symptoms of dental caries, early symptoms and signs of dental caries
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Dental caries symptom
Early symptoms: On the smooth surface, it is chalky plaque caused by demineralization, and then it is yellowish brown due to coloring, while the pit and fissure are dispersed like ink, generally without obvious cavities, but only rough feeling when probing.
Late symptoms: Caries have reached the deep layer of dentin, which is generally manifested as large and deep cavities, or the entrance is small and the deep layer has extensive damage; Pain detection can cause pain reaction to external stimuli (such as cold, heat, sweetness, acid and food embedding, etc.). When the stimulus source is removed, the pain disappears immediately without spontaneous pain.
Related symptoms: abnormal tooth color, enamel corrosion, cold and hot pain, exposed root, abnormal tooth eruption and pain
1. Caries prone sites
There is a close relationship between the prone parts of caries and whether food is easy to stay. Some places on the tooth surface, where bacteria and food debris are easy to stay, have more plaque accumulation, which easily leads to caries. These places are the places where caries is prone, including pit and fissure, adjacent surface and tooth neck.
Pit and fissure of teeth is a defect left over from the process of tooth development and mineralization, and it is also the primary incidence site of caries. The adjacent surface of teeth is second only to pit and fissure, which is generally caused by food impaction caused by wear of adjacent contact surface or atrophy of interdental nipple. Tooth neck is the junction of enamel and dentin, which is conducive to the retention of food and bacteria, and is also a weak link of tooth tissue, especially when enamel and cementum are not in contact and dentin is directly exposed, caries is more likely to occur.
2. Caries-prone teeth
Because of the characteristics of different anatomical morphology and growth sites of teeth, the incidence of caries in each tooth is different. A large number of epidemiological investigation data show that the tooth position distribution of caries is basically symmetrical on the left and right sides, with more mandibular than maxillary, more posterior teeth than anterior teeth, and the caries rate of mandibular anterior teeth is the lowest.
3. Degree of caries
The change of color, shape and quality of dental caries can be seen clinically, and the change of color and shape is the result of qualitative change. With the development of the disease course, the lesion enters the dentin from enamel, and the tissue is constantly destroyed and disintegrated, and gradually forms a cavity. Clinically, it is often divided into three stages according to the degree of caries, which are shallow, medium and deep caries, and their respective manifestations are as follows
Shallow caries: Also known as enamel caries, caries is limited to enamel. At the initial stage, it showed chalky plaque caused by demineralization on the smooth surface, and then it became yellowish brown due to coloring, while the pit and fissure were dispersed like ink. Generally, there was no obvious cavity, only rough feeling when probing, and shallow holes confined to enamel appeared in the later stage, without conscious symptoms and no response when probing.
Medium caries: The caries has reached the superficial layer of dentin, and there are obvious cavities in clinical examination, which may cause pain detection, and may cause pain reaction to external stimuli (such as cold, heat, sweetness, acid and food embedding, etc.). When the stimulus source is removed, the pain disappears immediately without spontaneous pain.
Deep caries: The caries has reached the deep layer of dentin, which is generally manifested as large and deep cavities, or the entrance is small and the deep layer has extensive damage, and the response to external stimuli is heavier than that of medium caries. However, after the stimulus source is removed, it can still relieve pain immediately without spontaneous pain.
Caries show black transmission area on X-ray film. For those who are difficult to diagnose (such as adjacent caries), X-ray film can be used to assist in diagnosis.
4. Types of caries
1) Chronic caries
Dental caries generally progresses slowly, especially in adults, most of which are chronic. Because of the long course of disease, dry texture and less soft caries, such patients have a long repair process, and usually there is sclerotic dentin layer at the bottom of the cavity.
2) Acute caries
It is more common in children, adolescents, pregnant women or people with poor health. The course of treatment is short and the progress is rapid. There are many soft caries, soft texture, light coloring, light yellow or chalky color, easy to be excavated, and lack of hardened dentin layer at the bottom of the cave.
3) Static caries
Because the local cariogenic factors are eliminated, the progress of caries is very slow or completely stopped, which is called static caries.
4) Secondary caries
It is more common in the process of caries treatment that the caries tissue is not purified or the edge of the restoration is not close, forming cracks and causing caries to occur again.
II. Diagnostic criteria:
1. Ask about the response to hot, cold, sweet, sour and other stimuli, and whether there is food impaction and spontaneous pain.
2. Check the color, shape and quality changes of tooth hard tissue, the location, depth and type of caries. Pay attention to the cavities on the adjacent surface, neck or gum cover. X-ray photos can be taken when necessary.
3. According to the degree of caries, it can be divided into ① shallow caries. Caries are limited to enamel or cementum, and generally have no conscious symptoms. ExploreThere is no response. ② Middle caries invades the superficial layer of dentin, and may cause pain and pain by cold, heat, acid and sweetness. ③ Deep caries invades the deep dentin, but does not penetrate the pulp. Generally, there are excitation pain and probing pain, but no spontaneous pain.
4. According to the types of caries, it can be divided into ① chronic caries has a long course, and the caries tissue is hard, dry and deeply stained. ② The course of acute caries is short and progresses rapidly, and the caries tissue is soft, moist and lightly stained. For example, in a very short time, most teeth and even the whole teeth have acute caries, which has a wide tooth surface and develops rapidly to the deep part. It is often annular in the neck of teeth, which is also called fierce caries. ③ The cavity of static caries is shallow dish-shaped, and the development of caries is very slow or static. The cavity often exposes hard, smooth and colored dentin layer. ④ Secondary caries occurs at the edge of fillings or restorations.
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