Tooth decay in decompensated form

Decompensated form of caries is, in fact, an intensively developing caries, a pathological process that takes place very actively in the hard tissues of the tooth and leads to their rapid destruction. Often carious cavities with this form of the disease are multiple and are immediately in many teeth.

In dentistry, there are several classifications of caries. When classifying by the severity of the process, the following forms of the disease are distinguished:

• compensated;
• subcompensated;
• decompensated.

Decompensated (sharp, blooming) caries is the most dangerous form, as it develops much faster than in compensated and subcompensated forms. Acute caries can lead to tooth loss in just a few weeks. In this case, the enamel and dentin are destroyed very quickly, and the transition from the initial to the deep stage is much faster than during the chronic course of the disease.

On a note

The name “decompensated form” itself means that the development of a carious process is in no way compensated for by the response of the organism. It is in the absence of any obstacles that the process takes place especially quickly and with very serious consequences.

The causes of the development of pathology in decompensated form are reduced bactericidal properties of saliva, lack of oral hygiene, poor diet and hereditary factors, unhealthy lifestyle. Sometimes acute caries develops due to weakened immunity.

 

Diagnosis of decompensated caries

Acute caries is most dangerous when the tooth is not treated. But unlike other forms, it is easily detected. The main symptoms that signal the development of a serious problem are as follows:

• multiple noticeable external manifestations of caries on the surface of the tooth enamel;
• sharp, prolonged pain in the teeth;
• severe reaction to cold, chemical, mechanical stimuli.

If you experience such sensations in the oral cavity, you should immediately contact your dentist.

Important:

If the carious surface lesion is very small,but the symptoms described are present, it is impossible to postpone the visit to the doctor. Under the small entrance there can be a large carious cavity. An additional clue would be the loss of gloss of enamel, its grayish or chalky shade.

The dentist easily diagnoses the decompensated form of caries in the following ways:

• broad base carious form;
• narrow entrance;
• a large amount of softened dentin;
• acute pain in the sensing process.

For the diagnosis is usually sufficient probe and dental mirror. But if a carious cavity in a separate tooth is hidden from view, an X-ray is taken or transillumination is used (the “flashing” method hidden carious sites bright flux of lamps). Also, with decompensated form, fissurotomy is often used (this is a method of diagnostic search for hidden caries with the help of prophylactic excision of “darkened” fossae and enamel grooves on the chewing teeth).

 

Who is at risk

Decompensated form of caries develops the faster, the lower the body resistance. Therefore, the acute form is most often observed in people with weakened immunity.

There are several groups of patients who are most at risk of the onset of this pathology:

• children with milk teeth;
• people who have recently had an infectious disease;
• people with metabolic disorders;
• elderly people with weakened immunity.

To avoid the development of acute caries, it is recommended to undergo a planned reorganization of the oral cavity 1-3 times a year.

 

Danger of decompensated form

Acute caries is dangerous for many reasons. The neglected form of the disease often leads to the following problems:

• development of pulpitis and periodontitis;
• the development of periodontitis;
• tooth splitting;
• tooth loss.

In addition, the decompensated form is a signal of disruption of the entire body. Unhealed caries It is often the result of a decrease in saliva production and a reduction in its bactericidal properties, which affects the general condition of the oral cavity as a whole. In pregnant women, this may affect the general physical condition of the expectant mother and the health of the fetus.

 

Types of disease

Acute caries has two forms:

• medium sharp;
• deep sharp.

The difference between medium and deep acute forms lies in the size of the carious cavity. With average acute caries, there is no need to remove the nerve, and the tooth can be treated and restored. With deep acute caries, depulpation is usually required, and with severe tooth decay, it is necessary to remove it.

Since in the acute form of pathology, the destruction of tooth tissues occurs very quickly, and children are most susceptible to the disease, in their pediatric dentistry their grouping is accepted:

1. Compensated form (I group);
2. Subcompensated (II group);
3. Decompensated (group III).

Groups created for the implementation of follow-up.

Children's Dentist Vinogradova T. F. identified several dispensary groups:

• practically healthy teeth;
• compensated form;
• subcompensated form;
• decompensated form.

Children with compensated form are examined once a year, with subcompensated - 2 times, with decompensated - 3 times. Planned rehabilitation reduces the risk of complications in the development of caries, decreases the number of fillings and teeth extracted. Also, the need for treatment is almost halved, the number of annual scheduled examinations decreases.

Monitoring risk groups allows you to keep records on a number of criteria:

• general incidence of caries;
• anamnesis of life;
• health status;
• severity of the disease.

Planned rehabilitation and timely caries diagnostics in adults and children provide an opportunity not only to cure it in the initial stages, but also to prevent the development of blooming caries.

 

How is the treatment of flowering caries

Treatment of decompensated forms of caries can be divided into three stages:

• removal of all tooth tissues affected by caries;
• nerve removal (if necessary);
• tooth restoration.

Since there is severe pain during flowering caries, all stages of treatment are performed under local anesthesia or under general anesthesia (less often). That is, for the patient, the procedures are painless. Modern anesthetics are absolutely safe, hypoallergenic, so this treatment is available even for pregnant women.

Removal of the affected tissue is predominantly carried out with a drill. But this is not the only possibility. There are more modern techniques: washing with dental sandblasting, evaporation with a dental laser.Unfortunately, these modern techniques do not yet have a good evidence base of their effectiveness for the treatment of serious carious lesions, and have not received wide distribution in our country.

At the next stage of treatment (if necessary), removal of the dental nerve is carried out using special equipment. Then the dental canals are cleaned and sealed.

Restoration is the last stage of treatment. With the help of filling materials, the dentist restores the original shape of the tooth.

Treatment of acute caries is a complex and long process. Most often it takes place in two visits. During the first, the affected tissues are removed and medication is performed. During the second visit, the tooth is restored.

 

Prevention of decompensated forms of the disease

Prevent the development of acute caries for everyone. Even with hereditary predisposition, problems with teeth occur when oral hygiene is not observed and nutrition is not correct.

Prevention of decompensated forms of the disease is quite simple. For its implementation it is necessary:

• brush your teeth in the morning and in the evening;
• use fluoride toothpaste;
• clean the interdental spaces with dental floss;
• do not eat too cold and burning food, drinks;
• limit the amount of soft and sweet food, since after its reception a plaque forms on the teeth, contributing to the enamel demineralization;
• 1-3 times a year to visit the dentist.

Routine reorganization of the oral cavity makes it possible at the earliest stages to identify caries and prevent its transition into an acute form. Regular visits to the doctor allow you to quickly detect weaknesses in the care of teeth and gums, make adjustments and prevent their diseases. Therefore, a visit to the dental clinic to check the condition of the teeth should be the rule for everyone who cares about their health.

 

Useful video: what is important to know about the treatment of caries and its complications

 

And here is the actual processing of the tooth with a drill and the installation of a seal

 

How to properly brush your teeth with a toothbrush