Treatment of deep caries in children. Caries of primary teeth in children

Many parents worry because their children's teeth begin to deteriorate at an early age. This problem is especially of concern to mothers and fathers of 1-3 year old children who notice signs of caries on the teeth of their young children. We have collected information that will help find out the reason childhood caries, choose a method of treating teeth affected by this disease and prevent the occurrence of this problem in the future.

Factors leading to caries in a child 1-3 years old

Caries(lat. Caries dentiis) is a pathological process that manifests itself after teething, during which demineralization and softening of hard tissues occurs, followed by the formation of a cavity.

Causes of damage to baby teeth by caries:

Illnesses suffered by the mother and medications taken in the first trimester pregnancy can contribute to improper formation of dental buds in the fetus. The consequences of this may be early caries.
Infection with carious microbes from parents through kisses and while eating with one spoon.
The main cause of dental disease is insufficient oral hygiene . The child should learn to brush his teeth as early as possible.
Harmful food addictions – another cause of caries. For example, prolonged use of pacifiers and falling asleep with a bottle contribute to the development of “bottle” caries, which primarily affects the incisors. It is not advisable to allow your child to snack on sweets and chocolate between meals, since the carbohydrates contained in such food promote the growth of bacteria that damage the teeth. After eating these foods, you need to brush your teeth to avoid tooth decay.

How to identify caries in a child?

Signs of damage to baby teeth by caries:

Presence of stains on teeth.
Painful reactions to cold, hot, sweet.
Bad breath. Bacteria cause rotting of food debris, which contributes to the appearance of a specific odor in the oral cavity.
The dissolution of enamel on many teeth at the same time is a characteristic sign of caries in children.

Depending on the depth of the lesion, there are 4 stages of caries:

Initial caries. Characterized by the appearance of various stains on tooth enamel. A timely visit to a doctor can stop the process of dental damage that has begun.
Surface. It is characterized by deeper damage to the enamel. The formation of a carious cavity is possible. There is a painful reaction to sweet, salty or sour foods. Treatment involves filling the affected teeth.
With an average depth of damage dentin tissue is injured. Such caries is accompanied by stronger painful sensations and additional reactions to hot and cold. In this case, filling the tooth cavity is required.
Deep damage to teeth can spread to layers of the tooth such as pulp. Treatment will depend on its condition - filling or the use of special dental dams.

In the absence timely treatment caries can cause complications such as pulpitis (damage to the soft tissues of the tooth, including nerves) and periodontitis (inflammation of surrounding tissues, possibly with purulent contents). In any of these cases, you must immediately contact a specialist, as the child experiences unbearable pain.

Treatment of caries in children under 3 years of age: traditional and modern methods

When children are affected by caries at an early age, they need the help of a dentist. Treatment methods for young patients are reliable, safe and minimally traumatic in relation to the child’s psyche. Pediatric dentistry nowadays has a wide variety of methods for treating this pathology.

Modern methods of treating caries in children

Treatment method for caries in children	How is caries treated using this method?
Laser (photodynamic therapy)	One of the modern treatment methods using special medicinal materials that provide healing effect under the influence of a laser.
Silvering	For superficial caries, a solution based on silver nitrate is applied to the affected area. A special film is formed that has a healing effect. The procedure must be repeated several times with a weekly break.
Reminerilization	Restoring the mineral composition of the tooth by applying microelements such as sodium and calcium. The treatment is quite long. The duration is determined by the attending physician. Only used with superficial damage tooth tissues.
Sponge fluoridation	The special drug Enamel-liquid allows for the treatment of superficial caries effective and painless with additional long-term remineralization of tooth tissue.
Manual processing (ART-method)	Special hand tools allow you to remove the affected tooth tissue, then the carious cavity is treated with antiseptics. The prepared area of the tooth is filled with glass ionomer cements saturated with fluorides.
Depophoresis	A solution of copper-calcium hydroperoxide injected into the affected tooth allows you to clean small tubules with deep caries damage and save the tooth. The procedure site is anesthetized
ICON technology	The enamel is cleaned of plaque, then a special gel is applied to the carious stain to remove the affected area of enamel. Complete the process applying a highly flowable polymer, which hardens under the influence of a special lamp. The polymer provides durable and reliable protection tooth
Preparation of a carious cavity	Used for deep dental damage. The cavity is opened using a drill. After cleaning the inner layer of the tooth, the cavity is filled with calcium-containing preparations. and install a temporary filling.
Ozonation	In the early stages of carious lesions, ozone is used, which allows you to remove bacteria from the surface of the tooth that cause caries.
Treatment under anesthesia	It is carried out only when necessary, strictly according to indications, if the child under no circumstances allows treatment.

What should parents do to prevent the development of caries in children?

Get into the habit of brushing your teeth from an early age. To prevent dental diseases, it is necessary to teach your child to brush their teeth from an early age. For babies, cleansing is carried out using special finger brushes. From the age of two, children are taught to clean themselves.
Choose the right toothpaste. Experts have different opinions regarding toothpastes. The paste must be appropriate for the child's age. Since babies do not know how to rinse their mouths and swallow large amounts of toothpaste, they toothpaste should not contain fluorine or its amount should be minimal to prevent poisoning. Fluorides are acceptable for toothpastes intended for children over four years of age.
Learn how to brush your teeth correctly. It is necessary to accustom children to brushing their teeth in a playful way, so as not to discourage the child’s desire. The front teeth are brushed with vertical movements, behind the cheeks - in a circular motion. The chewing surface is cleaned with horizontal movements, back and forth. On the tongue side, the teeth must be “swept” from the gums to the top. Teeth must be brushed for 10 minutes or at least 6 movements per area. Your baby's teeth should be brushed morning and evening.
Organize proper nutrition for the child, because it prevents caries. It must be balanced in proteins, fats, carbohydrates, minerals and vitamins. It is advisable to exclude sweets and chocolate.
Visit the pediatric dentist with your child for a preventive examination twice a year to examine the condition of baby teeth.

By following simple rules of oral hygiene, as well as providing your baby with proper nutrition, you can prevent the development of caries in your baby.

Dental problems can occur in patients of any age, including very young children. Unfortunately, parents do not always pay enough attention to the health of their child’s teeth and are in no hurry to visit the dentist for a preventive examination. This approach could lead to serious problems in the future. Caries of primary teeth in children can progress at a much faster rate than in adults, quickly affecting the teeth and having a negative impact on the rudiments of permanent ones. Bite pathologies can lead to changes in the correct structure of the jaws and disruption of the harmony of a person’s appearance.

Caries diagnosed in a child requires immediate treatment. To avoid the development of the disease, it is necessary to carefully monitor, carry out regular hygiene procedures and monitor the child’s diet. If, despite preventive measures, caries does occur, treatment must be carried out immediately, otherwise the infection may spread deeper, affecting future permanent teeth.

Important! If you independently detect signs of caries in a child, you should immediately seek help from a pediatric dentist. The doctor will be able to adequately assess the extent of tooth damage and prescribe the necessary treatment.

IN in rare cases therapeutic measures not required. This usually occurs when the initial stage of caries is detected on baby tooth, which should fall out within a few months and be replaced by a permanent one. In other situations, caries must be treated.

Caries of primary teeth is the development of a pathological process in the hard tissues of a child’s teeth, leading to the gradual destruction of tooth enamel and internal tooth tissues.

Features of childhood caries

The child’s immunity is not yet strong enough to fully resist the influence pathogenic bacteria on dental tissues. The process of enamel mineralization continues after teething, so the disease progresses faster on weak teeth.

Attention! According to pediatric dentists, caries on a baby tooth can go through all stages from the formation of a stain on the enamel to the complete destruction of deep tissues in just one month. The rapid development of the disease is facilitated by general malaise. In children who are often sick, caries can progress faster.

Newly erupted baby teeth also sometimes develop caries. It is called bottle or nursery. This variety is characterized by carious spots on the upper incisors and canines. The affected tissues are located in a circle in the area of the tooth neck. The development of the disease begins with the leaching of mineral salts from the enamel and the formation of stains, quickly spreading deep into the dentin and tooth root.
This type of caries usually occurs in children under 2-3 years of age who drink formula or other drinks containing sugar at night.

Nursery caries is a disease that occurs as a result of night feeding of children without subsequent oral hygiene procedures.

The main causes of caries in primary teeth

The main risk factors for developing the disease are two reasons:

Insufficient oral hygiene. Improper brushing techniques or irregular procedures lead to the accumulation of microbes and the formation of plaque on the enamel surface. The nutrient medium is excellent condition for the development of carious infection.
Wrong diet. The child must receive a sufficient amount of vitamins and minerals from the food they eat, which is the key to strong teeth. Excessive use sweets are undesirable, since carbohydrates are excellent food for bacteria, which high speed multiply on the surface of teeth after eating candy.

These are the main reasons that lead to disruption of the protective functions of enamel. The protective layer of the tooth can no longer resist infection, and caries penetrates inside, affecting dentin and deeper tissues.

Children should be given sweets only after meals. It is best to teach your child to eat not sweets and cakes, but fruits, dried apricots, raisins or, in extreme cases, marmalade or marshmallows.

Conditions for the development of childhood caries

There are a number of factors that create conditions conducive to the formation of pathology in children. These include:

congenital anomalies of the structure of the dentition;
hereditary factor of predisposition to carious infections;
weak immune system;
individual characteristics of saliva (composition and amount released);
poor diet (eating only soft foods, excess sweets);
insufficient oral hygiene;
excess fluoride in drinking water, causing fluorosis;
infections suffered during the prenatal period.

The greater the number of factors that are relevant in each specific case, the higher the likelihood of developing caries and the rate of spread of infection.

The connection between tooth decay and breastfeeding

One of the ways to naturally prevent caries is breastfeeding a child up to one and a half years old; mother’s milk has a protein component that has a antimicrobial effect in the oral cavity.

The disease is caused by a large number of streptococcal bacteria that multiply in dental plaque. Low levels of acidity provide conditions favorable for these microbes.

Attention! Mother's milk does not change the acidity of the baby's mouth. This product contains maternal immune cells, which, on the contrary, help fight streptococci. Breastfeeding until a child is one and a half years old and longer helps to increase the level of lactoferrin in the child. This is a protein component that has an antimicrobial effect.

Through breast milk, the baby receives various vitamins and minerals that may not be enough in regular foods. The phosphorus and calcium contained in milk help strengthen dental tissues and accelerate the process of enamel mineralization.

Symptoms of the initial stage of bottle and cervical caries

Before the age of three, caries most often develops in the cervical area of the front teeth. The disease mainly affects the upper jaw, since the lower teeth are better cleaned by saliva and the tongue after bottle feeding. Caries located in this part of the tooth can be bottle and cervical.

Symptoms of cervical caries

This variety is characterized by the following characteristics:

location of carious tissue in the gum area;
the initial stage of caries (in the form of a spot) is visible only to a qualified dentist;
There is no increased sensitivity of the tooth;
after the top protective layer thins, the enamel often changes color;
over time, the carious spot becomes larger and a depression appears in it;
With the development of a carious cavity, the child experiences pain.

The deep stage of cervical caries can lead to damage to the roots and result in tooth loss.

Signs of bottle caries

Nursery caries manifests itself with the following symptoms:

plaque formation on the front teeth;
the appearance of multiple spots of white and yellowish tint;
several teeth are involved in the process at once;
spots are located in a circle closer to the neck of the tooth;
there is an increase in sensitivity;
over time, the color of the spots changes to dark shades of brown;
the baby begins to complain of pain when eating hot or cold food, eating sweet and sour foods.

If there is no treatment, bottle caries spoils appearance smile of the child, and also quickly progresses to complications in the form of pulpitis.

This image shows two types of carious lesions in children's teeth: bottle caries - visible to the naked eye, because the color of the enamel changes, as well as cervical caries - the initial stage can be determined by a dentist, it becomes noticeable at a more advanced stage.

Treatment of caries in children should not be delayed, regardless of age. The earlier measures are taken, the less invasive they are. The development of caries, regardless of the child’s age, includes four main stages:

Formation of light spots. As a rule, obvious symptoms are absent, but sometimes the child may complain about increased sensitivity tooth It is very difficult to detect spots on the enamel on your own, however, an experienced dentist is able to diagnose them. This stage of caries can last from several weeks to several months depending on the totality various factors(age, nutrition, oral hygiene, etc.).
Superficial caries. The spots become darker, and the boundaries of the affected tissue become obvious. The child may notice discomfort when the teeth are exposed to thermal (hot, cold) and chemical (sour, spicy, sweet) irritants. After eliminating the irritant, the symptoms quickly disappear.
Average caries. The enamel structure is destroyed and caries penetrates into the deeper tissues of the tooth. Carious cavities are clearly visible to the naked eye. Painful sensations become more intense and longer lasting. Bad breath often occurs due to the proliferation of microorganisms and tissue decomposition.
Deep stage. Carious lesions affect the deepest tissues, noticeable destruction and deep dark cavities appear on the tooth. The unpleasant odor intensifies, and the pain in the tooth practically does not subside. The child often complains, is capricious and suffers from unpleasant sensations.

Stages of development of childhood caries: spots appear on the teeth - spots darken, pain appears - the enamel structure of the tooth is destroyed - deep dentin tissues are affected - tooth destruction.

Diagnostic measures

There are plenty of methods for diagnosing caries in modern dentistry. The methods used depend on the qualifications of the doctor, as well as on the capabilities of the specific dental clinic. The most common research methods are:

Visual examination by a doctor using dental instruments (probe, mirror).
Transillumination. The teeth are illuminated with rays of a special spectrum, which makes it possible to detect darkening and changes in the structure of the tooth.
Radiography. An X-ray allows you to identify caries in hidden areas and assess its extent and depth. In this way, you can examine 1-2 teeth or take a panoramic picture of the entire jaw.
Laser methods. The direction of special rays onto the tooth, which, reflecting from the surface with certain deviations, makes it possible to judge the presence of pathology.
Caries markers. A common technique involves applying special indicators to the teeth that color the affected tissues in a bright color. The most commonly used dye is methylene dye, which gives blue areas affected by caries.
Luminescent study. In a specially darkened room, the oral cavity is illuminated using UV rays, assessing the color change on different areas. Damaged areas of the tooth appear darker than healthy ones.
Drying. A stream of air is directed onto the surface of the tooth. The healthy surface of the tooth remains smooth and shiny, while areas with initial signs of caries are dull.
Electroodonometry. A study involving the use of a weak electric current to determine the degree of tooth sensitivity.

Sometimes the doctor prescribes several research methods at once to obtain a complete picture and correct purpose treatment of caries in children.

Transillumination is a method of examining teeth based on passing a cold beam of light through the tooth, which is harmless to the body. At the same time, signs of caries damage are detected in the form of specks of various sizes.

The initial stages of caries are often similar to the symptoms of fluorosis and tooth enamel hypoplasia. To avoid mistakes in determining the disease, the dentist conducts differential diagnostics.

Features of caries treatment in children of different ages

The treatment method and its duration are mainly determined by the stage at which the disease is detected:

Stage of formation of a carious spot. In such a situation, conservative treatment is possible, which consists in restoring the properties of the enamel and saturating it with minerals. For the remineralization procedure, a solution of sodium fluoride (2-4%) and calcium gluconate (10%), as well as the drug Remodent, is used.
The superficial stage and all subsequent ones require the use of a drill. The tissues affected by caries are completely removed, the cavity is disinfected with an antiseptic, and then a filling based on a composite or other modern material is installed.

Before starting treatment, the doctor assesses the likelihood of pain during treatment and the need for anesthesia. Anesthesia is performed by injection or by applying an anesthetic superficially (in the form of an aerosol or gel). After filling, the dentist performs finishing and polishing of the tooth.

Attention! If caries has reached the deepest stage, tooth depulpation may be required. In this case, the doctor removes the nerve and fills the root canals.

Treatment of caries in children can be complicated due to the fear of young patients before the doctor. That's why important point is to meet the doctor, have a calm conversation and explain the need for a procedure that you shouldn’t be afraid of at all.

The most common method of treating cavities is surgery. It involves excision of necrotic tooth tissue and restoration anatomical shape using filling materials.

Treatment of the youngest children

The patient's age does not play a decisive role in the choice of treatment method. Treatment procedures are determined depending on the stage of the disease and the degree of tooth damage. In any case, before visiting the doctor, adults should prepare the child by explaining what manipulations await him in the dentist’s office. Fortunately, it is now possible painless treatment any stage of caries, which is extremely important for pediatric patients.

Use of silver

The method involves applying silver nitrate to the surface of the tooth. Silver plating has a pronounced antimicrobial effect, causing the death of all pathogenic bacteria on the tooth surface. The protective properties of enamel are enhanced. After six months, as a rule, another procedure is prescribed.
Silvering has an unpleasant side effect - the child’s teeth acquire a dark gray tint, which does not disappear until the teeth are replaced with permanent ones.

Remineralization

This manipulation involves saturating tooth enamel with substances that it has lost due to the onset of the carious process. Preparations containing calcium, fluorine and phosphorus are applied to the cleaned tooth. They help restore the protective functions of the enamel.
The procedure is good prophylactic. It can be done every six months to prevent the formation of caries. During remineralization, the child does not experience any unpleasant sensations, so the procedure is an excellent way to prevent and treat caries at the stage of stain formation. Unfortunately, it is not effective when a carious cavity has already appeared.

Tooth filling

This method is used in children over 1 year of age when other measures are no longer effective. When treating a child under 3 years of age, dentists try to avoid using a drill. If caries has not reached a deep stage, it is possible to treat the tooth with special acids that cleanse the cavity of tissues affected by infection. After this, the surface is disinfected and a filling is installed (usually light-curing).
Unfortunately, with deep caries you cannot do without drilling. The dentist administers anesthesia to the child and then carefully cleans the surface using a drill.

Remineralization of teeth is a preventive procedure that can significantly strengthen enamel, replenish the deficiency of mineral components, reduce tooth sensitivity and prevent the development of caries.

Treatment of children over 2-3 years old

Treatment of caries in patients of this age category requires the use of the following additional procedures:

Ozone therapy (use of gas to treat the dental cavity).
Preparation (opening a carious cavity with its cleaning, antiseptic treatment and filling).
Depophoresis (a physiotherapeutic technique consisting in the introduction of calcium preparations into the tooth cavity through the action of an electric current).
Phototherapy (use of special medicinal paste, applied to the tooth followed by laser treatment).

Ozone is one of the most powerful antiseptics. In this regard, ozone therapy is an effective way to combat bacteria, viruses, fungi and protozoa in the oral cavity.

Possible complications

When a child is diagnosed with caries, treatment should begin as early as possible. If the disease is ignored, the process can lead to consequences that can affect both the physiological and psychological health of the baby.

Important! Caries left without treatment will not go away on its own, but will almost certainly lead to the development of complications. Infected tissues are a source of spread of pathogenic microflora.

The most common consequences of advanced caries are:

spread of the inflammatory process from the oral cavity to neighboring tissues;
development of pulpitis and periodontitis;
chronic allergic reactions;
cardiovascular diseases.

Preventive measures

At any age, it is better to prevent caries than to deal with its treatment and consequences later. In the case of a child, prevention is especially important.
Dentists recommend adhering to the following recommendations:

Daily oral hygiene (in the morning after breakfast and in the evening before bed) under the supervision of adults. Dental care products should be selected in accordance with age and the dentist’s recommendations.
Limit foods containing large amounts of sugar.
Balanced diet, rich necessary for the child minerals and vitamins.
Additional intake of vitamin D, in accordance with the recommendations of the pediatrician.
Mandatory preventive examination by a pediatric dentist, recommended every six months.

Translated from Latin, “caries” is translated as “rotting.” This pathological, sluggish process in children with poor heredity or children who have received poor nutrition since childhood can be observed already on the first, milk teeth, and continue when they are replaced by permanent ones. No matter what advanced methods of treating caries in children are used, without proper prevention, teeth will still rot, so teaching your child proper oral hygiene is the first thing parents should do in order to prevent the disease.

Caries– this is the destruction of hard tooth tissues by microorganisms living in the oral cavity with the formation of cavities. Predisposing factor to development early caries in children is poor nutrition. When your diet contains a lot of meat and grains, this leads to the formation of increased alkalinity in the body. This does not mean that these products should be abandoned, but they just need to be given to children in moderation. You can correct the position and strengthen your teeth by introducing dairy products into your diet, orange juice, nuts and raw fruits and vegetables (especially green ones).

In this article you will learn how the disease progresses and how to treat caries in young children.

Prevalence of dental caries in young children

Among the many problems of pediatric dentistry, caries occupies a special place, affecting the teeth of infants and children. preschool age, called “early”, “creeping”, “carob” or “nursing caries”. How common is this pathology? It is known that it brings a lot of trouble to the child, his family and the doctor. Early dental caries in children occurs in about a third of children under two years of age and in almost half of children aged three years.

The prevalence of dental caries in children is 60% of the total number of those who sought help in children's departments of dental clinics. IN lately there is a tendency to increase the intensity of the carious process permanent teeth in the first years after their eruption into the oral cavity. Features of examination of children and adolescents, complexity of diagnosis various forms caries in teeth of temporary and permanent dentition, difficulty in choosing a treatment method requires high vocational training pediatric dentist.

Nowadays, young children with supposedly destroyed teeth are very often observed. First, yellow spots appear on the teeth, then they darken, turn brown, and uneven stains appear. In fact, this is not a carious lesion, but a defect in the development of enamel. In other words, something happened during pregnancy that disrupted the proper formation of dental tissue in the fetus. It could be a viral infection, occupational hazard, chronic foci of infection in the mother, which, by the way, includes carious teeth.

Over time, caries is added to the disorders associated with loose, immature enamel.

Why children have dental caries: reasons for the development of the disease

The destruction of dental tissue is the result of the activity of microorganisms that cause caries. These microorganisms enter the child’s oral cavity from the mother through so-called “salivary contact”: when trying to drink from his bottle or food from his spoon, when licking (“cleaning”) a fallen pacifier, kissing, etc.

It has been proven that the more carious teeth the mother, the more often and earlier caries appears in the child. It has been noted that bacteria that cause caries do not remain in the oral cavity of children under six months of age. The colonization of the oral cavity by these microorganisms becomes possible with the appearance of erupted teeth in the oral cavity, on the hard surface of which microorganisms that cause caries can live and multiply.

When the child’s body eliminates the obstacle to colonization of the oral cavity by infection. Typically, in children aged nine months to two years, immunity is especially reduced, which is associated with the gradual loss of maternal immunity and the immaturity of their own immune system.

The period from 9 to 18 months is generally called the “window of infection.” At this time, children most often get sick for the first time.

Another cause of caries in children is dental plaque, which is leftover food and is an excellent breeding ground for microbes. They multiply quickly, forming an entire colony within 12 hours. Their waste products corrode tooth enamel. Microorganisms are especially active at night, which is why it is so important to brush your teeth at night.

The risk of tooth decay in young children increases if the baby's food contains large amounts of sugar. This also applies to medicines (syrups, dragees, effervescent tablets) containing sugar. With frequent or long-term use of these medications in children with chronic diseases, the incidence of caries increases sharply in children who are often ill.

The duration and frequency of meals for the prevention of caries of temporary and permanent teeth in children is also of great importance.

If a child, during daytime sleep and for 10–14 hours at night, without waking up, periodically sucks on the breast of a mother sleeping next to him or on a bottle left in his crib, this contributes to the development of caries. The fact is that during sleep the amount of saliva decreases and its protective properties.

When sucking, food first envelops the incisors upper jaw, which most often suffer because they are constantly immersed in a “carbohydrate lake” and do not have sufficient protection from saliva.

The incisors of the lower jaw, on the contrary, are better protected: the nipple (or mother's breast) is located on the incisors of the lower jaw, covering them from exposure large quantity carbohydrates, which are excellent food for microorganisms that cause caries.

Another reason why children develop caries is heredity. Of course, hereditary predisposition plays a big role, but not a leading one. Heredity and the course of pregnancy can affect the correct or abnormal development teeth. There is such a thing as resistance to caries. If the conditions for the formation of teeth before birth, during pregnancy, are good, then less likely early childhood caries. And vice versa, the worse the conditions for intrauterine tooth formation, the higher the likelihood of carob caries.

Parents should be convinced that the considerable mental and physical efforts required to strictly follow the rules of feeding and raising a child will pay off handsomely - at least, they will protect the child’s teeth from destruction and thus avoid the stress associated with the need for treatment or tooth extraction.

Symptoms and clinical manifestations of caries in children

Caries often develops painlessly. The disease occurs unnoticed because pain occurs when the gum tissue surrounding the root of a carious tooth becomes inflamed or the hard tissue defect becomes significant. In the second case, symptoms of caries in children appear, such as increased nervous sensitivity tooth to common irritants (cold, hot, sour, sweet). When examined, caries in children looks like an area of darkened enamel (dark brown) and enamel defects - carious cavities.

Children aged 3 to 6 years are mainly affected side surfaces teeth. At 6-7 years of age, the chewing surfaces of the lateral teeth become damaged. At an older age, the lateral surfaces of the central incisors are more often affected. During adolescence due to hormonal changes and in the presence of chronic diseases, multiple caries can develop, when more than 10 teeth are simultaneously affected. The carious process is complicated by disturbances in calcium metabolism in the body, as well as by decreased immunity and various intestinal diseases.

The first carob caries in a child is characterized by an obvious connection with the unreasonable use of nipples for artificial feeding of children, high aggressiveness and very difficult conditions for dental treatment.

The peculiarity of the course of carob caries in children is that it affects the child’s teeth in a sequence corresponding to the timing of their eruption. The incisors of the upper jaw are the first to suffer, then the remaining teeth can be successively involved in the pathological process as they erupt. The incisors of the lower jaw, as a rule, are not affected by carob caries, which makes it possible to distinguish this pathology from defects in the development of enamel, which most often affect all teeth.

These photos show what caries looks like in children:

Caries is a lifestyle-related disease. Indeed, a lot depends on the parents. Following a rational feeding regimen does not harm the child’s teeth. However, often mothers offer their children bottles filled with products other than formula and water, not only and not so much for feeding, but to calm the child, stop his crying and help him sleep.

Prevention of carob caries, started in the second half of pregnancy, continues up to three years. In this case, at least once every six months, the child must be examined by a dentist.

Among the reasons for frequent and long-term use Horns are called several pedagogical and medical errors.

Extreme leniency towards the child's wishes and whims.
Failure to recognize the true reasons for his restless behavior.
Neglecting the child's problems. Parents, irritated by their children's crying, can easily restore silence by offering the restless child a sweet drink in a cone.

Free access to the breast or horn can be used by the mother to comfort and support a child born from a difficult pregnancy, weak, and often ill.

Children often eat sweets in between meals. Sweet and sour foods greatly destroy enamel. This creates conditions for the development of caries in primary teeth in children.

First caries of primary teeth in young children

Temporary teeth have a number of differences in their anatomy and structure from permanent teeth, which affects the course of pathological processes in them and the choice of treatment method.

The structural features of temporary teeth include the small thickness of the enamel compared to permanent teeth.

The teething process is complex. It is influenced by various factors. It is believed that the process of eruption is directly related to the hormones of the pituitary gland, parathyroid and thyroid glands.

In many children, before teething, salivation increases, children become restless and capricious. Pediatricians often associate fever and dyspepsia with teething in children. Nevertheless, many researchers have found that the process of teething is a normal physiological process. As a result of observing children infancy It has been established that the normal process of teething does not increase the likelihood of developing respiratory infections and does not cause diarrhea, cough or sleep disturbances. Fever and cold symptoms during teething should be considered as diseases accompanying teething, and not related to the process. Often, a few weeks before the primary teeth erupt, a small bluish-brown swelling appears on the alveolar ridge, which is classified as an eruption cyst. It appears as a result of soft tissue trauma during chewing. This condition does not require special treatment.

After birth, the child develops only a small part of the enamel of the incisors, 50% of the canines and most of the enamel of the molars. These factors must be taken into account in the differential diagnosis of non-carious lesions and caries of primary teeth.

Among forms of caries in primary teeth, milk bottle caries accounts for 35%. At a dental appointment, we often have to observe children aged 1.5 – 3 years with carious lesions in the frontal group of teeth. However, due to the age characteristics of children, it is extremely rare to carry out full treatment and, as a result, by the age of 3–4 years, the necrotic pulp becomes a source of infection, which causes an inflammatory reaction in the area of the apex of the tooth root. As a result, teeth become a source of odontogenic infection and most often must be removed.

Caries of primary teeth in young children is a rapidly developing pathology in babies who are bottle-fed at night. The main cause of milk bottle caries is substrate drinking at night. The child is given sweet and sour drinks or milk to drink at night in order to quench excessive anxiety. Long-term exposure to a cariogenic substrate that comes into contact with teeth for 8 hours leads to a metabolic explosion in the oral cavity. As a result, a large amount of organic acids is formed. The impact of organic acids on the enamel of temporary teeth, the resistance of which is not high enough after eruption, and the thickness is small, leads to rapid destruction of tooth tissue.

Caries in preschool children primarily affects the front teeth of the upper jaw. Secondly, the carious process affects the chewing teeth of both the upper and lower jaws. The frontal teeth of the lower jaw are not affected by caries due to constant contact with saliva.

For differential diagnosis Milk bottle caries and hypoplasia of primary teeth use the method of vital staining of dental tissues with dyes. The diagnosis is established on the basis of assessing the condition of the enamel of not only the upper, but also the lower incisors, since all stages of amelogenesis in the upper and lower temporary incisors occur at the same time.

A feature of the clinical picture of “milk bottle” caries is its rapid spread over the entire surface of the incisors. Parents often note that teeth begin to decay immediately after erupting. The child refuses food, especially sour and cold food.

Upon examination, carious cavities are identified, which are localized on the proximal sides and vestibular surface of the frontal and lateral incisors. In some children, the first molars are involved in the process, upon examination of which carious cavities are found, localized on the occlusal surfaces.

What to do for caries of baby teeth in children: how to treat the disease

Before treating dental caries in children, in the early stages of the carious process, avoid drinking substrate at night and in between meals. Therapy begins with hygiene care behind the oral cavity. At the next stage, a course of remineralizing therapy is carried out for teeth with initial demineralization of enamel and filling of teeth with carious cavities with glass ionomer cements. The main stage of treatment for such patients is the process of weaning off sweet drinks. As practice shows, it is often difficult for parents to wean their child off sweets. Studies of the development of caries in children have shown that the threshold for sensitivity to sweets up to 9 years of age is significantly lower than in adults. Constant stimulation of sweet receptors helps to stabilize food-procuring reflexes in children. Therefore, stopping the intake of sugar in children causes anxiety and irritability, and sleep disturbance. A more physiological way to wean yourself off sweet drinks is to replace sugar with a sweetener and reduce its concentration over the course of a week. Oral hygiene in children with active caries should be carried out using special napkins. Usage standard means hygiene for such children is recommended after complete sanitation of the oral cavity. A feature of the treatment of caries in children using the method of remineralizing therapy is that it is indicated for varying intensities of the carious process. It is recommended to treat all teeth with fluorides and calcium phosphate complex in courses of an average of 10 days every six months. For applications, you need to use preparations in the form of gels, mousses, and jellies.

In order to cure caries in a child as effectively as possible, preparation of carious cavities in children under 3 years of age is recommended to be carried out using atraumatic methods using hand instruments or using a chemomechanical method. The essence of the chemomechanical method of preparation in the treatment of temporary teeth comes down to softening the dentin of the tooth affected by caries chemicals followed by its removal with a hand tool. The chemical components of preparations for chemomechanical preparation are selected in such a way that they do not destroy dentin that is not damaged by the carious process, therefore this method can be classified as a gentle preparation method. In addition, this method of preparing carious cavities does not cause discomfort in children.

Taking into account the clinical course of dental caries in children, at the first stage of preparation, the overhanging edges of the tooth enamel are removed using a carbide bur. Then a small amount of the mixture is introduced into the carious cavity from a special tube-syringe. After 10 s. Using an excavator, part of the softened dentin is removed from the cavity. The stage of softening and removing dentin is carried out until all infected dentin is removed. To determine the quality of the preparation, it is recommended to use the dentin staining method.

Taking into account the characteristics of caries in children, filling of temporary teeth is carried out with glass ionomer cements. The use of glass ionomer cements for filling temporary teeth has a number of advantages over other filling materials, firstly, because glass ionomer cements form biological ionic bonds with tooth dentin. Secondly, their use does not require thorough drying of the tooth cavity. However, when using glass ionomer cements, the instructions for mixing the material must be strictly followed.

Features of the clinical course of caries of permanent teeth in children

The process of mineralization of the enamel of permanent teeth begins after birth and ends several years after teeth erupt into the oral cavity. After tooth eruption, the process of tertiary mineralization of the enamel occurs, which depends on the composition and properties of the oral fluid washing the tooth. The peculiarity of the clinical course of caries of permanent teeth in children is that in the stain stage the disease is asymptomatic.

Poor oral hygiene, consumption of large amounts of refined sugar, and poor health in children lead to an increase in the severity of caries in permanent teeth during the first years after teething.

Treatment of caries in young children during the period of enamel formation has features that are determined by the structure of the tooth tissues.

An important stage in the treatment of caries of permanent teeth in children is a thorough diagnosis of the carious process for the purpose of early detection and rehabilitation of foci of dental demineralization. The use of minimally invasive methods for the treatment of caries is important for maximizing the preservation of the anatomical shape of permanent teeth in children and the full formation of organs of the maxillofacial region (MFA).

Methods for treating caries in the spot stage in young children (with photos and videos)

Caries in the spot stage (focal demineralization) is asymptomatic. The only one clinical manifestation serves to form a white spot - a section of enamel that, when dried with air, loses its shine and becomes dull. When staining a stain with a 1% solution of methylene blue, staining is observed. This is due to the increased permeability of the enamel structure and the formation of microspaces in the subsurface layer. Such pores are formed as a result of the release of acid-soluble carbonate from the apatite crystal lattice.

White spots during caries should be differentiated from hypoplasia, which occurs as a result of damage to ameloblasts during the formation of enamel, and with fluorosis, which occurs as a result of excessive fluoride intake into the body.

The localization of spots may vary. When second primary molars are removed, a carious stain is often found on the medial surface of the permanent molar.

The ability of dental tissues to restore in the initial stages of caries has been proven, which is ensured mainly by the mineral substance of the tooth - a crystal of hydroxyapatite, which changes its chemical structure. When some calcium and phosphorus ions are lost, hydroxyapatite can be restored to its original state through diffusion and adsorption of these elements from saliva. Remineralization is possible only if the protein matrix of the enamel is preserved.

What should be done for caries in children in this case? For remineralizing therapy use various drugs fluorine in the form of applications. The frequency of applications depends on the activity of the carious process, the degree of damage to the tooth enamel and the resistance of the enamel. The optimal drugs for remineralizing therapy of caries in the spot stage are amino fluoride and calcium phosphate complex.

Applications of products for remineralizing therapy in the treatment of caries in the spot stage in children are recommended to be carried out after professional oral hygiene, once a week for 2 – 3 months. The effectiveness of remineralizing therapy using the drug "Multifluoride" in children with low enamel resistance is 44%, in children with moderate enamel resistance - 52%. Numerous studies have established that there are two possible ways of transforming a white spot: the first is the formation of a carious cavity in the form of an enamel defect (superficial caries); the second way is the process of remineralization of the white spot and stabilization of the process.

Enamel caries (superficial caries) can be asymptomatic; sometimes patients complain of short-term pain from exposure to chemical irritants, often sour and sweet. Clinically, a white or pigmented spot is detected, upon probing of which roughness is determined. At this stage of development, the carious process has a distinct histological manifestation and, when localized on approximal surfaces, is clearly visible on an x-ray.

Upon examination, the roughness of the enamel is determined by probing. When staining, the affected area is stained with a 2% methylene blue solution. Considering the morphology of the process, it is clear that remineralizing therapy in this case will be ineffective.

Treatment of superficial caries can be conservative; complete infiltration of caries with the drug “Icon” leads to stabilization of the carious process and sealing of micropores and spaces in the enamel layers. The caries infiltration technique is based on the properties of fluid resins of a certain viscosity to penetrate through the interprismatic spaces into the deep layers of enamel and fill the formed micropores.

Indications for caries infiltration are caries of the approximal and vestibular surfaces of permanent teeth. Contraindications are dentin caries, enamel hypoplasia, and fluorosis.

See how caries is treated in children in these photos:

To carry out the technique of infiltration of approximal caries, it is necessary to thoroughly clean the tooth using a polishing paste, brush and floss, and isolate the tooth using a rubber dam. It is not recommended to use rubber dams based on thermoplastic elastomers. When infiltration occurs on the approximal surface of the tooth, teeth are separated using a special plastic wedge. The approximal tip is inserted into the interdental space with the perforated side facing the infiltrated tooth and through it is applied to the contact surface of Icon Etch. When infiltrating the vestibular surface, etching is carried out over the entire surface of the tooth. The pseudo-intact layer is removed after 2 minutes. The etching gel is washed off with a stream of water for 30 s. A jet of air dries the surface. Icon Dry is then applied to the treated surface. Icon Infiltrant is applied to the tooth surface through the nozzle for 3 minutes. The nozzle is removed and illumination is carried out for 40 minutes. Icon is then applied for another minute
Infiltrant. After illumination, excess material is removed.

The carious process is reliably blocked, which is confirmed by the absence of secondary caries a year after the procedure.

The technique allows you to avoid procedures that are unpleasant for the patient: anesthesia, preparation of tooth tissue.

The video “Treatment of caries in children” shows what methods are used to treat the disease:

Means and methods for preventing caries in children of early, preschool and school age

To prevent dental caries in children, regular oral cleaning should begin as soon as teeth appear in the mouth. Taking care of oral hygiene should become a mandatory morning and evening ritual.

Milk teeth differ from permanent teeth in having thinner enamel, so they are not as strong. And if you don't take care of them, they quickly deteriorate. But they should last up to 7–8 years! In addition, a permanent tooth that grows in place of a carious milk tooth is more susceptible to caries.

As early as one year of age, start teaching your baby to rinse his mouth with water after every meal. Encourage him to try to take the brush in his hand and repeat after you the movements up and down, left and right. Try to make this procedure fun and enjoyable.

It’s too early for him to brush his teeth himself, but it’s time to do the preparatory work. Show your baby how you brush your teeth.

After a while, brush your baby’s teeth yourself. Do this without toothpaste. Later, when he learns to rinse his mouth (most likely, this will happen closer to two years), you can squeeze a small amount (about the size of a pea) onto a soft toothbrush. Let her be funny. Take your baby with you to the store and let him choose it himself.

Teach your child how to care for a toothbrush. After " important work“It must be thoroughly washed with soap and placed in a glass or in the hole of a special holder attached to the bathroom wall. The brush should be stored in a dry condition with the handle down, preferably separately from adult brushes. Do not store your toothbrush in a plastic case. Change the brush every 2-3 months.

By the age of three, your baby will probably be able to brush his teeth on his own. Just explain to him that the paste cannot be swallowed. Brush your teeth with your child morning and evening so that he has a sample before his eyes. This process will take you no more than 5 minutes.

Once your baby can hold water without swallowing it to rinse his mouth, he can brush his teeth with toothpaste.

Compared to adults, children's toothpastes have a reduced content of fluoride and other substances, which in high concentrations can act too aggressively on delicate enamel. However, fluoride deficiency in drinking water and hygiene products is a risk factor for caries.

Gel-like pastes are suitable for baby teeth. Due to the absence of abrasive substances, they are completely safe for children's enamel.

Some children's pastes are very “tasty” because they contain up to 30% flavor additives. Therefore, be careful that your child does not eat toothpaste!

Prevention of caries should begin when the baby is one year old. Proper dental care helps preserve them even in a child with poor heredity. And everything can be the other way around: if you don’t follow the rules, you can neglect teeth that are naturally healthy.

Prevention of dental caries in children includes the following measures:

Monitor the condition of the teeth of those who communicate with the baby, and especially those who come into contact with his dishes. Doctors suggest that tooth decay can be contagious. The origin of this disease is not completely clear, but the presence of a microbial factor in the occurrence of caries is beyond doubt. Therefore, one cannot deny the possibility of caries transmission not only through dishes, but also by airborne droplets. So take a closer look at your own teeth. It is good to use oral antiseptics regularly.

To prevent caries in preschool children, feed your child properly. Often the cause of caries is excessive consumption of carbohydrates. Please note, not only sweets. Paradoxical as it may seem, it may be healthier for dental health to eat a chocolate bar and immediately wash it down with water, washing away harmful substances, than to chew a cracker for 30 minutes. The most dangerous enemies of weak teeth are lollipops that can be sucked on for hours. By the way, best way reduce their amount in the child’s diet - do not accustom them to them. Most often, we eat sweets not because we really need them, but because we are used to pleasing ourselves with chocolate, pastries and pies, and making porridge, pancakes, and cheesecakes very sweet. As a result, the mother, making the baby’s first porridge in his life, adds sugar to it, thinking that unsweetened porridge will seem very tasteless to him. But this will happen to an adult who has already formed habits, but a child may well like food without sugar. Plus sugar
can be replaced with fructose or dried fruits.

Doctors advise not to give candy to children under 5 years of age. Whether you follow this advice is up to you. However, in any case, keep in mind that eating sweets at night is especially harmful - even thorough brushing cannot always remove all remnants of sweet food from your teeth. During sleep, the circulation of saliva in the mouth practically stops, and the remaining sugar particles destroy tooth enamel. In this case, an apple can help, the peel of which cleanses the teeth and massages the gums.

Effective means of preventing caries in children are foods rich in calcium (milk, cheese, eggs, fruits and vegetables) and vitamin D (butter). Mother's milk helps babies have good teeth. To strengthen teeth and gums, unpeeled fruits are suitable and can be given to a one-year-old baby.

The temperature of food is of great importance for dental health. It should be warm, since alternating cold and hot foods can be detrimental to tooth enamel.

Try to wean your baby off the pacifier in a timely manner. After 1.5 years, any nipple can disrupt the development of the dentofacial apparatus. Until a child is one year old, the sucking reflex predominates, which needs to be satisfied, but after this, sucking a finger, pacifier or anything else will provoke incorrect formation jaws and bite.

It is advisable to introduce your child to the dentist before he gets a toothache. This is correct not only with medical point point of view, but also from a pedagogical point of view. The first impression is the most vivid, and let it be pleasant.

If a one-year-old child has not damaged his teeth, has not experienced problems with teething, and there is no plaque on the teeth and mucous membranes of the cheeks, then a visit to the dentist can be postponed until about 3 years. However, over time, visits to the doctor should become regular (once every six months). After all, it is very important to detect caries at an early stage of development, when its treatment is still painless. Usually it all starts with a spot that doesn't hurt. You may not notice it. It is also dangerous to miss the appearance of caries because it develops very quickly on baby teeth. Many parents are mistaken in believing that baby teeth do not need to be treated. The fact is that teeth affected by caries not only hurt, wearing out the heart and nerves of the little patient, but also spread the infection throughout the body, causing diseases of the stomach, kidneys and blood. The sooner the doctor starts treatment, the better. Modern techniques allow you to treat loose teeth without pain. In the early stages, caries can not only be stopped, but also cause the reverse process - healing of the enamel. This is achieved with the help of fluoride varnish, which is used to cover the diseased tooth. To prevent caries, children's teeth can also be coated with fluoride gel. This is a painless and even pleasant procedure, since the gel is a substance with a fruity odor and a pleasant taste.

Of course, the first thing, before visiting the clinic with your child, is to visit there yourself, choose a doctor and get to know him, and then, after making sure that your choice is correct, come with your baby.

Before you take your child to the dentist, prepare him for it. Try to make sure that he is not afraid of the doctor, but, on the contrary, is glad to meet him. Tell him why a person needs teeth and why it is necessary to show them to the dentist. Do not leave your child alone while he or she is in the dental chair. Let him take his favorite toy with him if he wants. And of course, after visiting the dentist, tell your baby that you are proud of him, kiss him and do something nice for him - something he loves.

Reasons to see a doctor:

unsightly dark plaque on teeth. Ego is not necessary
there may be caries, sometimes this is how dysbacteriosis manifests itself;
bad breath;
a broken piece of tooth;
darkened enamel;
painful reaction of teeth to low or high temperature.

Prevention in childhood

It may happen that the child’s teeth have just begun to emerge, and it is clear that they already have caries. Unfortunately, this is happening more and more often. This can happen in children born prematurely, or if the woman was at risk of miscarriage, severe toxicosis, increased convulsive muscle activity.

Due to these complications of pregnancy, mineral metabolism in the child’s body is disrupted, the teeth are not fully formed and immediately begin to decay. But if you immediately show such a child to the dentist, the situation can be corrected. In case of shallow damage to the tooth, the doctor treats it with drugs that nourish the tooth with minerals. Pastes containing fluoride or applications with calcium gluconate, which is able to penetrate the enamel structure and strengthen it, are also used as a remedy. Sometimes diseased areas of the tooth are treated with silver nitrate. True, it darkens the teeth almost to black where there is a depression or stain. For children over four years of age, teeth with initial caries are coated with fluoride varnish. On chewing teeth the recesses (fissures) are sealed when a dark plaque appears.

To prevent caries in young children, an infant should brush their teeth 2-3 times a day from plaque, in which microbes collect, with a bandage moistened boiled water or 10% calcium gluconate solution. When the baby has already cut 5-6 teeth, you can give him a children's toothbrush.

One of the effective methods of preventing caries in children is teaching the child to chew solid food. To do this, the child needs to be given bread crusts or dried bread, a hard apple or carrot. The point here is not that he eats these foods, even if he spits them out, the child needs to chew.

At one and a half years old, children already repeat the movements of adults and imitate them when they brush their teeth. The first brush should have synthetic bristles, no more than a centimeter high, and of medium hardness. Let your child brush his or her teeth without toothpaste first, moistening the brush with water. This should be done twice a day: in the morning after breakfast and in the evening before bed. When the child has all his teeth, you can use toothpaste, putting just a drop on the brush. It can be any children's toothpaste, but it is better not sweet. It is not so important to choose a toothpaste as to teach your child how to properly brush their teeth over the entire surface.

In infants who are bottle-fed, so-called “bottle caries” may occur. The structure of the enamel on the teeth changes. It can be seen that caries seems to encircle bottom part tooth, its neck. It quickly spreads from all sides along the surface of the enamel, and then penetrates into the depths, and then the tooth can break off. The upper front teeth especially suffer from this type of caries.

This caries is promoted by the fact that infant formula contains quite a lot of sugar, it contains 10 times more than in breast milk. If fructose is used in the mixtures, then it is better for the child’s teeth.

Bottle caries sometimes affects the teeth of breastfed children if they are given a lot of sweet water or juices between feedings. This changes the acidity level in the mouth and the teeth begin to deteriorate. The same thing happens when a bottle with a pacifier replaces a child’s pacifier and he does not part with it day or night.

In addition to a visual examination, tablets with fuchsin help determine initial caries in a child. If you chew the tablet, then where in large quantities Soft plaque accumulates and provides a breeding ground for microbes; the teeth turn red.

Some parents think that there is no need to treat baby teeth, since they will fall out on their own anyway. This is a misconception. If caries has gone far, then the pulp is also involved in the inflammatory process. If it dies during root formation, then the growth zone of the tooth is disrupted, its root does not have time to form and turns out to be shorter than others. Then the tooth will be weak and will not be able to withstand the load.

And we must also keep in mind that next to the roots of baby teeth there are the rudiments of permanent teeth, which can become infected from a diseased tooth. This will cause a violation of their structure, shape, enamel thickness and can lead to the death of the rudiment, and then the permanent tooth in this place will not grow at all.

For the proper formation and growth of teeth, fluoride is needed, which may be lacking in our water. Then you need to pay attention to products containing this trace element, for example it is found in parsley and spinach. For an infant You should add one teaspoon of pureed greens to any complementary food daily or use it in dry form. Older children should eat fresh greens year-round. Paste with fluoride helps strengthen teeth; it is best to brush the teeth of children after 4 years of age.

There are a lot of chewing gums on the market these days, and kids love to chew them. And adults worry whether it is harmful. It is not harmful if a child chews gum for 10–15 minutes after eating. Chewing gum creates acidity in the oral cavity, which stops the proliferation of microbes harmful to teeth. Thanks to the taste of chewing gum, the amount of saliva in the mouth increases, which, washing the teeth, nourishes them from the outside.

How to treat caries in children

Treatment is carried out in a dental office. Depending on the degree of damage to the tooth and the presence of pain, the doctor may give an anesthetic injection. The injection site is preliminarily lubricated with an anesthetic gel with flavorings.

Modern drills allow you to drill a hole in a tooth and remove damaged tissue in a matter of seconds and completely painlessly. The choice of filling materials is huge.

In young children, caries rarely penetrates deep into the tissues and more often affects surface layer- enamel.

In these cases, teeth often have to be removed. To prevent curvature of neighboring teeth and their displacement, it is recommended to place artificial plates in place of missing teeth.

In order not to bring the matter to such a level of severity, from the age of three, regularly take your child for a medical examination to the dentist, especially if he already has fillings.

If a child has more than 8 filled teeth, a preventive visit to the dentist is required at least 3 times a year. If there are less than 8 filled teeth, you need to visit the dentist 2 times a year. In case of multiple caries, consultation is required not only with a dentist, but also with a pediatrician.

During the initial examination, the doctor will draw up a dental chart, where he will note the teeth affected by caries that require treatment. Sometimes data is needed to carry out treatment x-ray examination. To do this, an X-ray of the tooth or the entire jaw is taken.

The doctor should pay attention to the presence of plaque: if there is a lot of it, this indicates that the child either does not brush his teeth at all or does it incorrectly. The dentist will teach the child and his parents how to brush their teeth correctly. He can also advise which children's toothbrush and toothpaste to choose. It is very important that the doctor establishes contact with the child. The success of treatment largely depends on this.

Parents are responsible for teaching their child how to brush his teeth in a timely manner, regularly visiting the dentist with him for preventive purposes, and setting up the child so that he is not afraid of these examinations. The choice of clinic also matters here. Pediatric dentist must also be a good psychologist and teacher rolled into one.

Pay attention to the atmosphere in the doctor's office; it should not frighten the child. It’s good when there are a lot of pictures, toys, and music playing around.

In addition, parents should remember that there are factors that contribute to tooth damage. Do not allow your child to drink hot food with cold drinks. Temperature changes cause damage to tooth enamel in the form of cracks, and this is the entry point for infections. The habit of gnawing nuts and candies is also not welcome. Children's teeth are still poorly mineralized and chips of the enamel may occur, where colonies of microorganisms can safely settle and, as a result, caries will develop.

If you notice damage to your child's tooth enamel, consult a doctor immediately. It will cover the surface of the teeth with fluoride varnish and thereby protect them from disease.

During periods of active growth, to prevent caries in children of early and school age, it is necessary to pay attention to calcium intake. The diet should include more dairy products, especially cottage cheese and cheese. In addition, you can give a course of calcium-containing vitamin complexes 2 times a year. They must contain vitamin D3, which promotes the absorption of calcium.

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All parents have to deal with caries in their children. And according to statistics, under the age of 5, about 70% of children have dental problems that require immediate help from a dentist. But what are the main reasons for the appearance of caries at such an early age? Is there any way to prevent it? What treatment methods do doctors use today? And is it true that children do not need to treat their baby teeth at all, since they will still fall out on their own, and healthy ones will appear in their place?

Caries

General information about caries

Caries is a complex pathological process in which tooth tissue is destroyed. According to the international classification, the ICD-10 code is K02. Caries in children can develop, including during breastfeeding, and until the age of about 8-9 months, it will not be possible to get rid of it, since the teeth are still forming.

Why is the enamel destroyed and a black spot forms in its place? This is due to the process of tooth demineralization. The provoking element in this case is either various types of infections or mechanical damage to the enamel.

When the area of decay reaches the dentin, that is, the inner part of the tooth, there is a high probability of inflammatory damage to the periodontium and pulp, which are a bundle of feeding vessels and nerve fibers. It is then that the teeth begin to hurt, actively rot, and they have to be removed.

Is there effective prevention caries in children? Doctors say that The most important thing in infancy is choosing the optimal diet, which will also include solid vegetables or fruits. It is also important to provide the baby’s body with the entire set of nutritional minerals and vitamins - they are directly responsible for health bone tissue(to which the teeth belong).

Caries in the photo

Bottle caries in the photo

Causes of caries in children

The main causes of caries in infants:

Pathologies in the formation of teeth. Moreover, they can arise even at the moment when the child is in the womb. Taking special vitamins for pregnant women and constant monitoring by a doctor will help prevent or at least minimize this.
Weak immunity. Due to the body’s weak resistance to various types of infections, unfavorable microflora arises in the oral cavity, accelerating tooth decay.
Failure to comply with hygiene rules. Although a child cannot brush his own teeth from birth, he still needs to take care of them. And this is the prerogative of parents. There are many options for brushing your teeth without using a traditional toothbrush and toothpaste.
Genetic predisposition. The structure of the tooth is individual for each person. And indeed there are those who are susceptible to caries much more than others.
Incorrect feeding. It occurs, for example, when the baby is not fed correctly. Dentists have a separate term for this – “bottle” caries, which is associated with improper use of pacifiers.

In older children (from about 5 years old), the main cause of caries is poor hygiene and the predominance of foods rich in carbohydrates and proteins in the diet. And, as practice shows, very rarely parents from an early age teach their child to visit the dentist for preventive purposes. It turns out that they undergo a full examination at school, when children already have permanent teeth, and they have to be treated for deep caries.

REFERENCE! Dental caries in children can also occur due to mechanical damage enamels. Even an unnoticeable small crack becomes an ideal place for bacteria to multiply. And it is there that the first signs of caries appear over time.

Types of caries in children

Caries is classified into many subtypes. For example, according to the location of the location in infants, they are divided into:

Bottle. Occurs on the front teeth. The main reason is improper feeding, when the child falls asleep with a bottle nipple clamped between the front teeth or lips.
Cervical. It is located in the area where the bone tissue connects to the gum. Occurs mainly due to non-compliance with hygiene rules in hard-to-reach places.

Dentists also use a classification based on the primacy of development:

primary (caries appears on a previously healthy tooth);
secondary (occurs again after treatment).

According to the degree of damage they are classified into:

single (occurs only on individual teeth that are not located nearby);
multiple, or generalized (affects entire groups of teeth at once).

IMPORTANT! Multiple caries in most cases occurs against the background of pathological processes in the body and is not associated with poor oral hygiene. For example, this phenomenon can be caused by a lack of vitamins C and D, as well as chronic bone diseases. In this case, traditional caries removal is pointless until it is eliminated. primary cause his appearance.

Stages of development

According to the stages of development, childhood caries is classified into:

Initial (aka fissure). It simply looks like small local spots on the teeth (usually the front ones). In this area, the texture of the enamel partially changes.
Surface. At this stage, a visually noticeable blackening appears, but does not penetrate the enamel.
Average. The enamel is significantly damaged, caries spreads to the dentin and actively “eats” it. However, there may not be toothache, since there is no open access to the pulpitis and nerve endings.
Deep. The tooth is practically destroyed due to caries, since the decay process also extends to pulpitis. His recovery is unlikely. In this case, milk teeth are immediately removed, permanent teeth are treated either by restoring their shape or by prosthetics (installation of implants).

IMPORTANT! Very often, cervical caries is diagnosed immediately at the middle or deep stage, when the tooth is practically destroyed. Outwardly, it looks practically healthy, only in some places darkening from the inside is noticeable.

By the way, the only period when a tooth can be cured of caries without opening it (that is, without using a drill) is the initial stage, when there is no depression in the enamel yet. In this case, it is quite possible to restore positive microflora.

Stages of caries development

The characteristics of caries in infants do not imply the presence of a middle stage, since the dentin in baby teeth is too small. Literally after the enamel rots, the process begins to cover and inner part tooth with gum. The spread of caries in them also occurs faster.

Treatment of caries

How is caries treated in children? In most cases, dentists use so-called minimally invasive methods that do not require opening the tooth enamel and dentin. More complex manipulations are performed mainly under general anesthesia.

Minimally invasive ones include:

Silvering. It is performed for superficial caries, when there is no depression in the enamel yet. Due to its properties, silver easily copes with bacteria and fungi, thereby preventing the exacerbation of caries and its penetration into dentin. It is the safest treatment option for childhood caries.
Remineralization. It is mainly used for complex tooth shapes, when strong plaque forms in excessively deep grooves. This form occurs due to a genetic predisposition. Remineralization is carried out using fluorine and calcium (based on them, so-called sealants are created - special filling material mineral based).
Ozone therapy. The most modern method of treating oral diseases. It is ineffective against caries, but against wounds, infectious foci and inflammation it is ideal. Refers to preventive methods treatment of childhood caries and can be used practically even in children under one year old (in practice - from 9 months).
Preparation. Removal of superficial caries is performed using a thin, powerful jet of water.
Depophoresis. Can be used as preparation before invasive treatment. Disinfection of hard-to-reach grooves and cavities is carried out with a special solution.

Treatment of caries of permanent teeth in children in most cases is carried out using a drill under general anesthesia, less often - under local anesthesia.

IMPORTANT! For filling children's primary teeth, different materials are used than for adults. Instead of standard “cement”, silicophosphate compounds are used. They are less resistant to mechanical and acid-base effects.

Treatment of caries under anesthesia

Mainly used for children under 5 years of age multiple problems with teeth. If he has only 1-2 teeth that are slightly damaged, then anesthesia is not used (local anesthesia is used, and it is used in small dosages, especially for psychological protection child).

Are there any disadvantages to general anesthesia? Several can be highlighted:

You will first need to undergo a comprehensive examination;
there is a possibility of development allergic reaction(this is checked by a doctor in advance);
There may be minor side effects (headache, dizziness);
the entire procedure will take longer (after treatment, the child should remain under medical supervision for several more hours).

For the rest they apply traditional methods treatment. That is, the tooth is drilled out and its damaged part is removed, and a filling is performed. If the tooth is significantly damaged, then it is removed by the root (this will prevent future curvature of the bite when permanent teeth appear).

Fissure sealing is an effective method of caries prevention

Prevention of childhood caries

Dentists say that the most effective methods prevention of childhood caries are:

Silanting. It involves closing deep grooves with special temporary fillings (over time they wear off on their own). Helps prevent the formation of caries in hard-to-reach places.
Applications with fluoride. Used in combination in the treatment of initial caries. The teeth are treated, that is, covered with a special composition. This method prevents severe demineralization of tooth enamel.
Professional teeth cleaning. It includes rinsing with special medicinal compounds, as well as removing tartar (mainly using ultrasonic waves). The procedure is absolutely painless and effective for caries at the stage of staining (without deepening in the teeth).

As for traditional brushing with a toothbrush and paste, it is recommended to practice it no earlier than 2-2.5 years. Moreover, each cleaning must be performed under the supervision of a parent.

IMPORTANT! “Adult” brushes and pastes are not suitable for children - they have hard bristles and a very aggressive composition necessary to dissolve soft plaque. Which one should your child choose? It is better to consult a pediatric dentist about this.

What does Dr. Komarovsky say about childhood caries?

Dr. Komarovsky repeatedly assured in his television program that caries occurs due to the neglect of parents. Namely:

the child holds the breast shallowly (and milk constantly gets on the teeth);
the child falls asleep with a pacifier in his mouth through which milk or formula is leaking;
excessive dry mouth is also one of the common causes, since in such an environment bacteria multiply much faster;
lack of micronutrients.

He also advises stick to it as long as possible breastfeeding . Mother's milk is the best source of vitamins and minerals, which are so necessary for the normal development of permanent teeth in the future. If the baby is transferred to complementary feeding too early, this can cause pathologies in the formation of bone tissue.

To prevent dental problems, Komarovsky advises:

nutritious nutrition based on breast milk(for children under 1.5 years old);
inclusion of calcium-rich foods in the diet (from 8-9 months, when complementary feeding begins);
If possible, avoid the use of antibiotics during treatment (they have an extremely negative effect on the microflora);
Brush your teeth with plain water and cotton swabs (sterile) at least 2 times a day.

And we should not forget about the need to visit a pediatric dentist. Moreover, all this needs to be done from the moment the first teeth appear, that is, from 3-5 months. And if a spotty plaque appears, then you should not postpone treatment “for later.” Modern techniques used in dentistry are many times more gentle than those that were used 10-15 years ago.

Educational cartoon about brushing teeth

Be sure to let your child watch this educational cartoon.

By caries, modern medicine means a pronounced pathological process with a slow course, which is localized in the tissues of the teeth and develops as a consequence of a number of provoking factors. IN modern world, this disease is classified according to several criteria.

According to ICD-10

Enamel damage;
Dentin caries;
Pathology of cement;
Suspended form of the disease;
Odontoplasia;
Other types of carious pathologies;
Unspecified caries.

The above gradation is not entirely convenient for practicing dentists, therefore, most often in the modern era, the disease is associated with topographic localization.

Simple, uncomplicated

It has three main subsections:

Carious spot. The most initial form of the disease, in which small chalky-colored localizations in the form of spots form on the enamel. It is difficult for a non-professional to visually notice such a defect, since apart from a slight change in shade, no other manifestations are observed. If caries of this type is identified at the very first stage, it is easy, quick, simple and inexpensive to treat;
Superficial lesion. The next stage of the disease is characterized by the beginning of destructive processes in the enamel. Most often, this is manifested by the pathology of demineralization - the affected area becomes rough, loses its shine, and the teeth themselves begin to react painfully to irritants - cold, hot, sweet and very sour, both dishes and liquids. Despite the serious situation, this stage of caries is quite simple to treat; only in some cases can the dentist apply full-length therapy, as a rule, usually when the pathology is located in an inconvenient or hard-to-reach place;
Average type of caries. The disease penetrates deeper and deeper, affecting not only the enamel, but also the dentin. Pain syndrome occurs regularly regardless of the presence of irritants. Treatment of this type of caries is classical;
Deep defeat. Carious destruction reaches the peripulpal area, and there are risks of developing serious complications - pulpitis and periodontitis.

Complicated

With a complicated form of caries, pulpitis and periodontitis are formed - in the first case, an inflammatory process of the internal tissues of the tooth is formed, and in the second, the integrity of the tooth ligaments, cortical plate and alveoli is disrupted, and due to bone tissue resorption, cysts are formed.

The final stage of caries can cause the most serious complications - from abscesses and phlegmon to blood sepsis.

Basic classification by pathological severity

Compensated stage. Low intensity of pathology, slow development of destruction, chronic sluggish inflammatory processes. It is easy to treat, the prognosis for the tooth is completely favorable;
Subcompensated stage. Average rate of caries development, typical for most age categories. This form is more difficult to treat, but in most cases it is possible to save the tooth using classical methods of preparation and filling. The prognosis is conditionally favorable;
Stage of decompensation. An acute form of caries, destructive processes form and develop very quickly, affecting the middle and deep layers of dentin. The therapy is extremely complex, often requiring the removal of the diseased tooth and the prevention of the remaining ones;
Systemic generalized lesion. The extreme stage of caries development with massive damage to the dentition and loss of an entire group of elements. The prognosis for treatment is unfavorable; conservative therapy is often poorly effective.

Classification by localization

Caries of fissure cavities and physiological cavities in the dentition;
Damage to the contact surfaces of molars;
Simple caries of incisors and canines;
Damage to elements from point 3 with involvement in the destruction of corners and cutting edges;
Complex caries of the cervical area of the entire dentition;
Atypical localization of the lesion, manifested on the cusps of the chewing teeth and the cutting edges of the frontal elements.

Duration of flow

Fast;
Slow;
Conditionally stabilized or temporarily frozen.

The essence of the pathology

Primary. Classic type of caries;
Secondary. As a consequence of relapse of destructive processes in already treated and filled teeth.

A significant proportion of cases of caries formation are regularly observed in children under 5–7 years of age - the primary dentition suffers. Why is this happening?

A number of factors have a negative impact here. First of all, baby teeth do not have such a thick layer of dentin; the enamel on them is not yet so strong. In addition, young children are not always properly trained to maintain proper oral hygiene - some parents begin to teach brushes and toothpaste only 5–6 years after the birth of the child.

An important point is the child’s unbalanced diet with an abundance of simple carbohydrates, sugars and sweets. This combination leads to the rapid proliferation of opportunistic bacteria and quick start destructive processes on enamel. In some cases, caries of primary teeth develops so rapidly that its visible manifestations are noticeable several months after the first warning signs of the disease.

Stages of caries of primary teeth

Dentists identify the following stages of development of caries in children.

Carious spots. It is a small whitish formation on the enamel, which is often confused with ordinary plaque. The surface layer of the tooth itself remains shiny, its basic protective properties are not impaired. Unlike adults, in children this stage very quickly progresses to more serious stages;
Superficial caries. The second stage of carious destruction is characterized by pathological processes on the enamel - segmental demineralization begins, individual areas on the tooth lose their shine, become rough and have a loose structure;
Average caries. At this stage, the destructive process affects not only the enamel, but also the dentin - darkening and small cracks are visually visible;
Deep caries. At this stage, carious processes affect the deep layers of dentin and reach the pulp. Significant holes and internal cavities form, part of the tooth may crumble and fall out with the formation of chips;
Complicated caries. The final stage of the development of the disease, in which a generalized carious lesion partially or completely destroys the dentition in its entirety, with the formation of pulpitis and periodontitis.

The main symptoms of primary teeth include the following:

A chalky stain on the enamel (with initial stage), various darkenings (with superficial and medium lesions);
Pain syndrome. On primary stages the formation of the disease manifests itself as a reaction to cold, hot, sour, highly sweet liquids and foods. Next toothache may be regular and not dependent on stimuli;
Unpleasant smell from the oral cavity. Active proliferation of bacteria, inflammation and destruction processes, accompanied by decay, form the corresponding characteristic odor from the child’s mouth;
Visible processes of destruction. In the later stages of caries development, the activity of destructive processes is visible to the naked eye - these are holes in the teeth, chipped enamel, the formation of cavities with blackness inside, partial or complete destruction dentition.

Sometimes, it is not possible to independently determine caries in the early stages of its development - inconvenient localization of the lesion, the absence of visible symptoms until deep destruction is achieved, non-carious pathologies of the oral cavity and dentition, and other features create the prerequisites for late treatment at the dental hospital. If you suspect that your child is suffering from caries, but there are no visible symptoms, then you should contact your dentist for a preventive examination and diagnosis.

Did a visual inspection using a dental mirror reveal nothing? You can verify the absence of the disease using instrumental methods:

Radiography. A classic technique that allows you to qualitatively and quantitatively assess the level of caries development, as well as the degree of destructive processes;
Enamel drying. Method for diagnosing early caries of primary teeth in children. It is a short intensive drying of the dentition with a directed flow of warm air. In places of primary demineralization of the enamel, the surface shine will be absent;
Transluminescence. Using a photopolymerizer to illuminate the dentition from the inside and detect internal forms caries, when destructive processes occur in the thickness of dentin. The technique also allows you to detect hidden atypical forms of the disease - for example, cervical or root caries of baby teeth;
Enamel staining. Fuchsin is applied to the surface of the dentition: if there are localized carious spots in the first stage of the disease, the affected areas will change color;
Cold thermodiagnostics. Rapid cooling of teeth. In the presence of local carious processes, the child will feel slight pain.

Causes of caries in baby teeth

There is no single cause of caries in children - the start of destructive processes is determined by a number of provoking factors that increase the risk of developing the disease. Caries itself under unfavorable circumstances is a change in acidic and alkaline environment in the oral cavity, under the influence of which individual representatives of the local microflora begin to multiply and carry out glycolysis of excess carbohydrates. Aggressive organic acids are formed, destroying the enamel and creating a channel for dentin infection.

Predisposing factors:

Poor and insufficient oral hygiene in a child;
A diet rich in sugar and simple carbohydrates - muffins, sweets, baked goods, etc.;
Weak general immunity, causing a decrease in local defenses;
Disturbances in the formation of dentition in childhood - crooked teeth, malocclusion, uneven, slow or too rapid growth of the dentition, etc.;
Lack of important minerals and trace elements in the diet - calcium, phosphorus, fluorine;
Genetic predisposition expressed in too thin enamel coating;
Poor salivation and lack of fluid intake. Small amount of saliva that cleanses in a natural way dentition and oral cavity, can provoke caries;
Systemic diseases Gastrointestinal tract;
Other hidden reasons.

Just a few decades ago, dentists for caries in baby teeth recommended exclusively removing the diseased element, citing the need to free up space for the molars. As modern statistics show, early mass removal of temporary teeth does not bring benefit, and often even harms, provoking the development of orthodontic pathologies.

Medicine today offers to treat caries of primary teeth using a variety of methods, both innovative and classical in cases of complicated forms of the disease.

Drug therapy

It is prescribed to children in rare cases, most often with complicated forms of caries and conservative dental procedures. Typical groups of drugs are anesthetics, non-narcotic painkillers, antiseptics and topical antimicrobial drugs.

Remineralization

The procedure for restoring tooth enamel in early forms of caries of primary teeth.

Main stages:

Cleaning teeth from moisture and plaque;
Treating the enamel surface with citric acid extract;
Washing the oral cavity and dentition;
Complex application for a carious spot combination drug(remodent, sodium fluoride, calcium gluconate).

The total duration of the course is 10 days.

Art technique

It is used for both initial and intermediate types of caries. Atraumatic restorative treatment involves the superficial use of a special hand instrument until the enamel and dentin are cleaned of destructive mass, after which the areas are treated with an antiseptic.

The last stage is filling with glass ionomer cements. All of the above procedures are carried out manually without a drill, as correctly and individually as possible, which relieves the child of fear of dental procedures. Painful sensations in this case they are practically absent.

Treatment of complicated caries of primary teeth

Complicated forms of caries of primary teeth in children cannot be cured using the methods described above. In this case, the dentist may suggest a standard treatment regimen:

Main stages:

Determination of the localization of destructive processes - visually and using instrumental diagnostic methods;
Local anesthesia of the child’s dentition and oral cavity;
Cleaning the dentition and oral cavity from all types of contaminants;
Preparation of carious cavities with a drill with parallel isolation of nearby healthy teeth;
Antiseptic treatment of former destructive localizations, if necessary, the use of dental adhesives using the self-etching method;
If necessary, remove pulpitis, complex therapy periodontitis;
Installation of fillings - ceramic or compote;
Grinding and polishing of fillings.

In the absence of the possibility of effective conservative therapy The diseased tooth is removed.

To prevent the development of caries in children, it is necessary to implement measures aimed at reducing the risks of developing the disease. What to do? Work should be carried out in two directions - neutralizing a possible cariogenic situation and increasing the protection of the dentition against caries.

Means for caries prevention

Toothpaste. It is better to choose products that contain a high concentration of fluoride;
Antiseptics. Rinse solutions are widely available in the pharmacy chain. They must be used after the dental cleaning procedure;
Dental floss. If your child can master the use of dental floss, teach him the basic procedures for cleaning teeth from plaque and food debris;
Chewing gum. Sugar-free chewing gum with xylitol helps prevent tooth decay if used for no more than 10 minutes each time after eating.

Prevention methods

Careful oral care - regular brushing of teeth for at least 3 minutes, rinsing, monitoring the child’s activities in this range;
Correction of the power plan. Eliminating sugar and foods containing high content simple carbohydrates;
Fluoridation. Additional rinsing with liquid with a high fluoride content;
Regular dental examinations.