But did this make the patient feel better? Of course not. Therefore, it is not surprising that modern adults are more afraid of dental treatment than children. After all, the new generation of patients in dental clinics is accustomed to a different level of service - when providing them with assistance, the dentist does everything possible so that the client does not experience pain or negative emotions at all.
So is it painful to treat caries today? No, if you make an appointment at a good dental clinic with an experienced and responsible doctor. Modern anesthetics make the treatment of carious cavities painless and absolutely not scary.
The only unpleasant moment is the painkiller injection. Many people fear it as much as the dissection procedure. But even here, pain can be eliminated one hundred percent - for this, the gums are pre-treated with an anesthetic. In extreme cases, general anesthesia may be used. Therefore, there will always be a way to cure teeth without pain.
Description of the pathological process
Its occurrence is provoked by cariogenic microorganisms, streptococci and lactobacilli (some types of them), which appear due to insufficient oral hygiene. Typically, bacteria begin to multiply in plaque, which is difficult to clean with a brush (most often on the back surface of the incisors). The carious area is difficult to notice on your own, especially in the early stages, since darkening begins to appear only when the area is already very widespread. That's why regular checkups with a dentist are so necessary - only he can carefully examine the entire oral cavity using a small mirror or take an x-ray.
Sometimes people wonder: “can children have caries on their front teeth?” Unfortunately, yes, it is also called “bottle” or “carob”.
It occurs in a small child if he often eats sweets (baby formula, cotton candy, candy, etc.). Such products contain a large amount of carbohydrates, which quickly destroy fragile tissues.
You also need to be careful with breast and cow's milk. It often sticks to the teeth in the upper jaw when children accidentally fall asleep with a bottle in their mouth. This product also contains sugar (albeit natural), and it quickly oxidizes and destroys the enamel. During sleep, this is especially dangerous due to the fact that the intensity of salivation, which is created for self-cleaning of the oral cavity, decreases. You can see the result of the defeat in the photo.
Caries on the front teeth: what to do and why it occurs
In fact, there can be many reasons for its appearance:
- Hereditary predisposition. Our genes determine the thickness of the enamel. The thinner this tissue is from birth, the higher the likelihood of disease. But often the protection is weakened due to a person’s fault when he abuses hard, spicy, sour foods, carbonated drinks and sweets.
- Lack of hygiene procedures. Sometimes we are too lazy to carry them out thoroughly, so we either brush superficially, forgetting about hard-to-reach places, or we completely neglect this process. Because of this, plaque accumulates, and this is “fertile soil” for microbes.
- Poor nutrition. Vitamins and microelements are important for healthy teeth; without them, the enamel becomes thinner and changes its structure.
- Deformed jaw. It can be this way from birth or change during life from injuries or improper growth of the incisors. Most often, caries affects curved units: they are more difficult to clean, so plaque often accumulates on them. People with a narrow interdental gap or too wide fissures (grooves on the chewing surface) are also at risk.
- If a person works in a hazardous enterprise, he often unknowingly inhales air through his mouth containing chemicals that corrode enamel.
- Artificial injury. This applies most of all to seed lovers and seamstresses who bite threads instead of using scissors.
- Bad habits. Alcohol and nicotine not only thin the dental tissue, but also change its color, which makes their appearance unpleasant.
Symptoms
You need to understand that the enamel on the incisors is very thin, so the disease develops on them much faster. Many people do not know what caries on the front teeth looks like initially. It begins with the appearance of a small white or yellowish spot. Further, the enamel becomes thinner and sensitivity increases: it becomes difficult to drink cold drinks or eat ice cream. Later, periodic pains of aching or throbbing nature appear. In the final stages, pulpitis (inflammation of a bundle of nerves and blood vessels) or periodontitis (damage to tissue around the root) develops.
It is best to go to the doctor at the first stage, so the treatment process will be easier, faster and more comfortable. But usually they do not pay attention to a minor formation - then the lesion begins to spread at high speed.
What is a root canal
In addition to enamel and dentin, any tooth has a fairly large internal cavity. Its main part is called the pulp chamber. Thin tubules extend from it. They are located along the entire length of the roots. These are root canals. The number of roots varies among different groups of teeth. Accordingly, the number of channels is also different. The front teeth have only 1 canal. Side groups can have from 2 to 4.
Dental tubules are narrow tubes with many branches. They originate at the top of the root. This place is called the apical foramen. From here, neurovascular tissue passes to each root. If it is inflamed or dead, it is removed during endodontic treatment. Next, the resulting cavity is cleaned of its residues, disinfected and sealed.
Is it possible to determine the onset of the disease yourself?
In most cases, it is not possible to notice the problem at an early stage of its development. Most often, caries occurs in hard-to-reach places (between the teeth or on their back surface).
But sometimes they show specific signals that there is trouble with the incisors:
- when there is a sharp change in temperature, short-term pain occurs;
- sometimes the uneven edges of a carious cavity can be felt tactilely, using the tongue;
- a specific odor appears from the mouth, especially in the morning before meals;
- a dark spot becomes noticeable.
It is important to understand that such signs are not always present, and only a doctor can determine the onset of the disease. It has all the necessary tools and devices for high-quality diagnostics. Therefore, you should not neglect a visit to the doctor and check in time whether everything is in order.
Types of pain relief
Local anesthesia is an adequate and safe method to make visiting the dental clinic a routine procedure rather than a stressful one. The person remains fully conscious, but the nerve leading to the tooth is blocked by medication, so no signals are sent through it.
Two options are used to deliver an anesthetic drug:
- Infiltration. Using a syringe, the drug is infused into the tissues located in the immediate vicinity of the tooth. The medicine reaches the peripheral nerve endings in a few minutes and blocks them.
- Conductor. The injection is performed in the place where all the nerve fibers innervating the treatment site are collected in a bundle. In this way, a large area in the oral cavity is numbed.
Both options provide blocking of the nerve pathways along which the pain signal is delivered to the brain, that is, during treatment the patient does not experience any pain at all.
Types of damage
Before you find out how caries on the front teeth is treated, you need to understand to what extent it has developed. There are several types of the disease based on the scale of spread:
- Superficial (shallow damage to tooth enamel). Usually at this stage the patient does not yet experience discomfort.
- Average. Slightly affecting contacts and causing aching pain when sugar enters.
- Deep. At this stage, the dentin (the main part of the incisor) is damaged.
- Radical. Here, the carious formation is already difficult to eliminate without complete removal.
- Atypical. It first affects the cutting edge as a result of heredity, smoking or poor nutrition.
Before understanding how to treat cervical caries on the front teeth and whether it hurts, the doctor needs to determine at what stage the disease is.
If the dentist does not do this and only carries out superficial work without completely cleaning the canals, then in the future a cyst may form in the jaw. And it will already be necessary to remove it with the help of surgical intervention, until the pathology has grown to the brain. The sooner treatment begins, the less pain the patient will feel, so it is better not to put off going to the doctor until tomorrow.
The sensations experienced by the patient during the treatment of various forms of caries
Symptoms of the resulting oral disease directly depend on the degree of tooth decay. Based on the depth of damage, caries is usually classified into three groups:
- Surface. The destructive process affects only the enamel. It is an outer protective sheath and does not contain nerve endings. Therefore, during its treatment, pain is completely excluded. The contact of the drill with the damaged surface causes minimal discomfort due to strong mechanical impact - nothing more.
- Average. Is the most common. In this form of the disease, the carious lesion affects the upper layer of dentin - specialized connective tissue that fills the entire length of the tooth. This does not mean that there will be pain during drilling - it all depends on the individual characteristics of the patient’s body, his pain sensitivity threshold. The doctor may begin treating the cavity without giving an injection. But at the request of the patient, the injection can be performed at any time.
- Deep. The most advanced form of the disease. With it, the dentin is already destroyed, and the inflammatory process includes the dentinal tubules, which contain nerve endings. With deep caries, the forehead feels pain if it takes cold or hot food, something very sweet, sour or salty, or if it presses on the tooth. You should not place a filling without anesthesia in such a situation. It is better to administer an anesthetic before starting the preparation and completely numb the working area.
If we talk about the types of caries by location, and not by the degree of damage and involvement of surrounding tissues, then it can be:
- Lateral. Localized on the side of the tooth. If it is located far from the cervix, it does not cause severe pain. Whether an anesthetic will need to be administered directly depends on the patient’s subjective feelings.
- Contact. Located at the junction of neighboring units. The patient may not even be aware of its presence due to the nature of its location until severe pain occurs. During its treatment, approximately the same sensations arise as with an average degree of destruction.
- Cervical. Located at the root part of the neck. It is very painful during treatment and therefore requires the mandatory use of painkillers. The cervix is the part near which the nerves pass - hence the pronounced pain.
The deeper and larger the carious cavity, the more noticeable the procedure to eliminate it. You should not put off treatment until later out of fear. A large hole can cause pulpitis. Then the therapy will be much more complex, lengthy and unpleasant.
Possible complications
There are those who want to learn how to get rid of caries on their front teeth or hide it themselves. But we must understand that a simple disguise will not please you for long. Soon the person will feel severe pain, which will mean that the problem has reached a severe stage. If the patient is not provided with timely medical assistance, pulpitis may form, which develops in just a few hours. In such cases, the patient is called an ambulance. He feels an increasing throbbing pain, which intensifies in the lying position.
When a carious formation reaches the root, it is useless to treat it; the unit must be removed completely. If this is not done, inflammation may begin, which will soon affect the soft tissues of the face and cause osteomyelitis, abscess (damage to the root zone) or phlegmon (swelling of the jaw and impaired mobility).
When is anesthesia needed?
Theoretically, it is not always possible to give an injection before treatment. If the carious cavity has just appeared, and the drilling is superficial and short-lived, then often this does not cause discomfort. But if serious treatment is required, and even more so with the removal of a nerve and filling of canals, then it is impossible to do without pain relief.
Among patients, there is a separate category of people who believe that pain relief is an undesirable procedure that requires unnecessary costs and causes harm to the body.
The latest generation of drugs are radically different from their predecessors: they are quickly eliminated from the body and do not have a negative effect on it. At the same time, pain during manipulation can cause an increase in the patient’s blood pressure and an acceleration of the heart rate, which should not be allowed.
As a rule, the need for anesthesia is directly proportional to the fear of dentists: the more the patient is afraid, the lower his pain threshold. This is easily explained from a physiological point of view: adrenaline, released during fear, increases painful sensations several times.
Front teeth - how to remove caries if it has spread deeply
In this case, very careful treatment must be carried out. It is necessary to take an x-ray to determine the exact depth of the damage. If you make a mistake during processing, you can hit the pulp (neurovascular bundle), and it will begin to die. Typically, the dentist uses a drill and then fills the drilled area. Sometimes special tabs are used that are more resistant to external influences and are easier to chew. In this case, you do not need to drill much into the fabric to insert them, and preliminary heat treatment makes the material as durable as possible.
Canal treatment using a microscope
The diameter of the root canal of a tooth is approximately 1 millimeter. In such conditions it is impossible to work with it without special optics. The dental microscope allows you to increase visibility up to 32 times. Therefore, it is increasingly used in modern dentistry.
Advantages of using a dental microscope:
- The specialist can see and remove only tissues affected by inflammation, without touching healthy ones.
- An excellent overview of the tubule orifices is achieved. Seeing the number of their branches, depth and directions is very important during endodontic treatment.
- Due to targeted treatment of the pulp, complications can be avoided. The possibility of perforations is also eliminated.
Features of restoration
It is important not only to correct the appearance of the tooth, but also to cure the disease. At an early stage, when white or brownish spots just appear on the surface, sanding or bleaching can be done. But you don’t need to do this at home, the doctor will make the procedure much more effective and protect against complications. He can use professional grinding discs and polishers. Severe cases require the use of a drill.
Air abrasive is a more gentle processing method. It involves spraying a special substance that affects dental tissue. But this technique is not effective in all cases and is very expensive. Some clinics use laser; this is a simpler method, but requires more investment. Moreover, its effectiveness has not been proven one hundred percent; there is still debate among experts about it.
Question about pain when removing a nerve.
Usually, when it is necessary to remove a nerve, patients succumb to the fear that this is a very painful procedure. But there is no point in worrying! Each qualified specialist in his arsenal has a large number of anesthetics that desensitize the diseased tooth and surrounding tissues. Just one injection, and the person does not feel anything in the area of the diseased tooth.
Local anesthesia is most often used. If the drug is chosen correctly, the entire operation from injection to nerve extraction will be completely painless.
Elimination of the disease
There are several options for treating caries; the choice of one or the other depends on the stage of its development and the financial capabilities of the patient.
Installation of veneers
Recently, this method has become very popular, especially among show business stars. It is good because with the help of special ceramic or polymer crowns you can hide all defects (shape, shade, etc.). But to install the plates, you need to grind off the dental tissue by about half and drill out all the affected areas. The custom-made veneer is then bonded using a non-toxic substance.
With high-quality installation, it can remain unchanged for up to 10-15 years.
The price of such a procedure at Dentic is about 30,000 rubles per tooth.
Crowns
They are used when the disease progresses to a deep stage and covers both sides of the incisor. They are usually made of metal and ceramics: these materials are very durable and are relatively cheap: 20 thousand rubles. But they also have a drawback: it is very difficult to choose a shade that will not stand out in the teeth. To avoid big differences, it is necessary to choose crowns made entirely of ceramic or zirconium.
Implantation
When caries destroys tissue down to the root, more serious measures must be taken. The diseased area is removed, and in its place an implant is implanted into the jaw. It is a strong rod that will hold the crown. Nowadays they make it very natural and aesthetic. The cost at Dentic starts from 30,000 rubles.
Prosthetics
There are cases when installing an implant becomes impossible, for example, when there is a risk that it will not take root, or the gums are not thick enough. Then special zirconium or ceramic prostheses are created, which are attached to adjacent units.
Treatment of caries between the front teeth with pinning
If only the root of the affected incisor remains intact, then a pin is inserted into it, having been carefully processed beforehand. It is then masked with a temporary crown for about a week while it takes root. Next they set a constant.
Diagnostics
Only a dentist can correctly determine the nature and stage of development of the disease.
Therefore, you should not neglect going to the doctor at least once a year. Now clinics use various examination methods:
- Vital coloring. A solution of 1% methylene blue is mixed with 0.5% red and applied to the tooth surface, after which the lesion acquires a different color. This is a very economical option, but not the most effective: the depth of distribution cannot be determined.
- Fluorescent radiation testing. If a carious process begins in any area, it will not glow.
- Electroodontometry. When exposed to electric current, the condition of the pulp is determined. This method is absolutely safe for all ages.
Side effects
Side effects from injections are rare, but they should not be completely forgotten. A qualified dentist always asks the question before starting the sanitation: have you ever had an allergy to medications? This is due to the fact that some patients may have an allergic reaction to the components of the medications.
In this case, there may be an increase in pressure, swelling of the mucous tissues in the oral cavity, and a change in body temperature. But you should not think that in case of allergic reactions a person cannot use any painkillers, and he will have to endure pain. The list of similar dental preparations based on other active ingredients is now very large, so the doctor will be able to choose one that will be tolerated normally.
How to remove caries on the front teeth in adults
If the disease overtakes children, then nothing terrible will happen, although it must be treated in the early stages so that the infection does not penetrate the jaw. Over time, the milky affected incisor will simply fall out, and a new strong one will begin to grow. For a mature person, the situation is more complicated: it is necessary to cure and preserve it, otherwise the element will be lost forever. We have given the main treatment methods above, but it is worth adding a few more important nuances:
- When the doctor completes the procedures, he must prescribe preventive measures. If this is not done, the problem will reappear.
- After the filling is installed, it must be sanded and polished, otherwise it may damage the lips, cheeks or tongue.
- The material for it should be selected so that the patient’s smile looks natural.
Old methods of root canal treatment
Previously, endodontic treatment involved removing the pulp. For this purpose, for example, arsenic paste was used. It was inserted into the affected cavity and contributed to the death of the tissue. After this, the doctor removed the pulp from the tooth and filled it. This was the end of the treatment. Another common method was the placement of a resorcinol-formalin mixture. It froze in the cavity, thanks to which it was possible to stop the disintegration of tissues.
These methods had the following major disadvantages:
- Resorcinol-formalin and arsenic mixtures do not always completely kill the nerve. Therefore, when healing tissue, the patient could experience acute pain.
- Arsenic and resorcinol-formalin mixture are very toxic. They can accumulate in different organs.
- After pulp removal, tissue may remain in the root canals. Often they caused re-inflammation.
These methods of endodontic treatment were used due to the lack of adequate anesthesia, under which the affected pulp could be completely removed. Today dentistry has much more gentle methods.
How to avoid getting sick
You need to regularly monitor the condition of your teeth, not only from the outside, but also from the inside. It is no coincidence that doctors advise cleaning them 2 times a day - this is required to prevent infections. But don’t forget about following your diet; you need to eat enough:
- hard vegetables and fruits (apples, carrots, cucumbers, beets, etc.);
- greens (parsley, lettuce, dill, celery);
- berries (currants, grapes, strawberries, cranberries);
- nuts (almonds, cedar, cashews);
- dairy products (cheese, cottage cheese, natural yogurt without additives);
- citrus fruits (grapefruit, lime, orange);
- seafood (fish, shrimp);
- eggs (chicken, quail);
- honey;
- water and tea without dyes (green and black).
Do not forget about the correct cleaning technique: you need to brush each unit from the gum to the cutting edge so that the dirt does not remain in the crevices and does not oxidize. It is convenient to use dental floss for this.
About the cost of treatment
Most often, a paradoxical situation occurs: a person wants to save money on the dentist and waits until the tooth is destroyed. But you need to understand that the later you see a doctor, the more expensive his services will cost. If the problem has already appeared, it will need to be solved, and the sooner, the cheaper. Conventional preparation of a carious cavity in the early stages costs only about 4,000 rubles. If you wish to install ceramic fillings, the amount will increase to 10 thousand rubles. But some patients wait until the destruction is complete, and then they have to pay 30-50 thousand for one incisor.
We described in detail how caries of the front teeth in adults is treated. For the process to go well, it is better to choose a good private clinic. You can contact: there the work with clients is at a high level, they feel comfortable physically and psychologically. In addition, the clinic received the title of one of the best in Russia in the StartSmile rating. And on the site there are often many special offers and promotions that will significantly reduce the cost of services. Hurry up to sign up for a consultation!
How the injection is performed
Many people are afraid of injections in principle, but you should know that for these purposes in dentistry they use not standard syringes, but special ones - with a very thin needle that easily enters the gum. Most often, the dentist will perform multiple injections from different directions to ensure that the medication is distributed to all of the peripheral nerves.
Then you should wait a certain period of time until the pain relief begins to take effect. This interval differs for different drugs. “Articaine” and “Piromecaine” act the fastest: treatment can begin within 2 minutes. The duration of the period when the patient will not be in pain also varies from 20 minutes to 12 hours, so the choice of medication is determined by the amount of work to be performed.
