Initial caries in the stain stage is the first stage of damage of this kind. Outwardly, the disease manifests itself as a white formation on the enamel. Initially, it does not lose the luster characteristic of healthy teeth, but is characterized by a massive deposition of soft plaque. Caries in the white spot stage often goes unattended and untreated. The disease is localized near the neck of the tooth, so sometimes it can make itself felt by increased sensitivity of the enamel. Without treatment, a white carious spot becomes brown or black over time, the enamel in this place becomes dull. This is how further demineralization of hard tissues is manifested.

Navigation

Causes of carious spots on the teeth

The main one is the emergence acid-base imbalance in the oral cavity, occurring with direct participation of bacteria. Pathogenic microorganisms are involved in the process decomposition of leftover food with education organic matter. The latter dissolve the constituents of the enamel mineral compounds.

In this regard, the list of causes of initial caries in the stain stage is as follows:

Treatment methods for initial caries

It is important to detect the disease at an early stage. In this case, it can be cured by conservative methods without tissue preparation and filling. And in the future to manage only the prevention of secondary morbidity. And this is an opportunity to save teeth for a long time.

Remineralization

In fact, the initial caries in the white spot stage is the loss of calcium and other components that give it hardness and impermeability to bacteria by the upper layers of enamel. Therefore, in order to restore the surface of the teeth of these qualities, it is necessary to fill the voids formed with the lost substances. For this, remineralization is carried out.

The technique is carried out by sequential actions:

Similar procedures do 15 days. Remineralization will be even more effective using electrophoresis. The device will give the particles of drug components a smaller size, and hence the greatest ability to penetrate tissues. Procedures with electrophoresis are also needed in the amount of 10. The result will be education in enamel structure of hydroxyapatite crystals, which in turn retain the fluoride needed by the teeth.

A similar technique is used with a more advanced Remodent preparation. It is a mixture of calcium, phosphorus, magnesium, potassium, sodium, chlorine, organic substances. The composition also contains a small amount of manganese, zinc, iron and copper.

Remodent is used in applications on damaged teeth:

They clean their surfaces, block the way with moist cotton swabs, dry them;
For the next 15-20 minutes, tampons impregnated with Remodent are applied to the enamel, which are changed 2-3 times during this time.

Such procedures are effective if they are carried out a couple of times a week, 2 hours after each do not eat, do not drink liquids, do not rinse your mouth. The course of treatment will be 10-12 sessions. During all this time, the enamel will be restored completely.

Deep fluoridation

This is the enrichment of damaged enamel with fluoride ions introduced into its structure with dental gels and pastes.

Highly dispersed composition easily penetrates into the formed pores and dissolves well without disturbing protein structure. Surface treated with abocidic solutions of magnesium fluoride silicate, and then alkaline suspension copper-calcium hydroxide.

The first agent dissolves, disintegrating with the formation fluoride silicate and polymerized silicic acid. The components are placed in the pores of the enamel without being afraid of washing out. All the time of their existence they allocate highly concentrated fluorine. Chalky spots disappear, the surfaces of the affected tissues are compared in color and structure with healthy ones.

Ozone therapy

If the initial caries is advanced to the state of a dark spot, it is advisable to apply ozone treatment first. Preparations containing it are able to destroy pathogenic bacteria that provoke the disease.

The affected area is isolated from external influences silicone patch. A jet of ozone penetrates under it, which eliminates pathogenic microorganisms. The whole process will take no longer than 40 seconds. After exposure to the device, it is necessary to carry out the already mentioned remineralization procedure.

Tissue preparation

It is also used at the stage of a dark spot, if other, more gentle methods have been useless. carious lesion removed with hand tools or dental equipment. The resulting cavity is isolated from environmental hazards filling material. Usually this light-curing compound, which is easy to choose according to natural shade of teeth.

Indispensable conditions of treatment

Conservative measures to get rid of the initial caries in the stain stage can only be effective for a while if the conditions that cause the disease are not eliminated.

We are talking about the old diet, containing a lot sugars, calcium and fluoride deficiency, as well as disregard for dental hygiene. Ignoring these conditions favorable for caries will lead to recurrence of the disease in the same place, possibly spreading to enamel surface. To ensure the success of treatment, it is necessary to establish proper nutrition, cleaning teeth and mouth, regular dental check-ups, repeated courses remineralization and fluoridation.

Experts evaluate the effectiveness of conservative treatment not only visually. The disappearance of chalk spots and the restoration of enamel luster are not always sufficient evidence of success. An indicator material is applied to the previously affected areas, which changes color if carious areas remain on the surface. Therapy is considered sufficient if they have disappeared completely. The result is favorable, but requires continued treatment if the manifestations of caries have decreased. The former size of the spots requires more serious dental procedures.

Caries affects the teeth of a person at any age and, as a rule, patients seek dental care already at an advanced stage of the carious process. You can determine caries at the initial stage if you visit the dentist regularly and carefully examine the condition of your own teeth. White or milky spots often appear on the tooth enamel, indicating the beginning of the development of a carious process. Caries in the stain stage is characterized by the progression of the demineralization process, when, against the background of the appearance of spots of various shades, the tooth enamel loses its natural luster, acquires a matte surface and calcium is washed out of it.

White caries

Caries in the white spot stage (white caries) is characterized by the appearance of white and dull spots on the enamel. Tooth enamel at this stage does not yet lose its characteristic luster. There is a massive deposition of soft plaque, which indicates inadequate and poor-quality hygiene measures in the oral cavity, carried out earlier.

The main reason for the appearance of whitish spots is the activity of pathogenic microorganisms. These bacteria digest food residues and form organic acids, which destroy tooth enamel, making its surface porous and thinned.

The bacteria that cause the development of the carious process feed on the remains of food (mainly carbohydrate-containing), which accumulate in the interdental spaces with insufficient oral hygiene. Therefore, we can safely consider the main predisposing factor in the development of caries - insufficient oral hygiene.

With poor nutrition, a lack of essential minerals and vitamins, thinning and destruction of tooth enamel also occurs.

Patients often do not even realize that they have white caries, discovering it by chance in the area of the necks of the front teeth during a visual examination. Sometimes there may be sensitivity of tooth enamel - if the carious stain is localized in the area of the neck of the tooth. White caries is quite reversible with timely treatment and does not require serious dental intervention.

Gradually, in the absence of proper treatment and the growth of demineralized tooth enamel tissue, white spots begin to darken, acquiring brown and even black shades. This is due to the penetration of pathological microorganisms into the porous structure of the affected enamel.

Diagnosis of caries in the stain stage

It is very important to differentiate caries in the stain stage from other dental diseases, which are also characterized by the appearance of stains on the enamel of the teeth (hypoplasia of tooth enamel, fluorosis, pigmented plaque).

Diagnosis of caries

Most often, caries is diagnosed in the stain stage by staining the surface of the teeth with a solution of methylene blue or a caries detector that contains fuchsin, which stains the affected enamel pink.

A very important diagnostic method is the drying of the tooth surface. First, the teeth are washed with hydrogen peroxide, rinsed and surrounded with cotton swabs. Subsequently, the surface of the teeth is blotted with napkins and dried with warm air. After that, the affected areas of enamel become noticeable - they acquire a pronounced white tint.

For the diagnosis of caries in the initial stage, ultraviolet stomatoscopy is actively used. It is performed in a darkened room with a fluorescent stomatoscope. The surface of the teeth is subjected to preliminary cleaning from soft plaque. On the carious area, luminescence quenching is observed in comparison with healthy tooth enamel. With this method of diagnosis, the boundaries of the carious process are clearly visible. With a routine dental examination, such an accurate diagnosis cannot be achieved.

Treatment of caries in the stain stage

Usually, at the initial stage of the development of the disease, no drilling of the affected surface is practiced, therefore, caries in the stain stage, the treatment of which must be started as early as possible, is preferable to be eliminated by conservative methods.

Apply remineralization treatment. First, the teeth are cleaned of plaque and pellicle (thin dental film) and the tooth enamel is treated with low concentration acid solutions. After that, applications are applied to the carious surface with a 10% solution of calcium gluconate or calcium hydrochloride, 1-3% solution of "Remodent". It is possible to enrich tooth enamel with calcium using electrophoresis. According to this principle, treatment is carried out for 10 days.

Remineralization treatment

At the next stage, the tooth enamel is enriched with fluorine-containing agents (dental pastes, gels). Preparations with fluorine are rubbed into the carious area for several minutes. Then they are removed with a cotton swab and rinsed with a soda solution. The course of such treatment usually lasts about a week.

During the treatment of caries in the stain stage, it is mandatory to take multivitamin preparations enriched with calcium, phosphorus and fluorine, which contribute to the speedy restoration of the mineral composition of tooth enamel.

Sometimes the process of remineralization can occur on its own due to the protective properties of saliva. But this rarely happens, because the oral hygiene of most people leaves much to be desired, and the diet of a modern person is dominated by unhealthy foods containing large amounts of simple carbohydrates, leading to increased reproduction of microorganisms that cause caries. So, you should not hope for self-healing and it is better to immediately contact your dentist.

Modern dentistry has a huge selection of drugs that are used during remineralizing therapy. Ordinary calcium gluconate is not able to penetrate into tooth enamel - only calcium ions have this property. They are used in all dental formulations of the new generation.

The most important stage of modern dental treatment is a constructive explanatory and educational conversation, which allows you to master the basic rules of oral hygiene. The dentist explains to the patient the mechanism and causes of the development of caries in an accessible language, the importance of regular check-ups and a responsible attitude to the health of their teeth.

The main advantages of modern dental preparations used in enamel remineralization:

fluorine and calcium are contained in them in the form of ions or in such a compound that is capable of decomposing into ions in the humid environment of the oral cavity;
all professional dental preparations have a very high concentration of minerals necessary for the restoration of tooth enamel.

The most effective German-made preparation for enamel remineralization is considered to be the "Enamel - sealing liquid Tiefenfluorid" containing active fluorine and calcium dioxide.

For the treatment of caries in the dark spot stage, preparations containing ozone are often used, which destroys all existing pathogenic microorganisms. After that, remineralizing therapy is carried out. A dark stain that cannot be treated is monitored and, if it begins to increase in size, occupying more than half of the tooth area, then the tooth is prepared and filled with a photopolymer material.

www.spbgmu.ru

INITIAL CARIES (CARIES IN THE SPOT STAGE)

The occurrence of a cariogenic situation in the oral cavity is predetermined by a number of interdependent factors, conditionally divided into endogenous and exogenous.

The former include: variability in enamel resistance due to the chemical composition of hydroxyapatite (HA), the value of its Ca/P coefficient (from 1.3 to 2.0); morphological features of the enamel structure (location and number of lamellae, spindles and bushes of organic matter, shape and depth of fissures and pits); expressiveness of contact points; anomalies in the position of the teeth. These factors are determined by the constitution, heredity and previous diseases, especially during the period of tooth formation.

Oral factors defined as local include saliva, microflora, and food debris. The mineral composition (concentration of calcium, inorganic phosphorus, fluorine, molybdenum, vanadium, selenium) of saliva, as well as its quantity, buffer capacity and antimicrobial properties, largely depend on the general condition of the body. The same indicators are affected by the nature of nutrition and the level of hygiene.

In a caries-resistant situation, the balance of the composition of enamel and the surrounding biological fluid - saliva is ensured due to the resultant action of two processes: the dissolution of enamel GL and its formation.

Dental plaque (dental plaque) is an accumulation of predominantly acid-forming bacteria (streptococci mutans, mitis, sanguis, lactobacilli) and their metabolic products in the retention areas of the tooth surface fixed on the pellicle. In the course of their vital activity, all organisms synthesize intra- and extracellular polysaccharides (dextrans, glycans, levans) from easily fermentable carbohydrates, which maintain the volume of the plaque matrix and constantly provide them with a nutrient substrate. The enzymatic activity of dental plaque bacteria (anaerobic glycolysis) leads to the formation of organic acids (lactic, pyruvic, acetic, etc.), causing a local decrease in pH under the plaque to 5.0 - 4.5. The presence of plaque interferes with the buffering activity of saliva, and enamel demineralization begins. The dissolution of HA occurs primarily in the least stable areas of the enamel surface: in the Retzius lines and interprism zones. After acids, microorganisms penetrate into the subsurface zone of the enamel and the demineralization process continues.

Pathological anatomy of initial caries

The lesion in the enamel with a white spot has a triangular shape in cross section, with a pigmented spot it is trapezoidal. The wide base of the lesion is located on the surface of the enamel, and the apex of the triangle or the narrow base of the trapezium faces the dentin-enamel junction (DEJ). In the hearth distinguish four zones(in the direction from the enamel surface to the dentin-enamel junction).

1. Superficial, up to 20 microns thick, retaining the enamel structure, but the pellicle swells and dissolves. This zone contains calcium, phosphorus, fluorine, strontium even somewhat more than the areas of intact enamel. The volume of microspaces corresponds to intact enamel (1-2%), but the Retzius bands are somewhat wider, which ensures its increased

permeability.

2. The subsurface zone ("body" of the lesion) is a zone of pronounced demineralization. The content of mineral components can be reduced to 20%, microhardness is sharply reduced, the volume of microspaces is increased to 20 - 25%, and permeability is significantly increased.

3. Zone of hypomineralization, defined under the previous one. Changes in the structure of prisms are expressed to a lesser extent, microspaces occupy 2–4% of the volume, microhardness is slightly below the norm.

4. Hypermineralization zone - transparent. Covers the previous one from the dentino-enamel joint.

It is well expressed in the chronic course of caries. The microhardness and volume of microspaces correspond to the first zone (0.5 - 1.0%), and in the areas corresponding to the Retzius lines, a normal level of mineralization is observed.

According to electron microscopy, the destructive process begins along enamel prisms: microscopic bonds are broken, gaps appear, the orientation and shape of HA crystals change, and some of them are destroyed. In the zone of demineralization, gaps are formed, filled with organic matter coming from saliva, or amorphous mineral salts. In the remineralization zone, lacunae are filled with calcium phosphate granules; their presence is also noted in enamel prisms. Violation of the structure of the organic stroma in the early stages of caries (white spot) was not found, but in the demineralization zone, the connection of the protein matrix with mineral components is broken. On the basis of chemical and X-ray diffraction analysis, it was established that demineralization, depending on the color of the spot, progresses in the sequence: white, light brown, brown and black spot.

Clinical manifestations

Complaints about local changes in the color of the tooth, a feeling of soreness may appear. White spot, characteristic of the acute course of caries, this is a progressive demineralization of the enamel. A pigmented spot is an intermittent or suspended demineralization observed in a chronic course. light brown spot can be regarded as stopped caries when remineralization processes prevail over demineralization processes, which usually occurs as a result of changes in local conditions (removal of an adjacent carious tooth). Such carious spots are often found on the proximal surfaces of the teeth. However, there is no guarantee that if the conditions that ensure the balance of de- and remineralization processes change, the process will not begin to progress. Brown spot (dark brown, black), especially large, - the least favorable kind of initial caries. The lesion in cross section has the shape of a trapezoid with a wide base facing the surface of the enamel. The lesion usually extends to the entire depth of the enamel, capturing the dentin as well. Pigmentation of tooth tissues may be the result of direct staining with food pigments and (or) the result of the enzymatic activity of the microflora, which converts phenylalanine and tyrosine into melanin-like substances.

Localization of caries due to both different resistance of enamel to demineralization, and local factors that contribute to the formation of plaque. The study of intravital solubility of enamel made it possible to establish some regularities. For teeth maxillary solubility was generally higher than for the teeth of the lower jaw. Moreover, in the upper jaw it is highest in premolars, lateral incisors and first molars; the vestibular surfaces of molars are less soluble than those of premolars and anterior teeth. In the teeth of the lower jaw, the vestibular surfaces are more soluble than the oral ones. The enamel of the lower canines and incisors is most resistant to dissolution. In addition, it should be remembered that each anatomical type of tooth has its own microarchitecture of the solubility of individual sections and even points. Common to all teeth is that the most soluble cervical zone of enamel, contact, especially distal surfaces, and the least soluble surfaces located above the equator of the tooth.

Dental caries is a common problem that occurs in almost everyone. But, unfortunately, many are in no hurry to go to the dentist at the initial stage of this pathological process, and they are dragging on to serious complications. But if you start treatment even at the stage of the appearance of the stain, then everything can be quickly eliminated without brushing the tooth and filling. Therefore, many dentists strongly recommend visiting dental clinics as often as possible in order to detect the presence of caries at the initial stage (in the white spot stage).

Initial caries is a pathological lesion that occurs as a result of demineralization and the process of softening of hard dental tissues. Usually this process goes unnoticed and is difficult to notice visually. This type of lesion is detected only during the examination of the dentist. The doctor may notice that the tooth has lost its luster, has become dark, this will indicate that the process of demineralization of the tooth tissues has begun.

Initial caries develops as a result of softening of hard dental tissues, the tooth begins to lose its natural luster, which indicates demineralization of the enamel.

Often this type of carious lesion first affects the neck of the tooth, then it slowly causes the destruction of other structures of the tooth, while moving into other more complex stages. The initial stage is considered the simplest and at this stage the defeat is the easiest to prevent. But the thing is that this process is almost impossible to notice on your own and therefore, often this form passes into other more complex stages. But if this process is identified immediately, then everything can be quickly eliminated without resorting to preparation.
This type of caries can affect absolutely everyone, regardless of age - children, adults, and the elderly. In children, this process usually occurs as a result of increased consumption of sweets and sweets. In the elderly, this pathology usually occurs as a result of thinning and wear of the bone tissue of the teeth, as well as due to a lack of calcium and fluorine in the body.

The reasons

The main factor in the occurrence of the initial form of caries is the appearance of an acid-base imbalance in the oral cavity, which occurs due to the increased activity of pathogenic microorganisms. The oral cavity is constantly inhabited by a large number of certain types of bacteria that take part in the decomposition of food. Usually, food remains along with these bacteria remain on the surface of the teeth and between them, all this causes an increase in harmful processes, which lead to the beginning of the destruction of the surface of the tooth enamel.

In addition, there are certain factors that cause the onset of the process of destruction of tooth enamel:

Poor oral hygiene. With incomplete or poor-quality cleansing of the oral cavity, gums, tongue, teeth, pieces of food often remain. After a certain time, all this leads to the formation of a white plaque, in which a large number of bacteria accumulate. For a full-fledged life, microorganisms use carbohydrates, which are precisely contained in the composition of deposits. As a result, harmful acids are released, which have a pathogenic effect on tooth enamel. To prevent this from happening, many doctors strongly recommend maintaining good oral hygiene - teeth should be cleaned regularly with a brush and toothpaste, gums and tongue should also be cleaned;
Genetic predisposition. The strength and structure of enamel in children is laid down during the period of inception and intrauterine development. If during this period in the mother's body there will be a lack of essential vitamins and components, calcium, fluorine, as well as minerals, then as a result the child will have fragile teeth in the future, which will be highly susceptible to carious damage;
Wrong nutrition. In order for the enamel to be strong, foods with a high content of fluorine, calcium, and phosphorus must be present on the menu. Such products include cottage cheese, milk, cheese, fish, nuts. But sweets, pastries and other high-carbohydrate foods should be consumed as little as possible. Often, with increased consumption of this food, there is a rapid defeat of tooth enamel and its further destruction;
Lack of professional care.
Attention! Often, caries at the stage of a white spot appears in the place of the neck of the tooth. This part is quite difficult to clean with a toothbrush, so there is a large accumulation of harmful bacteria that have a detrimental effect on the structure of the tooth. For this reason, it is necessary to go to the dentist's office several times a year for examination and professional cleaning of the teeth;
Increased viscosity of saliva and changes in its composition. Saliva for teeth is of great importance. This component is needed not only for wetting food, but also for cleaning the dentition from food debris. But sometimes, due to a change in its structure and composition, acidity increases in it, which has a devastating effect on the dentition.

stages

Initial caries, as well as other forms of carious lesions of the dentition, has several stages. Each of the stages has characteristic features that have certain differences. It is extremely important to know how each of them proceeds, and what factors are accompanied.

Caries at the white spot stage

Carious bacteria, interacting with the remnants of food, secrete acids that gradually wash out calcium from the enamel. Teeth become brittle and porous. This process is called demineralization, and white spots on tooth enamel are demineralization areas.

The presence of caries at the white spot stage can be identified by the characteristic white spots on the surface of the teeth. During this period, the enamel does not lose its luster, it retains its color. Also, there is usually an increased layer of plaque on the surface of the dentition. This plaque is a characteristic sign of poor-quality cleaning of the teeth.

Important! The main factor in the occurrence of carious lesions at the white spot stage is the active vital activity of pathogenic microorganisms. With poor cleaning of the oral cavity, teeth, gums, food remains remain, which the bacteria digest and, as a result, release acids. All this negatively affects the enamel and leads to the appearance of white spots on the teeth. Also, this process occurs with malnutrition.

In most cases, patients simply do not pay attention to the fact that they have stains on their teeth, therefore, during a visual examination, they are almost impossible to notice. But at this stage, caries is the easiest to prevent; in these cases, serious dental intervention is not even required.

dark spot stage

With untimely treatment of caries at the stage of a chalky spot, a deepening of the carious lesion occurs, which leads to a pigmentary change in the teeth.

This form is considered a more serious pathological lesion of tooth enamel. Usually it occurs due to untimely elimination of the first stage of carious lesions. During this process, the growth of demineralized tissues is observed, which eventually leads to a darkening of white spots, they can become brown or even brown. This is usually due to the fact that pathogenic organisms enter the composition of the porous structure of the enamel.

Symptoms

Some people think that a carious lesion at the spot stage is not to be disturbed in any way and it is simply impossible to determine it on your own. Of course, this stage of this lesion can only be found when examined by a professional dentist. However, there are some signs that will help to independently identify the presence of this lesion and conduct timely treatment.
The main criteria for the presence of the appearance of initial caries are the following symptoms:

Sometimes there may be a feeling of soreness;
The tooth has no reaction to the effects of some irritating factors - hot, cold, sweet or sour food;
In some places, the enamel may change its color, and sometimes the shine disappears, the structure becomes dull.

Disease differentiation

It is important to be able to distinguish carious enamel lesions at the white spot stage from pathologies such as enamel hypoplasia or fluorosis. Fluorosis usually occurs as a result of increased fluoride intake.

Fluorosis is a chronic disease that develops before teething as a result of prolonged ingestion of water or foods with a high content of fluorine compounds.

It is possible to distinguish the presence of caries in the form of a white spot from other pathological processes by characteristic factors:

Location zone. Usually caries in the form of white spots is located on the contact or chewing parts of the tooth;
During this stage of the carious lesion, a single spot appears, the parameters of which are usually from 3 to 5 mm;
In caries at the stage of a white spot, there are usually no clear boundaries, and the spot can be with a smooth and matte structure;
Until the appearance of a white spot, there were no obvious signs on the surface of the enamel. With fluorosis and hypoplasia, spots appear from the period of the appearance of the first units of the dentition and remain for life;
In a further period, caries passes into a carious cavity, and with fluorosis and hyperplasia, defects appear in the dentin structure.

Features of diagnosis

During the examination, it is very important not to make a mistake, because there are a large number of diseases that have similar manifestations. For example, pigmented plaque has similar features of caries in the form of a dark spot, and it usually accumulates in the cervical region of the tooth.

Plaque on the teeth is the accumulation of a large number of microscopic residues of various substances that settle on the enamel of the teeth, in the spaces between them and other parts of the dental cavity. Depending on the stage, plaque can be white, yellow, brown and even black.

Examination rules:

For diagnosis, a caries detector is often used, which contains fuchsin in its composition. During the use of this tool, the enamel is stained pink;
Another simple method of examination is the draining of the enamel. During this process, the enamel is washed with a peroxide solution and then dried thoroughly. Drying is carried out with the help of cotton and gauze swabs and warm air. After that, you can easily see areas with white spots that are visually very different from the healthy structure of the enamel;
Currently, the examination often uses such an instrument as a stomatoscope. Before using this device, the surface of the teeth is thoroughly cleaned of the layer of plaque. After that, the patient is taken to a dark room and using this device, the dentition is illuminated with ultraviolet radiation. As a result, you can easily identify the main differences between healthy tissue and damaged tissue. In addition, the boundaries of the pathology are revealed, which cannot be seen with such accuracy when using other examination methods.

Features of treatment

Therapeutic therapy of the initial stage of a carious lesion at the white spot stage is usually carried out using conservative means, while preparation and drilling of the tooth is not used. If the staining process occurs due to the leaching of calcium and other essential minerals from the tooth enamel (demineralization), then the whole process of therapeutic therapy usually consists in saturating the dental tissue with useful components, this process is called remineralization.

Remineralization of teeth is a procedure for restoring the mineral composition and density of damaged enamel, it is carried out using special gels, varnishes or pastes that contribute to the delivery of mineral components to the upper layer of enamel.

During remineralization, various dental professional preparations are used. In the last century, gluconate tablets were used to restore tooth tissue, which were rubbed into tooth enamel. The thing is that calcium gluconate is an insoluble salt and cannot dissociate into ions. But in order for the structure of the tooth to be completely restored, it is necessary that ions enter it. Therefore, modern preparations are made in such a way that when they are used, all the necessary ions and components penetrate into the composition of tooth enamel.
All dental remineralization products have several main features:

These products contain calcium and fluorine. These components have an ionized form or are contained in compounds. As a result of getting into the oral cavity in a humid environment, these components begin to quickly dissociate into ions;
These preparations have a high concentration of calcium and fluoride, which is much higher than in conventional fluoride toothpastes. Due to this property, the use of these agents makes the remineralization process more efficient.

Stages of caries treatment at the white spot stage at the dentist's office

The whole process of treatment of the initial carious lesion is quite fast and painless. This stage is treated without the use of drilling, opening the cavity of the carious area. Usually, only the restoration of the surface with a stain is carried out.

Remineralization includes stages: tooth cleaning - drying - application of specialized products - consultation on dental care - further monitoring and prevention.

The remineralization process is carried out according to the following scheme:

At the first stage, plaque and tartar are removed. In this case, soft layers on the enamel surface are removed, and tartar is also removed. After that, the entire surface is completely polished;
Next is remineralization. During this process, the affected areas with white spots are treated with special dental preparations that are based on calcium and fluorine. Often during this procedure, the most effective and best remedy for enamel remineralization is used - "Enamel - sealing liquid Tiefenfluorid". The composition of this tool includes two main elements - highly active calcium hydroxide and highly active fluorine. These elements are applied as a layer on the surface of the teeth, they must be applied in turn. Everything is applied according to the recommendations in the instructions. The course of application is about 10 procedures;
At the next stage, the dentist must tell the patient all the rules of oral hygiene. The main condition for the success of treatment is the correct implementation of hygienic procedures for the care of the oral cavity in the future. The doctor must explain and show the patient how to properly brush their teeth. If hygiene is not of high quality, then in the future a carious lesion may occur again;
In the future, it is imperative to periodically monitor the general condition of the teeth. After the restoration procedure of teeth with caries at the stain stage, it is recommended to make an appointment with the attending physician no later than in 2-3 months. During this period, you can assess the general condition and quality of oral hygiene.

Features of treatment at home

Restoration of tooth enamel with caries at the white spot stage can be done at home. But best of all, before you carry out the remineralization procedure at home, you should go to the dentist for an appointment so that the doctor removes all plaque and tartar deposits. Also, after remineralization, it is necessary to carefully monitor the state of oral hygiene, it is necessary to brush your teeth twice a day with a brush and toothpaste, in order to clean food debris from hard-to-reach places, you should use special brushes.

There are many toothbrushes: they differ in color, size, diameter of the working surface. Synthetic bristles are attached to a thin, durable wire covered with a plastic layer. The main function of the brush is to remove food debris between the teeth.

Application of the remineralizing gel R.O.C.S. Medical Minerals

The composition of this drug includes increased dosages of calcium, phosphorus, magnesium. These components are easily digestible; after application, they quickly penetrate into the composition of tooth enamel and strengthen its structure. After using this gel, a thin film appears on the surface of the dentition. In the future, all components from this film gradually penetrate into the structure of the dental tissue.
The gel should be used after the necessary oral hygiene, namely cleaning the teeth. For cleaning before the procedure of remineralization of tooth enamel, it is recommended to use a toothpaste that does not contain fluorine in its composition.
In order for all calcium to penetrate into the structure of the dental tissue and assimilate, after the remineralization procedure, you need to use special products with fluorine. If R.O.C.S. Medical Minerals is used in the morning when brushing your teeth, then in the evening it is recommended to use special toothpastes and special products with a high fluorine content.

Gel R.O.C.S. Medical Minerals is a special toothpaste with a high fluoride content, used as a way to prevent tooth demineralization.

The most effective fluoride-containing drugs include the following:

Therapeutic toothpaste ROCS Medical. This paste contains a combination of amino fluoride and sodium fluoride. The fluoride level is -5000 ppm. This agent is usually applied to the surface of the teeth with applications or used as a cleansing of the surface of the teeth. If the paste is used for cleaning, then it must be carried out for 3-4 minutes;
Elmex gel (Elmex, Germany). It is a highly effective high fluoride gel that is used to clean dentition units. The composition includes a combination of aminofluoride and sodium fluoride. The fluoride level is almost 12500 ppm. In order to fix the result of applying the R.O.C.S. Medical Minerals Remineralization is recommended to be used only twice a week. The gel is used at bedtime;
Toothpaste "Elmeks - protection against caries". This toothpaste has a high level of amino fluoride in its base. The total fluoride content is about 1400 pmm. This paste can be used regularly as a preventive therapy. It can be used not only to consolidate the result of remineralization, but also when white spots of a carious lesion appear.

Preventive measures

Many dentists note that the main component of effective treatment and dental health is the observance of the necessary preventive measures. These rules of care will help prevent serious consequences that often occur when all doctor's recommendations are not followed.
Remember the following important prevention rules:

It is necessary to regularly clean the oral cavity, this procedure must be carried out every day twice - in the morning and in the evening. It is advisable to use high-quality toothpastes that kill all harmful microorganisms and clean the teeth and mouth from food debris and other harmful bacteria. Toothbrushes should be chosen with medium hardness so that during brushing they do not injure the gums and soft tissues. You can also use a special sterilizer with an ultraviolet lamp. These devices help to destroy all pathogenic bacteria that cannot be cleaned out while brushing your teeth with toothpaste and brush;
It is better to give up regular snacks and malnutrition. After short-term snacks, it is not always possible to carry out a high-quality cleaning of the oral cavity, therefore, in these cases, pathogenic bacteria will remain on the surface of the teeth, which can further damage tooth enamel. The diet should include various fruits, vegetables, foods high in calcium, phosphorus and fluorine - milk, cottage cheese, kefir, cheese, fish, nuts. It is worth consuming sweets, fast foods, chips, sweet soda as little as possible;
Be sure to visit the dentist's office twice a year. During the examination, the doctor can identify the onset of pathological processes and quickly eliminate everything. In addition, he will clean the enamel from plaque and tartar, and will also treat everything with special solutions that have a high content of calcium and fluorine;
Try to avoid contact with the surface of the teeth of chemicals. It is also worth abusing bad habits as little as possible, for example, opening bottle caps with your teeth, do not bite your nails, and so on. It is advisable to give up substances that can stain the enamel - wine, coffee, smoking.

Caries at the white spot stage can be easily prevented even at home, the main thing is to notice it during the time. Usually people simply do not notice the appearance of this ailment, the whole process is delayed and turns into a severe form. In order to prevent this from happening, it is better to visit the dentist regularly for prevention and carefully monitor the health of your teeth and oral cavity.

The main cause of any caries is the activity of acid-forming bacteria (Streptococcus mutans and others). Poor hygiene and high carbohydrate intake are the main factors in the formation of plaque with an increased concentration of pathogenic microorganisms. The disease clearly demonstrates the mechanism of decay: during the initial caries, minerals and trace elements are “washed out” in the enamel. Enamel demineralization provokes the formation of small light spots: they signal the onset of the carious process. Under microscopic magnification, these areas appear more porous and rough compared to healthy enamel. The protective properties and aesthetics of enamel are noticeably reduced, but its structure is not disturbed. This is how initial and superficial caries differ: in the latter, the enamel layer is destroyed, which leads to a corresponding reaction of the tooth (in particular, to a reaction to thermal stimuli).

Stages of initial dental caries

Chalk stage. At this stage, the stain has a white color, much lighter than healthy areas of enamel.

Dark spot stage. A more severe form of initial caries that affects the deeper layer of enamel. Food dyes penetrate there, due to which the stain becomes brown or brown.

Diagnosis of initial caries

So, we found out what caries looks like on the teeth of the initial stage, now we need to tell you how the diagnosis goes. This is not as simple as it might seem at first glance. The clinic of initial caries is mild. The disease has practically no characteristic symptoms, and this is especially true for pain. Only occasionally the patient may feel slight discomfort after drinking cold drinks. Diagnosis of initial caries today is carried out using several methods.

Methods for diagnosing initial caries

Drying. A common visual assessment technique. The tooth is thoroughly dried with peroxide, after which the affected areas become visible.

X-ray. Not the most reliable way, but dental x-rays are an integral part of the preparation. White spots are especially noticeable in sighting shots.

Coloring. After applying a solution of methylene blue, the affected areas turn into a characteristic blue color.

Transillumination. The teeth are translucent with a special fluorescent device, as a result of which areas of demineralized enamel and their boundaries are detected.

In addition, specialists can resort to differential diagnosis. This is a set of procedures aimed at distinguishing diseases that are similar in symptoms and clinical picture. In the case of initial caries, these are non-carious lesions of the enamel (fluorosis, hypoplasia, and the like).

Treatment of initial caries

Most patients are interested in how to get rid of the initial caries if you have signs of its manifestation? Initial caries in the stain stage is quite easily treated, and, importantly, today this rarely requires the use of a drill. Modern dentistry offers non-invasive methods that cope with the disease and do not require tooth preparation.

Non-invasive methods of treatment of initial caries

Remineralization. Before the start of therapy, professional hygiene is carried out, which is designed to remove plaque and carious stains, as well as drying the teeth. The most common method is applications with a solution of 10% calcium gluconate, as well as other drugs, such as fluorides. It usually takes 10-20 treatments to remove the stain. In modern clinics, remineralization is often performed using electrophoresis technology. It is also possible to carry out remineralization at home (for mild forms of the disease and for prevention). Usually special gels and pastes are used for this.

Deep fluoridation. Applying preparations containing fluorine, copper hydroxide and calcium to the surface of the teeth. To fix the result, fluorine-containing pastes are used. Fluoridation reduces the body's ability to absorb sugar, so the procedure is not recommended for people with diabetes, as well as with an excess of fluoride in the body.

Icon technology treatment. This is an infiltration technique that involves treating the tooth with a special polymer composition that seals the carious cavity and prevents the development of the disease.

Installation of a seal in case of initial caries

The treatment of initial dental caries in most situations does not require the use of a drill, however, in some cases, a filling is performed. This usually happens at the dark spot stage, when the doctor is not sure about the success of the remineralization therapy, and for some reason the Icon technology treatment cannot be performed. A light filling with initial caries is considered the most effective, since it has high functional and aesthetic performance.

When is the outcome of initial caries treatment considered successful?

The initial stage of caries is the easiest to correct, but incomplete or poor-quality treatment almost always leads to the transition of the disease to the next - more serious - stage. The outcome of the treatment of initial caries is considered successful when:

the carious stain disappeared, the color of the tooth became uniform;
repeated diagnosis confirms the absence of traces of enamel demineralization;
there is no reaction to temperature stimuli and the feeling of soreness disappears, which sometimes appears at the stage of initial caries.

Prevention of initial caries

To prevent initial caries, it is enough to follow a number of simple rules, since in most cases the disease develops against the background of poor hygiene and malnutrition. To minimize the risk of a carious spot, doctors recommend: