How to avoid extensive damage: treatment of chronic caries. What kind of disease is this - deep caries? Superficial caries - acute and chronic course

A disease of the hard tissues of the tooth, characterized by a violation of the integrity of the dentino-enamel junction. Average caries is manifested by the presence of a defect (hollow), short-term pain of moderate intensity, and increased sensitivity of the teeth. Probing reveals a carious cavity filled with softened pigmented dentin. The diagnosis of moderate caries is established taking into account examination data, electroodontodiagnostics, and radiography (radiovisiography). Treatment of average caries consists of preparing the carious cavity, applying an insulating lining, and placing a filling.

General information

Middle caries (caries media) is a carious lesion of a tooth with a cavity localized within the enamel and the middle layer of dentin. Caries is the most common disease in therapeutic dentistry; at the same time, medium and deep caries are its most common clinical and morphological forms. Medium caries is an intermediate stage between superficial and deep caries. Medium caries occurs mainly in young and mature adults, but often affects baby teeth. From the point of view of the clinical course, acute and chronic intermediate caries are distinguished. According to localization, average caries can be cervical, fissure, or contact.

Reasons

The basis for the development of the carious process is a combination of three factors: the presence of cariogenic microflora of the oral cavity, a diet high in carbohydrates, and a decrease in the resistance of hard dental tissues to the effects of adverse conditions. According to modern concepts, enzymatic fermentation of carbohydrates, carried out with the direct participation of microorganisms, leads to the formation of organic acids that contribute to the demineralization of tooth enamel and the penetration of microbial flora deep into the tooth tissue.

Treatment

Complex treatment of moderate caries includes a number of strictly sequential stages of tooth preparation and filling. Typically, the entire range of therapeutic measures is carried out by a dental therapist in one visit.

Treatment of medium caries is carried out under local infiltration or conduction anesthesia. With the help of spherical burs, the carious cavity is opened and expanded, the overhanging edges of enamel and softened dentin are removed. At the stage of formation of the tooth cavity, optimal conditions are created for fixing the filling. After finishing the cavity, it is medicated with antiseptics and thoroughly dried. An insulating gasket is placed on the bottom and walls of the cavity, on top of which a permanent filling is applied, usually made from a chemically cured composite or light-curing materials. The final stage is grinding and polishing the filling.

Prognosis and prevention

If all principles are followed, treatment of moderate caries is usually successful: pain disappears, the aesthetic and functional usefulness of the tooth is restored. If left untreated at this stage, medium caries can rapidly progress into deep caries, leading to the development of complications - pulpitis and periodontitis.

The key to preventing secondary caries is systematic visits to the dentist, carrying out preventive measures (remineralizing therapy, professional hygiene), timely elimination of initial forms of caries, and nutritional correction. It should be remembered that regular and proper oral hygiene reduces the need for dental treatment by 75-80%.

Caries– a pathological process that occurs after teething and consists of demineralization of the hard tissues of the tooth with the subsequent formation of a cavity and occurs with the indispensable participation of microorganisms.

The clinic uses a classification of dental caries according to the following principles: depth of damage and course.

Cariesology uses 4 main research methods:

1. Inspection.

2. Probing.

3. Cold reaction.

4. Percussion.

Additional research methods:

1. Electroodontodiagnostics (EDD).

2. Radiography

To diagnose initial caries use:

1. Transillumination.

2. Luminescence.

3. Electrical resistance measurement.

4. Vital staining.

Description algorithm:

Preliminary diagnosis.

Differential diagnosis.

Final diagnosis.

All forms of caries have common symptoms, but in some cases there are difficulties in differential diagnosis with other diseases.

Acute initial caries

Complaints(whitish spot, sore throat, quickly passing pain from sweets) or complaints may be absent.

History of the disease: lasts for weeks.

Objectively: in the cervical region there are 21 milky-white, oval-shaped carious spots with fuzzy edges. The surface of the stain is slightly rough. When probing, the enamel is slightly pliable. Cold reaction and percussion are painless.

To clarify the diagnosis, it is necessary to carry out vital staining according to E.V. Borosky and P.A. Leus. The principle of vital staining: the dye does not linger on a smooth surface, but does linger on a rough surface.

1. Methodology for vital staining.

Clean the tooth being examined from plaque, isolate it from saliva, and apply a 2% aqueous solution of methylene blue (aniline dye) to the stain with a cotton ball for 2 minutes. After 2 min. Remove the dye from the surface of the tooth with a cotton ball.

If the spot is of a carious nature, it will turn blue of varying intensity (an indicator of the degree of demineralization of the enamel). The more intense the color, the more pronounced the demineralization. To assess color intensity, a standard typographic ten-field blue scale of 100% with a hue gradation of 10% is used.

2. Luminescence.

When a surface is illuminated with light from a luminescent source at the location of the carious spot, the glow is extinguished.

3.Transillumination: a carious spot gives a shadow against the background of a luminous

tooth crowns.

4. Determination of electrical resistance.

The electrical resistance of enamel affected by caries differs from the electrical resistance of intact enamel. Healthy enamel is a dielectric (does not conduct electric current).

Does enamel conduct heat? - No. And dentin conducts heat, so when placing an amalgam filling, a cement spacer is placed to insulate the dentin.

5. Drying the surface of the carious spot with a jet of air

(the carious spot becomes bright white).

Variants of the outcome of acute initial caries.

1. Formation of a carious cavity.

2. Chronization of the process (transition to chronic initial caries).

3. Cure (restitution = restoration) under the influence of remineralizing therapy.

4. Self-healing (transformation into a black spot).

5. Dynamic balance (the processes of de- and remineralization are balanced). Such a carious spot can exist for months and years.

Treatment of acute initial caries is conservative.

Chronic initial caries

Complaints More often than not, sometimes there are complaints about an aesthetic defect.

History of the disease: months and years.

Objectively: on the vestibular surface of the cervical region 14 there is a carious oval-shaped spot of dark yellow or brown color with unclear contours and a slightly rough surface upon probing. The reaction to cold and percussion is painless.

Chronic initial caries does not require treatment.

Acute superficial caries

Complaints to quickly passing pain from sweets, less often to the cavity (if the process is localized before the transition of the enamel-dentin border, there are complaints about chemical irritants; in case of moderate and deep caries - to cold).

Objectively: carious cavity within the enamel, with overhanging edges. The enamel is whitish. Probing the bottom is slightly painful. Cold reaction and percussion are painless.

Remark. There is no superficial caries in the cervical region, since in the area of ​​the tooth neck the minimum enamel thickness is 0.001-0.002 mm.

Histologically: The shape of the carious cavity in superficial caries is triangular, the apex of the triangle faces the surface of the enamel.

Treatment of acute superficial caries is surgical (filling).

Chronic superficial caries

There are no complaints about the formation of a cavity.

History of the disease: years.

Objectively: a carious cavity within the enamel, the cavity is wide open, without overhanging edges, the enamel is dense and pigmented. Probing, reaction to cold, and percussion are painless.

Chronic superficial caries is treated conservatively: the edges are ground off followed by remineralizing therapy.

Acute medium caries

Complaints of quickly passing pain from thermal and chemical irritants, localized pain (as opposed to pulpitis).

Medical history: months.

Objectively: on the chewing surface 36 there is a carious cavity of medium depth (within the mantle dentin), with overhanging edges, light softened dentin. Probing in the area of ​​the dentin-enamel junction is slightly painful, in the bottom area it is painless. Quickly passing pain in response to cold (you cannot write a positive reaction to cold). Percussion is painless.

Remark. Clinically (visually), mantle and peripulpal dentin do not differ from each other. The conventional boundary between them is half the thickness of the dentin.

Histologically: the shape of the carious lesion is a rhombus, with two vertices facing the surface of the enamel and pulp of the tooth. The largest diagonal of the rhombus is located at the enamel-dentin junction. This is due to the concentration gradient of mineral components in the hard tissues of the tooth (in enamel, the concentration of minerals decreases with depth, and in dentin, on the contrary, it increases).

Chronic average caries

There are no complaints about the presence of a cavity.

History of the disease: years.

Objectively: on the chewing surface 36 of medium depth there is a saucer-shaped carious cavity, wide open without overhanging edges (they wear out under the influence of chewing forces). Dentin is dense, pigmented, the probe glides along the bottom like glass. Cold reaction and percussion are painless.

Acute deep caries

Complaints to quickly passing pain from thermal stimuli, sometimes from mechanical stimuli (the thin strip of dentin separating the carious cavity from the tooth cavity is pliable, and, for example, when pressing on a raspberry grain caught in a deep carious cavity, pain may occur. But this is not pain when biting on a tooth, as in periodontitis, when the periodontium is involved in the inflammatory process).

Remark. The indifferent zone for incisors is 30 degrees (50-52 degrees – reaction to heat, 17-22 degrees – to cooling). In pathological processes, a narrowing of the indifferent zone occurs, when minor deviations from body temperature (by 5-7 degrees) already cause a response).

Objectively: on the chewing surface 36 there is a deep carious cavity that does not communicate with the tooth cavity, there are overhanging edges of the enamel, the dentin is light, softened, removed in layers, the reaction to cold is quickly passing. Probing in the bottom area is painful. Percussion is painless.

Remark. If, after eliminating the cold stimulus, the pain lasts for several seconds, this indicates the involvement of the dental pulp in the pathological process.

Chronic deep caries

There are no complaints (asymptomatic) or presence of a cavity.

History of the disease: years.

Objectively: deep carious cavity on the chewing surface 36, not communicating with the tooth cavity, without overhanging edges, dense pigmented dentin. Probing and percussion are painless. The cold reaction sometimes causes pain that passes quickly.

With the same depth of the carious cavity in acute and chronic deep caries, the dentin layers separating the carious cavity from the tooth cavity are different due to the formation of replacement dentin in chronic deep caries (protective reaction).

The therapeutic effect depends on the correct diagnosis, since acute and chronic deep caries are treated differently.

Caries in dentistry is considered the most common pathology, which has two types of manifestation - compensated (chronic) and decompensated (acute).

Both types lead to extensive dental damage, but only in the chronic form does the destructive process proceed slowly, almost imperceptibly to humans.

Without an integrated approach to treatment, accompanied by proper dental care, diet correction and elimination of possible causes of its occurrence, chronic caries remains incurable. New outbreaks of it will constantly appear.

Chronic (typical) caries is a sluggish form of ordinary caries, characterized by gradual damage to all layers of dentin.

The disease can progress over several years with minimal or smoothed symptoms, and not accompanied by pain (except when the disease is in the last stage).

The following symptoms are typical for the chronic carious form:

1. The appearance of small areas of damage with dark enamel, but at the same time it still retains a dense, unchanged structure.
2. A little later, when the situation begins to worsen, the enamel surface becomes heterogeneous and rough.
3. Soreness is almost always absent or appears very weakly (smoothed out) and does not last long, and only in response to thermal or mechanical stress. The reaction to sweets is very active. But the pain goes away quickly if the causative factor is eliminated.
4. In the compensated form, the enamel is almost not affected, but the destructive process quickly damages the dentin. That is why dentists are often faced with a situation where, despite the integrity of the enamel, a cavity very quickly forms in the tooth, lined with dead tissue.
5. The resulting cavity is characterized by steep, gentle edges and a fairly wide entrance. Its bottom and sides are covered with pigmented and very dense dentin.

This disease is characterized by incomplete remission, those. it can last throughout life or relapse under the influence of a number of factors.

According to medical statistics, typical caries is more common than its decompensated form. The transition of pathology into stages occurs gradually, and their change can last from a couple of months to several years.

In his opinion, caries manifests itself under the influence of organic acids, which are produced by pathogenic organisms (usually Streptococcus mutans) in the presence of low molecular weight carbohydrates in the oral cavity.

The causes of chronic caries are identical to those factors that lead to the acute form. The disease begins to develop as a result of the combined effect of local and general causes on the oral cavity.

Common causes include the following conditions:

• unbalanced diet, which is based on fast carbohydrates, as well as the absence of products that saturate the enamel with vitamins and microelements;
• severe pathologies that a person suffered during the formation of hard dental tissues;
• insufficient fluoride content in water;
• genetic predisposition, when such indicators as the thickness of dentin and enamel, their resistance to the action of pathogenic microorganisms, are only hereditary.

Dentists also noted that compensated caries more often occurs in people with a history of chronic metabolic and endocrine disorders, with a severely weakened immune system.

Local reasons include:

• lack or insufficient oral hygiene, leading to the active proliferation of bacteria on the teeth;
• pathologies leading to a decrease in saliva production and changes in its composition;
• demineralization of enamel;
• congenital (acquired) anomalies in the structure of the dental system;
• low resistance and changes in the structure of all dental tissues.

Important! Timely elimination of many of these factors will help significantly reduce the possibility of the disease occurring.

Babies at risk

From the practice of pediatric dentists, it becomes clear that chronic caries of mammary units is one of the most common phenomena among children.

The main cause of the disease, according to doctors, is that some parents start teaching their children too late to take care of their teeth.

Important! To prevent the development of pathology, it is necessary to start brushing the child’s teeth as soon as the first incisor appears.

Infrequent treatment of the mouth or its complete disregard leads to the fact that saliva ceases to fully suppress the activity of bacteria and cope with the occurrence of certain oral diseases.

Parents are mistaken in believing that caries on baby teeth can be left untreated, since the affected units will eventually be replaced by healthy ones, and do not take the child to the dentist.

But this is far from the case. The condition of future permanent teeth depends on the health of children's dentition, and if treatment is not started in a timely manner, caries can affect the rudiments, and they will erupt already sick.

Stages

In chronic caries, as in its acute form, there are four stages of development. The transition of the disease from one stage to another occurs very slowly and almost imperceptibly.

Chalky spots

The disease begins with the appearance of an unnaturally white small spot on the enamel, which resembles chalk in color. That is why the initial period of the disease in dentistry is called the “chalk spot stage.”

This is a completely reversible stage of the pathology, i.e. The development of caries can be quickly stopped.

The appearance of the stain is explained by the washing away of vitamin and mineral compounds from the enamel, the transformation of its entire structure.

Surface

The second (superficial) stage is characterized by further destruction of the enamel, when small holes and cavities (recesses) with flat edges are already formed on it, observed gradual darkening of whitish spots. They can range in color from light brown to dark gray.

There is no pain symptom, and upon examination of the affected area it is noted heterogeneity and looseness of the surface.

Average

Next stage – Dentin caries or average. It is distinguished by the penetration of caries into the surface layer of dentin. Diagnosed by the following symptoms:

• expansion of the spot area;
• the appearance of causal pain, which disappears almost immediately after the irritating factor is eliminated;
• the formation of a narrow cavity.

Deep defeat

The last and most severe of all stages is deep caries. Large dark brown or black cavities form, and the interdental spaces expand.

The tooth edge is destroyed so that its sharp edges can be easily felt by the tongue. The carious process, having completely destroyed the enamel and dentin, spread to the pulp.

There is no constant severe pain, as in the acute form. The symptom is temporary and appears only under the influence of irritating factors.

Diagnostics

Detection of caries, including its chronic form, involves several examination methods:

1. Visual inspection, during which the dentist examines the condition of the oral cavity and determines the degree of dental damage.
2. Treatment of all surfaces of hard fabrics with a special dye, which helps to identify the pathological process at the beginning of its development. If, after applying the dye under a fluorescent lamp, darkened areas are visible against the background of white enamel, you can diagnose the progress of the carious process in them.
3. Electroodontometry– a technique that allows you to measure the degree of sensitivity of the pulp. If the impact of the current causes a short-term pain reaction, it means that the fragment is affected by caries.
4. Examinations using the Diagnodent apparatus. Acting on the enamel with light waves, he analyzes the light reflected from its surface. If there are changes in the composition and structure of the enamel (which is typical for caries), the device informs about this.
5. Radiography. Caries, invisible during visual inspection, is easily detected on an x-ray. In the image, unaffected (healthy) tissues are light, and destructive areas, even very small ones, are shown in black. X-rays also allow you to determine the depth of penetration of caries into the tissue.

Learn more about the symptoms, types and diagnosis of caries from the video.

Therapy methods

The treatment of typical and acute caries is very similar. The only difference is that in the chronic course of the disease, the entire therapeutic course is aimed at both stopping the carious process and eliminating the very cause that led to the disease.

Based on the stage of caries and how deeply it has affected the tissue, the dentist uses appropriate treatment methods. The doctor also takes into account the patient’s age and general health.

Remineralization

This is the process of saturating the enamel with potassium and phosphorus. Remineralization allows you to restore the density of the enamel and its mineral composition, and reduce sensitivity.

For this purpose, two concentrated preparations are usually used: a 3% solution of Remodent and Calcium Gluconate 10%. Each of these compositions is applied to a previously cleaned tooth surface for 10-15 minutes.

During this entire time, to improve the penetration of minerals, the enamel surface is exposed to special light.

Each of the products is applied in several layers, after which it is washed off with a special solution, removed with a swab, and the enamel is well dried.

The number of remineralization sessions is determined by the doctor, based on the initial quality of the enamel and the degree of tissue damage by the disease.

Important! The procedure is effective if only primary damage to the enamel is observed, i.e. caries is in the chalk spot stage.

Deep fluoridation

In terms of technique, the method is very similar to remineralization, but the only difference is that preparations containing fluorides are used to coat the teeth.

Their application leads to the formation of crystals that penetrate all layers and fill all microcracks in the enamel. To improve penetration, the tooth is exposed to ultraviolet rays for some time.

Fluoridation helps reduce the rate of spread of caries, prevent its occurrence in other units, improve the quality of all tissues in the oral cavity, increase the density of enamel and its hyperesthesia.

The procedure is recommended to be carried out no more than once a year at the initial stage of caries.

Fissure sealing

It is carried out in case of superficial carious lesions, when the grooves are sealed on the painters.

First, the dentist prepares the fissures to remove the affected tissue. Next, he covers the treated clean surface with a special heavy-duty composite mass, which contains remineralizing compounds.

Sealing takes place quickly; it takes no more than 15 minutes to close the grooves of one element.

Sealing

The technique is used if the destructive process has affected the deep layers of dentin. It involves the complete removal of all destroyed tissue and the creation of a cavity for a filling.

If the inflammation has reached the pulp, then it is treated by extracting the nerve. Upon completion of cleansing, the cavity is treated with an antiseptic solution, the root canals and the cavity itself are closed with a composite.

Important! The selection of material for the filling depends on the location of the “sick” unit and its functionality.

The filling time is about 40-50 minutes, and if the procedure is performed without removing the nerve, the total time is reduced by almost half.

Prevention

Preventing the manifestation of chronic caries consists of eliminating the main factor in its development, as well as implementing the following recommendations:

1. Treat those dental diseases in a timely manner, provoking the reproduction and spread of pathogenic microflora.
2. Clean your mouth regularly and efficiently with the mandatory use of remineralizing and anti-inflammatory agents - pastes and rinses.
3. Supplement daily treatment teeth using additional hygiene devices - floss, irrigator, dental brush.
4. Balance your diet by eliminating or greatly reducing the consumption of baked goods and products containing simple carbohydrates.
5. Give up habits gnawing nuts, cracking seeds, removing stuck food from interdental spaces with a sharp object.
6. Avoid damaging the enamel.
7. Visit the dentist(at least once every 6 months) to conduct a preventive examination and timely treatment of the problems identified by him.

Important! Following these rules will help preserve the health of the oral cavity and teeth, which cannot be fully restored even by high-quality treatment by a highly qualified specialist.

Price issue

The cost of treatment for compensated caries depends on the stage at which it was detected. The earlier the disease is diagnosed, the cheaper its treatment will be.

This table shows the approximate cost of all methods of treating the disease used in dentistry.

These numbers are not final. To these you will have to add payment for a doctor’s consultation and diagnostic methods performed.

Chronic caries– This is a longer lasting tooth decay compared to acute caries.

Let's summarize what the possible outcomes of the carious process may be.

After the appearance of superficial damage to the enamel (and caries always begins with this) - white caries, the outcome is of two types.

1. At the site where a white spot appears on the enamel, if the dental plaque continues to act and no therapeutic or hygienic measures are taken, a defect gradually appears, the hard tissues of the tooth soften and a carious cavity appears, which requires surgical treatment and a filling.
2. The second outcome of the initial stage of caries may be a relatively favorable outcome. If preventive measures are taken in time, good hygienic care, and sufficient intake of microelements into the body, then the white spot on the enamel gradually thickens and darkens to brown.

You've probably seen such stains on your child's teeth or on your own teeth. This is evidence of the transition of caries from the acute state of “white caries” to the chronic form. The spot is usually dense and rough. It can remain on the tooth enamel for a long time if there are no predisposing factors to the further development of caries.

However, such teeth cannot be left without constant monitoring. They need constant monitoring.

If a defect has already formed in the tooth in the form of a carious cavity, then transition to a chronic form is also possible. The walls of such a cavity become compacted and acquire a dark color - to a dark brown color. In these cases, surgical treatment is necessary. Removal of altered dentin and closing of the defect with filling material.

You may ask why, because chronicity predisposes to a long period of caries development. But the presence of a cavity allows for longer residence of food debris and the activity of microorganisms. In addition, the penetration of their waste products through the dentinal tubules into the dental pulp. And if you do not take urgent measures to treat such a tooth and do not contact a dentist, then even with a chronic form of caries, further tooth destruction gradually occurs and the carious cavity deepens. The layer of dentin between the tooth cavity, where the pulp is located, and the carious cavity decreases and caries acquires the “status” of deep caries. The tooth becomes sensitive to temperature stimuli and begins to feel cold and hot. Pain appears when food gets into the carious cavity and until it is removed, the pain does not stop. But immediately after removing the food, the pain stops.

This is a signal that the pulp begins to react to the carious process occurring in the tooth. The outcome of deep caries if not treated in a timely manner is inflammation of the pulp - pulpitis.

This is already the transition of caries into a complicated form, which includes pulpitis - when inflammation spreads to the tooth pulp and a more severe complication - when inflammation from the inflamed pulp through the root canal enters the tissue surrounding the tooth root - periodontitis.

From all of the above we can draw a conclusion. Caries is a disease characterized by changes in the hard tissues of the tooth with the formation of a defect. And it can have both an acute and chronic course.

As caries progresses, destruction affects not only the upper, but also the deep layers of the hard tissues of the tooth. When deep caries affects dentin, the chances of restoring the tooth become less and less, but complications in the form of inflammation of the pulp or periodontal tissues increase.

Deep caries clinic

The clinical picture of deep caries is short-term pain and a prominent deep cavity inside the tooth (with sharp edges, loose dark dentin).

Under the influence of any irritant - temperature, chemical (food residues) or physical (pressure with a medical instrument, chewing) - acute pain occurs, which subsides after the source of irritation is removed.

Symptoms of advanced caries

• The first symptom of deep caries is acute but short-term pain while eating.
• If teeth begin to react to hot and cold drinks, sharp pain “shoots” occur when chewing solid food, then it can be assumed that the tooth tissues have lost their density, the dentin layer has become catastrophically thinner.
• When you visually examine your teeth, you can see the growth of brown-black spots on the enamel, and when you brush them, you can detect the breaking off of small particles.

In some cases, deep caries develops outwardly imperceptibly, for example, under a filling. The appearance of pain should be a signal to visit the dentist, who will conduct a differential diagnosis.

Methods for diagnosing deep caries

To avoid mistakes, the doctor can prescribe a differential diagnosis in relation to:

• focal pulpitis;
• medium caries;
• fibrous pulpitis.

Tactile methods (probing the bottom of the cavity, tapping the walls of the dental crown) do not always give an accurate idea of ​​the extent and nature of the pathology, so they are most often used in combination with x-rays.

By studying the image, the doctor will be able to measure the thickness of the healthy dentin layer and make an appropriate conclusion.

Why is advanced caries dangerous?

A carious tooth is a source of infection that very quickly spreads to adjacent crowns. If left untreated, deep caries gradually covers several teeth, causing not only the destruction of enamel and dentin, but also inflammation of the soft periodontal tissues, acute pulpitis and periodontitis.

People suffering from severe chronic diseases, women during pregnancy and breastfeeding should monitor the vitamin balance of their diet. By including foods containing calcium, they protect teeth from premature decay. The lack of this element contributes to the softening of dentin, which can cause relapse and development of the pathology into a chronic form.

Prevention of deep caries in children

In children, the rate of progression of the disease is several times higher than in adults. Some parents do not consider it necessary to treat baby teeth and consult a doctor only when the infection literally “eats” them.

This behavior can lead to the development of deep caries in permanent teeth, since advanced caries does not go away without a trace. To restore healthy microflora, the child will have to undergo a long course of treatment.

As preventive measures to prevent the disease, it is necessary from a young age:

• teach your child to brush their teeth daily;
• control the consumption of acidic, carbonated drinks, sweets;
• Visit your pediatric dentist regularly.

How to treat deep caries in an advanced stage

When selecting a course of treatment for deep caries, the doctor relies on the ICD 10 classifier. If the depth of the lesion allows one to determine the degree of pathology as dentin caries, then restorative procedures should begin with cleaning the carious cavity.

Stages of treatment of deep caries:

• anesthesia;
• cavity preparation;
• antiseptic treatment;
• drying and degreasing the cavity;
• installation of therapeutic and insulating pads.

After drug treatment, the tooth is filled. Pain after treatment is not always associated with a complication. The procedure for treating a dental cavity is carried out with mechanical instruments, so pain for one to two days is considered normal.

Increasing pain, swelling of the cheekbones and gums, and increased temperature indicate a complication - you should immediately consult a doctor.