Conservative dentistry - Restorative dentistry
Caries is a process of decaying the hard tooth tissues. If dental hygiene is insufficient, a layer of dental plaque forms on the teeth. This contains bacteria that produce acids from sugars in our diet. The teeth are made of different types of lime. Acids descale the outer layer of the tooth. If this process can continue for a sufficiently long time, a hole is created. Such a carious defect or carious lesion cannot heal and must be repaired by means of a filling, or a restoration. After removing the affected tooth material, a filling material is applied that restores the shape and function of the tooth or molar; preferably in an aesthetically pleasing manner (tooth-colored filling material). Caries occurs in a large percentage of the population as a result of insufficient oral hygiene and a sugar-rich diet.
Caries usually develops in specific places that are difficult to clean. These so-called predilection sites, for caries are listed in order of occurrence (see figure below):
- The fissures on the occlusal surfaces of molars and premolars and the foramen caecum on the palatal side of the lateral incisive in the upper jaw;
- The approximal planes of adjacent elements;
- The cervical surfaces of all teeth, buccal, labial, lingual and palatal.
The predilection sites of caries: the fissures and pits, approximal and cervical.
Some people appear to have cavities much faster than others, while oral hygiene and diet are globally the same. These people are risk patients for caries, they have a high caries risk.
Caries starts in the surface of the dental element and then expands towards the pulp. The expansion of the caries process is as follows:
- First there is a superficial defect in the enamel, the dentin has not yet been reached. We speak of descaling or initial lesion. Descaling can still be restored by remineralization of the enamel.
- If the caries has spread to the dentin via the enamel, we speak of superficial caries, caries superficialis or white spot lesion. Now the caries lesion can no longer recover and treatment is necessary.
- The next step is an expansion of the caries in the dentin. We speak of caries media.
- If caries media is not treated, a very deep cavity is created. The lesion has expanded to (near) the pulp. We call this caries profunda. Pain symptoms arise, the element becomes weakened and can break down (see image below).
Stages in the caries process: a descaling; b caries superficialis; c caries media; d caries profunda.