In the early stages, caries is asymptomatic and therefore often goes unnoticed. A tooth affected by caries of the initial stage does not hurt, looks absolutely healthy, does not react to sour / sweet and hot / cold, there are no visible signs of tissue damage on it.
Caries at the initial stage is a disease in which there is a loss of minerals in the teeth. The first signs of the presence of caries are the tarnishing of tooth enamel, its friability, the appearance of a white area. Most often, caries occurs in the neck of the tooth. This is due to the fact that it is in this part that the tooth enamel is the thinnest, and therefore the most vulnerable, although in some cases white spots can occur in other parts of the teeth. These spots can be better seen if the enamel is dried.
At first, such a spot is small, but after some time without treatment, it begins to grow rapidly. When moving to the second stage, the stain may begin to darken, since dyes from food and various microorganisms will constantly get into the loose enamel. Over time, the color of the spot can become brown, almost black and turn into a superficial form of caries.
The main cause of caries in the white spot stage is insufficient care for the oral cavity, the presence of microbial plaque, and food debris.
Bacteria in the mouth digest food debris and secrete substances that leach minerals from the teeth. As a result, tooth enamel becomes too fragile and porous.
It is important to note that caries in the white spot stage is a reversible process, that is, it can be easily cured if you see a doctor in time. However, due to the absence of unpleasant symptoms, patients often let the disease take its course, and turn to the dentist already in the last stages of the disease.
Diagnostics
Most often, initial caries is found in the puberty period, since at this time a person's immunity is usually greatly weakened, as a result of which the reproduction of pathogenic bacteria occurs faster. For the same reason, dentists advise their patients to come for check-ups after serious illnesses. After all, caries is dangerous precisely because in the initial stages it does not show symptoms and a person may not even be aware of his illness.
It is possible to detect the initial stage of caries only on examination in the dentist's office. The patient himself, most likely, will not pay attention to the faded enamel. Therefore, it is recommended to visit the dentist 2 times a year.
As a rule, a tooth affected by the initial stage of caries does not respond to any irritants, and if such a reaction exists, it is mild and disappears very quickly.
During the diagnosis, the doctor stains the tooth enamel with a weak solution of methylene blue. This diagnostic method in this case is the most popular.
In addition, the dentist must probe the surface of the enamel. Usually, during this procedure, patients do not feel discomfort, but the doctor will be able to examine the roughness of the tooth enamel.
During a routine examination, the doctor will be able to easily diagnose the initial caries in the stain stage if it is located on the outside of the tooth. In the event that a carious spot is located between the teeth, it is almost impossible to detect it with the naked eye until a black spot forms there.
In order to be sufficiently convinced of the presence of caries of the initial stage, the specialist must clean the teeth from plaque and treat them with a weak solution of hydrogen peroxide. Then the oral cavity is rinsed with clean water and dried with air. After that, white spots appear on the teeth affected by caries, which will stand out strongly against the general background.
In the event that caries is located in the interdental space and it could not be diagnosed, it is important to catch the moment when the stain just starts to darken and become noticeable.
Therefore, you need to go to the dentist, even if there are no complaints.
An experienced dentist will always be able to notice areas with softened dentin. When viewed with a probe, the instrument will seem to "get stuck" in such areas. If your doctor suspects caries, he may also order an x-ray of your mouth.
What should be distinguished from the initial caries?
Caries at the initial stage is very easy to confuse with a spotted variety of fluorosis or hypoplastic processes in the enamel. Only a dentist can correctly distinguish these pathologies. In general, the differences between these diseases are as follows:
- Spot location . As a rule, with caries, there is a single spot on the tooth, which is located on the chewing surface, the neck of the tooth, or in the grooves. Patients with enamel hypoplasia or fluorosis have multiple stains on the teeth. They are usually located on the buccal or labial surface of the tooth. What is not typical for caries.
- Appearance of the lesion . With caries, the spot is chalky or pigmented. It does not have clear contours. The surface of the area affected by caries is smooth, there is no shine. In patients with hypoplasia or fluorosis, the spot has clear contours, it is shiny and smooth. With endemic fluorosis, the spot in the center has a white color, which gradually darkens towards the borders and smoothly merges with the rest of the enamel. The surface of the spot with this pathology is smooth, devoid of shine. In some cases, slight yellowish pigmentation may be observed.
- Time . In patients with caries, changes occur suddenly, before that, as a rule, the enamel was absolutely healthy. Fluorosis occurs even before eruption, at the time of tooth formation. This means that white spots in patients are present throughout life.
- Consequences . As a result, the initial stage of caries without treatment almost always leads to carious lesions and further destruction of the tooth. With fluorosis or hypoplasia, hard tissue defects form on the teeth.
Therapy of initial caries
After the doctor's suspicions about the presence of caries are confirmed during the examination, the specialist will choose the most effective method of treatment. If caries was diagnosed at the earliest stages, then filling the tooth can be avoided. In this case, saturation of the affected areas of the tooth with minerals is usually carried out.
It is also worth noting that in some cases, treatment may not be needed at all, only regular monitoring will be enough, since often the pathology stops developing on its own. This is especially true in patients with genetic resistance to caries. However, if desired, the patient can still carry out a procedure to “fill” the tooth with minerals. This procedure is carried out using electrophoresis.
Most often, for the treatment of the initial stage of caries, the doctor uses remodent, gluconate or calcium phosphate. All these drugs are produced in the form of weak solutions. It is important to understand that such procedures can only be carried out in the dental office, otherwise there is a high risk of burns from chemical reagents.
The number of necessary procedures is chosen by the doctor based on the individual characteristics of the body and the neglect of the process.
Patients with a hereditary tendency to form caries are advised to saturate their teeth with fluoride from time to time in the dentist's office. The essence of this procedure is to apply applications of fluoride-containing pastes for 15 minutes on pre-cleaned teeth. After that, the teeth are brushed again.
After these procedures, patients should not eat or drink for 2 hours. Dental care also needs to change. Oral hygiene should be carried out 2 times a day using fluoride-containing toothpastes. In addition, it is recommended to reduce the amount of sweet and sour foods consumed and increase the consumption of dairy products, vegetables and fruits.
Forecast
With timely treatment and further observance of the rules of oral hygiene, the prognosis of the disease is favorable. Most often, the white spot either stops developing or disappears completely. In the event that the stain began to darken and it was dissected or sealed, then the development of caries in the future is completely excluded.
If the stain was not detected on time or if it was not treated, and the attitude to oral hygiene did not change, then the outcome of this condition is the same - the formation of caries, which will have to be filled in the future.
If the stain is not treated, but you begin to follow the rules of oral hygiene, then the stain may also stop developing or disappear.
But, despite this, if a white spot is found on the tooth, you should immediately go to the dentist, and he, in turn, will already tell you how best to deal with the affected tooth.
