Cervical caries is a special type of tooth decay which is characterized by destruction of bone tissue at the cervical margin of the tooth. This disease progresses very rapidly permeating into the dental tissues and affecting the nerve canals. It is very difficult to detect this dental caries type at early stages and hard to manage it at more advanced stages. Frequently cervical caries affects people over thirty years of age but it is often observed in children
There are several stages of cervical caries development in children and adults. They are: a demineralized spot lesion, superficial caries, median and deep stages of dental caries. Cervical caries can be accompanied by different disorders of the thyroid, diabetes mellitus in particular. That is why it is necessary to undergo endocrinological examination along with cervical caries management. This disease often provokes the onset of circular caries in children. It can be accompanied by baby bottle tooth decay.
Photo 1. Cervical caries.
Continuous multiplication of microorganisms which are present in dental plaque and dental calculus is the principal cause of cervical caries development. The layer of tooth enamel is thinner in periapical regions and it is more difficult to brush the bacteria away from these zones. Hence, dental plaque accumulates very quickly. Some patients are predisposed to gingival layering which can result in cervical caries. Food gets into periodontal pockets and a great amount of pathogenic bacteria accumulate in these regions. These bacteria produce lactic acid which demineralizes both the enamel and the crown. Thus, the main causes of cervical caries are insufficient hygiene care and anatomic features of the patient’s oral cavity.
Photo 2. Dental calculus.
Cervical caries occurs on the gingival line. Classical symptoms like hypersensitivity to hot, cold and sweet are not observed at the initial stages of the disease progression. The signs of the disease can be noticed in external changes: that is the enamel darkens and white spots emerge. When the disease progresses painful reactions to temperature drops as well as to sour and sweet products may become frequent. On more advanced stages even tooth exposure to cold air may cause intolerable pain. Painful feelings while biting and chewing can be experienced. This disease is dangerous because of its rapid progression to the root of the tooth. Moreover, the affected tooth acquires a bad esthetic appearance. The disease may cause such complications as puplitis, gingivitis and periodontitis. Cervical caries is transmitted from one tooth to another that is why treatment is obligatory. Moreover, advanced stages of cervical caries are accompanied by parulides, abscesses and phlegmon occurrence. These complications are life-threatening and the patient needs immediate hospitalization.
Photo 3. Tooth hypersensitivity.
Cervical caries must be treated immediately as the carious cavity may look much smaller than it really is. This caries type affects the tissues which are adjacent to the root that is why the position of the tooth may be considerably weakened. It can lead to crown chipping or tooth fracture. On the initial stages of tooth decay the dentist will prescribe special calcium and fluorine-containing creams to remineralize the enamel. If cervical caries has affected the dentine, filling of the affected tooth and fixing a dental crown is done under local anesthesia as there can be absolutely destructed tooth structure under a small carious spot. Dental manipulations will induce severe pain. If the caries has reached the pulp, the endodontic procedures must be fulfilled: the nerve canals must be cleaned and treated. On the advanced stages of cervical caries the tooth has to be extracted and replaced by an implant. It is exceptionally difficult to treat this caries type in children as it is located in an extremely sensitive zone. That is why anesthetics are used while cleaning and filling such carious cavities.
Photo 4. Cervical Caries Treatment.
Proper dental hygiene should be maintained: high-quality tooth brush and tooth paste must be used to clean the teeth. To brush in between the teeth it is necessary to use dental floss. Gingival massage and mouth rinsing with herbal decoctions are recommended to promote enamel regeneration. Well-balanced nutrition is a key factor of dental health. Dental prophylaxis also presupposes regular dental examinations, even when nothing bothers the patient. The dentist will perform professional teeth brushing, remove dental calculus, whiten and remineralize tooth enamel. It is necessary to remember that sweets themselves do not cause caries. It occurs as a result of poor hygiene of the oral cavity where the microorganisms multiply. That is why parents should monitor the process of their children’s teeth brushing.