Dental Caries|Tooth Decay Treatment

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Dental Caries

Dental Caries: The treatment of caries as an infectious disease will consist of two fundamental parts. The first will be the elimination of the infectious agent and dental tissues affected by the infection. The second part will be restoration or rehabilitation of the tooth, if possible.

In case of impossibility of restoration, the extraction or extraction of the tooth will be the treatment to be performed. The dentist should assess the placement of a space maintainer if the extraction is of a temporary tooth and the eruption of the permanent tooth is far in time. If the extracted tooth is a permanent tooth, it will be replaced by an implant, a bridge (fixed prosthesis) or another type of prosthesis.

Tooth Decay Treatment

Tooth Decay Treatment

Tooth Decay Treatment: Before deciding the treatment to be applied to caries, two aspects should be assessed: the degree of involvement of the affected tooth and whether the tooth is temporary or permanent. In adolescents with definitive but still immature teeth, their treatment will also be differentiated from the adult permanent tooth with fully formed roots.

Dental Caries Fillings

Dental Caries Fillings

The treatment of caries affecting enamel and dentin without affecting the pulp or vascular-nervous tissue of the tooth is the filling or filling, which will be the same in both temporary teeth and permanent teeth.

In incipient caries that partially affect the surface of the enamel, the patient will be urged to improve oral hygiene and periodic clinical control will be carried out in consultation.

In children with a high risk of caries, fissure sealing will be assessed as a caries prevention method .

When caries already affects the thickness of the enamel and advances towards the dentine, the treatment will begin with the removal of the infected tissue. Once the diseased dentine has been removed, the restoration of the tooth will be carried out using composite resins or composites. These composite resins or composites have virtually replaced amalgam in our country (metallic color fillings).

One of the most positive aspects of composite versus amalgam is aesthetics. The composites have a wide range of white colors that approach the natural color of each patient, and may go unnoticed. The adhesion of the composites to the tooth by treating the healthy surface of the tooth with adhesive agents has been another advantage with respect to the metal fillings.

The amalgams did not adhere to the dental tissues and techniques were used that took advantage of the expansion properties of these alloys. Retentive cavities of convergent walls were made towards the masticatory or occlusal surface that prevented the filling from falling. Within a few hours, there was the expansion of the material that was totally retained in the tooth.

The drawback of this technique was the sacrifice of healthy tissue in pursuit of a retentive design of the cavity. In contrast, composites respect healthy tooth tissue, with less loss of tooth structure. The composites have been improving their characteristics of resistance, elasticity, and hardness. These characteristics are important in molar restorations that are subject to significant forces during chewing.

Root canals

When there is a deeper involvement of the tissues of the tooth reaching to contact the caries with the pulp. It manifests with a pulpitis (nerve involvement, toothache and pulpal tissue inflammation), the treatment of choice in this case will be the endodontics of the adult’s permanent tooth (killing the nerve).

The endodontic treatment is the elimination of the vascular-nervous tissue of the dental pulp that is found in the pulp chamber (inside the tooth) and in the root canals of the roots of the teeth. Once this tissue is removed, it is replaced by a bacteriostatic material that prevents the recurrence of tooth infection.

Other caries treatments

Other caries treatments

In temporary teeth, the treatment of pulpitis will be more conservative, using techniques such as direct and indirect coating, pulpotomy and pulpectomy.

In the final teeth with roots information, conservative techniques such as direct coating, pulpotomy, and a pico formation will also be used.

1.Direct coating: Will be used in asymptomatic patient. It is the covering or sealing by calcium hydroxide of the vital pulp when it has been exposed minimally by trauma or by iatrogenia when removing decayed tissue. This technique can be applied to both permanent teeth and temporary teeth.

2. Indirect coating: Is performed in asymptomatic patients. Dentin affected by caries is left to avoid exposure of the pulp and covered with calcium hydroxide. This technique can be applied to both permanent teeth and temporary teeth.

3. Pulpotomy: It is the elimination of the pulp contained in the pulp chamber and the sealing of the root canals, not affected with a material that, generally, is calcium hydroxide. This technique can be applied to both permanent teeth and temporary teeth.

4. Pulpectomy: It is the total elimination of the pulp of the coronary chamber as well as the root pulp to then fill the ducts with zinc oxide eugenol. The zinc oxide eugenol is absorbable and thus facilitates the resorption of the root when the eruption of the permanent begins.

5.Apicoformacion: This technique is used in permanent teeth with immature roots with clinical involvement of the cameral pulp and the pulp of the ducts. Both are eliminated by cleaning the root canals and the pulp chamber and calcium hydroxide is introduced instead. Once the root formation is complete, we will continue with the tooth’s endodontics (a technique previously described).

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