The cavities dental It is a communicable infectious disease that affects dental hard tissues. It has a multifactorial etiology that involves interactions between the host, diet, microorganisms, and time.
The development of this disease is an episodic and clinical process, since there is a balance between the process of demineralization and dental remineralization. So tooth decay occurs when there is an imbalance and the demineralization phase is favored.
Tooth demineralization is caused by acids produced by cariogenic bacteria in dental plaque deposited on tooth surfaces.
Dental caries can be classified according to the type of injury in:
- Incipient cavities. It is the first clinical manifestation with the appearance of a white spot, a sign of dental demineralization. At this stage the injury can be stopped or reversed so that there is remineralization.
- Secondary caries, also called recurrent caries. This type of caries is located adjacent to a dental restoration.
- Residual caries. It is the persistence of cavities under dental restorations.
When does secondary caries occur?
The secondary caries it is a carious lesion that develops at the interface of the dental restoration and the tooth.
This type of tooth decay can be caused by two factors:
- Poor tooth decay removal, meaning that the decay has not been completely removed and it continues to advance.
- A faulty seal. The reconstruction of the tooth has not been performed optimally and there are irregular margins that allow the infiltration of pathogenic microorganisms.
How can recurrent cavities be detected?
To be able to detect recurrent caries, it is very important to carry out regular checks to assess the oral status.
This type of dental caries can be detected by clinical inspection. During the dental examination a dark shadow is observed along with the dental restoration, this data suggests the possibility of having a secondary caries.
In addition to the inspection, this has to be complemented with the realization of specific radiographs, bitewing radiographs, in order to diagnose dental caries. These types of X-rays give specific information about the tooth and the spaces between the teeth. In this way, the presence of a radiolucent (dark-colored) shadow can be evaluated under a restoration, which indicates the appearance of secondary caries.
What is the secondary caries treatment?
In the case of presenting a secondary carious lesion with cavitation, it must be removed. Once its removal, dental reconstruction must be done following the protocols of a dental filling. Completion of the reconstruction must include polishing to avoid defective margins and thus the surface remains homogeneous and smooth, and the possibility of marginal infiltration by cariogenic microorganisms decreases.
Importantly, restoration is not the only treatment for tooth decay. Rather, the management of caries as a disease implies:
- Arrest of progression of primary and secondary lesions
- Caries risk assessment
- Control of the diet ingested by the patient
- The proper use of fluorides
- Control of dental plaque
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