What is the treatment for dental caries

Caries is one of the most common diseases worldwide. In Germany, 99% of all adults are affected. With that comes the bacterial infection of the oral cavity 5 times more often than asthma and even 7 times more often than allergies. If we talk about a hole in the tooth, almost everyone can contribute their own little story of suffering. Children are just as affected as adults and seniors.

In the following you will learn:

  • Why tooth decay doesn't start with a hole in the tooth.
  • The role of saliva in preventing tooth decay.
  • How a hole in the tooth can be treated without drilling.

Tooth decay - the search for a definition

What exactly is tooth decay? Colloquially, an answer can be found quickly - tooth decay is a hole in the tooth. From Mouth rot speaks the vernacular. There is little medically correct about this: tooth decay starts much earlier. It is a lengthy process before damage occurs to the tooth. The teeth don't rot either. Rather, dental caries means one Demineralization of the tooth substance. This decalcification of the teeth progresses.

If you don't do anything about it, a hole will appear in the tooth: the tooth substance will break down and cavities, so-called cavities, will form Cavities. Tooth decay penetrates the tooth enamel.

The enamel comes off the teeth, especially in older people. At the exposed tooth neck Tooth decay develops quickly. At the latest when the caries has reached the living core of the tooth, the dreaded pain occurs. Because there are blood vessels and nerves. If the tooth pulp rots, it can die.

Medicine distinguishes 2 types of tooth decay:

  • Initial caries
  • Established tooth decay

At Initial caries the surface of the tooth is still intact. However, the descaling has already started. If there is an established caries, the tooth surface is defective.

Caries affects different layers of the tooth:

  • Superficial caries - the enamel is defective.
  • Caries media - the second layer of teeth (dentin) is defective.
  • Caries profunda - all tooth layers are defective.
  • Caries sicca - the caries stands still.

Anyone can get tooth decay. In children and adolescents, tooth decay usually occurs on the chewing surfaces and where the teeth touch. The disease occurs more frequently in old age Transition of teeth and gums on.

In many cases, tooth decay can be stopped. But if left untreated, the disease progresses: the tooth pulp becomes infected. The infection can extend into the maxillary sinus and muscle tissue. The tooth can be lost in the process.

How is a hole made in the tooth?

It takes a long time before tooth decay is visible to us. Because it is a lengthy process. The time until tooth decay breaks out varies. The reason: The Texture of the tooth substance is individually different. Diet and individual dental care are also crucial.

Every tooth is surrounded by a sticky film of bacteria. The doctor calls this layer Plaque. When eating and drinking, the food components come into contact with plaque. The bacteria produce acids from the sugar contained in the food. These acids attack the tooth enamel and sooner or later lead to tooth decay.

Most of the plaque is located on the gumline and on the surface of the molars. The risk of tooth damage is particularly high as a result. Has the Tooth decay has broken through the enamel, the dentin is at risk. Dentinal caries means that the dreaded hole in the tooth is visible.

Tooth decay and its causes

Several factors influence the development of tooth decay. Hundreds of types of bacteria live in the oral cavity. The Microorganisms keep the oral flora healthy. Some bacteria feed on sugar and excrete acids as metabolic products. The acids dissolve minerals from the tooth enamel. This starts the breakdown of the tooth.

Dental hygiene versus bacteria

Frequent tooth brushing reduces the number of Bacteria in the mouth. After each meal, the bacterial film slowly builds up again on the teeth. In the case of irregular or inadequate dental care, a thick layer is created. The bacteria that cause caries multiply in the plaque. Tooth decay is therefore often due to one poor oral hygiene traced back.

Brush your teeth after every meal promotes dental health. There are exceptions: citrus fruits or cola roughen the tooth enamel. So that you don't wear it off while you brush, it is essential that you wait at least half an hour before you pick up your toothbrush.

Not all sugar is created equal

Those with a sweet tooth are more likely to develop tooth decay. Because household sugar, grape sugar and fructose attack the teeth. The bacteria can utilize sucrose, glucose and fructose particularly well.

Complex carbohydrates have long-chain sugar compounds. Consuming whole grain products therefore does not promote tooth decay.

Strong immune system against tooth decay

Whether the bacteria have an easy job also depends on the nature of the immune system. Is this Weakened immune system, tooth decay is more common. The chronically ill and the elderly are particularly at risk.

By the way: the immune system is also attacked by taking cortisone preparations and antibiotics.

Saliva protects against tooth decay

We often underestimate the spit. Saliva can help against tooth decay. The liquid in the oral cavity supports teeth cleaning, repels harmful acids and ensures a Remineralization of the tooth enamel. The saliva contains all the important minerals that a damaged tooth surface needs.

Low salivation promotes the development of tooth decay. The same effect can be observed when saliva is severely diluted. This occurs in small children, for example Vial tooth decay on. Food components that the saliva does not carry away are increasingly deposited on the tooth crown and in the spaces between the teeth.

Saliva cleans the oral cavity and dilutes the harmful acids. Since our spit also contains hydrogen carbonate, ingested fruit acids can be partially intercepted. As a result, the harmful substances do not stay in the oral cavity for so long.

Tooth decay and its symptoms

The symptoms of tooth decay depend on the stage. Initially, tooth decay usually does not cause pain. However, those who miss treatment run the risk of the infection spreading. Then the first symptoms appear.

Tooth decay in the early stages

In the early stages (Initial stage) tooth decay is barely visible. You will probably not notice the disease until whitish stains form on your teeth. This is a sign that minerals are loosening from your teeth. As a result, the tooth enamel loses substance and becomes porous. Over time, the white spots change color and turn yellowish or brown. The reason: they absorb colorings from food.

At this stage, those affected can still make up for the mineral deficit. Regular and careful oral hygiene can help rebuild tooth structure. Toothpastes containing fluoride support the mineralization of the teeth.

If thorough and targeted dental care is not taken, the tooth decay worsens. Minerals are lost, the tooth substance breaks down and a hole (dentine caries) is created. At the latest now the disease penetrates into consciousness, because the first pain occurs. The teeth react to hot and cold or hurt because of the Bacteria have reached the tooth nerve.

Caries at an advanced stage

The pain has become a constant companion. The tooth is sensitive to stimuli. Chewing is difficult. Pain also occurs when the tooth rests and does not have to endure any loads. Many complaints worsen at night. A general discomfort in the oral cavity occurs and Bad breath can be an additional burden.

A untreated tooth decay This stage can be dangerous: if the inflammation affects the jawbone, the bacteria can enter the bloodstream and damage other organs.

Toothache comes in many forms. There may also be painless sections. Nevertheless, do not postpone your visit to the dentist! Because when the pain suddenly stops, nerves and blood vessels have already died. If there is no treatment, the infection spreads and an abscess develops.

Caries as a repeat offender - secondary caries

If tooth decay recurs after treatment, it is often due to a lack of care: Finds insufficient oral hygiene instead, tooth decay often forms again on the edges of fillings or crowns. Over time, small gaps develop between the tooth and the filling or between the crown edge and the gums. You cannot reach these small cracks with the toothbrush. Bacteria have an easy job. Medicine speaks of Secondary caries.

With adequate dental care, secondary caries is rare. It can occur on the neck of the tooth, between the teeth or on the edges of fillings and crowns. A quick treatment is necessary so that the infection does not spread to other teeth. The therapy includes the removal of the tooth tissue infected by bacteria and the rendering of the pathogens harmless by filling and sealing.

To support the treatment, the dentist can prescribe a disinfectant in the form of a mouthwash solution. It promotes the killing of harmful bacteria in the mouth.

Something else is a Caries recurrence. Here, tooth decay occurs on a part of the tooth that has not been adequately treated. In this case, the dentist has made a malpractice.

Risk group children

Children and adolescents are particularly susceptible to tooth decay. Their enamel is not as strong as it is in adults. Deep grooves and furrows run between the molars. The medic speaks of Fissures. These are difficult to reach with a toothbrush. Children are also often less careful about dental care.

An incipient tooth decay can be by a seal stop the fissures. Before the treatment, the endangered areas are cleaned with special brushes. The dentist then seals the fissures with plastic.

Treat tooth decay

Is a hole in a tooth you can't avoid the drill: Before the dentist puts on the filling, he removes it with a Diamond grinders or round burs the destroyed tooth tissue. For you as a patient, the unpleasant part of the treatment begins, because drilling causes pain: The pressure exerted by the instrument irritates the nerve fibers. In addition, the rotation of the drill generates heat. And the cold water in the mouthwash triggers another stimulus. The intensity of the pain depends on the depth of the damage. To avoid pain, many patients have the tooth anesthetized locally before treatment.

When inserting the fillings, the dentist will check the Bite of the jaw. There must be no feeling of a foreign body in the mouth. Otherwise problems with chewing and pain in the temporomandibular joint can occur.

In the case of advanced tooth damage, the dentist has to rebuild the shape of the tooth from the outside. Matrices serve as a templateso that the tooth finds its natural shape again. A kind of band surrounds the tooth. The dentist then puts on the filling. The matrix prevents the filling compound from escaping and running over the tooth.

Throbbing pain indicates that tooth decay has advanced to the tooth nerve. The treatment goes beyond simply sealing. A Root filling serves as protection of the attacked nerve tissue. The substance contains calcium hydroxide and is supposed to support the dentin in its regeneration. After inserting the root filling, the normal tooth filling follows.

Tooth decay and fillings

Different materials can be used to treat caries:

  • Ceramics
  • Plastic (composite and compomer)
  • Metal (gold)
  • amalgam

These materials are plastic fillings. The dentist fills the substance into the tooth as a liquid. The material hardens there.

Most caries is treated with plastic fillings. On the market are too Inlay fillings. An inlay made in the laboratory compensates for the hole in the tooth.

The Type of filling depends on various factors. Since the filling materials have different properties and are not the same in terms of value, the dentist looks for individual solutions. The costs are also important: the health insurance company does not pay for every tooth filling. Inlays e.g. B. are very expensive and no cash benefits.

Composite against tooth decay

Composite consists of a salt of silica and plastic. The material is durable and dimensionally stable. According to the application scheme, the composite adapts very well to the existing tooth color at. If the damage to the tooth is minor, the dentist cleans the hole and adds composite in the same operation. The fabric hardens under a special light.

Treat tooth decay with compomer

With compomer only sensitive tooth necks and milk teeth to treat. The material is too soft for the heavily loaded chewing surfaces. Another disadvantage: the shelf life of compomer is limited. Therefore, compomer fillings must be checked regularly by the dentist.

Tooth decay and gold

The method of filling holes in the tooth with thin gold foil is new to the market. The dentist places the foil on the affected tooth and taps it into the existing hole. This enables the contour of the tooth to be reproduced well. A Gold hammer filling is very complex. In addition, the filling is noticeable and therefore not suitable for front teeth. One advantage is the durability of the material. The health insurers have not yet paid for the treatment.

Amalgam against tooth decay

Many people view treatment with amalgam critically. The filler has come under discussion because of its Mercury content. Amalgam also consists of silver, tin and copper. Mercury is bound in a solid state in the fillings and is therefore not dangerous. However, when the fillings are replaced, mercury can loosen and enter the oral cavity.

Amalgam is an approved and financed dental filling. The danger of dental fillings containing amalgam According to scientific considerations, it is no greater than that of mercury, which is ingested with food. In any case, dentists only use amalgam to a limited extent in children and pregnant women.

Caries without drilling

One helps in the early stages thorough oral careto protect teeth from serious damage. The dentist does not pick up the drill immediately. Incipient tooth decay can be stopped by applying gels or varnishes. These substances seal the attacked surface of the tooth. The fluoridation of the teeth stimulates the storage of minerals on the defective tooth surfaces.

Lasing instead of drilling

Laser technology is an alternative to drilling. The bacteria can be removed by the laser beams. The patient finds the treatment less painful compared to drilling.

Danger: A Laser treatment is not a cash benefit. You bear the costs yourself.

Compressed air instead of drilling

Doctors in the USA are testing this method. With the help of compressed air, tiny active substance particles reach the carious tooth. The particles should do that Detachment of bacteria promote. As a result, the dentist should get by without a drill and remove the bacteria only with a suction device.

Scraping instead of drilling

The Swedes are testing another method: They use a special gel. When applied to the defective tooth area, the substance softens. The carious material can then simply be scraped off. The dentist does not need the drill.

Both methods are not yet standard in German dental practices.

Trapping the bacteria in and digging them out

Against it is Icon method already arrived in German dental practices. The dentist does not drill the tooth. Instead, he fills the hole with plastic from the outside. Due to the inclusion of the bacteria, they are no longer viable.

Tooth decay versus fluoride

Fluorides harden tooth enamel and can prevent tooth decay. You can take the active ingredient or have it applied directly to the teeth as a gel.

In Germany, fluorides are not added to drinking water or milk, as is the case in many countries. To improve your fluoride supply, you can use table salt with iodide and fluoride. After cleaning your teeth, the dentist can apply fluoride to the surfaces of your teeth.

Fluoride is a substance that should be treated with caution. If you eat too much of it, you can Fluorosis to get. Milky-white to brown spots form on the teeth. In areas with fluoridated drinking water, the numbers are alarming: between 40 and 80% of children there are affected. Lifelong tooth damage can be the result.

Is tooth decay contagious?

Tooth decay is considered bacterial infection. All infections of this type are contagious.But the risk of infection in normal everyday life is hardly a concern. Everyone has bacteria that can cause tooth decay. Various risk factors are necessary for this to happen. Kissing or sharing eating utensils or toothbrushes are not critical to the development of tooth decay.

Adults are not at risk. The situation is different for small children, as the oral flora of small children is structured differently. They have far fewer microorganisms than adults. If the children have no teeth yet, the bacterial colonization in the oral cavity is completely absent. If a mother wets the child's pacifier with her saliva, she can transmit tooth decay. The scientists argue about how high the risk of infection actually is.

Is tooth decay hereditary?

On this point too, opinions often differ. Tooth decay in itself is not inheritable. If the disease occurs more frequently in certain families, you can hereditary factors definitely play a role.

These factors are inheritable:

· Composition of saliva

· Salivary flow rate

· Formation of the fissures in the tooth surface

Lots Eating habits have a direct impact on the likelihood of tooth decay in families. If sweets are often on the table and family members tend to do their dental care sporadically, the risk of tooth decay increases.

The tooth position and possible misalignments in the jaw are also inheritable. A close tooth position makes it difficult to clean the teeth. If you do not use dental floss, it is difficult to reach the narrow spaces between your teeth with a toothbrush.

After caries treatment

After the treatment at the dentist, the pain is a thing of the past. At least ideally. Shortly after the treatment, the Anesthetic injection still. A few hours later, the pain can start again. It is not uncommon for teeth to calm down 2 to 3 days after treatment. The tooth can also remain sensitive to pressure for some time. Many patients complain of pain at night. Because when the tooth is lying down, the blood flow to the tooth is stronger, which makes the pain feel more intense.

If the pain has not subsided after a few days, go to the dentist. Cooling the tooth can help against acute pain. Pain reliever medication only helps in the short term, but does not solve the problem.

Chewing gum for tooth decay?

Chewing gum - is there a better way to prevent tooth decay? It actually works, as clinical studies have confirmed: Through that Chewing sugar-free gum Caries can be prevented after eating. 20 minutes are enough. This means that more saliva is formed and fewer nutrients stick to the teeth. This creates fewer harmful acids. But brushing your teeth cannot replace chewing gum.

To brush your teeth at least twice a day and once thoroughly Floss cleaning is the best prevention against tooth decay. You can look after your teeth with a healthy diet that is as sugar-free as possible. In addition, do not miss the annual check-up at the dentist. It checks the condition of your teeth and detects tooth decay before it is visible to you.

Treating tooth decay - what does the health insurance fund pay for?

The assumption of the costs for the legally insured depends on the medical report. The decisive factor is Condition of the complete set of teeth. The dentist records this in the treatment and cost plan. The statutory health insurances determine a standard care for each submitted report. According to the Social Code (SGB) V, Section 12, Paragraph 1, they assume the costs of “sufficient, appropriate and economic” services.

Submit that Treatment and cost plan before treatment at your health insurer. Only after the examination is it clear what proportion of the costs this will cover and what amount you will have to pay out of pocket.

Standard care provides for plastic or amalgam for dental fillings. Simple amalgam fillings subsidize the health insurers completely. For high-quality fillings adapted to the individual tooth color, however, the health insurance fund only pays the amount intended for the amalgam filling. You pay the difference yourself. In the case of caries in the anterior region, the health insurers also cover the full cost of plastic fillings.

Example: If you have a carious tooth treated in the lateral area, only one amalgam filling is paid for. For a composite filling in an individual tooth color, you have to reckon with additional costs between 40 and 120 €. That's why it's worth it private dental insurance. Tooth preservation from ERGO, for example, covers up to 100% of your costs for inlays, onlays and plastic fillings.

Informed and secure in every situation
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