Classification of tooth decay. Types and classification of caries in children

Caries is a disease known all over the world, and it is difficult to find a person who does not face this problem at least once in life. The disease affects the hard tissues of the tooth, thinning the enamel and penetrating into the deep layers of the dentin, creating a carious cavity in them. Most of the damage is visually conspicuous, except in cases where only the deep layers of tissues are damaged.

Causes of the disease

Dentists identify a lot of theories of the appearance of carious lesions, but the main ones remain unchanged:

• Abuse of excessively salty or sweet food.
• The lack of a diet of carbohydrates and vitamins.
• Low content of fortifying fluoride in tooth enamel.
• Neglect of oral hygiene.
• Infectious diseases.
• Genetic predisposition.
• Features of the structure of the tooth, the presence on the surface of the enamel of natural furrows, in which microorganisms accumulate, prone to subsequent decay.

All the above factors to some extent affect the acid-alkaline balance of the oral cavity, creating beneath the dental enamel a favorable environment for the development of pathogenic bacteria. As a result of the gradual washing out of calcium from the dental tissue, the enamel breaks down and a carious cavity is formed. Criteria on which the classification of caries is based, there are many, and this is fully justified. The expanded classification by several parameters allows you to put the most reliable diagnosis, determine the degree of neglect of the process and the treatment options for the disease.

Classification by Black

The most used dentists is the classification of caries according to Black. It reflects not only the location of carious destruction on the surface, but also the depth of the lesion under investigation. Designations of the species of the latter occur through classes - the higher the class, the more neglected the disease:

1. I class. The initial stage is a very weak caries, the chewing surface of the tooth enamel is infected. Damage is concentrated in the areas of conical tooth grooves. Accompanied by the gradual destruction of enamel, and subsequently dentin. With timely access to the dentist, the process at the first stage can be stopped and completely cured by the tooth, without resorting to the help of a drill.
2. II class. Weak caries formed on the contact surface of the lower and upper chewing teeth. Enamel in this place becomes lighter, most often the changed parts resemble small triangles. Such damage is hidden between the teeth, and in most cases it is impossible to identify them even to an experienced specialist.
3. III class. According to this division, as the classification of caries, this is a lesion of moderate severity, in which the cavities are formed on the surface of the front teeth. The cutting edge of the latter at this stage remains unscathed. Most often this kind of caries affects people who abuse sweets and rarely use dental floss.
4. IV class. Heavy caries, which is a progressive stage of defeat of the third class. If the surface disorders of the incisors are not treated, the dentin begins to break down in the region of the cutting edge of the tooth.
5. V class. A very serious degree. Classification of dental caries characterizes this form of deep damage to the tooth region along the gum. Caries of this form is called cervical, it is the most dangerous, since the carious cavity is located in the immediate vicinity of the root. At the initial stage, the border between the gum and the tooth body is covered with almost imperceptible white edges. Most often, radical caries affects several organs, sometimes all are infected. If you ignore the treatment of "white caries", complications arise in the form of foci of carious destruction. In some cases, with a severe complication of the disease may be the question of removing the most damaged tooth.

Classification by WHO / ICD 10

Classification of caries according to WHO (World Health Organization) is based on the identification of a particular affected area and identifies the following items with the codes:

• K02.0. Initial destruction of the enamel, expressed by the formation of white spots on the surface.
• K02.1. The code denotes the stage of destruction of dentin - the tissue under the enamel.
• K02.2. Carious destruction of cement, or radical caries. This code is used to indicate damage to the root of the tooth.
• K02.3. The designation of the stage at which carious destruction is suspended.
• K02.4. To it carry odontoklaziyu, children's melanodentium and melanodontoclase.
• K02.8. Other varieties not listed in the preceding paragraphs.

Classification of caries according to the ICD (International Classification of Diseases) is considered the most popular practice in modern dentists. It is convenient because it has clarifications in the form of points on the suspended illness and its other forms.

Classification by disease priority

Dental practice divides caries according to the frequency of occurrence:

• Primary - on the tooth not previously exposed to the disease, caries are formed, the etiology, the classification of which occurs through analysis and attitude to one or another category.
• Secondary, or relapse, appears on the surface of an organ that has been previously sealed. It arises due to a violation of the seal of the seal to the tooth tissues, resulting in a gap in which a favorable environment for the development of pathogenic bacteria is created.

Topographical classification

This is a gradation that distinguishes caries from the degree of canal damage. It is the same common in the definition of a diagnosis, as is the classification of caries in the ICD 10. The following stages of damage are determined:

1. Education spots. The initial stage, excluding the destruction of enamel. At this stage, a light or dark spot appears on the surface of the tooth. There is no damage in the structure of the enamel - it remains smooth, the pain does not bother. At this time, it is easiest to cure caries, since this occurs with minimal interference in the tooth tissue - the stain is removed from the surface, remineralization of the enamel is carried out.
2. Caries surface. This stage implies damage, the focus of which is not deeper than the area of tooth enamel. It is characterized by periodic pain and reaction to hot and cold. Treatment follows the same pattern as in the initial stage.
3. Average caries. The process has gone beyond the boundaries of the enamel and progresses in the area of superficial dentin, the pain manifests more intensively and more often. The treatment process involves cleaning the carious cavity and installing the seal.
4. Deep caries. The defeat of tissues is very difficult, the pulp protects only a thin layer of the preserved dentin, the patient experiences severe pain. If the filling is not performed in time, the disease can hit the pulp, and tooth extraction can not be avoided.

Classification by intensity

On the intensity of infection of the oral cavity, there are 2 types of the disease:

• Single tooth decay - affects one tooth.
• Multiple - the disease affects several teeth at once.

Among patients with multiple caries, people with diseases of the cardiovascular system are often found. If the disease affects the teeth of a child, most likely, he has had scarlet fever or tonsillitis. A careful prevention of multiple caries for a child of up to three years is the silvering of baby teeth.

Classification by education of complications

Untimely treatment of patients to the dentist with dental diseases is observed quite often. It is not difficult to guess what this ignoring of the problem is fraught with. Of course, today there is a classification of caries for complications. According to her, he happens:

• Complicated. The disease is accompanied by inflammatory processes in the oral cavity. A kind of flux is a kind.
• Uncomplicated. Classification of caries allows us to understand that this is a type of ailment proceeding according to generally accepted stages, including superficial, medium and deep.

The rate of development of the carious process

The development of the disease occurs in each person with varying intensity, depending on external factors and individual characteristics of the organism. There are several categories of caries:

1. Acute. Signs of the disease appear very quickly - within one to two weeks.
2. Chronic. The disease develops for a longer time and is characterized by the appearance of yellowish or brown spots on the affected surface of the enamel.
3. Flowering. Progressive type, in which multiple enamel lesions are observed in a relatively short time.

Features of the course of the disease in children

Classification of caries in children is carried out by the same criteria as in adults. In children's dentistry there is also a gradation in intensity, primary disease, the presence of complications, etc. The only distinguishing feature is the division into dental caries of a dairy and permanent tooth.

Carious lesions of the dairy organs cause no less discomfort than permanent diseases. In children, tooth decay occurs much more often than in adults, so it is necessary as early as possible to accustom the child to proper oral hygiene and to limit the consumption of sweet. Given that the baby teeth are still temporary, the tactics of treatment may be slightly different from the treatment of a permanent tooth.

Silvering of baby teeth in children

Modern parents with a preventive visit to the dentist face such a thing as silvering the teeth in a child. This procedure is carried out for the prevention and treatment of the initial stages of caries. In fact, the process is a "freeze" of the course of the disease.

The procedure is painless, during which the dentist applies a special composition containing silver to the tooth enamel with a cotton swab. The teeth form a protective film that prevents the deposition and development of pathogenic bacteria on the surface of the enamel.