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Главная  -  Лечение  -  Caries


Many people think that treatment of caries is the most regular and banal thing for an experienced doctor-stomatologist? However, it is an error. Understanding comes together with the accumulated experience, that every work is individual, and that one should constantly master the knowledge and skills.

Stopping of teeth in our clinic is produced with the use of modern composite materials which possess sufficient durability, to maintain loadings in the process of mastication, and, in addition, in colour and undistinctive transparency from the enamel of natural teeth. We reach an excellent cosmetic effect with the minimum preparing of tissues of own teeth, it  allows to save the resived result for a long time, practically except the appearance of the secondary decay.

Tooth decay is a  disease, characterized by making progress destruction of hard tissues of tooth and subsequent forming of defects as a cavity. Сausative agent  is streptococcus mutans, saved on the top of enamel as a soft dental raid.

Unfavourable factors, that promote the development of tooth decay:
• Unsatisfactory teeth care;
• Deficit of calcium, phosphorus, fluorine and other oligoelements in the organism;
• Surplus consumption of saccharose and sweetnesses.

Depending on the depth of tooth defeat there are 4 stages of caries:
1. Caries in the stage of spot
Caries in the stage of spot can show up only by appearance of whitish spot on a tooth and can remain long time in a stable form without changes.

2. Superficial caries
Superficial caries is accompanied with destruction of tooth within the limits of dental enamel and appearance of small sensitiveness on hot and cold.

3. Middle caries
Middle caries is characterized with destruction of tooth within the limits of dental enamel and dentine and appearance of clear sensitiveness on sweet, cold, hot. Pain in this case passes very quickly.

4. Deep caries
 Deep caries is the defeat of tooth tissues located near the nerve. A carious cavity is deep, frequently with the overhanging edges of enamel, filled with pigmented and softened dentine. Shows up by great pain on irritants (cold, hot etc.).

The modern views on the origin of tooth decay foresee a few groups of cariogenic factors:
General cariogenic factors :
-Inferior food and drinking water.
-Diseases and violations of the functional state of internalss.
-Somatic diseases, changes in the functional state of organs and systems in the period of forming and ripening of tooth tissues.
-Extreme influences.

Local cariogenic factors :
- Dental deposits, dental plaque and dental raid, that are full of microorganisms, carbohydrate sticky food tailings in the mouth cavity.
- Microflora.
- Breach of composition and properties of mouth liquid.

Stability of teeth to the caries, or caries resistance, is provided by:

• chemical composition and structure of enamel and other tooth tissues;
• optimum chemical composition of saliva and its mineralizing activity;
• enough amount of mouth liquid;
• low level of permeability of tooth enamel;
• good masticatory loading and self-wiping of surface of teeth;
• properties of dental raid;  
• good hygiene of mouth cavity;
• features of diet;
• correct forming of rudiments and development of dental tissues;
• timely and valuable ripening of enamel after an odontiasis;
• specific and heterospecific factors of defence of mouth cavity.

Receptivity of teeth to the caries, or caries sensibility, is promoted by: 
• inferior ripening of enamel;
• diet with the deficit of albumens, maсro- and oligoelementss, surplus of carbonhydratess;
• water with the insufficient amount of fluorine;
• composition of mouth liquid, its concentration, viscidity, amount and speed of expiration;
• biochemical composition of hard tissues of tooth which determines the flow of caries, because a dense structure at minimum spaces of crystalline grate slows the flow of caries and vice versa;
• state of vascular-nervous bunch;
• functional state of organs and systems of organism in the period of forming and ripening of tooth tissues;
• maldevelopment of tooth because of general somatopathies.

How does an inferior nutrition influence on the development of caries?
The considerable cariogenic action is marked with surplus of carbonhydratess in the meal, deficit of mineral matters and oligoelementss in it, soft consistency of meal. By numerous clinical supervisions considerable prevalence of caries was marked for people who used a lot of carbonhydratess. Especially it was expressed with the use of digestible carbonhydratess — saccharose and glucose.
They render the most unfavourable action in child's age, when hard tissues of teeth are not mineralized fully.

What  digestible carbonhydratess do render the most expressed cariogenic action?
Cariogenic action of surplus of digestible carbonhydratess in nutrition was confirmed by a number of experiments with creation of models of caries in animals. It was exposed, that the most cariogenic effect is rendered by saccharose, in a less measure by glucose and then by other carbonhydratess. Cariogenic action of carbonhydratess shows up during their direct contact with hard tissues of teeth in the mouth cavity.

Does the insufficient entering of calcium in organism influence on the origin of caries?
The insufficient entering of calcium in organism (less than 0,5 gramme in a day) with food (especially milk) can result the development of caries. It is especially important to remember  for pregnant women, because their need for calcium increases.

What are the important components of food affecting the mineral metabolism of hard tissues of teeth?
Minerals, especially calcium, phosphorus, fluorine, etc are important components of food. Calcium and phosphorus are the main mineral components of dental tissues, and phosphorus also stimulates bone formation. It must be remembered that an excess of phosphorus and fat inhibits the absorption of calcium, and an excess of protein and magnesium activates it. Milk and milk products are the most balanced in mineral composition for the absorption of calcium. Calcium content in milk is approximately 120 mg%, in cheese - 135 mg%. Daily requirement for calcium is 400-500 mg and can be met through its water-soluble compounds found in milk and milk products (preferably sour milk products), fish, eggs and some vegetable products (cereals, peas, beans, legumes, and etc.).   The optimum ratio of calcium and phosphorus is 1:1,15 in cereals and meat products, it ranges from 1:8 in bread and to 1:21 in beef. In fruit and vegetables, this ratio is somewhat different -1:0,5-0,7, so, it is recommended to include them more in the diet. It is advisable to combine foods containing different amounts of mineral salts, such as meat and fish rich in phosphorus, with a garnish of vegetables that are rich in calcium.

Does drinking water influence on the occurrence of dental caries ?
Epidemiological studies revealed a high prevalence of dental caries in people who consume water with low (less than 0.8 mg / l) level of fluoride. This dependence is revealed clearly enough, and confirmed by the low prevalence of caries in areas with optimal levels of fluoride in drinking water (1-1,5 mg / l), as well as the favourable impact of  cariespreventive fluorine, additionally introduced into the drinking water or the body in the form of various chemical compounds. 
Does the the composition of drinking water influence on the occurrence of dental caries?
Some role in caries promotion is played by different  microelements,  an excess of them (selenium) or insufficiency (vanadium, iron, copper, zinc) in drinking water can trigger its occurrence. 
How does the consistency of food influence on the occurrence of dental caries?
The consistency of food also has some influence on the occurrence of dental caries. Modern culinary treated soft foods do not require intensive mechanical processing by teeth, that are at the same time eliminating the need for physiological loading. Soft pieces of such food items collected in the retention of teeth (pits, fissures), make the last susceptible to caries.
What is the role of food debris in the development of dental caries? 
Food debris that accumulate on the teeth and interdental spaces, have expressed cariogenic effect. Stopping and accumulating in retention areas, they are a breeding ground and the material from which acid can be formed by microorganisms. The most important in this regard are easily digestible carbohydrates, especially sucrose and glucose. Carbohydrate food residues are very easy to transform, not only in acid but also in dextrans, levans, that played a significant role in the formation of dental plaque and its attachment to the tooth surface. Quite a significant thickness of food residues prevents penetration through these parts of buffer system some saliva, which further creates the conditions for accumulation beneath acids. 
What factors determine the resistance of dental tissue disorders?
Defective structure of dental hard tissues, the chemical composition of dental tissues, unfavorable genetic code, that is hereditary.

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