Fissure caries - what is it? Causes, treatment, prevention
One of the most common forms of tooth damage is fissure caries. It is very difficult to diagnose in a timely manner. Running the pathological process can lead to tooth loss. To prevent this, you need to know the methods of preventing the disease and always follow them.
Description of the disease
The tooth consists of the root, neck and crown. On its masticatory surface there are small indentations, called fissures. They are divided into two types:
- Open, which have a good view of the bottom.
- Closed, resembling in its form a groove with almost closing walls.
This kind of caries has to be faced not only by adults, but also by small children. They have dental grooves so deep that they always get stuck with pieces of food. As a result, a deposit is formed. In the process of chewing food remains of products under pressure remain in the tubercles. There they decompose, creating a favorable environment for the reproduction of bacteria. Even a thorough brushing of teeth does not always guarantee protection from the disease.
Many underestimate fissure caries, delaying its treatment in the long box. Over time, the pathological process involves all new areas. Often patients get an appointment with the dentist when caries has captured not only the surface of the enamel, but also the pulp itself. At this stage of the disease, throbbing pain accompanies a person constantly, even in the absence of external stimuli. Usually such a symptom indicates the occurrence of pulpitis or periodontitis.
Causes of the disease
The main cause of the disease is considered to be incorrect oral hygiene. The fissure of the tooth is a vulnerable place where the remains of food constantly accumulate. Subsequently, they begin to rot and destroy the enamel. Over time, the pathological process leads to the development of caries, which gradually spreads to new areas of the tooth.
Among other factors provoking the appearance of the disease, the doctors distinguish the following:
- large size of dental grooves;
- low enamel resistance;
- changes in the composition of saliva on the background of chronic diseases;
- malnutrition with a predominance of carbohydrate products.
In the presence of these factors caries is not always evident, but the likelihood of its occurrence increases several times. People who are at risk should be examined periodically by a dentist. In addition, more attention should be paid to oral hygiene.
How to recognize pathology on your own?
Fissure caries is one of the few dental diseases that you can easily diagnose yourself. It is worth mentioning that this is an open type of grooves. The first manifestation of the pathological process is the darkening of the enamel. In this case, the tooth surface retains its integrity. This symptom is supplemented by attacks of monotonous or pulsating pain. Gradually sensitivity of a tooth in relation to external irritants raises. Eating too hot or cold food is always accompanied by unpleasant sensations.
Closed tooth fissure is a more complex case. The disease can develop for a long time without causing anxiety. External signs of the pathological process are almost always absent. It is not possible to recognize the illness independently.
Diagnosis methods for
When the first symptoms of a carious process appear, you need to seek help from a dentist. Do not be afraid and postpone visiting a doctor. The sooner a specialist reveals pathology and proceeds to treat it, the less likely it is that complications develop.
For the diagnosis of fissure caries in modern dentistry the following manipulations are used:
- Visual inspection with a probe. This method is effective only for open fissures. Using it, you can examine the grooves and consider the state of the enamel.
- Hardware diagnostics. This modern method of investigation makes it possible to identify closed and open fissures. During the procedure, the doctor examines the patient's teeth with a special laser. Any private dental clinic can provide a similar service, which can not be said about free medical facilities.
- Radiography. This method is used to diagnose closed fissures, when the main symptoms of the disease are absent. To his help resorted to in case of patient complaints of increased sensitivity of the teeth.
- Fissurotomy. For the procedure, the dentist uses special soft burs that allow the dental groove to be opened by 0.6 mm. In most cases this is sufficient to detect pathology.
- Application of caries-markers.
If you suspect a tooth decay, you will usually use several diagnostic options at the same time from the ones listed above. However, the most informative is the hardware method. Laser treatment of teeth affected by fissure caries is not applied. The device is used exclusively for diagnostic purposes.
When to start treatment?
Opinions of dentists on this issue are significantly different. Some believe that dark spots on the enamel do not require specific treatment. The patient in this case is given advice on the proper care of the oral cavity in order to delay the further development of the pathological process and the destruction of the tooth enamel. Only after the disease has shifted to a new level can therapy begin.
Other dentists have a different opinion. They believe that a dark spot is a favorable environment for the life of disease-causing bacteria. The absence of timely therapy can lead to the destruction of the entire tooth.
Treatment of the disease is carried out in two ways - with the help of sealing and the use of special tabs. All therapeutic measures are aimed at removing carious tissue. They differ only in the choice of the material and the technique by which the tooth form is restored.
Filling with light-polymer materials
Treatment of a problem tooth begins with the removal of carious tissues. To do this, use diamond burs, whose rotation speed is about 30 thousand revolutions per second. This high speed and the use of water cooling ensure a painless procedure. Pathological tissues are removed to the level of healthy structures
. In the next step, the dentist etches the prepared cavity. This procedure involves the treatment of the bottom and walls of the tooth with orthophosphoric acid. As a result of etching, micropores are formed on the entire surface of the cavity.
Then the doctor applies a special formulation - an adhesive. This is a sticky substance that fills all microcracks on the tooth surface. Also, its use is necessary to better connect the material of the seal with solid tissues. This concludes the preparatory stage.
Pre-dried cavity dentist fills with filling material. The shape of the tooth and its functions are restored. In modern dentistry, the most popular light seal, which is otherwise called a photopolymer. It is characterized by high resistance to abrasion, the absence of toxic effects on the body.
The final stage of the treatment is polishing the installed seal. With the help of special brushes and rubber bands, the dentist smooths all irregularities, roughness.
Treatment with the help of repair tabs
The procedure for working with a sick tooth is practically the same as the treatment plan with the use of a seal. The doctor first drills out carious tissues in the cavity, preparing it for the installation of a kind of microprosthesis - the restoration tab. Then it applies an adhesive compound to eliminate microcracks.
After this, a mold of the tooth is made, according to which the technicians in a special laboratory can make an exact copy of the plaster. A restorative tab is made for this model. It can be made from ceramics, silver or a medical alloy of semiprecious metals. The resulting microprosthesis fills the grooves of the chewing surface of the tooth. At the final stage, the dentist gently adheres it to a special cement.
Which is better: seal or repair tab?
Most dentists favor the use of replacement tabs. They explain their choice very simply. Often tooth decay extends not only to the tooth itself, but also to the filling. As a result, there are small gaps that can lead to the development of a secondary form of the disease. When using tabs, this problem can be avoided.
Microprostheses have a longer service life than seals. Ceramic tabs have an attractive appearance. Over time, this material will not fade as opposed to seals.
Today every private dental clinic offers services in the treatment of fissure caries. In most cases, the restoration tabs are used during the restoration work. To be sure of the quality of the result, you can get acquainted with examples of the work of dentists. Practically in every medical institution there is a stand with photos before or after treatment. In addition, specialists always give a guarantee for the work done.
How much does dental treatment cost?
To answer this question unambiguously is not possible. The decisive value in the final cost of therapy is the choice of the material used. For example, to treat caries with a light seal, you have to spend 3 to 6 thousand rubles. Additionally, in dentistry, charges for anesthesia can be taken.
How much is dental treatment using a repair tab? In this matter, the choice of material also plays a direct role. A microprosthesis made of medical alloy will cost much less than its ceramic counterpart. However, the latter is characterized by greater durability and wear resistance. It should also be taken into account that the cost of the treatment will include the work of the imitation technique. On average, the final price can vary between 10-20 thousand rubles.
Fissure caries is a disease that can be avoided by following preventive recommendations. Among them:
- Regular visit to the dentist. At the reception the doctor will be able to identify the nascent pathology and painlessly eliminate it.
- Compliance with the basic rules of oral hygiene( use of dental floss, rinse aid).
- Remineralization of the teeth every 6 months.
- Taking medications with calcium. It is worth noting that any medicine can be prescribed only by a doctor.
For people with a complex fissure structure, when there is no way to clean the grooves qualitatively, dentists recommend a sealing procedure. It implies the application of a special gel to the problem areas of the teeth.