Non-carious lesions of teeth: treatment, diagnosis

Non-carious lesions of teeth are widespread, therefore, the relevance of questions about their treatment, and diagnosis of those States of interest to many. This concept brings together about a dozen different diseases, each of which has a characteristic clinical picture and symptoms.

If the decay occurs due to the development of pathogenic microflora and the addition of waste products, non-carious diseases have polietiologichesky nature. We will try as much detail as possible to understand this question.

Non-carious lesions of teeth – what is it?

Call such non-carious defects of hard tooth tissues, which are formed without the involvement of an infectious agent. This is an extensive class of dental diseases, the second most spoken language after the decay.

There are two major groups of pathologies:

  • congenital diseases that occur during fetal formation of the child and in the process of laying the rudiments of the permanent teeth. They appear to eruption;
  • acquired condition such defects of hard tissue formed in the process of life due to contact with certain substances.

These lesions affect the enamel and dentin layer, can occur at the root cement in the cervical region, to spread to the whole dentition or to hit only the detached teeth. Defects have different symptoms, the etiology of, and approaches to the treatment of the destroyed tissues.

Classification

A single list, allowing to submit a complete systematization of non-carious lesions, no. In the post-Soviet countries, the most common classification of who (ICD-10) and Patrikeev. Each of them reflected the main essence of the pathologies of non-bacterial etiology and there is division in the state, incurred up to the time of teething, and also after it.

Non-carious diseases arising before the eruption.

  1. Mottling of teeth (fluorosis pandemicheskim).
  2. Violations occurring in the process of formation of the rudiments – hypoplasia or hyperplasia of enamel dysplasia of all structures of hard tissues, teeth Turner.
  3. Hereditary effects – imperfect Amelot-, dentin -, or odontogenic.

The state formed after the eruption of the teeth.

  1. Increased abrasion.
  2. Erosion.
  3. Abrasive wear (wedge shaped defect).
  4. Pathological resorption.
  5. Hyperesthesia of dentin.
  6. Necrosis.
  7. The discoloration of the teeth.

Consider in more detail each of the types of pathological conditions.

Fluorosis

Endemic mottled teeth relate to systemic violations of development of hard tissues and is manifested by the appearance of the enamel stains, discolored. This condition appears due to the increased revenues of fluorine. This can occur when excessive use of fluoride products and dental hygiene products, as well as in areas where the content of this trace element in water and soil greater than 2 mg per liter.

The severity of signs depends on the type of pathology. According to the classification by Patrikeev is set to 5 forms.

  1. Spotted.
  2. Bar.
  3. Malovydne-speckled.
  4. Erosive.
  5. Destructive.

Fluoride is also contained in almost all foods, however, proved that they could not lead to the formation of fluorosis. Greater risk of disease occurs when exceeding the allowable dosage of fluoride tablets or drops, used to prevent tooth decay. For this reason, should be strict control over the use of drugs.

Clinically fluorosis is manifested as the change in enamel:

  • it acquires a matte finish loses gloss and transparency;
  • becomes yellow or even brown;
  • the spots are more pigmented color in the center and blurred outlines;
  • healthy enamel does not lose its luster;
  • lesions of multiple, affect all surface of the tooth.

Treatment of mottled teeth symptomatic, so as to restore the affected structure and to eliminate the effect of damaging factor is completely impossible. The choice of therapeutic technique depends on the degree of severity of the clinical manifestations:

  • teeth whitening is an effective with a slight mottle enamel with a yellowish tinge, and also at spotting when there is no disruption of the structure. For this purpose, there are different gels that contain carbamide peroxide. They can be used in the dental office and at-home bleaching using custom-made cap;
  • microabrasive – involves sosotoyanie thin enamel layer before the formation of the intact surface. For this purpose, it uses a special handpiece running at low speed as well as abrasive powder and rubber brush in the shape of cups. Always use PPE as the doctor and the patient. Microabrasive allows you to remove only the surface changes of hard tissues;
  • restoration – runs filling material when the depth of the irregularities is large and has a strong color change of the enamel. For this it is necessary to cut the layer of the affected enamel and dentin, and the loss of tissue make up the composite;
  • veneers and Lumineers are used in erosive and destructive forms of fluorosis, when the defects affect the entire vestibular surface of tooth.
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Related article: what to do if fluorosis touched you?

Hypoplasia

Such disruption of enamel formation is manifested as a qualitative and quantitative defect. The reasons for the appearance of hypoplasia several.

  1. Violation of exchange of phosphorus and calcium.
  2. Severe toxicity in the mother.
  3. Mechanical damage to the bone structure of the jaws.
  4. Traumatic and toxic injury, caused by the influence of microorganisms in the process of fetal development.

Hypoplasia is of three kinds:

  • system – noted defects of the enamel of all teeth or those that have the same laying period the enamel organ;
  • local lesion affects no more than two teeth;
  • focal pathology observed on the adjacent teeth, regardless of the timing of the eruption.

Visual inspection of the affected crowns are defined by spots or grooves that have the color from white to yellow-brown. They are parallel to the marginal ridges or cutting edge. A characteristic feature of hypoplasia is that it always involves an even number of teeth, and pockets are defined on the vestibular surface. The plots have a shiny surface with a smooth bottom, and surrounding the enamel is not changed.

Therapy for low-severity defects are generally not required if the enamel has visually defined areas of the lesions, then for their remedy is used whitening, microabrasion or filling.

Hyperplasia

The overgrowth of enamel, which looks in the form of drops. They are also often called «enamel pearls». On a healthy tooth surface in the cervical area are the projections that give it a roughness. There are five types of such entities:

  • enamel is composed only of surface tissue;
  • enamel-dentin – drop with a coating of enamel contains within dentinal areas;
  • polperro-enamel-dentin – connective tissue inside the lesions is the beam;
  • nutridrine are in the dentine layer;
  • drops Rodriguez Ponti – inclusions, which are located in the periodontium.

For this pathology the complaints of the patient are absent, with the exception of an unsatisfactory smile. At small defects in the treatment is not carried out, in other situations it is possible to sosotoyanie supernumerary tissue.

Inherited disorders of tooth structure

Congenital pathological changes of hard tissues are of three types:

  • imperfect dentinogenesis – affects the structure of the dentin, while crowns can have a natural form, but quite often there chipped enamel, due to which the teeth wear away quickly. Also for them a distinctive amber translucent shade;
  • imperfect odontogenesis – manifested as the syndrome of Stenton-Capdepon characterized by the eruption of the teeth in normal terms, they are gray in color, and when the beam of fluorescent lamp – translucent. Happen quickly chipped the surface layer, and also observed increased abrasion;
  • imperfect amelogenesis – breach of laying on enamel, but dentin and pulposa camera developed fully. The modified teeth could look like the surface is corroded or missing the point completely top coat.

Not fully understood the causes of inherited disorders of the structure of hard tissues, and therefore to carry out prevention against them is impractical.

The discoloration

Violation of the color of the teeth can be innate, therefore the violation of the natural shade of dentin is changed before the eruption.

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There are several reasons for the appearance of discoloration.

  1. Incompatibility of blood groups of the parents, as well as rhesus incompatibility between mother and child.
  2. Congenital pathology of the biliary system.
  3. Inherited disorder of the metabolism of pigment cells (porphyria).
  4. Welcome tetratziklinovykh drugs during pregnancy.

Externally, the pathology manifests itself in different tooth shades, depending on what was the prerequisite for the development of this condition.

For the treatment of congenital discoloration whitening not used because usually the process involves the deeper layers, therefore it is recommended aesthetic restoration, and the use of Lumineers, veneers or porcelain fused to metal crowns.

Increased erase

Refers to non-carious lesions that arise after eruption of teeth is a pathological condition. The reasons for it are many: the important role of food addictions, bad habits, the quality of the orthopedic treatment and the presence of defects of the dentition. There are three degrees of abrasion reinforced.

  1. The first teeth are erased within the enamel.
  2. The second – the wear and tear crosses the enamel-dentinal connection, but does not reach the pulp chamber.
  3. Third – the loss of more than 2/3 of the height of the crown.

Clinically it may be manifested in the following forms of wear:

  • horizontal – teeth wear at the occlusal plane, since the chewing surfaces of the molars;
  • the vertical loss of hard tissue at saggital often erased for this type of premolars and canines;
  • combined loss of enamel and dentin is uniform in two dimensions.

For effective treatment, it is necessary to eliminate the factor causing such pathological effaced, and then the method of replacing lost tissue is selected individually in each case.

Wedge-shaped defect

Abrasive wear is the most common among all varieties of non-carious diseases. For this pathology there is a mechanical aggressive effect on dental enamel of different stimuli, resulting in it wears out, forming a V-shaped recess in the gingival margin. Often wedge-shaped defects are located at the canines and first premolars, due to anatomical peculiarities of their location in the jaw bones.

The severity of symptoms depends on the depth of defeat:

  • in case of violation of the enamel – complaints are absent, or occur short bystroprokhodaschee pain from thermal stimuli, the color of the tooth is not changed, the decline of the cloth does not exceed 1-2 mm;
  • when you wear that cross the enamel-dentinal connection – the patient indicates pain when brushing your teeth and eating. The color of the hard tissues in the cervical area from yellow to brown, flaw depth is 3-4 mm;
  • when erasing more than 2/3 of the dentin, a characteristic of spontaneous pain which elimination will take deponirovanie. By visual inspection in pricesavvy area is determined by the loss of tooth thickness more than half.

Treatment consists of a comprehensive approach to the problem.

  1. Etiological – the elimination of the damaging factor.
  2. Symptomatic – the struggle with increased sensitivity.
  3. Recovery – restoring the structure of the filling materials.

Erosion

Manifests as loss of structure of dental tissues due to acid impact on them, together with the erase factors. Where does acid in the mouth? This happens for several reasons:

  • features of the diet is the prevalence of acidic foods in the diet leads to its damaging effects on the enamel;
  • frequent vomiting – the contents of the stomach has acidic pH, so when regurgitation takes place, the settling of particles on the mucous membranes of the oral cavity and the teeth, which leads to erosion. This happens in bulimia, alcoholism, or during toxicosis of pregnant women;
  • professional features – often found in wine tasters;
  • drugs – misuse of drugs leads to negative effects on the oral cavity.

In the early stages of the disease, the enamel loses its natural Shine. With the progression of the pathology, its surface acquires a roughness, there is a minor recess. The erosion has the form of a circular defect, which has smooth and shiny bottom, a characteristic feature can be considered that the lesion is in the transverse direction, passing through the most protruding part of the vestibular surface of the crowns.

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Treatment will not be complete if you do not identify the cause that led to such changes. Even in cases of severe hypersensitivity not canceled daily hygienic cleaning. To cope with the hypersensitivity to help drugs desensitizer and aesthetic restoration or coverage crowns.

Necrosis

The destructive process which occurs with complete loss of superficial tissue in a limited area of the tooth. The work in the chemical industry has a negative impact on health and, in particular, on the condition of the enamel. Also to the disease are hormonal correlation. Pair of harmful substances deposited in the tissues and lead to their dissolution.

Characteristic symptoms:

  • loss of gloss and loss of fabric;
  • the appearance of stains on the tooth surface;
  • pitted enamel;
  • severe sensitivity;
  • set on edge.

Nekrotizirovannye stations are located in the neck area on several adjacent teeth. Treatment is aimed at elimination of the damaging factor, as well as removal of hypersensitivity of the dentin.

Hypersensitivity

The condition of the oral cavity, in which there is pronounced painful reaction in the site of carious or non-carious defects when exposed to various provoking factors. This symptom affects more than half of the world’s population, it manifests itself as a sharp paroxysmal pain, which quickly passes after the influence of the stimulus.

Hyperesthesia is of several types:

  • distribution – limited and generalized;
  • origin – arises from the loss of enamel and dentin or the cause of systemic disorders in the body;
  • the manifestations — the pain only occurs from exposure to high or low temperatures, teeth that are sensitive to chemical stimuli as well as spontaneous pain.

Treatment depends on the severity of the pathology. With a slight sensitivity, it is recommended to use toothpastes designed to eliminate hyperesthesia and enamel coating of fluorine-containing varnish or desensitizer, Nude which seals the dentinal tubules and does not allow to penetrate the stimulus to polowym fibers.

With significant loss of hard tissues recommended filling defects, if the pain from the stimuli, and then saved, deponirovanie of the tooth. When the patient has gingival recession, which exposes the connection of the cement and enamel, repair it is possible only through surgical intervention. If the cause of hyperesthesia is abnormal wear resulting from malocclusion, you need the help of an orthodontist.

Video: non-carious lesions of the teeth and oral cavity.

Prevention

Preventive measures to prevent the occurrence of non-carious lesions aimed at elimination of influence of negative factors during pregnancy, as well as on careful attitude to the state of the oral cavity after the eruption.

  1. Health care of the mother during pregnancy.
  2. Reducing the likelihood of infection toddlers infection and inflammatory pathologies.
  3. Comprehensive timely elimination of somatic diseases.
  4. Careful hygienic care of the teeth using a tooth brush soft or medium hardness.
  5. Limiting consumption of acidic fruits and juices.

Further questions

► Code for ICD-10

Non-carious disease refer to section K. 03, where each of the pathologies is of your cipher.