This is a specialism which involves the treatment of caries at every stage, from minor to major destruction of the dental tissue.
The treatment of dental caries is based on the elimination of the infected tissue and the subsequent reconstruction of the lost tissue with compatible biomaterial.
In the University Dental Clinic we offer you the most advanced techniques in dental aesthetics.
Questions and answers
What is dental caries?
Dental caries is a disease caused by multiple factors that increase acid in the mouth and cause tooth demineralisation. It involves a "loss of calcium" in the enamel and the dentine then produces "holes" in the teeth which become caries. Some people are more predisposed to having caries, and they are considered to be at a "high risk" of having caries, while others are "low" or "medium" risk. This risk can be controlled or reduced. With suitable treatment a "high risk" patient can become "low risk" through this treatment.
What causes caries?
The appearance of caries is due to the ability of bacteria to "perforate" the teeth, after creating acids that dissolve the surface of teeth. Therefore, it is the acid that determines whether caries will appear. Every time we eat something (whether a little amount or a lot), the acidity in our saliva increases a lot (the pH drops), and therefore the decalcifying effect increases enormously. This acidity lasts for around half an hour. Fortunately part of the calcium that dissolves comes back and becomes deposited on the surface of the tooth after that half an hour. The calcium deposit is slower than the loss of calcium, which means that it will take hours for you to recover from the loss you have suffered in that half an hour. Eating more than 4 times a day (by eating we mean not necessarily a proper meal, but also a snack or a sugary drink, since these are enough to drop the pH in your saliva) means that there are more opportunities to recover the lost calcium than when the number of times we eat something in increased. Therefore it is important, to reduce the amount of times people consume food throughout the day (whether sweet or not), especially for someone who regularly suffers from caries.
Refined sugars generally promote the production of acid due to bacteria, and help the bacteria to adhere to the surface of teeth. Therefore we need to reduce our consumption of sugar as much as possible, although the quantity of sugar is more important than the frequency with which it is consumed. Therefore, from the point of view of caries, eating a whole cake would not be a serious problem, however eating a sweet or a piece of chocolate three or four times would be.
What causes dental caries?
Caries leads to the destruction of dental tissue. After the destruction of the enamel it attacks the dentine until it reaches the dental pulp (the tooth's nerve) causing pain and inflammation and then necrosis. It can also lead to abscesses.
Once it reaches the nerve then endodontic treatment is required to "kill the nerve". This destruction can reach such a degree that the tooth can become non-viable and has to be extracted.
Caries is the main cause of tooth loss in young people.
Caries on its own does not tend to cause pain and once it reaches "the nerve" it rarely hurts. This absence of pain does not necessarily mean an absence of caries. We can have caries without feeling pain. Therefore whether it is painful or not it is necessary to get a professional to check them now and again.
What is dental caries?
Dental caries injuries are progressive. If the infection is not treated it can reach the dental pulp and then create an inflammation in the area surrounding the root tip (the edge of the tooth's root). All of this can evolve and become a phlegmon, sometimes accompanied by severe pain.
When dental caries has extended into the dental pulp it is necessary to undertake an endodontic intervention to "kill the nerve" and reconstruct the tooth with a large "filling" or possibly a crown. Therefore if we are in time to treat the caries then we will avoid a potential endodoncy or extraction if the tooth cannot be recovered.
What is dental caries?
In order to prevent dental caries action needs to be taken on various levels:
First reduce the frequency of your food intake to the minimum possible (including sugary sweets, sugary drinks, and snacking between meals; even in small quantities)
Reducing the quantity of bacteria and food deposits by brushing your teeth at least twice a day, after breakfast and before going to bed at night. The brushing must cover all of the surfaces of your teeth and it must last for a minimum of two minutes.
We can also make the demineralisation of the bacteria more difficult by reinforcing the surface of your teeth. This can be achieved using fluoride. It is important to use toothpaste with fluoride in it. It is also important to use mouthwash containing fluoride occasionally. The frequency can be either weekly or daily (once a day or once a week, doing it more frequently will not improve resistance), depending on whether we choose a concentration of either 0.05% or 0.2% respectively.
It is possible to improve the protective action by undertaking fluoride treatments in your dental consultation, once or twice a year. This is especially important in patients who are at a high risk of developing caries, in which case it is often advisable to use antiseptic mouthwashes for a limited period of time.
All of these measures, as well as other ones that a particular patient may require, are very useful in order to reduce the risk of caries, but they are not measures that can achieve absolute control in any case. Therefore it is necessary that people go to the dentist for a check-up to ensure that no new caries have appeared at least every 12 months, and for patients who have suffered from caries previously, every 6 months. This check-up, which often involves intra-oral x-rays, allows caries to be diagnosed at an early stage, when there are more opportunities to limit its progress through non-invasive means (without a filling) or just a small filling. It is important to highlight that caries injuries do not become obvious to patients until they are very advanced, when the only solution tends to be an endodoncy, or even a tooth extraction.