If the tooth substance is already damaged by bacteria, a caries treatment is needed. Without treatment, caries progresses continuously. The bacteria can be transmitted to nerves and bones and cause severe inflammation. The sooner caries is detected and treated, the better the prognosis. Read all important information about caries treatment here.
Caries treatment in the early stages
With caries in the early stages are only on the surface of the teeth changes, a hole has not yet emerged. At such an early stage, treatment by the dentist is not essential. You can try if you can remove the decay yourself.
Above all, you should pay attention to improved oral hygiene and your eating habits. People who eat a lot of sugary stuff (pudding, ice cream, candies) and sugar-rich drinks (soft drinks, juices) are at an increased risk of caries spreading further. Fructose (fructose), which is mainly found in fruit and pastries, can damage the teeth. If you can not brush your teeth right after meals, you can also chew chewing gum (without added sugar), which will at least positively influence the pH in the mouth and stimulate salivation.
In case of already existing tooth decay the correct oral hygiene is important. Doctors also recommend brushing your teeth after each meal. The toothpaste should also contain fluoride. This inhibits, among other things, the metabolism of the bacteria and additionally supports the remineralization of the teeth.
In order to be able to cure caries, regular professional fluoridation measures should be carried out as a supplement. For this purpose, the dentist first removes all deposits that have accumulated on the teeth. Thereafter, a fluoride varnish is applied to the affected areas. In some cases, an additional antibacterial treatment takes place. Special rinsing solutions or gels are prescribed to reduce the amount of bacteria in the mouth.
After this caries treatment periodic checks should be made at the dentist, in which the caries is observed. In the most favorable case, caries has been stopped by these measures and the previously mined minerals are replaced over time by constituents of the saliva. But it can also come as well to a progression of tooth decay.
Caries treatment in advanced stages
Once the caries no longer affects only the surface of the tooth, but already deeper layers, a caries treatment must be done at the dentist. Depending on where the damage is located, how far it has progressed and what costs you are willing to wear, there are various ways to remove caries.
Usually the drill is used. For sensitive teeth, this caries treatment is performed under local anesthesia. The drilling removes excess bacteria. Subsequently, the environment of the borehole is cleaned. The resulting hole is closed with a filling and sealed from the outside with a seal.
If much of the tooth substance has already been lost, the shape of the tooth is restored from the outside. This so-called matrices serve as a template to bring the tooth as possible back to its natural form and prevent any Kauschwierigkeiten with the opposite side of the tooth.
If tooth decay is very close to the tooth nerve, a special therapy is necessary. If the nerve tissue is already damaged, it must be protected with a root filling. For this, the dentin is filled with a Calciumhydroxidhaltigen substance. This is supposed to stimulate the dentin to form new substance. Only then can the normal tooth filling take place.
Root canal treatment
The aim of a root canal treatment is the preservation of a heavily damaged tooth. Most of the root canal treatment is performed on a damaged tooth nerve (pulp). Previously, damaged teeth in which the tooth nerve was affected, pulled. Root canal treatment today allows tooth extraction in many cases to be avoided. For a permanently good result bacteria and dead tissue must be completely removed from the root canal. Later, the canal is sealed with a filling material. Root canal treatment may be necessary for a living, inflamed or already dead tooth nerve.
Caries treatment: fillings
As fillings, different materials are used for caries treatment:
- Plastics (compomer / composite)
- Metal alloys (such as gold)
Which filling is suitable for you depends on various factors. On the one hand, they have different properties (lifetime), they are each suitable for different problems with the tooth and last but not least, the costs are different. And not all fillings are taken over by the cash registers.
The indication of the durability of the fillings is based on statistical data. In the individual case, the lifetime may differ greatly from this information. Decisive influence thereby has the dental care behavior.
These fillings are all part of the so-called plastic fillings. This means that they are introduced into the tooth in a liquid state, where they are exactly adapted to the resulting hole and then cured. Alternatively, there are also insert fillings (so-called inlays). These are made in the laboratory after a previously poured model of the hole in the tooth. Insert fillings are very expensive and therefore have little significance in caries treatment.
Caries treatment with composite
Composite is an artificially produced material that consists of about 80 percent of a salt of silica and about 20 percent of plastic. Composite is very dimensionally stable and extremely durable. In addition, it adapts very well to the natural tooth color depending on the application scheme. In the case of small caries damage, it is often sufficient to prepare the hole, to insert composite in a single work step and to allow it to cure with a special light.
Caries treatment with compomer and glass ionomer cement
Compomer and glass ionomer cement are two substances that are only suitable for the caries treatment of deciduous teeth and tooth necks. They are not suitable for the filling of occlusal surfaces. Since they are relatively soft, they do not withstand the great pressure on the chewing surfaces. In addition, they are only limited shelf life and must be checked regularly by a dentist.
Caries treatment with amalgam
Especially in Germany often in the discussion is the caries treatment with amalgam. Amalgam is a metal mixture of silver, copper and tin together with liquid mercury. Mercury is in its crystallized, that is solid, form bound in these dental fillings and thus harmless. However, it can not be ruled out that traces of it will be released and then freely present in the oral cavity – especially if the fillings have to be replaced or processed.
Amalgam is still approved as a filling, despite ongoing discussions. The mercury uptake by amalgam-containing dental fillings is estimated to be about as high as the mercury uptake by the diet. This amount is considered harmless according to international standards. The use of mercury-containing fillings is limited only in children and pregnant women.
Caries treatment: Goldhammer filling
A very rare filling method today is the Goldhammer filling. In the process, individual thin gold foils are placed on the tooth and knocked into the existing hole. The side surfaces or the chewing surfaces with their numerous surveys are re-formed piece by piece. Gold hammers are rarely used today because they are very complex in their application and the finished filling is also clearly visible. Its advantage, however, is that it is very durable.
However, costs for this method are not yet covered by the health insurance companies.
What to do against tooth decay: newer methods
An alternative to drilling to treat tooth decay is laser technology. The bacteria are removed using laser beams. This method has the advantage that it is less painful. However, the costs for a caries treatment with a laser are not covered by the statutory health insurance and must be borne by yourself.
Two other new methods of caries treatment come from the US and Sweden. In the US, caries treatment is currently being tested with compressed air. It is sprayed with compressed air tiny particles of a special drug on the carious areas. These particles are said to dissolve bacteria and can then be removed with a nipple. In Sweden, a gel is tested, which is applied to carious sites. This should make the spots so soft that they can easily be scrapped afterwards. Both methods are still in the trial stage and are not part of the standard caries treatment.
Another new method that is already used by dentists is infiltration with plastic (also called the icon method). The hole in the tooth is not drilled, but filled from the outside with plastic. The bacteria should be so quasi enclosed and thus rendered harmless.
After the caries treatment
After a caries treatment, the symptoms are eliminated at best in the best case. Especially in case of deep surgery toothache can occur over two to three days after the caries treatment. These only become noticeable a few hours after the visit to the dentist, when the effect of the anesthetic injection subsides. Pain occurs especially at night, as it comes through the lying position to increased blood flow to the tooth. Also a pressure on the affected tooth can exist in the first time.
Toothache over two to three days after a caries treatment are quite normal. But if the pain does not subside afterwards, the dentist should be visited again. Cooling or analgesic drugs help against the pain. Even with analgesic drugs, however, that the intake should not be necessary for more than three days after the caries treatment.
A single caries treatment does not protect against caries recurrence. People who have ever had tooth decay follow the dentist’s instructions and pay attention to nutrition and oral hygiene, especially in the early days after caries has been treated. However, most people become careless over the course of several months and years. So it comes in most cases to a renewed caries treatment.