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Therapy in Dentistry : Tooth decay
One of the most frequent reasons for visiting a dentist is dental caries. So called the defeat of hard tissue, which begins with the destruction of enamel. If not to take any measures and not to carry out preventive maintenance, carious process extends deep into. Cavities are formed, various complications can join. With an unfavorable course of tooth loss occurs.
The cause of caries is considered to be the destructive effect of bacteria on the hard tissues of the tooth. A large number of various microorganisms inhabit the mouth of a person, already 2–4 hours after thoroughly cleaning the teeth, their number can reach up to 1 million. They actively attach to the surface and act on the enamel, which causes caries. The main cause of caries are Streptococcus - Streptococcus mutans and Streptococcus sanguis. Moreover, the activity and harmfulness of bacteria depends largely on the body's resistance and the presence of predisposing factors.
The fastest way is the reproduction of bacteria in a favorable environment for them, which is formed under different conditions. These include:
improper oral hygiene, especially irregular or insufficiently effective cleaning of the teeth;
poor nutrition with an excess of soft carbohydrate foods and lack of raw vegetables;
hypovitaminosis;
low content in drinking water of certain minerals (fluorine, phosphorus and calcium);
violation of the formation of teeth, which is often associated with rickets or tuberculosis in childhood;
reduced immunity;
the presence of diseases of the gastrointestinal tract.
Such conditions contribute to a change in the structure of the enamel, inadequate cleaning of the teeth from plaque and an increased content of bacteria in the oral cavity. It causes tooth decay. For prevention, these predisposing factors must be eliminated.
In some cases, the person himself may suggest the presence of caries, based on a change in the appearance of the teeth or the appearance of some symptoms. But in order to reliably diagnose the disease, you need to go to the dentist, as some examinations allow you to determine the caries. Three main methods are used for this: vital enamel staining, ultraviolet irradiation and radiography.
Staining enamel allows you to determine the initial stages of caries, for this purpose, a special dye is applied to the previously cleaned and dried tooth surface. Enamel damage areas do not change color. If such disorders are detected, the doctor may prescribe a remineralization course to restore the structure of the surface tissues. Such an examination can be useful during routine inspections for the prevention and early detection of caries.
Examination with the help of ultraviolet requires cleaning the teeth from plaque and subsequent drying. Areas of development of caries under the action of ultraviolet do not emit a luminescent glow, unlike healthy enamel.
X-ray method does not require special training and allows you to determine the degree of destruction and the state of adjacent tissues.
Stages of caries development
Depending on the depth of the lesion, there are 3 stages:
the initial stage is a spot or superficial caries, at the same time white demineralization centers first appear, and then the damaged enamel darkens and becomes rough;
medium caries, when the dentin layer under the enamel is damaged and a carious cavity is formed;
deep caries, in which there is a transition of inflammation beyond the dentin and the development of various complications.
The rate of destruction may be different. In adults, the process most often has a chronic sluggish nature. And children often have acute caries, which causes the rapid destruction of milk teeth.
What is dangerous caries, if not treated
Insufficient attention to the condition of the teeth leads to the progression of caries, from which there is a risk of developing various complications. This occurs when the infectious-inflammatory process spreads beyond solid tissue.
The development of pulpitis
Inflammation of the soft tissues of the tooth (internal neurovascular bundle) is called pulpitis. It is accompanied by severe pain. In the absence of adequate treatment, the inflammation takes on a purulent character, the pulp dies off, the tooth tissues stop receiving nourishment from within.
The development of periodontitis
The spread of infection through the channels inside the tooth causes inflammation of adjacent tissues, which are called periodontal. If the process is spilled, they talk about periodontitis. And during the formation of a purulent cavity at the roots, the diagnosis of periodontal abscess is established.
Cyst development
In case of periodontitis, the destruction of bone tissue may occur with the growth of granulations and the formation of cavities among them. Subsequently, a radicular (located at the root) cyst of the jaw arises. It is most often filled with pus. If such a condition is detected, the doctor performs a puncture and, if necessary, excises the cyst.
Flux development
Severe swelling of the gums and / or cheeks is called flux. The cause of this condition is the spread of inflammation to the periosteum, which covers the bones outside. Periostitis develops with periosteum detachment, the resulting space is filled with pus. During treatment, it is necessary to evacuate pus through the incision and eliminate inflammation with the help of antibiotics. If a decision is made to preserve the tooth affected by caries, it is necessary to conduct a full treatment of pulpitis, periodontitis. This is the prevention of re-flux.
How to prevent the development of caries
Brush your teeth properly
Brushing your teeth should be done twice a day, the procedure should take about 2 minutes. Thorough cleaning of the internal surfaces, circadian, interdental spaces and tongue allows to eliminate the main causes of dental caries. Mechanical regular cleaning - effective prevention of dental caries. Proper selection of toothbrushes and toothpaste will help make this process even more efficient.
Use mouthwash
To prevent caries, it is advisable to rinse your mouth after each meal. A morning and evening cleaning of teeth to complete the use of mouthwash for the mouth. Such prevention of dental caries can significantly reduce the risk of harmful action of bacteria.
Fill the lack of fluoride
In many regions, drinking water does not contain enough fluoride, which leads to insufficient strength of the enamel. To compensate for the deficiency of this trace element can water fluoridation. But it is easier to use special rinses. In addition to these tools, you can add more seafood to the menu; this is a natural prevention of dental caries.
Avoid taking temperature contrasting foods.
The use of excessively cold, hot or contrasting food adversely affects the state of enamel, and microcracks can appear on it. They become the entrance gate for carious bacteria.
Visit the dentist regularly
A dentist should be contacted not only when various complaints appear. Regular examinations by a specialist are the prevention of the development of complications and help prevent the early loss of teeth. With the mineralization of plaque and the formation of tartar, it is desirable to conduct regular professional oral hygiene. Adults need to undergo a dental examination every six months. And it is desirable for children to show themselves to the doctor every 3 months, since they need to determine caries as early as possible.
Teeth restoration
Aesthetic dentistry necessarily includes various methods of restoration and restoration of the dentition, allowing to fill it and retouch color change and pigmentation. Restoration is carried out in the process of therapeutic treatment (tooth filling) or with the help of microprosthetics (method of "orthopedic" restoration). If the restoration does not imply the establishment of crowns, then veneers or lumineers are used - thin ceramic or porcelain plates. Before applying them to the front of the tooth, they are pre-processed, the uppermost layer of enamel is removed, then thin veneer or lumineer is fixed on it. It must be said that the former are thick with a piece of paper, and the latter are even thinner than the plate and are considered more modern and comfortable.
Filling
Filling is a way to restore the shape and function of a tooth decayed by caries. When the dentist seals the tooth, it first removes the tooth tissue that is damaged by caries, cleans the infected area, and then fills the cleaned cavity with a filling material.
Closing the areas into which bacteria could penetrate, filling also helps prevent further development of caries. The materials used for filling include: composite materials (filling in the color of the teeth).
What type of filling is better?
There is no such type of sealing that it is ideal for everyone. The option that is suitable for you may depend on how much restoration is required, if you are allergic to certain materials, in which part of the oral cavity you need filling and the cost of dental services. The choice of various materials includes the following types of them:
Composite material is chosen according to the color of the teeth and therefore it is used where the natural appearance of the teeth is necessary. The components are mixed and placed directly in the cavity of the tooth, where they harden. Composites may not be the best materials for large fillings, as they may slip or wear over time. They can also stain with coffee, tea, or tobacco, and do not last as long as other types of fillings — generally from 3 to 10 years.
If caries or a crack damaged most of the tooth, you can put a crown. If the caries has reached the nerve, then 2 treatment options are possible - either root canal treatment (if the nerve is damaged, it is removed), or a protective pulp of the tooth (to keep the nerve alive).
How to put a seal?
First, the caries-affected tissue is removed and the affected area cleaned. Then the cleaned cavity will be filled with one of the materials mentioned above.
How do I know if I need a seal?
Only your dentist can determine if you have a cavity that needs to be sealed. During the examination, your dentist examines the surface of each tooth with a special dental mirror.
Then places of doubt are carefully examined with special tools. Also, your dentist can x-ray your entire oral cavity or a specific area of it. The type of treatment your dentist will choose will depend on the number of carious cavities.
Teeth removal
Dental pulping is most often performed in the case of diagnosing diseases such as deep caries and pulpitis, when the removal of pulp is the only way to preserve a sick tooth for its further restoration and restoration of its basic functions.
Less often, the depulping of the teeth is carried out in case of severe periodontitis.
Features of the procedure of depulping teeth
Today, thanks to modern technologies and materials, the removal of the pulp, cleaning the canal of the tooth and its further filling can save teeth that might have been lost. Moreover, the depulpation of the teeth at the present time, thanks to modern anesthesia, is a process that is practically painless and fast enough.
And modern filling materials allow the patient's tooth after treatment to perform its functions on a par with healthy ones.
Removal of the pulp is a very painful operation due to the increased sensitivity of the nerves of the tooth; therefore, it is performed only under local anesthesia and in some cases under local anesthesia.
The essence of this operation is that the dentist, under the action of the anesthetic, opens the root canal and removes the soft tissue of the pulp inflamed by the disease, and then seals the cleaned canal.
The depulping procedure itself lasts about half an hour. In the same reception can be installed seal. However, quite often, a temporary seal is first placed, and only after a return visit has shown that the depulpation was successful, a permanent seal is established.
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