This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical professionals.
If the tooth substance is already damaged by bacteria, one is caries treatment necessary. Because caries progresses continuously without treatment. The bacteria can spread to nerves and bones and cause severe inflammation. The earlier caries is recognized and treated, the better the prognosis. Read everything you need to know about caries treatment here.
Early caries treatment
In early tooth decay, there are only changes on the surface of the teeth, a hole has not yet been created. At such an early stage, treatment by the dentist is not absolutely necessary. You can try whether you can remove the caries yourself.
For this, you should above all pay attention to improved oral hygiene and your eating habits. People who eat a lot of sugary things (pudding, ice cream, sweets) and sugary drinks (soft drinks, juices) have an increased risk of tooth decay spreading. Fructose (fructose), which is mainly found in fruit and pastries, can also damage the teeth. If you can’t brush your teeth right after meals, you can also chew gum (without added sugar), at least this has a positive effect on the pH in the mouth and stimulates the flow of saliva.
Proper oral hygiene is important for existing tooth decay. Here too, doctors recommend brushing your teeth after every meal. The toothpaste should also contain fluoride. Among other things, this inhibits the metabolism of the bacteria and also supports the remineralization of the teeth.
In order to cure tooth decay, regular professional fluoridation measures should also be carried out. To do this, the dentist first removes all deposits that have accumulated on the teeth. Then a fluoride varnish is applied to the affected areas. In some cases, antibacterial treatment is also given. For this purpose, special rinsing solutions or gels are prescribed, which should reduce the amount of bacteria in the mouth.
After this caries treatment, regular checks at the dentist should be carried out, where the caries is observed. In the best case, caries has been stopped by these measures and the minerals previously mined will be replaced over time by components of the saliva. However, caries can also progress.
Caries treatment in advanced stages
As soon as the caries no longer only affects the surface of the tooth, but already deeper layers, caries treatment must be carried out at the dentist. Depending on where the damage is, how far it has progressed and what costs you are willing to bear, there are different ways to have tooth decay removed.
Usually the drill is used. For sensitive teeth, this caries treatment is carried out under local anesthesia. Excess bacteria are removed during the drilling. The area around the borehole is then cleaned. The resulting hole is closed with a filling and sealed from the outside with a seal.
If much of the tooth substance has already been lost, the shape of the tooth is restored from the outside. So-called matrices serve as a template so that the tooth can be restored to its natural shape as far as possible and to prevent chewing difficulties with the opposite side of the tooth.
If caries is very close to the tooth nerve, special therapy is necessary. If the nerve tissue is already damaged, it must be protected with a root filling. To do this, the dentine is filled with a substance containing calcium hydroxide. This should stimulate the dentine to form new substance. Only then can normal teeth be filled.
Root canal treatment
The goal of root canal treatment is to preserve a heavily damaged tooth. The root canal treatment is usually carried out on a damaged tooth nerve (pulp). In the past, damaged teeth that affected the dental nerve were pulled. Today, root canal treatment can avoid tooth extraction in many cases. Bacteria and dead tissue must be completely removed from the root canal for a permanent good result. Later the channel is sealed with a filler. Root canal treatment may be necessary for a living, inflamed or already dead tooth nerve.
Caries treatment: fillings
Various materials can be used as fillings for caries treatment:
- Plastics (compomer / composite)
- Metal alloys (such as gold)
Which filling is suitable for you depends on various factors. On the one hand, they have different properties (lifespan), they are each suitable for different problems with the tooth and, last but not least, the costs are different. And not all fillings are taken over by the cash registers.
The information on the shelf life of the fillings is based on statistical information. In individual cases, the lifespan can differ significantly from this information. Dental care behavior has a decisive influence.
These fillings all belong to the so-called plastic fillings. This means that they are introduced into the tooth in a liquid state, exactly adapted to the hole created and then hardened. Alternatively, there are also fillings (so-called inlays). These are made in the laboratory using a previously cast model of the hole in the tooth. Deposit fillings are very expensive and are therefore of little importance in caries treatment.
Caries treatment with composite
Composite is an artificially produced material that consists of approximately 80 percent a salt of silica and approximately 20 percent of plastic. Composite is very dimensionally stable and extremely durable. It also adapts very well to the natural tooth shade depending on the application scheme. With small caries damage, it is often sufficient to prepare the hole, add the composite in a single step and let it harden with a special light.
Caries treatment with compomer and glass ionomer cement
Compomer and glass ionomer cement are two substances that are only suitable for caries treatment on milk teeth and on tooth necks. They are not suitable for filling up purchase areas. Since they are relatively soft, they cannot withstand the great pressure on the chewing surfaces. In addition, they have a limited shelf life and must be checked regularly by a dentist.
Caries treatment with amalgam
Caries treatment with amalgam is often discussed, especially in Germany. Amalgam is a metal mixture of silver, copper and tin together with liquid mercury. In its crystallized, i.e. solid, form, mercury is bound into these dental fillings and is therefore harmless. However, it cannot be ruled out that traces of it will come loose and then remain freely in the oral cavity – especially if the fillings have to be replaced or processed.
Despite ongoing discussions, amalgam is still approved as a dental filling. The mercury intake through dental fillings containing amalgam is estimated to be approximately as high as the mercury intake through the diet. This quantity is considered harmless according to international standards. The use of mercury-containing fillings is restricted only to children and pregnant women.
Caries treatment: gold hammer filling
A gold hammer filling is a very rare filling method today. Individual thin gold foils are placed on the tooth and tapped into the existing hole. The side surfaces or the occlusal surfaces with their numerous elevations are thus reformed piece by piece. The gold hammer filling is rarely used today because it is very complex to use and the finished filling is also clearly visible. However, its advantage is that it is very durable.
However, costs for this method are not yet covered by the health insurance companies.
What to do about tooth decay: newer methods
An alternative to drilling to have caries treated is laser technology. The bacteria are removed using laser beams. The advantage of this method is that it is less painful. However, the costs of caries treatment with a laser are not covered by the statutory health insurance and must be borne by yourself.
Two other new methods of caries treatment come from the United States and Sweden. Caries treatment with compressed air is currently being tested in the USA. Tiny particles of a special active ingredient are sprayed onto the carious areas with compressed air. These particles are intended to detach bacteria and can then be removed with a vacuum cleaner. In Sweden, a gel is being tested that is applied to carious areas. This should make the areas so soft that they can easily be scraped off afterwards. Both methods are still in the testing stage and are not part of the standard caries treatment.
Another new method that is already being used by dentists is infiltration with plastic (also called the icon method). The hole in the tooth is not drilled out, but filled with plastic from the outside. The bacteria are supposed to be enclosed and thus made harmless.
After caries treatment
In the best case scenario, complaints are completely eliminated after caries treatment. Toothache can occur for two to three days after caries treatment, especially during deep interventions. These only become noticeable a few hours after the visit to the dentist when the effects of the anesthetic syringe wear off. Pain occurs especially at night, since the lying position increases the blood flow to the tooth. There may also be pressure on the affected tooth in the first time.
Toothache over two to three days after caries treatment is normal. However, if the pain does not subside afterwards, the dentist should be visited again. Cooling or painkillers help to relieve pain. However, even with painkillers, it should not be necessary to take it longer than three days after caries treatment.
A single caries treatment does not prevent caries from recurring. People who have already had tooth decay, especially in the early days after having tooth decay treated, follow the dentist’s instructions and pay attention to nutrition and oral hygiene. However, most people become careless over the course of several months and years. So in most cases there is a new one caries treatment.
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