Dental caries

Dental caries

Description caries

Tooth decay is obtained defect hard dental tissue, which has been known to mankind since the Stone Age. With the development of civilization and diet changes that came during development, its incidence is still rising. An important role was played by the transition from the coarse diet with high-fiber diet to chemically and mechanically treated.

Caries in different countries vary considerably, mainly as a resultof preventive programs. They are very good in Scandinavia or Switzerland.

To caries is involved in a number of causes. The basic underlying cause is dental plaque. This is a soft coating that is deposited in places difficult to access so. Samoočišťování teeth which occurs during chewing rigid diet. Such places are especially necks of teeth, holes and grooves on the crowns and interdental spaces.Plaque levels for each patient other connected not only with the oral hygiene, but also with the composition of the diet. Plaque is not only the basis of dental caries, but also the development of periodontitis.

What does the plaque consist of? Plaque contains large amounts of bacteria and bacterial products established in the salivary base. Relatively good adhesion to the tooth surface and the longer the tooth occurs, the more claims experience and we are talking about its maturity. Mature plaquecontains a large amount of so-called. caries bacteria, that is bacteria contributing significantly to caries (e.g. Streptococcus mutans).

The dental plaque run fairly complex processes, which easily explains Miller’s “parasitic challenges from acidogenic theory of decay” from 1889. It is based on the assertion that caries is involved in these particular bacteria that are able to convert sugars (carbohydrates) to organic acid. They then together with the bacterial enzymes disrupt the hard dental tissue. Theory is therefore based on four fundamental factors, namely: the presence of bacteria, carbohydrates (dietary) resistance of hard dental tissues and also plays an important role time.

In addition to the plaque on the caries also involved in genetic predisposition (shape and position of teeth, the quality of hard tissue of teeth, eating habits), quality and quantity of saliva, sex, age and civilization factors (diet, hygiene).

Saliva plays an important role. It protects the teeth secondly mechanically but also chemically.Bathes and cleanses the surface of the tooth and its chemical action reduces the solubility of enamel. Patients who are affected by decreased production of saliva (hypoptyalism to asialie), the incidence of caries incomparably large compared to the healthy population.


Risk factors for dental caries

The most important risk factor is poor (incorrect and irregular) oral hygiene.

Furthermore, frequent intake of simple carbohydrates (sweets), drinking acidic and sugary drinks, reduced saliva production and increased tooth decay in the family, or inflammation of the esophagus (esophageal reflux disease), when the acidic gastric juice ingredients come during sleep in the oral cavity (tj.regurgitace ), thus distorting the structure of the tooth and easier formation of caries.

As a risk factor even we consider age when changing the composition of the diet and the amount of saliva produced, just as it is during pregnancy, when the influence of hormones may change the composition of saliva and probably a pregnant woman eats and otherwise.


Caries prevention

Tooth decay is a disease whose treatment is not cheap, even though the patient are some of the performances fully or partially covered by insurance. Preventing patient’s perspective today is primarily motivated by economic aspect.

Prevention is aimed mainly trigger factors – plaque and carbohydrates. Caries is best preceded by proper and regular dental hygiene, dietary manipulation and the use of fluoride to increase the resistance of tooth tissue.

Modifying eating habits include restrictions so. Sticky sugar (chocolate, candies, biscuits) from which organisms are able to quickly generate acid. A similar effect is also sweetened drinks and some fruit, for example. Bananas. Appropriate diet is then balanced diet with vitamins, minerals and fiber. Contribution has food stimulates saliva – vegetables and whole grain breads harder. Saliva can promote the chewing gum.

Its place has a proper toothbrush and toothpaste. The working part of the toothbrush should be shorter to allow cleaning and less accessible places (e.g. retromolar area). The adults usually fits brush of medium hardness (medium). In children, the elderly and people with sensitive teeth are suitable soft brushes (soft), in such a case is probably the best choice to purchase the product in the pharmacy (e.g. brushes or brand Curaprox Oral B).

Electric toothbrushes are suitable for people with reduced mobility. Replacing the brush should be planned, and after about two months. Although the brush may look undamaged fibers are already slightly frayed and unclean precisely as the original (new) state, notwithstanding the possible damage to the gums.

Toothpaste should contain fluoride that promotes hardness of dental tissues. In our market, the number of trap with varying levels of fluoride. Generally, children paste containing fluoride or less, and for this reason it is assumed that a child of the paste swallows. Therefore, does not need fluoride in toothpaste so much, yet it receives through the digestive tract.

There are also various abrasive paste capability. For smokers and tea lovers can recommend a paste with higher abrasive abilities or slight whitening effect, for people with sensitive teeth are in place pastes intended for this purpose (Sensodyne, Elmex sensitive). Foaming power is not a prerequisite for good clean teeth, it can handle even the right technique and a brush. In children and the elderly can cause eczema paste foaming around the mouth.

The teeth should be cleaned after every meal, at least twice daily, especially in the morning and evening.

Chewing surfaces clean with a circular motion, the lateral surfaces are vertical strokes from the gums to the crown tooth brush at an angle of 45 degrees.

After cleaning, tooth brushing should follow the treatment of dental floss that very well removes remaining plaque from interdental spaces. Practicing proper use of toothbrush and dental floss can be done by your dentist or dental hygienist. In patients with wide interdental spaces (older age or genetically determined) can be used interproximal (interdental) brushes of varying thickness and shape.

The last part of prevention in addition to regular inspections by the dentist fluoridation, ie. The enrichment of fluorine compounds. In the Czech Republic fluoridovala drinking water from 1958 until the 80s, when this step was abandoned for lack of funds. The measures led to a significant reduction in dental caries in young population. Nowadays, it favors the use of fluoridated pasteand administration of fluoride tablets (be administered to children from six months of age).Commercially available is fluoridated salt and mineral water with a higher content of fluoride, i.e. about 1 mg / l (1ppm) (Crown, Poděbradka).

A few more tips at the end. Apple does not clean his teeth before bedtime so as toothbrush, however, is appropriate after a meal when you can not brush his teeth, for example. After lunch.

The teeth should not be cleaned at least one hour after drinking juices, because of the reason that caused the acidic environment in the mouth supports demineralization (decalcification) of tooth enamel and it is susceptible to damage (toothbrush). When adjusting the pH (acidity) in the mouth is gradually remineralization (re-mineralization) enamel. The latest reminder of the fact remains that each of us has some discoloration of enamel, which is given by (if not smoke and do not drink coffee and black tea) genetically.

They say that the glass is yellower than the naturally beautiful white teeth, is generally more resilient compared to dental caries. Chemical bleaching enamel using variously concentrated peroxide is currently big business and brings namely visible results, but at the cost of potential damage to the tooth enamel.


Signs and symptoms of dental caries

Dental caries in its classical form manifest pain tooth, in particular cold and hot, possibly sour and sweet.

Instead of decay usually has a chalky white color and may gradually increase, form bumps on the surface of the tooth and the like. However, sometimes it can take place in secret and so the patient does not (temporarily) no problem. Such decay can then spontaneously stop (typical then black defect), but may also extend into the dental pulp and cause inflammation (pulpitis) or in the vicinity to other teeth or cause the affected tooth decay.

Greatly feared is an infection that can be entered into the blood and other body parts – especially may endanger heart infective endocarditis, which can be a fatal condition.


Treatment of dental caries

Tooth decay, as mentioned above, occurs most frequently in the wells and grooves, around the neck and in between teeth. According to localization is selected and the method of his removal, which depends on the balance of your dental practitioner (dentist).

Using dental instruments is caries removed to healthy dental tissue and the resulting space (cavity) is filled with a filling material, most often of plastic material (solidifies in the cavity after removed caries – e.g. silver amalgam, composite resins, glass ionomer cements) or by use of so-called.inlays, fillings which are made in the laboratory according to the teeth marks. Into the interior of the tooth is then attached using special cement.

If the doctor assumes the pain of surgery, it is possible tooth and its surroundings numbing anesthetic. It is not always filing numbing injections necessary or beneficial.


How can I help myself

Tooth decay would not heal on their own, do best when made with a sore tooth as soon as you set out to your dentist and let it professionally treated. For pain and suffering you definitely worth it.Moreover, they need not be only a trivial tooth decay, but also an infection of the dental pulp, which is very painful and can lead to death of the tooth.


Complications caries

Complications of dental caries is the continuation of the process inside the tooth pulp inflammation (pulpitis) to the destruction of tooth decay or involvement of other tissues (osteomyleitida – inflammation of the bone marrow) and spreading the infection to other teeth in the mouth.

A serious complication of the penetration of infectious agents into the blood stream, which is dangerous particularly for individuals with heart disease, artificial heart and the flaps in individuals in whom surgery is planned for the heart. Therefore, part of the preoperative evaluation includes a tour of the dentist and dental X-rays to rule out the presence of infection on the tooth (ie. Odontogenic focal infections).

Other names: caries, caries dentis

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