Average caries: diagnosis and treatment

Forms an average decay after the initial phase of the disease and the so-called stage spots. Due to the demineralization of tooth enamel and negative her effects of organic acids there is a loss of dentine. Separate the acute and chronic form, and other types depending on localization. Further development of the pathological process can prevent the timely intervention of the dentist, after which you can talk about a favorable projections and preventing the destruction of the hard tissues of the tooth.


If the patient visits the dentist every six months, it is unlikely he will allow the decay to grow significantly and will carry out all the necessary remedial measures. But the situations are different, sometimes we skip preventive visits and come to the specialist when concerned about specific symptoms. Consider the evidence that the disease is in the middle stage (according to the classification Lukomski).


As such the pain at this stage is a clear symptom, a short and slightly expressed in periods associated with exposure to the affected tooth sweet, sour foods, hot or cold temperatures. For example, it may be a little whining, if you and Claus quickly get into a warm room, the difference makes itself felt. And since the average decay is accompanied by the destruction dentinogenesis connections and education in his place of substitution tissue, and many do not feel any discomfort.


With a significant expansion of carious cavity not to notice the aesthetic defect is almost impossible. The very recess has a cone shape whose top is located closer to the bottom. Here coexists several areas of dentine softened destroyed structure, transparent (without content of lime) and substitution. This means that the softening of the tissue has not yet managed to acquire a significant scale, so it all depends on the timely treatment to a specialist, which will not only prevent the further destruction of the molars, but also give it an attractive appearance.

Also note the color of the tooth if it has changed compared to the natural, most often it is gray, it is about accompanying periodontitis. Is an inflammatory process, which can have unpleasant consequences, therefore requires additional treatment.

Bad breath

If the patient there are multiple carious lesions, most likely of such unwanted symptom can not be avoided. The greater the size of the cavity is destroyed, the more food debris it deposited, organic accumulations begin to rot and, accordingly, to show themselves. Microorganisms feeding on these particles start to secrete organic acids, which further contribute to the development of the pathological process.

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However, breath is not so often accompanies middle caries and may not signal a problem, even when there is a need to see a specialist. So don’t wait for any negative symptoms declare itself, checking every six months is enough time to carry out remedial measures and to keep the teeth intact, avoid removing them at a young age.


Before an accurate diagnosis is diagnosis, which includes several methods:

  1. Visual inspection and study of the cavity with a special probe. If it goes bad and gets stuck in the fissures (grooves on the tooth surface), the result is interpreted positively;
  2. The temperature of the sample. Most commonly used cold air, which with the help of dental gun is directed at the diagnosed a molar. If there is a positive reaction, it is a sign of secondary caries, the pain recedes almost immediately;
  3. Staining with special reagents. Depending on the impact of dyes, evaluation and diagnosis.

Thus differential diagnosis aims to exclude other diseases with similar symptoms. For example, it may be chronic forms of periodontitis or pulpitis, sometimes isolated and not carious defeats fluorosis, hypoplasia of the in the running form, wedge-shaped defect.

Other forms of tooth decay

In the differentiation of a particular form of carious damage of tooth is of great importance visual inspection. For example, the resulting cavity is typical for the middle and later stages, in the earlier stages it is imperceptible. To exclude deep forms studied its depth, and bottom condition.

Chronic apical periodontitis

Symptoms in both cases, long time, almost can not be traced. Pain not even when probing the enamel-dentinal border, chemical, or thermal stimuli also did not affect the sensitivity. The absence of any reactions to it allows you to eliminate tooth decay.

The reason is simple — in case of chronic apical periodontitis pulp is already dead and therefore not sensitive. Also, when x-ray is the increase in the size of the periodontal gap and changes in the bone structure, if we consider the projection of the apical root.

Wedge-shaped defect

This change of dental tissues is characterized by a clear localization at the neck, and suffer front molars. Externally, the defect is V-shaped, visible due to the considerable darkening of the enamel shade compared to natural color. The walls of the affected area thus compacted, additional symptoms not observed. So, to know what is before us is dental caries or wedge-shaped defect, only a professional diagnosis.

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Forms of the disease

As mentioned above, the average decay is of two types — acute and chronic form. Each of them have their own symptoms and treatments.


Let’s start with the fact that in this case we are talking about a pretty dangerous situation because of the lack of clear symptoms. The patient may for a long time not to experience any discomfort and at the same time inside of the tooth is the formation of a fairly significant hole where there is pigmented dentin. While visually quite easy to see the hole with solid walls on the enamel surface, the localization mainly on the chewing side, the nerves often must be removed.


In this form of caries holes small, distinctive feature — a sharp and brittle edge. Cavity largely filled with the softened dentin, the localization is the neck of the tooth fissures.

Causes of

It is necessary to highlight the basic premises, why is there a middle caries, the progression of the disease contribute to:

  • The weakening of protective forces of an organism (immunity);
  • Bleeding gums;
  • Frequent Smoking;
  • Lack of effective oral hygiene;
  • Deficiency of fluorine, calcium, phosphorus;
  • Various anomalies of development of the dentition (crowding, defect occlusion, etc.);
  • Somatic disturbances (sleep, eating).

All this may provoke the development of caries process that requires early intervention by a dentist.

Therapeutic measures

As soon as carried out appropriate diagnostics, you can proceed to the next stage. Treatment of secondary caries — a laborious process that requires high qualification of the specialist compliance with selected circuits and equipment of carious cavity treatment, fillings and so on.


  1. A preparatory stage. Sure anesthesia, if indicated allergic tests. While children can be assigned to a General anesthetic, adults are infiltration/conduction;
  2. Removal of dead tissue. With the help of a dental drill, the dentist cleans the damaged cavity, it is necessary for the formation of borders of the future seal;
  3. The use of antiseptics. Special solutions are used for disinfection of surfaces of the tooth;
  4. The imposition of insulating gaskets. This is done, on the one hand, to prevent chemical irritation of the pulp and its toxicity, on the other hand, to reduce the possibility of shrinkage of the filling material;
  5. The introduction in the treated cavity of the adhesive. Special adhesive provides greater adhesion to the inner surface of the prepared tooth;
  6. The seal installation. Depending on the natural color of the enamel is chosen as close as possible to the shade of the restorative material, which is especially important for areas smile;
  7. Polishing and grinding. It only remains to bring the case to the end, giving the tooth maximum aesthetics.
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Prognosis after therapeutic interventions


If the patient came to the reception to a specialist and he found a middle caries, treatment received in a timely manner, may with great probability to save him from further destruction of the prepared molars.

Maybe it’s only with observance of all norms of sealing technology, the microscopic gap between the filling and tooth tissues can negate the result from this procedure.

Also after visiting the dental office you need to buy vitamin supplements with calcium and fluoride to strengthen the protection against dental caries.

The main goal — to prevent the destruction of the pulp, or the tooth may be the only way out of the situation. If more significant damage is necessary to resort to the use of special pins, composite filling materials.


Caries treatment in almost any stage is possible and necessary, but without systematic preventive measures, it is impossible to obtain the desired result. Here are a few tips that will help:

  • Refrain from eating a large number uglevodosoderzhaschie foods (fast carbs);
  • Regularly observe rules of personal hygiene of the oral cavity;
  • Eat rationally, the day you need to eat foods from dairy, meat, grain and fruit and vegetable groups;
  • Special attention should be paid to hard fruits — apples, carrots, etc., they further clean the surface of the teeth from the accumulation of harmful plaque;
  • Calcium can be taken not only in Supplement form, its a lot of green vegetables, nuts, dairy products;
  • Refrain from excessively hot or cold food in the enamel microcracks, which easily penetrate pathogens;
  • For better absorption of the calcium you need to increase the intake of vitamin D, its a lot of fish, also we receive through ultraviolet. This is not in the same meal to combine, for example, fish and milk, calcium reduces the absorption of vitamin D.