Types of dental caries and their complications

Tooth decay is the most common dental condition worldwide, affecting both children and adults, and can have negative effects on overall health and quality of life.

According to the International Dental Federation, 44% of the global population suffers the consequences of untreated dental caries, which can be most serious when the infection leads to systemic diseases.

Tooth decay is a condition that involves the breakdown of tooth enamel under the action of acids produced by bacteria in the oral cavity.

Approximately 700 types of bacteria live in the oral cavity, most of which are good bacteria that protect our oral health. However, there are also bacteria that accumulate in the form of bacterial plaque and convert food left on the teeth into acids, causing enamel erosion.

In the absence of daily dental hygiene and regular prophylaxis sessions, bacteria can promote the development of dental caries, gum disease and periodontal disease.

Genetic inheritance, frequent consumption of sweet foods, carbohydrates or fizzy drinks can also promote the development and complications of tooth decay.

Tooth decay does not heal on its own. Left untreated, cavities can progress and even result in tooth loss. A deep cavity is when the decay affects the enamel, dentine and pulp chamber, causing infection of the dental pulp and, implicitly, pain.

Types of dental caries

Tooth decay can be classified according to several criteria.

Depending on the stage of decay, they can be:

• Superficial;
• Medium;
• Deep.

Depending on the location of the lesion, they can be:

• Coronal caries or caries on the contact surface (occlusal, interdental and cervical);
• Caries on the lateral surfaces of the tooth;
• Radicular caries (on the root of the tooth);
• Secondary caries (appearing under existing fillings).

Tooth decay is one of the main causes of tooth loss, but it is within our power to prevent the spread of cavities. The loss of one or more teeth negatively affects oral health and lifestyle. The chewing process is affected, so food is not digested properly and nutrient absorption is reduced.

Dental prophylaxis (brushing twice a day and regular professional cleaning at the dentist's office) is an effective way to prevent the development of dental caries, thus avoiding complex and costly subsequent treatments.

Coronal or contact surface caries can be, in turn: occlusal caries, interdental caries and cervical caries (which occur near the gum line).

Occlusal caries

Occlusal caries are lesions that appear on the surface we use to bite and usually affect the molars at the back of the mouth.

This type of dental caries is common because food can get stuck in the grooves and pits of the occlusal surface and, without proper and regular brushing, demineralisation and then carious lesions occur.

Because, in most cases, early caries can only be detected by a dentist, regular visits to the dentist and dental prophylaxis sessions at least twice a year are essential to prevent their appearance and the spread of lesions.

In the case of complicated occlusal caries, laser root canal treatment will be necessary. Due to the major benefits for patients, DENT ESTET clinics use Biolase – WaterLase® and Epic Biolase lasers in endodontic treatments.

The dentist will use the laser to clean and disinfect the root canal wall during root canal treatments. Waterlase thus performs a deep cleaning of the dentine, removing bacteria and facilitating the treatment of the affected tissue.

Compared to traditional instruments, WaterLase and Epic Biolase lasers ensure a comfortable experience, significantly reducing pain and shortening healing time.

Interdental caries

Interdental caries are most often detected during check-ups at the dentist's office, as they are not easily visible. Usually, interdental caries are only noticed when the tooth is already affected.

If the teeth are crowded or crooked, detecting interdental caries becomes more difficult. To avoid this type of caries, dentists recommend brushing your teeth with interdental brushes, using dental floss, and also using a mouthwash.

Cervical caries

Cervical caries are those that occur near the gums, in the area between the tooth crown and root, called the dental neck. Without proper brushing and flossing, plaque and tartar accumulate at the junction of the teeth and gums, leading to this type of tooth decay.

In conclusion, poor oral hygiene promotes tartar build-up and gum recession, which can lead to complications.

Cavities on the lateral surfaces of the tooth commonly occur on the teeth found on the sides and affect their smooth surface.

This type of lesion develops the slowest and is the least common. Because it progresses more slowly, cavities on the side surface of the tooth are easier to treat. Often, this type of cavity can be resolved with fluoride treatments such as gels, toothpaste, or fluoride-enriched water.

However, if the carious lesion is not detected in time and remains untreated, a filling will be necessary to treat it.

A complication of this type of decay is interdental decay. In order to intervene, the dentist will need a digital X-ray to determine the severity of the lesion and the necessary treatment.

Root caries are lesions that affect the root, the part of the tooth inside the jawbone that anchors the tooth in the bone.

Root caries are more common in older people, who may suffer from gum recession. When the gums recede, the root of the tooth is exposed to factors that promote caries, such as bacteria and tartar.

Root caries are treated with root canal treatments, which have a success rate of 95% in most cases. To ensure the success of a root canal treatment, the endodontist will follow certain steps:

• proper isolation of the tooth (with a dental dam);
• access and correct identification of all canals inside the tooth;
• use of a dental microscope that magnifies the image inside the tooth.

Because the root is not protected by enamel, tooth decay can spread relatively quickly, so the endodontist's intervention is necessary as soon as possible to save the tooth from extraction.

Secondary caries are lesions that appear around existing fillings or prosthetic work. They generally appear between the material used for the filling and the edge of the initial caries.

One of the reasons for the appearance of secondary caries is the improper performance of the initial fillings, so it is extremely important to choose an experienced dentist, but also a clinic that can guarantee the quality of the services offered to patients.