Cervical caries is often a side effect of periodontitis
Exposed tooth necks are often not only very sensitive to pain, they are also one of the main causes of tooth neck caries. According to the fourth German oral health study (DMS IV), 21.5 percent of 35 to 44-year-olds and even 45 percent of all 65 to 74-year-olds have at least one root surface carious or filled.
Thus, in these age groups there is a significant increase in cervical caries due to sensitive teeth compared to previous studies.
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What is dental caries?
Cervical caries is the term used in particular to describe caries of exposed tooth necks, which can usually occur as a result of the regression of the gums. Adults and seniors in particular are affected by cervical caries; recent studies have shown that in the group of 65 to 74-year-olds almost half of all test subjects had at least one tooth root with caries.
Difference between caries and tooth neck caries
While caries usually affects the occlusal surfaces or the interdental spaces, cervical caries affects the tooth root. From a dental point of view, this difference is significant because advanced caries requires special fillings such as composites or glass ionomer cement.
For the person affected, there is a small difference in the symptoms. Before the patient experiences permanent pain as the infestation progresses, the sensitivity to cold and heat should not be too high.
Symptoms of cervical caries
As is usual with caries, there are no symptoms at an early stage. Typical, however, are whitish discolorations along the neck of the tooth, which indicate a possible caries of the neck of the tooth. In the further course the damage of the tooth root becomes clearly visible, in addition first pains occur with the consumption of cold and called food, as they are characteristic anyway with exposed tooth necks.
In addition to temperature sensitivity, root caries also shows symptoms when it comes into contact with sugary foods. Permanent, severe pain only occurs when the tooth nerve is exposed and constantly irritated.
Trigger of a tooth neck caries
A basic prerequisite for root caries are exposed tooth necks, which are triggered by a decline in the gums. Such exposed tooth roots are usually caused by periodontitis, i.e. inflammation of the periodontium.
By the way, periodontitis is particularly common among diabetics, who therefore also have a higher risk of tooth neck caries. If this basic requirement is met, caries can easily form at the critical transition between tooth enamel and tooth root because the bacteria can adhere comparatively well here. As with normal tooth decay, this is caused by a lack of oral hygiene.
Treatment of cervical caries
The specific type of dental treatment depends on the severity of the tooth defect. Minor damages can be repaired easily by drilling and a special filling. For example, glass ionomer cement is used, which additionally releases fluorine and thus additionally protects the teeth against renewed caries infestation. Root caries, however, of course still involves special risks, because it attacks the tooth’s foundation to a certain extent.
In serious cases, the tooth necks must therefore be crowned, whereby dental prostheses are only the last resort here, as in other areas of dentistry.
How do you prevent dental caries?
When the gums recede, sensitivity to cold and hot food is quite common. A toothpaste such as Elmex sensitive, which closes the tooth channels and allows the pain to subside, helps here. Furthermore, a regular and thorough oral hygiene should be carried out. More often than at the incisor, cervical caries occurs at the molar, especially the interdental spaces are affected. In addition to brushing teeth twice a day, dental floss should also be used for cleaning.
What happens if there is no treatment?
In principle, patients should undergo root caries treatment as soon as possible. If this procedure is postponed, there is a risk of serious consequences: In particularly severe cases, the tooth can no longer be saved. In addition, those affected are naturally not spared from severe pain, which is why treatment should not be delayed under any circumstances.
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Dr. Frank Seidel
Last update of this page: 27.09.2019 by author Dr. Frank Seidel.