Academy for Dental Education Karlsruhe, Poliklinik, Karies is a disease of the tooth hard substances: Dental Academy

Caries – a disease of the tooth hard substances.

What is tooth decay?

Caries is a disease of the tooth hard substances. It is caused by several influences. First of all, a bacterial plaque must be present on the tooth surface. If there is an additional supply of sugar, for example through the absorption of sweets, the bacteria from the plaque metabolize this sugar and this produces acid. This acid attacks the enamel, the outer layer of the tooth and dissolves minerals from it. At this point, the tooth becomes soft and porous so that the bacteria can penetrate deeper into the inside of the tooth until they finally reach the next layer, the dentin.

What are the implications?

In the naturally more porous dentin, the bacteria now spread at greater speed. Holes in the tooth” occur when areas hollowed out by bacteria and acid break in. If the caries gets near the tooth nerve, toothache develops. The process of tooth decay can lead to complete softening and dissolution and thus to the loss of a tooth.

How can we help you?

The ultimate goal is to prevent the development of caries. An early and regular clinical and radiological control supports this goal. The treating dentist can draw attention in good time to weak points in oral hygiene and possible other caries-inducing factors. If necessary, you will be integrated into our prophylaxis program, which consists of regular tooth cleaning and instruction and motivation for proper oral hygiene. If tooth decay has already occurred, regular monitoring ensures that it is detected at an early stage and is therefore easy to treat. If caries is discovered during the check, the therapy depends on the extent of the disease.

What’s your plan?

Depending on the stage of the caries, your dentist will initiate an appropriate therapy. At a very early stage, an optimisation of oral hygiene and fluoridation measures can make it possible to wait and see. In some cases, caries infiltration is a treatment option, a method of sealing caries without drilling. If the caries has already penetrated deeper into the tooth and the surface of the tooth is rough and broken in the carious area, a filling is necessary. If the caries has caused a very large loss of tooth substance, a laboratory-fabricated restoration may be necessary. In some cases, a root canal treatment will also have to be initiated. We will inform you in detail about the various options and materials, which must always be weighed up individually.

What can you do for yourself?

Regular check-ups at the dentist help to detect caries at an early stage or even to avoid it altogether. An oral hygiene guide as part of professional dental cleaning helps you to optimise your daily dental care and effectively remove the bacterial plaque that triggers tooth decay. Fluoridated toothpastes should be used for this purpose. It is particularly important to clean the interdental spaces with dental floss or interdental brushes. Nutritional advice is also helpful. Food and drinks that contain a lot of sugar and/or acid should be avoided.

Caries infiltration

Minimally invasive therapy without drilling for small carious lesions in the interdental space.

What is the initial situation?

Clinically the tooth looks as healthy as on the right picture. A “rubber dam” (protective rubber) was attached to protect the surrounding tissue in order to be able to work saliva-free.

What are the possible consequences?

If these small caries lesions in the interdental space are not recognized, they increase in size and a defect in the tooth structure occurs. Once this is the case, the minimally invasive method of caries infiltration no longer comes into consideration. Then the caries must be drilled out and a filling placed.

How can we help?

Small carious lesions in the interdental space can be treated with the infiltration method without drilling. After pre-treating the tooth with a gel, very thin plastic is applied to the area in the interdental space. This is done with the help of the device in the picture on the right. After curing by light, the carious area is filled and thus preserved (next picture on the right). The caries cannot progress any further.

What’s your plan?

In some cases this therapy can be carried out without anaesthesia. In the case of a given indication, however, an anaesthetic injection is necessary. The treatment takes about 30-45 minutes per lesion. You will also have to pay private costs depending on the location of the caries and its severity. Private health insurance companies and individual statutory health insurances cover the costs for this therapy. As part of the routine examinations, bite wing images must be taken regularly in order to check the results of the therapy.

What result awaits you?

The method of caries infiltration and its prospects of success have been well researched and proven by numerous scientific studies. By means of infiltration without drilling, caries progression can be prevented over a period of at least five years.

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Christina Cherry
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