Cervical caries stage. Cervical caries and features of its treatment

Cervical caries, also known as cervical caries, occurs quite often even with the capabilities of modern hygiene and is a common dental disease.

What is cervical caries

Cervical caries takes its name from the location on the neck of the tooth and spreads to nearby tissues. Due to the peculiarities of its location, cervical caries is usually not visible at the initial stage, so cases of its early diagnosis are rare. In most cases, cervical caries is diagnosed at a deep stage, when the pulp or root of the tooth is affected. In the latter case, the tooth can no longer be cured, and the doctor can only remove it. That's why early diagnosis cervical caries at the stage when the disease is asymptomatic, allows you to avoid problems in the future.

Factors causing the disease

Cervical caries appears primarily due to thinning of dentin. Dentin becomes thinner due to prolonged exposure to lactic acid, which accumulates on the neck of the tooth due to improper hygiene. Even with professional cleaning The neck of the tooth can be very difficult to process. The development of cervical caries is facilitated by a genetic factor, as well as a number of chronic diseases. Dentistry highlights following reasons development of cervical caries:

• Enamel demineralization

The presence of lactic acid waste products of bacteria present in the oral cavity and saliva contributes to the demineralization of enamel. Their long-term impact on the enamel is possible if the rules of oral hygiene are not followed.

• Avitaminosis

Vitamin deficiency has a direct impact on the condition of the gums: the gum pockets formed due to a lack of vitamins become a place for the accumulation of food debris and the proliferation of bacteria. As a result, the enamel on the neck of the tooth becomes thinner and becomes susceptible to caries.

• Chalky spots

This is the main symptom of the onset of cervical caries that you should pay attention to. If chalky spots are not noticed in time, the disease continues to develop to deeper stages, when serious treatment is required. Unfortunately, it can be almost impossible to notice cervical caries at the spot stage; this can only be done by a dentist during a routine examination.

Highlight following signs cervical caries:

• chalky spots of different sizes;
• discomfort and pain upon contact with food and liquids;
• tooth sensitivity to high and low temperatures, acid exposure;
• night toothaches;
• headache;
• discomfort and pain when brushing your teeth.

If you are concerned about these symptoms, you should see a dentist immediately. Otherwise, it is impossible to prevent the development of cervical caries.

Stages of caries development

The development of the carious process in the neck of the tooth occurs sequentially, replacing the stages of the lesion.

• Initial

This is also the spot stage. Appears unnaturally on tooth enamel White spot, but no discomfort or other symptoms are observed. The stain may be stained by food substances and liquids, making it difficult to evaluate on your own.

Cervical caries at this stage is diagnosed by visual signs that can only be assessed by a dentist, however, its treatment is carried out with the most gentle non-invasive intervention. This means that opening the tooth enamel with a drill is not required, so only one visit to the dental office will be enough.

• Superficial

It is at this stage that the neck of the tooth begins to react to contact with food, liquids, and temperature changes. This is due to the fact that at this stage of cervical caries the enamel is already damaged. Signs of superficial cervical caries cannot be ignored, as it inevitably progresses to more serious stages.

• Average caries

At this stage, caries affects not only the enamel, but also the dentin, so the tooth’s reaction to irritants intensifies. The pain goes away quickly, so many patients do not consider dental care necessary.

• Deep caries

The very last stage of caries, characterized by deep damage to the tooth, down to the pulp. Symptoms deep caries– unbearable, almost persistent pain that intensifies at night.

How is cervical caries treated?

To treat the initial stage of cervical caries, conservative methods are used. First, it is necessary to clean the tooth of plaque and stone, then the doctor prescribes remineralizing therapy with drugs that contain calcium and fluoride. Means for remineralization and fluoridation of teeth should be prescribed by the attending physician in clearly established dosages.

The stages of treatment of cervical caries at the onset of the disease are as follows::

• Professional cleaning of tooth enamel from plaque and tartar.
• Application of remineralizing gels and applications of preparations containing fluoride (carried out over 2-3 sessions).
• Reception medicines prescribed by a doctor.
• Compliance with doctor's recommendations for hygiene measures.

Treatment of cervical caries in case of damage to tooth enamel is carried out using a drill and consists of the following stages:

• Professional cleaning of plaque and stone.
• Choosing the color of the composite - it must fully match the natural shade of the enamel.
• Preparation of the tooth neck and adjacent tissues affected by caries using local anesthesia.
• Isolation of the tooth and creation of an adhesive coating in the created cavity.
• Filling a tooth and giving it an aesthetic appearance.
• Grinding and polishing of teeth.

Cervical caries is complicated by the subgingival location of the lesion, so the doctor must be highly qualified. Moisture and blood can get into the working space, and cervical caries is especially inconvenient when filling. When working, the dentist must be extremely careful not to damage the delicate gum tissue.

To treat caries, fillings made of glass ionomer cements, organically modified ceramics, light-curing composites, etc. are used. Correctly selected treatment allows not only to completely cure caries, but also to give the previously affected tooth an aesthetic appearance.

Despite the difficulties associated with the treatment of cervical caries, modern capabilities make it possible to cure any stage of it, including complications such as pulpitis and other serious consequences of an advanced disease. This is largely due to technological equipment that simplifies the diagnosis and treatment of diseases of the teeth and oral cavity.

Doctors by referral

11102, 11106, 11103, 11101, 11108, 11114, 11111, 11162

Zhigunova Svetlana Yurievna

Chief physician clinics on Kolomyazhsky Ave., 20
Periodontist

Dubinskaya Anna Yakovlevna

Dentist-therapist
Pediatric dentist

IvaninaVera Rashidovna

Dentist-therapist

TikhanovaAlla Mikhailovna

Dentist-therapist
Pediatric dentist

Tsarkova Tatyana Vladimirovna

Dentist-therapist

Shashorina Darina Gennadievna

Dentist-therapist

Batyukova Oksana Ivanovna

Dentist-therapist
Pediatric dentist

Zhivotovskaya Nina Arturovna

Dentist-therapist
Periodontist

• Lepikhova K.A.:

  I would like to express my sincere gratitude to Dr. A.A. Oganesyan. and her assistants for the quality treatment, responsiveness and such a responsible attitude to their work! I come to the appointment and want to smile, the doctors and staff of the clinic create an unusually kind, sincere atmosphere.

  I wish you interesting opportunities at work, good clients and, of course, prosperity in your personal life.

  I will come back to you again, but I am sure that with such high-quality treatment - only for a professional examination. Thank you!

• Koposovs:

  Many thanks to Komarova E.V. for your kind attitude, complicity and patience in the treatment of Nastya and Katya.

• Myasnikova Lyudmila:

  I would like to say a huge thank you to the dental surgeon Vitaly Konstantinovich Konishchev for his high professionalism, attention, and kind attitude. And I’m very glad that there is a truly “Good Dentist” clinic where you can come with confidence that you will receive qualified assistance. Thank you!

• Vorobyova M.N. (mother of Vorobyov Svyatoslav):

  Thank you very much to Dr. Kobalia V.M.!!! I removed a child’s teeth more than once, so that neither I nor the child understood anything. Thank you again for your work, more such specialists. I recommend it to everyone, especially children!

  Health, all the best.

Equipment used

Is it possible to cure cervical caries on your own?

It is generally accepted that it is impossible to cure caries at home. However, under some circumstances, home treatment of cervical caries gives good results. We are talking about caries in the stain stage, which has not yet damaged the tooth enamel, but is only developing on its surface. Treatment with remineralizing gels and preparations containing fluoride and calcium helps strengthen the enamel and allows you to postpone a trip to the dentist for a long time. However, when self-treatment caries at home, it is worth considering the following features:

• Uniqueness of each case

Cervical caries manifests itself in different ways, which is determined by the properties of the enamel, the depth of its damage, the localization of the disease and many other factors. The formation of cervical caries is influenced by the age of the patient, as well as his daily habits regarding compliance with hygiene rules. The process is aggravated by the general condition of the body, the condition of the remaining teeth, etc.

When choosing a remedy for treating cervical caries at home, only a qualified dentist can fully take into account all these factors. A remedy chosen independently and found to be effective can have a positive effect due to a fortunate combination of circumstances, since not every patient is able to independently assess the scale of the problem.

• Choice of drug

The pharmacological industry provides a wide selection of various means for the prevention and treatment of cervical caries. But no one guarantees that the remedy you choose will have the desired effect. The choice of medication and its dosage is a task for the attending physician. Pharmaceutical drug maybe for short term prevent the development of cervical caries at the spot stage, however, with increased concentrations of fluorides or other active substances the effect threatens to be the opposite.

• Diagnostic problem

Cervical caries can be cured on its own only in the initial stage. But only experienced dentist will determine the true extent of the disease. Moreover, visual signs that an ordinary patient mistakes for caries may in fact be ordinary pigmented plaque or tartar. Another serious pathology is often mistaken for caries: for example, enamel hypoplasia.

A characteristic symptom of cervical caries at the initial stage is a pain syndrome that accompanies a person constantly, intensifies at night or even appears only during meals. If for some reason going to the dentist is impossible, you can get rid of the pain for a while with the help of traditional medicine rather than experimenting with chemicals. And at the first opportunity you should go to the dentist for qualified treatment.

The following traditional methods of pain relief are effective: different types caries:

• Infusions: herbs are used for rinsing the mouth - oregano, knotweed, sage, lemon balm, mallow, blackberry leaves. Blueberries are also effective.
• Decoctions: decoctions of wormwood, tricolor violet, valerian, oak and aspen bark are used for rinsing the mouth.
• Roots: angelica and calamus - you need to chew them.
• Propolis tincture: you need to rinse your mouth with it, first diluting it with water.

Although the effect of folk remedies does not last long, they can still significantly reduce pain. But there is this method treatment back side: having quenched the pain, the healing tincture can mask developing pulpitis and other complications that threaten tooth loss. Therefore, no matter how effective traditional treatment, a visit to the dentist to relieve the disease is mandatory.

Cost of dental services

• Treatment of caries

Prevention

Cervical caries develops both with a hereditary or disease-related tendency, and in its absence. This is due to the fact that most patients do not realize the importance of preventive measures, which are more effective than any, even the most modern, treatment. Dentists recommend following simple rules, allowing you to save your teeth from caries:

• Limiting the amount of flour and sweets in the diet

These foods contain carbohydrates and large amounts of glucose, which creates a favorable breeding ground for bacteria on the surface of the teeth. Bacteria convert glucose into acid, which damages enamel. By limiting the amount of flour and sweets, you will reduce the risk of tooth decay.

• Proper consumption of carbohydrates

It is not necessary to completely exclude carbohydrates from your diet: it is enough to follow the basic rules for their use. It is not recommended to consume sweets at night and outside of main meals. After eating sweets, you need to brush your teeth well or at least rinse your mouth.

• Including foods with coarse fibers in your diet

Coarse fibers found in vegetables, fruits and grains help remove plaque and food debris from tooth enamel, especially when consumed after every meal.

• Regular teeth cleaning

Contrary to popular belief, brushing your teeth in the morning is not so important, since the main danger to enamel comes from food debris. It is much more important to brush your teeth immediately after eating, since it is at this time that bacteria begin to multiply on the enamel.

• Teeth brushing technique

Your hygienist will teach you the essential basics. Most people brush their teeth incorrectly, which often causes caries. Correct technique Brushing your teeth helps clean the surface of the enamel, so you should learn it from an early age.

• Flossing

This is an indispensable way to prevent cervical caries, since dental floss is the easiest way to penetrate the interdental space, including the gingival areas.

Every person who is interested in preventing cervical caries should have in their arsenal:

• Toothpaste containing fluoride from 1000 to 1500 pm prevents the occurrence and development of cervical caries.
• Fluoridated floss (dental floss) provides not only effective mechanical cleaning of teeth, but also their remineralization.
• Fluoride rinses: Complete the cleaning of teeth.

As well as products for home treatment, the above hygiene products should be selected in accordance with the recommendations of the dentist. Although for the most part they are completely safe, the advisability of their use is determined by other reasons. Fillings, dentures and missing teeth, the health status and age of the patient are what must be taken into account when choosing oral hygiene products. The concentration of fluoride in the water in your region also has an impact. Fluoridated hygiene products are not always really necessary: ​​an overdose of fluoride is just as dangerous as a lack of it.

Therefore, in order to collect a full range of oral hygiene products, it is better to consult a dentist. A competent approach to dental care and preventive measures will reduce the risk of cervical caries, even if you are prone to this disease.

And, of course, a mandatory preventive measure is a scheduled visit to the dentist. This is the only way to identify caries in the early stages and avoid expensive treatment in the future.

Each tooth consists of three parts: the root, the outer crown and the neck. The neck of the tooth is the area adjacent to the gum. It is in this zone that what is called cervical develops. Without treatment, all tooth canals can be affected, which can lead to tooth loss.

The concept of cervical caries in children and adults

Cervical caries is the most dangerous form dental diseases. The pathological process develops on the neck of the tooth and the tissues located next to it. The thickness of the enamel in this place is insignificant, so the infection quickly penetrates inside, affects all canals and progresses to a deep stage.

Cervical caries can appear on any tooth, but is most often localized in the smile area. All or several teeth may be affected at once (blooming or generalized form). Sometimes cervical caries covers the area of ​​the neck of the tooth bordering the gum. In this case it is called circular.

The pathology occurs more often in adults after 35 years of age, but can also develop in children. It does not even spare milk teeth, and it is they that are affected by circular caries.

Children are characterized by the involvement of several teeth in the process at once. The problem can arise as early as 3-4 years, and sometimes even earlier.

It happens that baby tooth, not having time to fully grow, it begins to deteriorate due to cervical caries. The reason is that the enamel of children's teeth is weaker and therefore erodes faster.

As a result of advanced cervical caries, a child may be left without baby teeth long before the permanent ones appear, and this leads to sad consequences, such as:

• swallowing poorly chewed food, which can lead to digestive problems;
• incorrect pronunciation of sounds;
• unattractive appearance, ridicule from peers;
• formation of malocclusion.

Cervical caries is dangerous because it destroys the tooth at the very base. At the beginning of the disease, you can get rid of the problem without much difficulty and without the help of a drill.

Developing in a place that is difficult for a toothbrush to reach, the pathological process can go unnoticed for a long time.

In advanced cases, this form certainly turns into pain, the acute pain from which forces the patient to literally run to the doctor. But if at this stage it is possible to save a tooth, then, as a rule, only at the cost of removing the pulp - the nerve that feeds the tooth.

Causes of cervical caries

The mechanisms of appearance of cervical caries differ little from those in other types of caries process.

1. The main reason is the lack of proper hygiene care. The gingival area is difficult to access for high-quality cleaning, so it is there that bacterial plaque accumulates, which is a material for the formation of plaque. Such deposits favor the development of inflammation of the gum edge, and there is a close relationship between this process and cervical caries.
2. The occurrence of pathology can provoke dysfunction of the salivary glands, in which saliva is produced in insufficient quantities. But it is precisely this that serves to protect tooth enamel from bacteria that live in large numbers in the oral cavity. In conditions of a lack of saliva, pathogenic microorganisms multiply well, exerting their detrimental effect on the teeth.
3. The following may be important for the development of cervical caries:
   • lack of vitamins and microelements in the diet;
   • unfavorable environment;
   • use of "hard" drinking water with harmful impurities;
   • severe stress;
   • smoking;
   • abuse of coffee and confectionery products.

In addition, there are specific reasons that lead to the occurrence of this particular type of caries:

1. The thickness of the enamel in the coronal part of the tooth is 0.5–0.6 mm, and in the cervical area it does not exceed 0.1 mm, so it can suffer from any external influence and is easily injured even when brushing the teeth with a hard brush or using abrasive pastes.
2. A genetically determined tendency to detachment of the gum from the neck of the tooth, leading to the formation periodontal pockets. Food debris that accumulates in these cavities is a favorable breeding ground for bacteria that secrete enamel-damaging acid. As a result, a carious lesion forms under the gum unnoticed by a person.
3. Pathological receding gums (recession). Due to endocrine diseases or age characteristics The gum becomes flabby, and its edge gradually sinks. The exposed neck of the tooth with thin enamel becomes easy prey for microorganisms.

The risk group for generalized cervical caries is:

• children and adults with pathologies of the endocrine glands ( diabetes, diseases thyroid gland);
• people with weakened immunity as a result of a long-term general illness;
• patients with heart disease;
• children with rickets, Down's disease, vitamin deficiency;
• pregnant women;
• teenagers during the period of hormonal changes in the body;
• children who have suffered from many infectious diseases.

Clinical symptoms and stages of the disease

Dentists distinguish 4 stages of development of cervical caries, each of which has its own features:

1. Initial stage. At this stage, nothing bothers the patient yet. A small unnaturally white or darkish spot with a smooth surface appears at the border of the tooth and gum.
2. Superficial clinical and morphological stage. The stain darkens and becomes rough - this means that the process of destruction of the enamel has begun. The tooth begins to react to sweet, sour, salty, cold and hot foods with short-term attacks of aching pain.
3. Cervical caries middle stage, having completely destroyed the enamel layer, switches to dentin. A crack or cavity appears in the area of ​​the tooth neck adjacent to the gum. The pain from hot and cold increases more and more, the tooth becomes sensitive to any touch. At this stage, the carious process can no longer be ignored.
4. The deep stage of cervical caries very soon replaces the previous one. Severe pain occurs when eating, brushing teeth, from cold water, and even from talking in a cold wind. A dirty black spot (or stripe) becomes clearly visible in the cervical part of the tooth. Often the process spreads to the necks of neighboring teeth.
   

   The carious cavity, having destroyed the layers of enamel and dentin, reaches the pulp. The next stage of the disease will be pulpitis.

Photo gallery: stages of cervical caries

Diagnostics

For appointment adequate treatment The dentist must make the correct diagnosis. Experienced doctor will be able to detect cervical caries at its initial stage.

The following methods are used to diagnose the disease:

1. Examination of the oral cavity to detect accumulations of plaque, tartar, stains, and streaks in the gum area.
2. Fluorescent stomatoscopy to identify the boundaries of the pathological process. The method is based on the property of intact tooth tissue to glow blue in ultraviolet rays.
3. Vital coloring. A 2% solution of methylene blue or a 1% solution of potassium iodide is applied to the affected area. The foci of cervical caries change color.
4. Thermal test. A cotton swab soaked in chlorethyl, ether, or simply cold water is applied to the affected area. This determines the sensitivity of the tooth to temperature stimuli.
5. Radiography. It will help determine the depth of the carious process and its distance from the tooth pulp.

In addition to this, it is necessary differential diagnosis cervical caries with wedge-shaped tooth defect. Similar and distinctive signs of these diseases are presented in the table.

Comparative table of cervical caries and wedge-shaped dental defects

Sign	Cervical caries	Wedge-shaped defect
Defect location	In the area of ​​the neck of the tooth on either side.	On the outside of the tooth.
Sensitivity to irritants	On late stages disease, the tooth reacts to any chemical and temperature stimuli.
Hearth shape	Could be anyone.	V-shaped.
Enamel color	At the beginning of the disease - unnaturally white, then yellow, brown or black.	Does not change.
Bottom and edges of the defect	Loose, rough, uneven edges.	Smooth, dense, polished, with smooth edges.

What to do and how to treat

When choosing a treatment method for cervical caries, the doctor proceeds from the stage of the pathological process. The sooner the patient contacts the dentist, the greater the chance that the development of the disease can be stopped without opening the tooth.

In the dental office

1. The most gentle method of treating the disease in conditions dental clinic- remineralization of tooth enamel. But its implementation makes sense only at the initial stage of the disease, when caries is a stain. The essence of the method is to apply fluoride-containing applications to the tooth. Therapy is carried out in sessions. As a result, the hard tissue of the tooth is completely restored.
2. Deep fluoridation is a type of remineralization. The enamel of well-dried teeth is treated with a fluoride-containing solution, after which a preparation with calcium hydroxide is applied to it.
3. At the initial stage of cervical caries it is also used conservative method Icon. A comfortable, painless procedure lasts only half an hour and consists of the following:
   • the tooth is isolated using a special latex plate (cofferdam);
   • treat it with sodium hypochloride gel;
   • dead dentin is removed with special instruments;
   • the surface is washed, disinfected, and dried with a stream of air;
   • a liquid polymer is applied, which penetrates the rough enamel, leveling and compacting it;
   • To consolidate the result, the tooth is illuminated with a special lamp.
4. When tooth decay has already begun, the treatment of cervical caries with filling does not differ from that for other carious processes:
   • under local anesthesia dental plaque is removed;
   • then the tooth defect is opened with a drill;
   • Having cleared the working area of ​​softened dentin, the doctor places a filling and grinds it;
   • in severely advanced cases, after filling, it is possible to cover the tooth with an artificial crown.

Cervical caries of the upper anterior teeth and its treatment with filling - video

At home

Treatment at home can only be done initial stage diseases. To remineralize tooth enamel, dentists recommend special medicinal pastes and gels containing beneficial microelements:

• fluorine;
• calcium;
• zinc;
• phosphorus;
• magnesium;
• selenium.

The product is applied to the affected area after regular teeth brushing.

After 3–4 months of regular use of such gels, patients note a decrease in the sensitivity of tooth enamel, and the stain itself in the cervical area becomes almost invisible.

From medicinal products for home use have proven themselves well:

• restorative cream for remineralization of tooth enamel Tooth Mousse;
• remineralization cream with calcium and fluoride Mi Paste Plus;
• Stomysens Vernicette Biorepair varnish with calcium and phosphorus;
• BioRepair medicinal paste, which acts as liquid tooth enamel;
• gel for enamel restoration “Liquid enamel”.

Toothpastes, creams, gels for remineralization of tooth enamel - gallery

Tooth Mousse is designed to strengthen and restore tooth tissues with their simultaneous fluoridation Mi Paste Plus will provide protection against caries BioRepair performs the function of liquid tooth enamel Stomysens Vernicette Biorepair helps treat early forms of caries (spot stage) and prevent its further occurrence

Folk remedies in the treatment of cervical caries

It’s worth warning right away that no folk remedies can stop the tooth decay that has begun. With their help, you can only slow down this process a little.

Some traditional medicine recipes can indeed temporarily reduce pain in a carious tooth, but a radical solution to the problem will still require the help of a dentist.

If a tooth hurts quite badly, and a trip to the dental clinic in this moment is impossible, then to relieve discomfort you can try the following folk methods:

1. Fir oil. Apply a cotton wool soaked in fir oil to the aching tooth. It is advisable to surround the tooth with such lotions on all sides.
2. Camphor alcohol. Place a swab soaked in medicine for 5-10 minutes near the disturbing tooth.
3. Garlic juice is a proven remedy for reducing pain in deep caries. Use a special machine to crush a clove of garlic, place the mixture on a gauze pad and apply it to the tooth. Keep it until the pain relieves.
4. Sage tincture. Being wonderful natural antiseptic, sage destroys bacteria that multiply in the carious cavity, thereby stopping the destructive process:
   • brew 1 tbsp. l. dry leaves of the plant 250 ml of boiling water;
   • wait until the tincture cools;
   • rinse your mouth and apply swabs soaked in liquid to the carious tooth.
5. Decoction of onion peels. This remedy is soothing toothache, and also cleanses the oral cavity of putrefactive microorganisms:
   • wash 3 medium onions;
   • remove the husks from them;
   • fill it with 400 ml of hot water;
   • bring the mixture to a boil;
   • turn off the heat and let the broth brew for 5–6 hours;
   • strain and rinse your mouth with it 4-5 times a day.
6. Propolis is one of the most effective remedies. To combat caries at home, apply a piece of it to the affected tooth. Cover the top with cotton and keep for 40 minutes.
7. Vodka tincture of calamus root relieves toothache well. Its disadvantage is that it takes a long time to prepare. To make the remedy:
   • add 200 ml of vodka to 2-3 tbsp. l. crushed calamus roots;
     

     For greater effectiveness, you can add a spoonful of propolis to the calamus.

Cervical dental caries is caused by the activity of bacteria Streptococcus mutans, so talk about some cardinal differences There is no cause of caries from other types. Visually, the lesion differs only in location and is observed, as a rule, among people over thirty years of age. However, cervical caries of primary teeth also occurs. In children, the disease often develops into circular caries, like a tooth encircling the neck. The disease should not be confused with enamel erosion and wedge-shaped defect.

Why is cervical caries considered the most dangerous?

1. The enamel in the neck of the tooth is the thinnest and most vulnerable, and the same can be said about dentin. Caries in the cervical region very quickly affects deep tissues.
2. When teeth are affected by cervical caries, the patient detects the disease only when pain occurs.
3. Treatment is complicated due to the proximity of the lesion to the gum line (especially molars). The most difficult case is considered to be cervical caries on a wisdom tooth.
4. It is caries in the cervical area that most often causes complications and is the reason for tooth extraction.

Causes of cervical caries

• Insufficient mineralization of enamel. Considering the fact that in the cervical region it is thinner by definition, this factor is one of the determining ones.
• Poor hygiene. Plaque and tartar are most often localized on inside teeth in the area of ​​contact with the gum.
• Vitamin deficiency and gum disease. In both the first and second cases, deep gum pockets are formed in which food debris accumulates, which is why there is a high concentration of pathogenic bacteria.
• Heredity. If one of the parents suffered from cervical or circular caries, then there is a high probability that the child will also develop this disease.

Otherwise, the causes of cervical caries are the same as classical ones. Diet has a great influence: foods high in carbohydrates have a negative impact on dental health, regardless of the quality of hygiene and hereditary predisposition.

Many people confuse cervical caries and wedge-shaped defect. However, these two diseases have completely different natures and are similar only in the affected area.

How to treat cervical caries?

Most patients are interested in the question of how to treat cervical caries, taking into account the characteristics of the disease? Although this type caries is considered the most aggressive and quickly spreading; with timely contact with dentistry for the treatment of cervical caries, many unpleasant consequences can be avoided.

Speaking directly about treatment methods, you need to understand at what stage the disease is. Below is a table showing methods of treating cervical caries at different stages of its development.

Stages of cervical caries	Description	Treatment
Initial (in the form of a spot)	A whitish spot forms on the surface of the enamel in the cervical area. Subsequently, the stain becomes more noticeable, the structure of the enamel is disrupted, and pain appears, for example, a reaction to cold and hot.	At this stage, treatment without therapeutic intervention is possible. Fluoridation and remineralization of enamel at the initial stage, as well as selection special means hygiene (toothpastes for cervical caries) and diet correction. For superficial lesions of the enamel, it is possible to treat caries without a drill (using Icon technology or using laser therapy).
Average	Caries affects the enamel and dentin, but the pulp and nerve endings are not affected. At this stage, the carious lesion becomes noticeable, and pain increases.	Treatment of the affected area and filling of cervical caries. If a patient is diagnosed with cervical caries of the anterior teeth, after therapeutic treatment, microprosthetics may be required to restore aesthetics.
Heavy	The deep tissues of the tooth are damaged, the patient suffers from severe throbbing pain. Deep cervical caries significantly deforms the cervical area of ​​the tooth.	The nerve is removed and the canals are filled. In case of extensive lesions, it is not always possible to install a stump inlay or crown. Often in advanced stages of cervical caries (especially if it turns into circular) tooth extraction is required.

With therapeutic intervention, pain after treatment of cervical caries can last up to two to three days. If the pain does not go away for a long time or severe, we advise you to immediately consult a dentist.

Treatment of cervical caries of anterior teeth

Treatment of cervical caries of the anterior teeth includes not only restoration of the anatomical shape of the tooth, but also aesthetics, so it is important to find an experienced specialist who will select the optimal material and color for the filling. The most commonly used are glass ionomer and light fillings, which are quite strong and durable.

Features of treatment of cervical caries at home

It is impossible to cure cervical caries at home when the enamel is already damaged. Conservative treatment perhaps at the stain stage, when the doctor prescribes enamel remineralization products and preventive hygiene products that can be used at home. Some experts advise using folk remedies, in particular, rinse with infusions of sage, lemon balm or propolis. However, such measures are only useful for the prevention of cervical caries and in no case can cure the disease in an advanced state.

How much does it cost to cure dental caries?

The average cost of treatment for cervical caries in Moscow is on average higher than the classical one. Light and glass ionomer fillings cost from 3,000 rubles. If the disease has affected the pulp, then filling the canals is necessary. In this case, the total amount for the treatment of cervical dental caries often exceeds 10,000 rubles.

Cervical caries is considered the most dangerous type of caries. It is often diagnosed in 30-60 year old people, children, and people suffering from endocrine diseases.

Causes

The gingival area is a difficult-to-reach area for high-quality hygienic care. When brushing, the brush does not completely cover the neck of the tooth, which is why more plaque accumulates here and tartar forms more actively.

1. Pathogenic bacteria multiply in plaque plaques Streptococcus mutans that produce lactic acid. It negatively affects the surface and subsurface layers of enamel, leaching calcium and fluorine from it and disrupting the mineral crystal lattice of the enamel.
2. Failure to comply with hygiene rules is not the only reason for the development of cervical caries. The development of the disease can also be provoked by too intensive brushing of teeth, during which the already thin enamel in the neck area becomes thinner (for comparison: 0.1 mm in the neck area and 1.7 mm in the cusp area). The condition of the enamel is also affected by the use of abrasive agents for teeth whitening and the use of certain medications.
3. Damage to several teeth at once by cervical caries is often observed when endocrine diseases(diabetes mellitus and thyroid diseases). The fact is that in diabetes the number of representatives pathogenic microflora increases significantly. This leads to accelerated demineralization of dental tissues. A high concentration of glucose in saliva also leads to an increase in the prevalence of tartar and plaques (in diabetes - up to 6.33 mg, normally - up to 3.33 mg)

Stages

1. Caries in the spot stage. The color of the enamel in the cervical area varies from white chalky to pigmented spots. In a limited area of ​​enamel, shine is lost. From sour and other chemical and temperature irritants, a quickly passing feeling of soreness may occur.
2. Stage of superficial caries. A shallow defect appears within the enamel. Roughness appears in the center of the white or pigmented spot.
3. Average caries. The shallow carious cavity is filled with softened dentin. The damage is shallow and does not affect the layers adjacent to the pulp.
4. Deep caries. A deep carious cavity appears with overhanging edges of the enamel, filled with softened dentin. A common complication is pulpitis.

Symptoms

Stage	Symptoms
In the spot stage	Lack of response to temperature stimuli
Surface	The appearance of short-term pain from sweet, salty, sour. Short-term pain at the neck of the tooth when exposed to temperature stimuli. Pain when brushing your teeth with a hard brush (in areas with a thin layer of enamel).
Average	Pain when exposed to chemical, temperature, mechanical irritants, which quickly passes after the irritant is eliminated
Deep	Pain when exposed to chemical, temperature, mechanical stimuli. The occurrence of long-term pain when food debris enters and gets stuck in the carious cavity. Pain when chewing. Painful sensations when inhaling cold air.

How to treat - a review of effective methods

How to treat cervical caries in a dental clinic

Depending on the stage of caries, tooth necks can be used various methods treatment.

In the spot stage

1. ICON technique (treating the tooth with an etching gel, filling the damage with a special composite composition).
2. Remineralization. Its goal is to saturate the enamel with calcium and fluoride.

Remineralizing drugs used in dental clinics:

• Tiefenfluorid - enamel-sealing liquid;
• Gluflutored;
• Remodent;
• Belagel Ca/P;
• Calcium gluconate solution;
• Sodium fluoride solution;
• Fluorine-containing varnish (fluorine varnish, bifluoride-12).

Treatment in later stages

In advanced cases, treatment of the carious cavity and filling are required. If the dentin is deeply damaged, root canal treatment or nerve removal may be required.

Filling is performed in stages:

1. Professional cleaning (removal of dental plaque and tartar).
2. Determination of enamel color (for selection of material).
3. Gum pushback (necessary to treat the affected area under the gum).
4. Treatment of the carious cavity with a boron, removal of necrotic tissue.
5. Isolation of the tooth from saliva with a rubber dam (it is necessary that the filling does not fall out within 2-3 months).
6. Treatment of dentin and enamel with adhesive (for reliable adhesion of the filling material to the tooth tissues), if necessary, application of an insulating and therapeutic lining.
7. Installation of a light polymerization filling, grinding and polishing with fine-grained discs.

The choice of material depends on the location of the carious cavity - near the edge of the gum or under it. In the presence of subgingival defects, the dentist's choice falls on a material that hardens in a humid environment (isolation from liquid is practically impossible). We are talking about glass ionomer cements (VITREMER), which have high strength and a triple curing mechanism. In addition, light-curing composites (Filtek, Enamel, Charisma), compomers, ormokers (organically modified ceramics with high biocompatibility) are used.

To return the tooth to its aesthetic and functional parameters, some dentists combine 2-3 filling materials, which allows them to cope with complex clinical cases.

To treat or not?

Cervical caries is fraught not only with problems of an aesthetic nature and the periodic occurrence of pain. Main danger- complete destruction of the tooth and its removal.

Other complications:

• Pulpitis with acute pain;
• Gingivitis (inflammation of gum tissue);
• Periodontitis (inflammation of periodontal tissues);
• Phlegmon (inflammatory process in the tissues of the head and neck).

Is it painful to treat cervical caries?

Patients who are afraid of the drill are often interested in whether it hurts to remove cervical caries. If dentin is damaged and caries has gone beyond the enamel and mechanical treatment of the cavity is required, then anesthesia is required. The fact is that the defect area is located very close to the gum, and the dentist’s manipulations can be really painful.

Can be used:

• Superficial application anesthesia of hard tissues;
• Regional injection;
• Electroanalgesia;
• Acupuncture analgesia;
• Anesthesia.

What instrument is used to remove caries in the cervical area?

Treatment at home

For treatment at home you can use:

• Toothpastes and gels;
• Dental floss impregnated with fluoride;
• Rinse aids.

Remineralizing gels and special toothpastes are effective only in the case of cervical caries in the spot stage. Choosing such a product on your own is quite difficult and there are several reasons for this:

1. At the spot stage, cervical caries is almost always visually invisible, and the detected defect may turn out to be a disease of non-carious origin, pigmented plaque, or still cervical caries, but in the superficial or middle stage.
2. Treatment with drugs chosen in the pharmacy network may be ineffective, because... should be considered general state health, depth of lesion and area of ​​cervical caries.
3. The wrong choice of home treatment products can cause harm to dental health. For example, the use of products with a high fluoride content can cause the development of fluorosis.

Advanced caries of the tooth neck can be cured only by removing the softened affected tissue.

Treatment with folk remedies

If a visit to the dentist is impossible due to insurmountable circumstances, then folk methods will help stop the development of cervical caries and get rid of pain.

Sage tincture

1 tbsp. herbs pour 1 tbsp. boiling water, after an hour of infusion, strain and use for rinsing. In order to prevent the spread of carious lesions, a cotton wool soaked in the tincture can be applied to the enamel.

Propolis

Propolis is rolled into a pea and applied for 30 minutes. per tooth To prevent the propolis from softening, place a cotton swab on top.

Onion peel tincture

3 tbsp. husks are poured into 500 ml. Boiling water is brought to a boil over medium heat, filtered and kept in a cool place for 8 hours, and then used for rinsing.

Calamus tincture

1/2 cup of calamus root is crushed and poured into 500 ml. vodka, leave for a week, then rinse the aching tooth with the tincture for 1-3 minutes. To fill microcracks, you can add 10-20 g of propolis alcohol tincture.

Herbal rinse

• Collection 1: St. John's wort, dried chamomile and calendula flowers (1 tbsp each). Pour 2 tbsp. boiling water and leave for an hour.
• Collection 2: lemon balm, nettle and strawberry leaves, wheatgrass and knotweed root (in equal parts). Measure out 2 tbsp. l., fill them with 300 ml. boiling water and simmer in a thermos for 2 hours.
• Collection 3: fennel fruits and mint leaves (25 g each). Infuse in 500 ml. alcohol for 3 months, after which rinse the mouth, dissolving 1 tsp. tinctures in a glass of warm water.

Toothpaste, gels, rinses and ointments for cervical caries

Anti-caries toothpastes

• Strengthen the mineral tissues of the tooth with fluorine and calcium compounds;
• Prevents the formation of dental plaque;
• Blocks the growth of bacteria in plaque.

In the stain stage, the following pastes show good results:

• Lacalut Fluor(strengthens and restores damaged enamel);
• Remodent(from animal bones, its use leads to an improvement in the composition and structure of tooth enamel);
• Colgate Maximum(increases caries resistance by restoring the hydroxyapatite crystal);
• Apadent(contains nano-hydroxypatite, particles of which fill microcracks in tooth enamel and enhance the mineral flow of saliva);
• Signal(fluoride-containing pastes with therapeutic and prophylactic effects);
• Blend-a-med(the fluoristat system of the paste retains calcium well in tooth enamel).

Gels

Therapeutic gel Fluocal

This relatively new dosage form may contain chemically incompatible substances (since the aqueous shell prevents the reaction between them). They are effective when used as an application for both prevention and treatment of cervical caries in the spot stage.

WITH therapeutic purpose are used:

• Fluocal;
• Fluodent;
• Elmex;
• Gel R.O.C.S. for office use.

Gels are applied to the teeth with a brush or a special application spoon for 3-4 minutes at certain intervals (they are installed by the dentist).

Therapeutic and prophylactic rinses

They are an adjuvant for remineralizing therapy in the spot stage. They are used 1-2 times a day according to the instructions, intensively passing between the teeth.

Popular anti-caries rinses:

• Oral-B;
• 32 Bionorm;
• Caries Protect;
• Caries Protect;
• Colgate Plax.

Anti-caries creams

Tooth Mousse- a water-soluble cream that restores the mineral balance of the oral environment in case of salivation pathologies, after curettage, teeth whitening, etc. This cream is suitable for children when other fluoride-containing preparations are not suitable due to age restrictions.

Tooth Mousse has been proven to “suspend” the development of caries on primary teeth and allow the use of anesthesia to be delayed. Apply the cream to the areas affected by cervical caries with a cotton swab for 2-5 minutes.

Complications

Complication	What to do
Pain in the gums after treatment. Inflammation of the gums can occur due to poor-quality root canal filling, filling material getting under and on the gum, unsuccessful administration of anesthesia, or trauma received during treatment.	Repeated filling of the canals, rinsing the gums with chlorhexidine, Miramistin, Stomatophyte, Rotokan
Secondary caries. Relapse occurs when necrotic masses are not completely removed or when an insulating pad is applied incorrectly. In this case, the person is bothered discomfort when exposed to temperature and chemical irritants, sweets.	Filling removal and re-treatment
Pain when biting. Occurs after the installation of a filling that prevents the teeth from completely closing.	Correction of the filling surface
Filling falling out. Possibly due to violation of the technology for installing the filling, unreliable isolation of the tooth from saliva when installing the gasket and filling, or the use of low-quality filling material. A filling that is too large may also fall out. This happens when a doctor recommends installing a crown, but the patient insists on filling.	Contact your dentist as soon as possible to correct the filling error.
Sensitivity of teeth after treatment. Pain may occur when pressing or eating hot/cold food.	Treatment of the canals, if after 2-4 weeks excessive sensitivity does not decrease

Cervical caries in children

The main reason for the development of cervical caries in children is insufficient thickness of enamel on baby teeth. It rarely reaches 1 mm and, due to certain difficulties in maintaining child oral hygiene, pathogenic microflora actively develops on it.

Cervical caries primarily occurs on the incisors upper jaw. While sucking on the nipple of the bottle, the main surfaces of the tooth are cleaned, but the cervical area does not have contact with the nipple. Gradually, microbes surround the entire tooth around the gum and corroded areas appear on all sides. dark spots. The lower teeth are protected by the tongue when eating from a bottle, so caries rarely occurs on them.

Without timely treatment, caries affects the entire tooth and it must be removed.

Treatment of cervical caries during pregnancy

During pregnancy, there is a high probability of cervical defects in the hard tissues of the tooth and the development of caries. Pregnancy is not a contraindication to treatment, however, taking into account the toxic effects of anesthesia, it is worth doing it in the second trimester.

If there is no risk of exacerbation in the third trimester, then it is advisable to postpone treatment to the postpartum period.

In the first and third trimesters, only emergency interventions are performed.

Cervical caries and wedge-shaped defect

Wedge-shaped defect is a disease of non-carious origin. It differs visually from cervical caries. Thus, with caries, the damaged surface has an irregular shape and Brown color, the enamel is loose and rough, and with a wedge-shaped effect there is simply a V-shaped depression, no darkening of the enamel occurs.

Prevention

1. Endogenous drug-free. Introduction to the diet of foods rich in amino acids, proteins, vitamins, consumption of calcium and fluorine-containing products.
2. Endogenous medicinal. Taking calcium and fluoride supplements by children, pregnant women, and people at risk.
3. Exogenous drug-free. Careful hygiene with the use of therapeutic and prophylactic pastes, professional hygiene, slow drinking of milk and tea, limited use carbohydrates, replacing sugar with sweeteners.
4. Exogenous medicinal. Local application remineralizing agents, rinsing.

Treatment price

The cost of treatment depends on the stage of the disease, the status of the dental clinic and the filling material used. Average cost of treatment of unadvanced root caries - 1600-4000 rubles. If the channels are damaged, this figure rises to 6,000 rubles.

If remineralization is indicated, the price of treatment will be lower. Coating one tooth with enamel-sealing liquid will cost 500 rubles, and complex fluoridation TUS MUS up to 4,000 rubles.

Additional expenses: removal of dental plaque (up to 4,000 rubles per jaw).

FAQ

Tooth hurts after filling cervical caries

If the pain decreases over time, then this is a normal reaction of the body to the intervention. An increase in pain occurs in the case of inflammation in the gum and pulp, incomplete removal of necrotic tissue by the dentist, penetration of filling material into the tooth, or violation of the filling hardening technology, which led to nerve injury.

How soon can you drink after treatment of cervical caries?

After treatment you cannot eat for 2 hours; you can drink, but only warm plain water without impurities. It is also better to abstain for 2 hours.

Why does the tooth react to tapping after treatment of cervical caries?

There may be several options - from the natural adaptation of the tooth to a new environment to errors in treatment, for example, the filling is too high, they made a mistake with the diagnosis (cervical caries turned out to be deep) and placed a filling without a gasket. If symptoms increase, contact your doctor for re-treatment.

What vitamins should you take for cervical caries?

Patients with a rapid form of enamel demineralization need complex therapy, affecting the immunological state of the body. So, for cervical caries, dentists recommend taking:

• ascorbic acid (0.1-0.2 g per day);
• vitamins A and E in oil (regulate phosphorus-calcium metabolism, a deficiency of these elements leads to a decrease in the resistance of teeth to caries);
• calcium preparations (glycerophosphate, gluconate, calcium pantothenate, lactate) in courses 2-3 times a year;
• fluoride preparations (sodium fluorate, fluoride) 1 mg twice a day;
• phosphorus preparations (phytin) 3 times a day, 0.25 g.

In addition to the above, for the synthesis of the complete bone structure, teeth need vitamin K1, silicon and manganese (participate in the synthesis of collagen, an element of the organic matrix of teeth). They are part of many vitamin and mineral complexes designed to strengthen teeth and reduce the risk of developing cervical caries (DentoVitus, Caltsinova, CalciumOsteoporosis, Forever Kids, Duovit, Centrum).

Caries in the cervical area under the gum

Subgingival caries is root caries in most cases. It is necessary to apply for an in-person examination.

Is it possible to put braces on cervical caries?

Teeth affected by cervical caries are healed until the installation of braces. Before installation, it is necessary to remove plaque and strengthen the enamel with fluoride and calcium containing preparations. If caries occurs while wearing braces, then the arch is removed from the diseased tooth, but this is extremely undesirable.

Treatment of cervical caries with nerve removal

Such treatment will be required if cervical caries has complicated to pulpitis, which has led to acute inflammatory process in the pulp. In this case, the patient complains of acute pain and the dentist may decide to remove the nerve.

Is it possible to put a crown on a tooth with cervical caries?

A crown cannot be placed on a tooth with decaying enamel, because... caries will eat the tooth anyway. First you need to cure tooth decay.

How to cure cervical caries of a wisdom tooth

The easiest way to treat a wisdom tooth affected by caries is to remove the problematic “eight”.

Cervical caries is a type of caries in which destruction of hard tooth tissues is noted at the border of the tooth root and crown. With cervical caries, the labial, lingual, and buccal surfaces of the frontal and lateral teeth can be affected. The disease most often occurs in childhood and in people aged 30–60 years and is one of the most dangerous types of caries, since the pathological process occurs in the most vulnerable area of ​​the tooth, which contributes to its rapid destruction.

The tooth consists of hard tissues (enamel, dentin, cement) and soft tissues - neurovascular bundle, the so-called pulp, which nourishes hard tissues and is located inside the tooth.

Anatomically, a tooth is divided into the coronal part (the visible part of the tooth), the neck (the transitional area) and the root (the part of the tooth that is located in the jaw). With the development of cervical caries, the pathological process can occur in the gingival area of ​​the tooth or spread to the entire root region of the tooth. Due to the thinness of the enamel in this area, the disease is prone to rapid progression: initial caries quickly progresses to a deep stage.

Causes of cervical caries and risk factors

The causes of cervical caries include the same factors that determine the occurrence of caries in other localizations, and in addition, specific conditions that occur in the root region of the tooth. These include, first of all, the inaccessibility of this area for hygienic care. For this reason, soft plaque often accumulates in this area, and the formation of tartar is often observed. Cervical caries often develops against the background of gum inflammation (gingivitis). The formation and development of cervical caries is facilitated by the thickness of the enamel in this area, which is approximately 0.1 mm (while in the area of ​​natural grooves on the chewing surface of the teeth, the thickness of the enamel is 0.7 mm, and in the area of ​​the tubercles – 1.7 mm). A thin layer of enamel is easily damaged when brushing your teeth, especially when using hard brushes and abrasive toothpastes, which also increases the risk of damage by pathogenic bacteria with the subsequent development of caries.

Other risk factors for the development of cervical caries include:

• some diseases that reduce the density of dental tissue (thyroid pathologies, diabetes mellitus, rickets, scurvy, osteoporosis);
• genetic predisposition;
• the use of medications that increase the porosity of tooth enamel;
• pregnancy period;
• frequent consumption of acidic foods and easily fermentable carbohydrates;
• lack of vitamins in the body (especially vitamin B 1).

In addition, the risk of developing cervical caries increases with age.

Forms of the disease

Depending on the number of affected teeth, cervical caries can be single, multiple or generalized.

Based on the condition of the pulp, cervical caries can be simple or complicated (in the latter case, they often talk about the transition of deep caries to the stage of pulpitis).

Caries of the cervical region can be acute (more often observed in children or in patients with reduced immunity) or chronic (typical of adults).

Cervical caries most often occurs in childhood and in persons aged 30–60 years and is one of the most dangerous types of caries, since the pathological process occurs in the most vulnerable area of ​​the tooth, which contributes to its rapid destruction.

Stages of the disease

IN clinical picture Cervical caries is divided into the following stages:

Based on the depth of the lesion, cervical caries is distinguished:

• initial (chalk spot stage) - due to the anatomical features of this area, cervical caries at this stage is extremely rare;
• superficial (within the enamel);
• medium (destruction extends beyond the enamel, dentin is also affected);
• deep (almost the entire enamel-dentin layer is affected while maintaining the integrity of the pulp chamber, i.e., a narrow layer of dentin remains, protecting the pulp chamber from destruction).

Symptoms

The clinical picture of cervical caries varies depending on the stage of the disease. At the stain stage, the enamel in the area of ​​the tooth neck loses its shine and becomes matte. A small white (chalky) or pigmented spot forms on the surface of the affected tooth, which can retain its shape and size for a long time. Painful sensations or any other discomfort at this stage is absent.

At the stage of superficial cervical caries, the surface of the spot becomes rough, which indicates the beginning of the destruction of the enamel. Painful sensations may be absent or observed when consuming sweet and/or cold drinks and foods; pain in response to such stimuli is short-lived and disappears almost immediately after the cessation of the stimulus.

At the stage of intermediate caries, a carious cavity forms in the affected tooth. Outwardly, this may not be noticeable, but food begins to get stuck in the affected area, causing discomfort after eating - usually this sign becomes the first manifestation of cervical caries. Pain, as in the previous stage, may be absent, but it can also become more pronounced, also appearing in response to chemical (sweet) and thermal (cold) stimuli. Pain often accompanies brushing teeth, especially if the patient rinses his mouth with cold water while brushing.

With deep cervical caries, food gets stuck in the cavity, and the pain can become very intense. It still appears in response to stimuli, but does not pass as quickly as in the previous stages, lingering for some time after the cessation of the stimulus. Pain often occurs when inhaling cold air.

Do not expect a visible cosmetic defect. The cavity may be relatively shallow - due to the thinness of the enamel in this area, even a slight depth of the lesion can be a sign of a deep stage of caries. In addition, the cavity may go unnoticed due to its location on the lingual or lateral surfaces of the tooth. In acute caries, there is often a small lesion of the enamel, under which, upon preparation, extensive destruction of dentin is discovered.

Cervical caries is characterized by a circular distribution. The pathological process quickly spreads to the middle part of the crown, can go deeper under the gum and cover the entire affected tooth in a circle.

Diagnostics

When carrying out planned medical examinations Cervical caries can be diagnosed at the spot stage. To do this, it is enough to examine the oral cavity, probe, and assess the hygienic condition of the oral cavity.

From additional methods diagnostics, dental radiography, dental radiovisiography, transillumination, electroodontodiagnostics, and thermal testing are used. In addition, vital staining of teeth can be performed, in which the patient is asked to rinse the mouth with a dye solution. In this case, the dye cannot penetrate the enamel of healthy teeth, but penetrates into the demineralized areas of the enamel of affected teeth. The previous color returns to the teeth a few hours after vital staining.

Differential diagnosis is carried out with fluorosis, enamel erosion, and wedge-shaped defect. If cervical caries is detected on several teeth, consultation with an endocrinologist is necessary.

With the development of cervical caries, the pathological process can occur in the gingival area of ​​the tooth or spread to the entire root region of the tooth.

Treatment of cervical caries

The choice of treatment regimen for cervical caries depends on the stage of the disease.

At the stain stage, professional oral hygiene is carried out, as well as remineralizing therapy, which is aimed at normalizing the mineral composition of the enamel and strengthening it. The patient is given recommendations regarding oral hygiene, since with improper care, relapse is almost inevitable.

When a carious cavity forms, treatment of cervical caries includes surgical treatment of the carious cavity and tooth filling.

The cervical area of ​​the tooth is highly sensitive, so before starting the preparation, the tooth is usually anesthetized using conduction or infiltration anesthesia. Using a drill, a carious cavity is prepared, and all tooth tissue affected by caries is removed. After this, the tooth is isolated from saliva, the cavity is first treated with an antiseptic, then with an adhesive to ensure strong adhesion of the filling to the tooth tissue. In cases where the bottom of the cavity is close to the pulp, therapeutic and insulating pads are placed on the bottom; at the stage of medium caries, only an insulating pad is sufficient.

Then the tooth is filled, using filling material the crown is given its physiological shape, which is corrected by grinding and polishing. If the carious cavity is located on the vestibular surface of the tooth, treatment can be supplemented by installing a veneer - a ceramic plate that protects the tooth and provides a high cosmetic effect.

Possible complications and consequences

Advanced cervical caries leads to the development of pulpitis, then periodontitis, and, as a consequence, tooth loss. In addition, caries can be complicated by gingivitis and periodontitis.

Forecast

With timely and properly selected treatment, the prognosis is favorable.

Prevention of cervical caries

Prevention of cervical caries includes:

• thorough and regular care for the oral cavity using individually selected products;
• regular (at least once every six months) preventive examinations at the dentist with professional hygiene oral cavity;
• avoiding snacking between main meals, especially without subsequent oral hygiene;
• rejection of bad habits.

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