Every year dentistry rises one step higher, expanding the range and scope of treatment of dentoalveolar pathologies. Open latest drugs, introducing more effective methods of treatment and prevention of dental diseases. However, in connection with the total urbanization, and the increasing pace of life, reduction of environmental indicators, dental disease remain a serious problem in the life of every person. One of such conditions is the destruction of the hard tissues of the teeth.
Quite often in a certain period of their life people noticing problems with teeth, begins to wonder, why do teeth crumble? This can occur on the background of systemic pathologies of pregnancy, after moving to an industrial city, assuming a responsible position in a large institution. Also important factors are: low stress resistance was the slow adaptation to new circumstances difficult family circumstances. Given the complexity of the concept of “crumbling teeth”, consider the most common causes of this problem.
Caries, pulpitis and tooth deponirovanie
One of the most common causes of tooth decay is tooth decay. The caries process involves demineralization of the hard tissues of the teeth. Causative agents are streptococci cariogenic group (Str. Mitis, Str. Sanguis, Str. Mutans and Str. Salivarus). After the appearance of dental plaque, it begins to reproduce the above-mentioned microorganisms. As a result of active activity of the streptococci secrete a variety of metabolites, enzymes, toxic substances.
As a result, the mineral components of the tooth “dissolve”, which leads to spots of demineralization, then the defect cavity and finally total destruction of the tooth. Risk factors of development of carious process is the poor oral hygiene, decreased intake of micro and macronutrients (especially phosphorus and calcium), diseases of the gastrointestinal tract, endocrine and nervous system, salivary glands, etc.
Clinically, dental caries may not be visible, or, conversely, to attract all the attention of the sick person. All depends on the stage and type of the pathological process. The first signs of decay is the appearance of the tooth Milovidova spots. Because the enamel of the tooth normally has a natural glossy Shine, caries in the stage spots will be determined visually, because it has a matte surface. Of course, we are talking only about those cases when the pathological process is located on visible parts of the tooth. Most often it is the lip surface of the incisors, canines and molars. In other cases, patients rarely notice focal color change of the tooth. It is connected with the fact that the initial form of tooth decay is not accompanied by pain.
Surface caries involves the presence of a defect in tooth tissues. This stage of carious process is accompanied by pain, but the massive destruction of the tooth structure is not defined. Therefore, a visit to the dentist, thorough removal of the affected tissues and production of quality filling for years to stop the progression of the pathological process in the teeth.
Medium and deep caries is the stage of carious process, which most often occurs demineralization of dental hard tissues with a noticeable loss of tissue in the coronal portion of the tooth. In some cases, the decay starts at the distal (posterior) parts of the tooth crown, and then spreads deeper into the dentin. It is worth noting that in dentine caries expanding its borders faster than in the enamel. Due to this, in the enamel carious cavity may be narrow, and in the dentin to exceed the first several times. As a result of such subtle destruction of people at some point will come to the doctor and say that he was hurt and crumble a tooth for no apparent reason.
As a special form of isolated flowering (generalized, multiple) tooth decay – it occurs more often in children up to 6 years. This is because in this period children have temporary teeth. As you know, the enamel of milk teeth is thin and porous. This allows the cariogenic microorganisms can easily penetrate into the tissues of the tooth, multiply there and provoke the occurrence of carious process. Successful activity of streptococci contributes to the low content of protective immunoglobulins in the saliva of the child’s body. At risk are children with abnormalities of the immune system, mineral metabolism, salivary glands and genetic diseases. The clinical picture of multiple caries is never left unattended. The child begins to complain of pain, which appears in several teeth. Parents often bring their child to the dentist with complaints that he had crumbling teeth. During the inspection identifies a large number of teeth with caries.
Treatment of caries is to remove the affected tissues and the implementation of direct restorations. Most often, this used composite materials to achieve the aesthetic result and reliable restoration of anatomic and functional integrity of the tooth. If you experience a flowering of caries or caries in pregnant requires a special approach that will be taken into account and adjusted the overall condition of the body.
Prevention of dental caries is the most important principle in saving healthy teeth. As the main condition for the appearance of clusters of streptococci is dental plaque, prevention of caries should begin with regular hygiene of the oral cavity. If you do not create comfortable conditions for life activity of streptococci, the risk of their occurrence is minimized. It is also worth to think than to strengthen the teeth so they don’t crumble. For this there are special toothpastes that contain in its composition of essential elements (calcium, phosphorus, magnesium, zinc, etc.).
Examples of toothpastes such compositions are: Colgate “Enamel Health”, Blend-a-med “Anti-caries” and so it Should also be noted toothpaste oral B “Biorepair” which contains substances that inhibit the activity of cariogenic bacteria (in particular Str. Mutans). An excellent means of prevention of caries is a process of remineralization of teeth. For this purpose there is a special gel ROCS “Medical minerals” (gel ROCKS “medical minerals”). It is applied on the teeth every day after brushing your teeth for 30-40 minutes. On the market there are many varieties of this gel with respect to the age and taste preferences. As stated by the manufacturer, this product is a source of the essential mineral components that form the structure of the tooth.
Destructive and erosive form of fluorosis
Fluorosis is a dental disease of endemic nature. This pathology is common in people who live in areas with fluoride content in drinking water of about 1.6 – 2.0 mmol/L. it Should be noted that in view of the individual not all people have manifested the disease. However, in the event of this disease, there are serious aesthetic and functional disorders. The pathogenesis of fluorosis, as well as most non-carious lesions of teeth, not fully understood.
At the moment it is considered that the stage of development of the rudiments of teeth excess fluoride in the body leads to the formation of specific connections – ftorapatita. In comparison with gidroksiapatit, which normally forms the enamel of the teeth, phtorapatite is more fragile substance, which leads to increased abrasion and the formation of defects.
The clinical picture of erosive and destructive forms of fluorosis is quite specific. In children with the eruption of permanent teeth determined by brown defects on the enamel. It is worth noting that the lesions are symmetrical, for example, on the teeth of the right and left canines. Also characteristic of fluorosis is the fact that one tooth can be placed several spots. The presence of fluorosis often notice parents have of their child. They complain that the child has erupted teeth with dark spots.
The child often feels the consequences of the destruction of the tissues of the teeth, which results in the formation of defects, chipping, abrasion, etc. Diagnosis of fluorosis is simple. Residence in endemic area and nature of the lesions clearly indicate the presence of the considered disease. Treatment of fluorosis is to restore the affected teeth with restorative materials or fixed constructions (crowns, veneers, etc.). For prevention of this disease should control the intake of fluoride in the body. To do this, DFP drink water and use toothpaste without fluoride.
Erosion of the teeth
Erosion of the teeth is a non-carious lesion that is manifested in defects of enamel and dentin on the external (vestibular) surface of the tooth. The cause of this disease is still not completely understood. Like some other non-carious lesions, erosion “surrounded” himself with a set of etiological theories. Interestingly, some theories contradict even the very term “erosion”. For example, the chemical theory suggests that the hard tissue of the tooth is exposed to various chemicals, e.g. acids. They are contained in citrus fruit, confectionery, soda and other products. However, in physics the impact of chemicals on the body is called corrosion.
But, in view of uncertainty of the true causes of the disease, even its name cannot be formulated clearly. The mechanical theory is that the tooth is exposed to different abrasive materials (toothbrushes, paste, solid food, foreign objects). When considering this theory, the term “erosion” sounds more logical, as it lies in the mechanical action of fluid or air to the surface of the physical body. However, this version occurrence of erosions in the same way as the previous have not received the necessary scientific justification. The third theory is that the cause of the erosion is hyperthyroidism. It is scientifically proven that people with hyperthyroidism dental erosion occur 2 times more often than in healthy people.
The clinical picture of this disease is that the person for no apparent reason appear matte at first spots, and then defects on the vestibular surfaces of the teeth. The lesions are converging with the deepening of, in connection with which the defects are called pan. Subjectively erosion only become apparent after the transition from the stage of the spot to the stage of the defect. In humans, there is increased sensitivity to cold and sour. Without clinical examination of the erosion is difficult to distinguish from dental caries, wedge-shaped defect and other lesions of the hard tissues of the teeth. Therefore, a person who dentistry not professionally connected, will complain about the fact that he had crumbling teeth.
To the question: “How to treat erosion?” cannot be answered clearly, because the etiology of the disease remains unclear. Therefore, the therapy is to eliminate symptoms of the disease, risk factors and the strengthening of hard tooth tissues.
Parafunction masticatory muscles
The work of the masticatory muscles of a person closely connected with the condition of his teeth. In the event of various paramountcy muscles tighten with excessive force, leading to increased load on the teeth. Moreover, in some types parafunctional activity jaw performs lateral and anterior-posterior movement that provokes pathological dental abrasion. There are two the most common types of paramountcy masticatory muscles, bruxism and clench.
Bruxism is parafunction masticatory muscles Central origin. Throughout the development of dentistry was highlighted in many of the risk factors of bruxism, but the main reason was not installed. Scientists who study sleep and its associated limbic system of the brain, claim that the cause of bruxism is a violation of the function of sleep. Some stamatovi who deal with gnathology and the study of occlusal relationships (contacts between teeth), I assume that the reason is the interference from the teeth. The most logical was the theory that says that bruxism is a protective reaction of the body aimed at dealing with stress.
As the modern world develops very fast, the pace of life is constantly accelerating, and the amount of new information increases. This leads to the fact that the person has a lot of problems, the solution of which is not enough time and effort. What’s more, high-paying jobs require a high level of responsibility that complements the stress. If we add to this such factors as the lack of sports, love relationships, new pleasant impressions and surroundings, he begins a chronic state of stress. As you know, stress is the most universal risk factor for disease. Diabetes, cancer, cardiovascular disease – all these can be triggered by chronic emotional stress. If the stress reduce, the risk of these diseases is also reduced. Therefore, when the bruxism, the body reduces emotional tension through muscle activity. From this the question arises: “What is to treat? Bruxism or mental condition?”
The mechanism of bruxism can be described as follows. From the Central nervous system receives impulses to muscles. Chewing muscles scoresheets with a strength 6 times stronger than normal force of contraction during chewing. The lower jaw can move forward and veer to the side, performing these movements throughout the cycle of bruxism. The duration of the attack varies from 5 seconds to several minutes.
The clinical picture of bruxism is characterized by tooth wear, cracked enamel, abbracciami and chipped. Some patients, watching at above, complain that they crumble and hurt your teeth. However, it is not because of weakened teeth, and due to the increased load on them.
Clench – muscle parafunctional activity in which there is clenching of the teeth without lateral and anterior-posterior movements of the jaw. I.e., the lower jaw moves only in the vertical direction. Complaints at klance about the same as in bruxism, the only difference is that abrasion is expressed to a lesser degree.
Diagnosis of bruxism is carried out only in a clinical setting. Performs a full medical history, the study of the tonus of the masticatory muscles, palpation of them. During the inspection pay attention to the wear of the teeth and the presence of gum recessions. Analyses of the diagnostic plaster models in the articulator. This allows you to determine occlusal relationships and identifying points on the teeth, which create obstacles for the movement of the lower jaw.
One of the diagnostic techniques is a comparison of facet abrasion. Method is to install the woofers in such a position that the upper and lower incisors in contact with each other. This position NCH deflect left or right and find the maximum correspondence between the planes of the upper and lower teeth. Most often this position is located at 1-3 cm left or right from the center position bass.
A more accurate method of diagnosis of bruxism are brocchieri. They are special aligners that a person wears at night. Thin colored coating mouthguard allows the opposing teeth to leave her fingerprint, which will allow the doctor to see the “unwanted contacts”. Diagnosis of clinch is also based on the study of the masticatory muscles and occlusal relationships.
Treatment parafunctional activity today is quite abstract. Not yet established the cause of the disease, it is considered to be a polietiologic. And if it polietiologichesky, the effect on its cause is impossible. Therefore, therapy aimed at reducing symptoms and eliminating abrasion of the teeth. In the presence of chronic stress is prescribed a course of psychotherapy. To protect the teeth and periodontium are special Kappa. In the presence of undesirable contacts of the teeth is performed a selective grinding of teeth. If the patient has misaligned teeth or dental defect, it is necessary orthodontic treatment and rational prosthetics.
Abbraccio (wedge shaped defect) is a non-carious lesion of teeth, which in the cervical region appear V – shaped area of destruction of hard tissues. Many researchers believe that the nature of wedge-shaped defects polietiologichesky. Some scientists build their hypotheses, which are related to mechanical and chemical stimuli. However, the most logical at the moment is the theory of lateral loads on the teeth. It so happened that the anatomical form of the teeth is thought nature very carefully. Human teeth can withstand the chewing pressure. Strong roots, proper inclination of the teeth, the optimal form hillocks on the chewing surfaces all contribute to an ideal load distribution on the teeth. However, if the direction is wrong, the power and exposure time is exceeded, then the hard tissue of the tooth begin to experience stress.
This situation may occur when the malocclusion, periodontal disease (tooth mobility), the defects of the dentition (when chewing load is distributed on the remaining teeth), parafunction masticatory muscles (bruxism), etc. All of these conditions can lead to the emergence of wedge-shaped defect. For a clearer understanding of the pathogenesis, you can imagine how broken dry branch of a tree. When you try to bend on the outer side of the bending occurs a zone of tension, and internal – a zone of compression. If we talk about the tooth – the zone of compression will be the vestibular surface, and the area stretching – oral.
Since the zone of tension of lack of space for the cells does not occur, the distance between them at first increases and then decreases without visible impact on the condition of the tissues of the tooth. In the zone of compression the situation is different: as a result of external influence cells squeeze each other, resulting in V-shaped destruction of the enamel and dentin. The clinical picture of this lesion has long remained unnoticed. This is due to the slow progression of the disease and absence of acute symptoms.
However, at some point a person begins to complain that the enamel of the teeth crumble. Diagnosis wedge-shaped defect is also fairly simple: there is a V-shaped defect, the surface of which is covered with an unmodified hard tissues (enamel or dentin). Treatment of this condition should begin with the exclusion of predisposing factors disease, which was mentioned earlier. Only under this condition it is possible to start the restoration treatment of the affected teeth. Restoring the function and aesthetics of the teeth is performed by using filling materials, porcelain veneers and ceramic crowns.
Pregnancy for women is one of the most important stages in her life. However, it should be noted that this condition sometimes causes significant damage to the health of the expectant mother. This is due primarily to the restructuring of hormonal and preferential direction of nutrients through the placenta to the fetus. Given the fact that the bone structure of the fetus are formed during the first trimester of pregnancy, the mineral components go through the placenta to a fairly large number. Thus, already in the first trimester of pregnancy in a woman may be a shortage of mineral components. Most often, pregnant women complain that they have hair fall out, crumbling teeth and nails.
In addition to calcium deficiency, the body becomes more sensitive to external stimuli and vulnerable to pathogens of various diseases. Activation of the saprophytic flora leads to the fact that even relatively harmless disease occurring in a rather aggressive manner. The same cavities, for example, the average person can be an isolated phenomenon that affects one tooth, and a pregnant woman caries can acquire the character of multiple and rapidly.
The fear of medical intervention during pregnancy may force a woman to endure pain and to defer the visit to the postnatal period. However, with this approach to the end of the third trimester you can lose a few teeth due to their total destruction and loss. The clinical picture in each individual case is different. If the decay progresses too aggressive, then the pregnant woman may complain of loss of old fillings and getting cold, hot and sweet food in the tooth.
In case when caries progresses pretty quickly, then people complain that their teeth crumble one by one. Several teeth have carious spot, and then cavity. Very often these problems are compounded by the pulpitis and periodontitis that requires anesthesia and conduction of endodontic treatment. To prevent these complications you need time to contact the dentist to perform diagnosis. It lies in the instrumental examination of the teeth, which identify areas of demineralization (caries).
Often to detect caries using the caries-detectors. This is a special pigment solution, which dye only the affected hard tissues of the tooth. Treatment of caries involves removal of all softened tissue. This can be performed using rotary tools (forest machine) or by manual extraction of the soft tissue with an excavator. Then filling the cavity one of materials (composite, cement, compomer, etc.). The choice of material depends on the depth and site of the damage, and economic and aesthetic preferences of the patient.
If you notice that you start to crumble the teeth, try to find the root cause of this status (poor hygiene, stress, diseases of other organs, pregnancy, changing jobs, or the parallel existence of these factors). Analyze recent events that have occurred in your life and try to note mentally and physically the most difficult for you. Maybe the fact that you have crumbling teeth is one of the symptoms of another disease. Unfortunately, in society there is a tendency that people do not consider it necessary to devote a dentist in their lives and their overall health. However, this will be worse only to the patient. The dentist will do the job: will remove the plaque, will complete the dental restoration.
But further Outlook remains in the hands of the patient. If he continues to work in hazardous environments, the teeth will continue to crumble. If people can’t get out of depression, then it can be other, more serious diseases. In the end, the next time this patient will return to the dentist with a more aggravated condition of the dentition. So don’t put off dental problems for the indefinite future. Your body should look comprehensively, as a fragile mechanism, where psychological and physical components are closely interconnected and require a reverent attitude.