Dental caries treatment

After eating and drinking, plaque forms on the teeth from food and beverage residues. This plaque is biological in origin and serves as a nutrient medium for bacteria, which is why it should be removed as often as possible throughout the day. Irregular or inadequate oral hygiene increases the risk of caries.

At home, even with all modern oral-care products, we cannot remove hard dental deposits. These deposits are called tartar (dental calculus), and they promote not only caries but also other oral problems: gingivitis, periodontitis, and increased tooth sensitivity.

When gastrointestinal diseases increase the acidity of gastric juice, this affects lip moisture and salivation and, as a result, disrupts the acid–base balance. These conditions promote the growth of harmful bacteria and, therefore, the formation and progression of caries. It also works the other way around: caries can cause gastrointestinal disorders when bacteria enter the stomach with saliva.

Tooth enamel is the protective layer of the tooth and is very strong, which protects teeth from rapid damage. When a tooth is injured — for example, chipped or worn down due to malocclusion — the enamel is lost. Beneath the enamel lies a more vulnerable tissue, the dentin. When the dentin is exposed and has no protective enamel, bacteria easily attach to it and multiply. This also applies to a lost filling, which leaves the tooth exposed and unprotected.

The initial stage of caries. It can be diagnosed during a dental examination, since a white spot does not always mean caries: sometimes it is simple pigmentation or a noncarious lesion (fluorosis, hypoplasia). White spots do not affect quality of life at all. They only indicate that a carious process has begun on the enamel surface. The process can be stopped with proper oral care and certain procedures (fluoride treatment).

As in the first case, when a white spot turns brown, you will feel no discomfort. The superficial caries stage means that the enamel has already been destroyed, and the dentin will be affected next. At the first two stages, the progression of caries can be slowed with a noninvasive method. In our clinic, superficial caries is treated without drilling or filling.

It is accompanied by symptoms such as increased sensitivity to cold, warm, and sweet foods, bad breath, and short-lived pain. All these symptoms indicate moderate caries, which requires immediate treatment to prevent complications.

The final stage is deep caries. The lesion has passed through the dentin and approached the next layer of the tooth — the pulp. It is accompanied by prolonged sharp pain in response to cold, hot, or sweet foods and food debris. The pain subsides as soon as the irritant is removed. If treatment is delayed, complications develop: pulpitis and apical periodontitis.

The traditional method of treating caries at all stages. Treatment is usually performed under local anesthesia: using a dental drill, the dentist removes the decayed tissue, shapes the cavity so that the filling material fits tightly and securely, isolates the tooth, and seals the cavity with a tooth-colored light-cured composite filling. The filling is then adjusted to the bite (so it does not interfere), finished, and polished.

Used to treat superficial caries at the white-spot stage, but it is of limited effectiveness for moderate or deep caries. A completely painless procedure that requires no drilling and is suitable for both children and adults. Ozone is delivered to the affected area with the HealOzone device (manufacturer: KaVo, Germany), which converts oxygen into ozone; the ozone destroys pathogenic bacteria without harming healthy tooth tissue.

The technique is used at the initial stage of caries; it can also be applied to moderate caries, but secondary caries is common in such cases. Using a special hand excavator, the dentist scrapes away the decayed tissue and then covers the tooth with a glass ionomer filling material.

A noninvasive method of treating superficial caries. The treatment is completely painless and suitable for patients of all ages. The tooth is treated with fluoride-containing agents. It is used both for treatment and for the prevention of caries.

A method of treating initial and moderate caries. The affected areas are cleaned with an air-abrasion device without damaging healthy tissue. This technique is used only in easily accessible areas of the mouth.

A minimally invasive method suitable for treating the first three stages of caries. The dentist removes the damaged tooth tissue with a laser, which simultaneously disinfects the healthy areas around the carious lesion.

In addition to brushing your teeth twice a day, it is recommended to use a water flosser once a week, as well as dental floss and interdental brushes. Mouthwashes are not mandatory in home care and are used as prescribed by your dentist. A healthy person’s toothbrush should have medium bristles; manual (classic), electric, and ultrasonic brushes are all suitable. Brushing technique and quality matter more than the type of toothbrush.

Fissures are the grooves, pits, and depressions on the chewing surfaces of the teeth. They are an ideal environment for caries and perhaps the most common site where it develops, because small food particles easily accumulate in these recesses, and the back teeth are hard to clean thoroughly. The sealing procedure closes these recesses and smooths the surface with a clear material that prevents food debris from accumulating.

Professional teeth cleaning twice a year is necessary for every healthy patient to remove hard dental deposits that contribute to caries. A dental checkup twice a year helps detect caries in time, even if it does develop, and treat it at an early stage with a noninvasive or minimally invasive method.

Fluoride enrichment of the tooth tissues is typically used for children and adolescents. Children rarely brush their teeth skillfully and thoroughly, and even if a child uses fluoride toothpaste at home, its effectiveness is often questionable precisely because of brushing technique and quality. This procedure helps compensate for the lack of fluoride and enrich the teeth with minerals.