the damage.
- Brush and floss your teeth regularly.
- Get rid of these bad habits how to crack nuts with your teeth, chew pencils and pens, and bite threads.
Healthy teeth - distinguishing feature successful and attractive person. Beauty, social status, and health directly depend on the condition of the oral cavity, so do not neglect taking care of your teeth.
Caries white spot Floss dental floss Medical mouth rinse
So, if you have one or more roots left after a tooth extraction operation, or for some other reason (short crown, caries, simple fight), then in such cases it is necessary restoration of tooth roots.
“So, what to do in such situations?” - is spinning in your head. The answer is very simple and cannot be delayed: urgently call your dentist or any dental clinic your city and make an appointment with a dentist. If you are worried about severe pain, then in this case you can be seen out of turn and without an appointment.
The doctor will examine you and take an x-ray to rule out or identify a cyst, destruction, inflammation, etc. and only then will he tell you his verdict. If everything is fine with the root of the tooth, there is no need to rush to remove it. Nowadays doctors use Newest technologies and many doctors with high levels qualifications that can restore the roots of your teeth without any problems. First of all, you will need to restore the root, and after that you can start building up.
Dental diagnostics is a very quick procedure; literally within half an hour the doctor will tell you everything about your teeth. And here restoration of tooth roots will take enough for a long time and of course costs. Initially, at your doctor’s appointment, you should definitely tell him about your allergies, pregnancy (if any), about your health, in general. All these precautions are very important both for you and for the doctor, so that during any procedure you do not encounter unexpected reactions from your body. After talking with your doctor, be sure to consult with him about the best materials to use for restoration. He will be able to advise you both the manufacturer and the product itself because he already knows it like the back of his hand. He knows what is easier to work with, which is important for the doctor himself. The most important thing when choosing a material is its hardness; it must be hard and moisture-resistant.
Currently, in dentistry, with a large selection of different materials, you can individually select those materials that will be suitable specifically for you in your situation. The simplest and fastest, which is why it is in demand, is the insertion of anchor pins; they are made of a special anti-corrosion alloy, which differs in length and diameter, and from more than twenty varieties it is much easier to make right choice. With the help of such pins, root restoration occurs quickly and efficiently, and the most important thing is that you follow preventive measures and consulted a doctor on time.
Today I want to continue presenting to you my own clinical cases, on the example of which some details of endodontic treatment can be more clearly understood.
In one of the previous posts, I showed one of the main reasons for the development of chronic inflammation in the bone tissue around the tooth root, namely, canals missed during primary treatment. Today I will show 2 more cases, approximately similar, when I had to deal not only with errors during the initial root canal treatment, but in addition to this, with an incorrectly chosen technique for restoring “dead” teeth.
Case one. Quickie...
A patient approached me with a request to try to “save” the lower 6th tooth from removal. This is what it looked like in the mouth.
The blue arrow shows the anchor pin showing through the composite filling. Black arrows indicate violations of the fit of the filling to the tooth. The patient often notices the problem only when there is a “hole” in the tooth, or when the tooth is completely falling apart. Such fillings, which at first glance last for several years, are no less dangerous because microflora from the oral cavity can penetrate through the cracks for a long time without any symptoms into the tooth and root canals. This is exactly what happens formation of granulomas and cysts at the tops of the roots.
What do we see here? Well, firstly, the tooth anatomy is completely absent. The huge cavity is plastered over (there’s no other word for it) without the slightest attempt to create on the tooth the surface relief necessary for chewing with tubercles and grooves between them. The anchor pin shines through the material, which is designed to hold this “slap” inside the tooth. Secondly, along the edges of the filling there is noticeable staining of the border, i.e. The filling has long been leaky, which means that the microflora of the oral cavity leaks inside, causing relapse of caries and an inflammatory process in the bone tissue around the root. Thirdly, we can see only 2 preserved walls of our own teeth, which are also quite thinned. Considering that the tooth has been dead for a long time, the restoration method clearly chosen was unsuccessful. And at the same time it was executed very poorly. The fact is that our chewing teeth experience quite serious loads when chewing (according to various sources, about 100 kg per cm 2), and the remaining tonic walls can crack at any moment. Often the crack goes deep under the gum and eventually the tooth has to be removed. Therefore, if a tooth is pulpless and has significant damage (as in our case), then it must be restored with a crown. Only in this case will you be insured against any unpleasant surprises. But for this tooth this is only half the story. There was no less problem inside.
On x-ray tooth we can discern several main problems. The red line outlines the outline of a bone tissue defect caused by chronic inflammation. The white dotted line shows a void in the canals that were not adequately expanded and sealed. The white arrow marks the position anchor pin, “strengthening” the filling. You can see that this pin only enters the canal a few mm, and therefore does not serve the function of holding the restoration. IN in this case It is not clear who is “strengthening” whom; rather, the seal is holding the pin. And finally, a pink arrow marks a filling hanging over the gum, which leads to food getting stuck between the teeth and gum inflammation. In general, a whole bunch of medical “jambs”.
This X-ray image shows primarily “empty” root canals and quite large sizes a focus of inflammation (what is often called a granuloma, a cyst) at the apex of one of the roots. In general, a whole bunch of mistakes and imperfections were concentrated in one tooth; in a word, this is an example of the dentist’s dishonest work. I always try to speak well of my colleagues or remain silent, but in this case we have to face the truth - it was the dentist who ruined the tooth. Initially there were no objective difficulties for high-quality work here. But now they have appeared. The future prognosis for such teeth is always based on 2 main problems - how successful canal re-treatment will be and how successful will be the attempt to adequately restore the tooth after that. Having assessed the likelihood of long-term success of these two components, you can decide whether to “save” the tooth from the surgeon’s forceps. After all, in any case, treatment costs money, and it is impossible to guarantee the result. One can only guess the likelihood of success. In this case, the channels did not appear impassable. And it was still possible to restore the tooth with a crown, even despite the high degree of destruction. Therefore, the decision was made to begin treatment. To begin with, the anchor pin was removed from the canal using ultrasound.
Then, not without difficulty, all 4 canals of this tooth were processed.
A control x-ray was taken immediately before filling.
This is what the final result looks like in the picture.
The canal treatment protocol in this case is standard, and is described by me. The first part of the rescue task was completed. Now this tooth will be under observation for 3-4 months. After this period, a control x-ray will be taken, which should show how successful our attempt was save a tooth from extraction, namely, we expect a decrease in the focus of inflammation around the root. If this trend is clearly noticeable, only then will it be accepted final decision about tooth restoration with a crown. And next in line for this patient is the “twin” neighbor of this long-suffering 6, the 7th lower tooth. What can I say?.. Recognizable handwriting of the previous doctor.
Case two. About the benefits of computed tomography in root canal treatment...
In the second case, everything started out quite similar.
In this case, everything is like a carbon copy, although this is a different patient. Here it also shines through (and actually sticks out) (indicated by a black arrow). And despite the fact that the filling holds quite securely in the cavity and does not think of falling out, it has long been leaky, as evidenced by the staining of the border between the filling and the tooth (blue arrow) and the general darkening of the tooth. As in the first case, this leakage leads to the penetration of microflora into the tooth and the development of granulomas on its roots.
The same leaky seal, the same anchor pin... at the same time hard tissues saved much better than the first case. Along the entire perimeter of the tooth, the cavity boundary is located above the level of the gum, which means that at least the prognosis for the longevity of the restoration will be quite optimistic.
After removing the old filling and anchor pin, you can see what is happening inside the tooth under the apparently good filling.
In the photo immediately after removing the filling and removing the anchor pin the reason for the darkening of this tooth is visible. In the canals, in addition to the filling material (orange-colored gutta-percha), there is a noticeable large amount of “dirt” that has seeped into the tooth for a long time through a leaky filling. However, the patient was not bothered by anything. Therefore, it is important that even if you do not have any symptoms, you show your teeth to the dentist at least once a year. Then you can avoid serious problems. Also, this situation is clear evidence that if the tooth remains standing for many years after treatment, does not bother you, and the filling has not fallen out, then this is not a reason to think that the treatment was carried out efficiently.
As for root canals, this is where the main difficulties were. Both canals were not very well processed and sealed, as a result of which marks appeared on both roots. granulomas.
This image also clearly shows the defects of the previous treatment. The black dotted line shows the outlines of the two roots of the problem tooth, the red line shows the untreated and unfilled areas of the root canals, the blue line shows the boundaries of the inflammatory process in the bone tissue.
But a regular X-ray produces a flat, 2-dimensional image, with different structures superimposed on each other, and the complex anatomy of the canals cannot always be seen. Which is what happened in this case. One of the channels had a double bend. During the previous treatment, the doctor, for some reason, was unable to see and pass this bend, but rested against the walls of the root, creating the so-called. "step".
This figure shows a diagram of the formation of a “step” - one of the most unpleasant complications in endodontics, which a dentist can do with his own hands. The blue arrow shows the true direction of the tooth canal. The red arrow shows the straight part of the canal that the doctor was able to process with instruments. The green arrow shows that very “step”, i.e. the dentist loses the true direction of the canal and creates an artificial passage. At re-treatment the instrument, as a rule, also rushes along the most straight path and getting back into the bend of the natural canal in order to completely process it is very problematic.
It's pretty unpleasant complication, because during repeated treatment, it is very difficult to “feel” again the real course of the natural canal. Without this, it is impossible to count on the success of treatment. Imagine that you need to feel, with your eyes closed, thread the thread into the smallest eye of the needle... In this case, the eye of the needle is located deep in the channel with a diameter of only 1-2 mm. This is approximately what the endodontist encounters every time in such cases. Solving such problems requires great skill, good equipment, spatial thinking, a fair amount of patience (and on the part of the patient too), well, and a bit of luck.
In this case, in order to more clearly imagine what structure each channel has, we made computed tomogram(CT) of teeth. Thanks to this method x-ray examination We have the opportunity to trace in 3 dimensions the structure of any part of the dentofacial system, incl. and root canals. In our case, we got the following pictures.
A tomogram allows you to “split” a tooth into parts and look at each root separately, and unlike a conventional x-ray, we can examine any structure in detail, since there is no overlap of different formations on each other. This is the palatal root of our tooth shown separately. And in this picture, its “trickiness” is now visible in all details - a double bend in the middle, which became a stumbling block during the previous treatment. A dark halo around the root apex is a granuloma around the palatal root.
Now we see the buccal root separately. It does not stand out in anything special. A regular straight root with the same straight canal. However, it was also not adequately processed, and we also remember that the seal was leaking. Therefore, as a result, there is also inflammation at the apex in the form of a dark halo.
This is another projection of the same tooth. Since the tomogram gives us a 3D image, we can look at the tooth from any side. In this case, it’s as if we cut it lengthwise into 2 halves, but in a different plane. And now we can clearly see the tooth cavity with two diverging canals.
After this, it became clear in which direction the tools needed to be bent in order to find the “eye of the needle” of the real channel. This is what the tools looked like after several attempts.
This is only half of the pile of tools that eventually had to be thrown away. This is a clear demonstration of why complex repeat endodontic treatment This is so time- and resource-intensive, and, accordingly, why it is so expensive.
But the main thing in all this is that if you manage to save your natural tooth from removal, then it’s worth it. Because with all the advancement of implantation technologies today, the coolest and best “implant” is your own tooth. And therefore, it is not surprising that many patients are willing to preserve their teeth, despite the fact that the cost of canal retreatment and subsequent tooth restoration is comparable to the cost of installing an average price category implant.
This picture shows how, after many attempts, we managed to find the true course of the channel. The red arrow shows the same "step" in the channel, which we managed to bypass and where the tool initially rested.
Photo of an absolutely clean tooth cavity after thorough washing, first of all, with sodium hypochlorite (“bleach”) and ultrasonic cleaning. Now the canals are ready for filling.
Final photo after completion of treatment. Both canals are sealed to the apex. The whole process took about 2.5 hours (for 2 visits). Now all that remains is to wait for the inflammatory process to disappear.
In this case, from an endodontic point of view, everything ended well for the tooth. In the future, after about 3 months, a control photograph will be taken to ensure the effectiveness of the treatment. Namely, we will wait for a decrease in the foci of the inflammatory process in bone tissue, i.e., simply put, dark spots around the tops of the roots should become smaller. In this case, such a tooth can be safely restored and count on its long service life.
This is what some look like errors and ways to eliminate them in root canal treatment. And here it is easy to notice that it is much simpler and cheaper to primary treatment prevent punctures rather than correct them later.
One of the most complex cases that the dentist may encounter is the detection of a root crack, which can present difficulties in diagnosis and in further treatment. There are several clinical and radiological signs on the basis of which a clinician may suspect this type of pathology.
The prognosis of treatment depends on many associated factors. For example, incomplete vertical fractures, cracks in the roots of teeth occur under the influence of strong chewing load, trauma, as well as during fixation of pins or inlays for tooth extension. A crack can only be detected through a thorough examination of the tooth using a magnifying glass or microscope. After a few months or years, the cracks may develop into a complete vertical fracture, which will lead to undesirable consequences. It should be borne in mind that microorganisms constantly leak through the resulting defect, leading to the resorption of bone tissue, which in the future can significantly complicate or make implant installation impossible.
IN clinical practice Most often, vertical cracks of the tooth root occur. The highest percentage of tooth root cracks occurs in teeth that have previously undergone endodontic treatment. But sometimes they also occur in an intact, previously untreated tooth. The crack can pass through either one or both walls of the root. For example, in molars, the crack/fracture line most often follows a buccolingual direction. The mesio-distal direction is less common. In the area of the anterior teeth, it is most often located in the bucco-lingual direction. The crack can originate from both the crown and the apex.
Vertical root cracks
This type is a longitudinally oriented crack passing through the root wall, penetrating from the root canal into periodontal pathology. A vertical crack may occur during treatment, in postoperative period or due to injury.
Diagnosis of cracks is often complicated because none Clinical signs, indicating their presence. Valuable aids in assessing the crack line are the fiber light source and the use of dye.
Possible reasons for the formation of a tooth root crack
1. Fixation of the pin structure (during or after the procedure):
— the diameter of the pin is unacceptably larger than the diameter of the channel;
- excessive thinning of the root walls;
— deviation from the axis of the root canal during the preparation process.
For example, after fixing a pin structure, as a result of the redistribution of chewing pressure from the crown to the root through the pin, there is a danger of cracks and root splitting.
*Modern research has confirmed that only elastic, namely carbon and fiberglass, pins made using modern technologies have physical properties similar to the structure of the tooth and can create a reliable structure.
2. Endodontic treatment:
— excessive pressure when using spreaders and pluggers during endodontic treatment;
— condensation of gutta-percha pins;
- excessive expansion of the canal in the middle third, on the internal curvature of the root;
— discrepancy in the selection of the size of the endodontic instrument in relation to the tooth root canal;
3. Trauma:
- inaccurate extraction of teeth;
- domestic trauma, etc.
4. A pulpless tooth due to lack of nutrition is susceptible to chips and cracks under stress.
Clinical manifestations of tooth root cracks
Clinical manifestations of cracked tooth roots have different symptoms, and the symptoms vary depending on:
— crack localization;
- type of tooth;
— time elapsed since the crack appeared;
- the state of the periodontium and the architecture of the bone adjacent to the fracture gap.
I. Teeth with vertical root cracks often have a history of long-term discomfort or pain, usually a local lesion is detected nearby chronic infection. Usually the pain is moderate or moderate, and there is pain when biting. The patient complains of pain when chewing, any load on a previously treated tooth, bad taste, feeling of discomfort. Sometimes the patient recalls a “clicking” sensation during condensation of gutta-percha or fixation of the pin. In this case, you can suspect the possibility of a crack in the root area of the causative tooth.
II. Bleeding during condensation and a clear drop in the resistance of the root walls lead to the fact that a large amount of gutta-percha can be introduced into the canal, which may indicate the presence of a crack/fracture.
III. In the oral cavity, in the area of the causative tooth, you can see a slight swelling of the soft tissues. The swelling is usually diffuse in nature and is projected in the middle third of the root. Palpation reveals swelling and tension along the root with slight involvement in the periapical region.
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crack at the root - remove?
Moderator: Lesya
crack at the root - remove?
Message DmitryN» Wed Aug 15, 2012 15:39
In a private clinic, after a small chip, 6 (46, an old problematic pulpless tooth) was prepared for prosthetics - an inlay and metal-ceramic crown. The canals were partially filled, an impression was taken, and a temporary filling was inserted. The insertion of the inlay was scheduled after 9 days, but about a week later the prepared tooth began to sag a little. When the doctor removed the temporary filling to insert the tab, there was slight bleeding from the distal root and pain was felt. Examined by a therapist. She said that when introducing an instrument of two channels coming minor bleeding, therefore, most likely there is a crack. They sent it for deletion, which made us very upset, because... I wanted to preserve my roots. The picture shows a chipped tooth before filling and after filling, when there was bleeding.
I wanted to clarify two questions: 1) do you really need to delete it, or are there any options with the tab? 2) what is better to place an implant (and which one) or a bridge with depulpation of the healthy five and a crown on the dead seven (doctors suggest)?
The tooth hurts a little when pressed.
Thanks in advance. Based on your answer, I will decide what to do next and where to get treatment.
Re: crack at the root - remove?
Message Lesya» Wed Aug 15, 2012 21:49
Good evening.
Yes, it's a root crack serious problem, especially when it comes to placing a tab on these roots.
If there is indeed a crack or perforation in the root, the main problem is that blood and fluid will leak from this place, thereby soon this tab will become cemented and the crown will fall out. That's why the doctor started talking about removal. If there is no chance of sealing this crack and being sure that it will work, then it’s a pity to charge you money for an inlay and a crown. Now there are materials that make it possible to hermetically close perforations, but it all depends on the size of the crack or perforation.
I cannot tell you what to do, since I personally cannot check the tooth. If you are in doubt, it is better to show up to someone else. Let you have the opinions of at least two general practitioners.
If the second one says that there is a perforation (or crack), then better tooth delete. Since any prosthetics for a cracked tooth will obviously be without a guarantee and most likely not successful. That is, at best, a year, then the root will crack and everything will collapse. If you are ready to take a risk, then you can try to seal the MTA perforations (if they are not large), do prosthetics without a guarantee and see what happens next. In this situation, the main thing is not to combine the 6th tooth with 7 crowns, let each one be on its own. So at least you don’t risk having to redo two teeth at once if the root cracks completely.
If the tooth is removed: what to do next?
The 7th tooth is in such a condition that it also needs prosthetics. Most of the tooth is already a filling, and in the absence of the main one chewing tooth(6), it will begin to collapse under the load. That is, it will have to be covered with a crown. And then it all comes down to finances and the condition of the 5th tooth. If the 5th tooth is without a filling, without caries, and you can afford to pay for an implant, then, of course, it is better to leave the 5th tooth alive and not make a bridge. If there is already caries on it, it is large and you understand that implantation is not yet possible for you, it is better to make a ceramic bridge, preparing the 5th tooth for this.
Therefore, for now, I would advise having the 6th tooth checked by another doctor, listening to another opinion and only then deciding what to do. But you need to consult in person, since the decision to delete is never made solely on the basis of the image. You must see it with your own eyes and hands. how bad is everything there?
Tooth root crack symptoms
1. Types of bone tissue defects
The internal zone of the chewing element is vulnerable, in which a crack in the tooth root may appear in the often encountered vertical or other direction.
Meet:
- lingual-buccal direction;
- mesio-distal;
- closer to the chewing part (crown) and, conversely, to the root cone;
- one- and two-sided.
A crack in the root of a tooth is an area that is difficult to access and must be treated. Since the bone tissue defect in the prognosis will turn into a break or fracture.
With such a nuisance as a crack in the root of a tooth, the symptoms will be different. The manifestation depends on whether there is a nerve inside. But in each case it will be painful to open your mouth.
- If it is not removed, the pain is intense.
- And in its absence, at first discomfort is felt while biting. And subsequently, due to the penetration of bacteria, inflammation occurs and the discomfort intensifies. If a tooth root crack has been present for a long time, the symptoms depend on the amount of inflammation.
X-ray image of the inside of the chewing element, which shows a defect (crack) of bone tissue
2. Various reasons
When a tooth root is cracked, symptoms may appear due to mechanical trauma.
The acquired defect has a different volume and occurs for the following reasons:
- injuries;
- poor condition of hard tissue.
This leads to:
- the resulting pressure on the walls of the internal part during canal treatment;
- large pin diameter;
- incorrect selection of the size of instruments for endodontic (intracanal) treatment;
- and ordinary trauma.
Leads to thinning of the walls poor nutrition tissues, which occurs most often in the treated pulp, in which the nervous apparatus is removed. Incorrectly installed filling material causes unnatural load distribution, which can result in thinning of the internal walls.
When a crack appears in the root of a tooth, what to do is chosen based on the diagnosed amount of traumatic damage. The walls are strengthened using a pin and durable filling material.
The most difficult restoration option is vertical. In some cases, the tooth is removed.
Description of tooth root fracture: causes, types, symptoms and treatment methods
A tooth root fracture is one of the most difficult cases for a practicing dentist. What makes treatment especially difficult is that the defect is localized inside the gum, and this makes it very difficult medical procedures. More often, tooth root fracture occurs in people over 40 years of age, although people of any age category are not insured against it.
The root acts not only as a support for the tooth - it contains vessels that nourish the tissue, so it is extremely important to try to maintain its integrity. Ignoring injuries can lead to complications, including tooth loss.
Causes of fracture
Cracks and fractures of the tooth crown and its root occur as a result of unevenly distributed loads. The pressure spreads in a vertical (during direct impacts) or perpendicular (during closing jaws) direction.
Most often, a tooth fracture is caused by injuries:
- Domestic injuries, such as a blow to the face or an unfortunate fall.
- Violation of tooth reconstruction technology. When installing a pin or during canal expansion, the doctor may destroy the root by applying too much force.
- Errors during treatment. If the bridge length is not optimal or the tooth crown is reconstructed incorrectly, the loads during chewing are distributed unevenly and the root may not withstand excessive impact.
Signs and symptoms of a fracture
The symptoms of a tooth root fracture are not always easy to diagnose, especially without consulting a doctor, although the resulting pathology is accompanied by a number of signs.
The main symptoms are:
- bleeding and swelling of the gums;
- When biting on a tooth, painful sensations appear;
- tooth mobility that has not been noted before;
- painful sensations when opening and closing the mouth due to inflammatory processes and damage to the dental pulp.
Classification of tooth root fractures
Tooth fractures can be classified depending on the location of the dislocation and the shape of the fracture. Depending on how exactly the tooth root fracture occurred, they distinguish:
Depending on the location, we can distinguish:
- Fracture near the root apex. Characteristic for childhood, due to the unformed growth zones.
- Fracture in the middle.
- Fracture of the upper third - the fracture line passes under the crown.
Diagnostics
Diagnosis of transverse tooth root fractures is often difficult due to the fact that they are located in a hard-to-reach place. Usually the doctor makes an assumption about the nature of the pathology, based on the patient’s complaints and the presence of previous injuries. To clarify the diagnosis, specific methods are used:
Treatment methods
The most difficult to treat are oblique and comminuted fractures. Typically, with such fractures, the tooth must be removed. After extraction, they wait some time for the gums to heal, and then proceed with prosthetics. At the same time, you shouldn’t wait too long either, because a long absence of a dental unit is fraught with malocclusion, as well as the occurrence of periodontal disease.
If the fracture is located in the middle part, the tooth cavity is opened, the pulp is removed from it, the canals are filled, and the root fragments are combined with each other using pins. If the root breaks in the immediate vicinity of the apex, it is enough to seal the canal.
Depending on how the fragments are located after a fracture, the following main forms of healing can be identified:
- If the fragments are located close to each other, then healing of a tooth root fracture occurs, as is the case with fractures of other bones: a calcified callus forms around the fracture site, and tissue remineralization occurs. The pulp, although not to its full extent, gradually restores its functions, the mobility of the tooth does not change, and a calcified callus can be seen on an x-ray in the future.
- If the fragments have spread over a fairly large distance, then fusion by connective tissue is possible. Sharp chips are rounded due to bone resorption processes, and fibrous tissue forms between the segments. During the healing process, tooth mobility will remain small.
- Combination of tissue and bone connections. When there is a large divergence of the fragments, newly formed bone tissue grows between them.
- Healing is possible without fusion of fragments when they are far apart from each other, due to the formation of granulation tissue. At the same time, it is possible to maintain mobility and painful sensations when biting on a tooth.
When a tooth root is fractured, treatment includes splinting, which will help avoid further displacement of the fragments and provide reliable fixation during healing. If it is not feasible to restore the tooth, the tooth is restored using pins or a crown is installed.
It is important for the patient to see a doctor as soon as possible. Timely treatment of a tooth root crack will help avoid complications: the development of a cyst or gumboil.
Dentist surgeon, implantologist
Article checked by doctor
The appearance of vertical cracks in teeth is a rather unpleasant phenomenon that requires the intervention of dentists. At the same time, some experts believe that if there are minor cracks, teeth need not be filled if they do not cause discomfort or lead to pain.
If a crack occurs in a filled tooth, medical intervention is necessary. Only a dentist can prescribe qualified treatment, as well as find out how deep the crack penetrates into the tooth and what danger it poses.
It is especially worth examining cracks in teeth that react to sharp changes temperatures, sweet or sour foods. The resulting discomfort may indicate the onset of caries or periodontitis, since healthy enamel does not respond to such food features.
A tooth cracked vertically: what to do?
Important! If an uncharacteristic and difficult-to-diagnose toothache occurs or there is a crack running deep into the root of the tooth, additional intervention by an endodontist who specializes in eliminating defects in the pulp and dental canals is required.
Options for cracked teeth
Causes of cracked teeth
The main reasons leading to the occurrence of vertical cracks in teeth are:
- excessive consumption of foods that contrast in temperature (cold ice cream and hot tea);
- excessive consumption of sour juices and highly carbonated drinks with phosphoric acid, which destroys and spoils tooth enamel;
- regular microtrauma of teeth in the process of biting off solid food, gnawing nuts, candies, seeds;
- unregulated grinding of teeth in sleep, opening jars and durable lids with teeth;
- constant use of whitening toothpastes containing soda and other aggressive abrasives;
- the beginning of the development of dental diseases - gingivitis, periodontitis, caries;
- violation of the acid-base balance of the oral cavity, which is caused by poor and poor oral hygiene;
- presence of bad habits – smoking, drinking alcohol and drugs;
- dental injuries - severe blows to the jaw, bruises, falls.
Causes of cracked teeth
Important! Often cracks occur due to a lack of calcium in the body. In this case, you need to review the menu and carry out a procedure to strengthen tooth enamel.
