Cervical caries is a carious process with localization in the posterior region, that is, in the area of the neck of the tooth. Depending on the stage, disease can be manifested by darkening of the tooth enamel in the near-gingival area; increased sensitivity of the tooth to temperature, chemical and mechanical stimuli; formation of a carious cavity of various depths, pain syndrome. Pathology is diagnosed during dental examination and radiography of the tooth. Treatment is carried out taking into account the stage of carious tooth damage and does not differ from that of other types of caries.
Cervical caries is a type of caries characterized by the destruction of hard tissues at the border of the crown and root of the tooth, next to the gum. According to the classification adopted in dentistry, depending on the localization, fissure, cervical (cervical), contact (approximal) and annular (circular) caries are distinguished. Pathology can affect the labial, buccal, lingual surfaces of the lateral and frontal teeth. Cervical caries occurs more often in people aged 30-60 years. Disease is one of the most dangerous types of caries, affecting the tooth in the most vulnerable place and contributing to its rapid destruction.
In general, caries of the cervical region develops due to the same causes and mechanisms as carious processes of other localizations. At the same time, the occurrence of cervical caries is favored by the special conditions available in the posterior region. First of all, this is the inaccessibility of this area for high-quality hygienic care, and, consequently, increased accumulation of plaque and the formation of tartar in the cervical region. There is a direct link between cervical caries and gingivitis.
In addition, in the area of the neck of the tooth, the enamel thickness is only 0.1 mm, whereas in the area of the bumps – 1.7 mm, and in the area of the fissures – 0.6-0.7 mm. A thin layer of enamel is relatively easily damaged when brushing teeth with abrasive pastes, tooth powders, and hard brushes.
Among other factors, the development of this disease can be promoted by frequent consumption of acidic foods and taking medications that increase the porosity of enamel, pregnancy. If several teeth are affected by cervical caries at the same time, most likely, one should think about endocrine dysfunction (diabetes mellitus, thyroid diseases).
In its development, cervical caries goes through the same stages as any other carious lesion: the stage of spot, superficial, medium and deep caries. In the initial stage, the enamel in the neck of the tooth loses its luster and becomes matte; a light (chalky) or pigmented spot with a smooth surface appears on it; there are no clinical manifestations.
In the future, the surface of the stain becomes rough, which indicates the beginning of the destruction of the enamel; subjective sensations are characterized by a short-term painful reaction to chemical, mechanical and temperature stimuli. This indicates the transition of cervical caries to the next clinical and morphological stage – superficial.
The weakness of the enamel in the neck of the tooth contributes to a fairly rapid progression of disease into the stage of medium and deep caries, which are clinically manifested by the formation of a carious cavity, food jamming, pain reaction when talking, eating, brushing teeth. Deep caries can be accompanied by significant tooth destruction and complicated by the development of pulpitis. Disease is usually localized on the labial or buccal surface of the teeth; sometimes the lesion covers the entire basal neck of the tooth by the type of circular caries.
An experienced dentist can recognize cervical caries even at the stage of a chalky spot. As in other cases, an examination of the oral cavity, probing, assessment of the hygiene index is carried out. Additional diagnostic methods for cervical caries may include thermal testing, vital staining, electro-dental diagnostics, transillumination, dental x-ray, radiovisiographic examination.
In the process of diagnosis, cervical caries should be distinguished from a wedge-shaped defect, enamel erosion, fluorosis. If a patient has several teeth affected by cervical caries, he should be referred to an endocrinologist for consultation to exclude the pathology of the endocrine system.
Methods of treatment of cervical caries depend on the stage of treatment to a specialist. In the early stages (the stain stage), it is advisable to carry out remineralizing therapy – a course of applications of fluoride-containing drugs, deep fluoridation of enamel.
When a cavity is formed, the process of treating cervical caries should include the following main stages: local anesthesia, removal of dental deposits, preparation of the defect and treatment of the cavity, the imposition of therapeutic and insulating pads (in the treatment of medium and deep caries), the placement of a light polymerization seal, grinding and polishing of the seal.
Prognosis and prevention
It should be remembered that cervical caries progresses very quickly, so if you detect the slightest changes in the neck of the tooth, you should consult a dentist. In uncomplicated stages, with the help of modern methods of treatment, it is possible to completely restore the aesthetics and functional purpose of the tooth. Complications of deep cervical caries are often also pulpitis, periodontitis, gingivitis. A neglected cervical caries can lead to the destruction and loss of a tooth, which will require prosthetics or dental implantation to restore.
Prevention of cervical caries includes regular and thorough dental care with the help of individually selected products (toothpastes, mouthwashes, dental floss), compliance with proper dental cleaning techniques, professional oral hygiene, prevention of gum diseases and endocrine disorders.