Wedge-shaped defect
The content of the article:
- Causes of wedge-shaped teeth defect
- Disease stages
- Symptoms
- Diagnostics
- Treatment of wedge-shaped teeth defect
- Treatment of a wedge-shaped tooth defect at home
- Potential consequences and complications
- Forecast
- Prevention
A wedge-shaped defect is a non-carious lesion of the dental tissue, characterized by the formation of a wedge-shaped (cone-shaped) section of enamel loss in the area of the tooth neck. The disease is widespread, diagnosed in about 25-30% of middle-aged and elderly people. However, the initial manifestations of enamel defects or the prerequisites for their further formation with a special examination can also be detected in young people.
Wedge-shaped defect - carious damage to the enamel in the area of the tooth neck
Causes of wedge-shaped teeth defect
Currently, the exact cause of the wedge-shaped defect in the teeth is unknown. The most common theories are:
- Mechanical abrasion. Explains the development of an enamel defect by the use of low-quality pastes with large abrasive particles and / or brushes with a hard bristle for cleaning teeth, rough removal of tartar or plaque, horizontal teeth cleaning technique.
- Chemical erosion. She sees the main reason for the wedge-shaped defect in the teeth in the systematic use of carbonated drinks and lozenges, which contain acids that can gradually destroy the enamel layer.
- Physical and mechanical impact (load theory). Associates the formation of a defect in the enamel layer with an irregular bite.
Dentists note that wedge-shaped teeth defects are much more often detected in patients suffering from diseases of the gastrointestinal tract (colitis, gastric ulcer and duodenal ulcer, reflux esophagitis) and the thyroid gland.
The pathological mechanism of the formation of a wedge-shaped defect is associated with two types of force effects on the teeth that occur at the moment of chewing (tension force and compression force). The greatest mechanical impact occurs in the area of the dental neck. As a result, bonds are broken between the hydroxyapatite crystals that form the enamel layer, which leads to the formation of microscopic defects. Further force, chemical or mechanical action leads to an increase in these defects, the formation of cracks of a characteristic type in their place.
Disease stages
In the clinical course of a wedge-shaped defect of teeth, 4 stages are distinguished:
- The stage of initial changes. During a normal examination, a wedge-shaped defect is not detected; it can only be detected using a special magnifying device.
- Stage of superficial lesions. The enamel defect is clearly visible to the naked eye, looks like a small crack up to 3.5 mm long and up to 0.2 mm deep. There is an increased sensitivity (hyperesthesia) of the affected tooth.
- Stage of moderately pronounced changes. There is an increase in the size of the wedge-shaped defect up to 4 mm in length and up to 0.3 mm in depth. Upon closer examination, it is noticeable that the defect is formed by two planes converging at an angle of 45 °.
- Deep propagation stage. The lesion center deepens to the pulp chamber and lengthens over 5 mm.
Stages of wedge-shaped defect
In patients under 35 years old, only the first two stages of the disease are usually observed, the last two are characteristic of persons of mature and old age.
Symptoms
The course of the wedge-shaped tooth defect is slowly progressive. It usually affects premolars, canines, and incisors, but it can also occur on molars. Defects are often multiple and are located on symmetrical teeth.
In the initial stages, the surface of the wedge-shaped defect remains smooth and dense, practically not differing from the surface of healthy enamel (this is the main difference from caries). Starting from stage III of the disease, pigmentation appears, which is associated with the spread of the defect to dentin. At stage IV, the neck of the tooth is exposed, which leads to the development of periodontal disease and fracture (chipping) of the dental crown.
Diagnostics
A wedge-shaped defect is diagnosed during a dental examination. This takes into account the density of the tissue, the shape and localization of the focus, differential diagnostics with cervical caries, tooth erosion and other dental pathologies are carried out.
The diagnosis of clinophide defect is made on the basis of a dental examination
Patients with multiple wedge-shaped defects should be consulted by a gastroenterologist and endocrinologist to exclude concomitant pathology.
Treatment of wedge-shaped teeth defect
Treatment of a wedge-shaped defect in teeth is carried out in several directions: therapeutic, orthopedic and, if necessary, orthodontic. Therapy of the disease also includes the elimination of the factors that caused its development:
- selective grinding of teeth to optimize occlusion;
- teaching the patient correct oral hygiene (correct selection of toothbrush and toothpaste, vertical cleaning technique);
- refusal to use carbonated drinks, especially sweet ones.
With a superficial defect, complex remineralizing therapy is indicated:
- taking vitamin and mineral complexes;
- deep fluoridation of enamel;
- enamel strengthening by application of sodium fluoride and calcium gluconate solutions.
Deeper defects of the dental surface need to be closed with a filling made of compomer or glass ionomer materials, a flowable light-cured composite. If necessary, orthopedic treatment is carried out - using veneers or crowns, as well as orthodontic - as a rule, it consists in installing a bracket system.
For deep wedge-shaped teeth defects, orthopedic treatment is used
If a patient is diagnosed with diseases of the gastrointestinal tract or thyroid gland during a detailed examination, their treatment is carried out by specialists of the appropriate profile.
Treatment of a wedge-shaped tooth defect at home
Traditional medicine for the treatment of a wedge-shaped tooth defect at home recommends:
- rinsing the mouth with calendula infusion 5-6 times a day;
- rubbing teeth and gums 3-4 times a day with a cotton swab dipped in a solution of sea salt (1 tsp per 100 ml of water);
- rubbing cranberry gruel into the gums several times a day;
- rinsing the mouth with decoctions of chamomile or oak bark.
However, all these methods can only slightly reduce the increased sensitivity of a diseased tooth to chemical (sweet) and thermal (cold, hot) irritants, but do not affect the further progression of enamel destruction. To strengthen the enamel, it is necessary to periodically carry out fluoridation and remineralization procedures. Patients can perform them on their own using special pastes, gels, rinses. Naturally, they should be used only on the advice of the attending physician.
Potential consequences and complications
The progressive wedge-shaped defect is complicated by the growing hyperesthesia of the affected tooth. The tooth reacts painfully to various mechanical, chemical and thermal stimuli, serving as a constant source of discomfort.
In the absence of treatment, significant destruction of dental tissues occurs, after which, under the influence of even a slight load, the tooth breaks in the neck area. Loss of a tooth is usually preceded by severe pulsating pain caused by the development of pulpitis (inflammation of the neurovascular bundle of the tooth). Untreated pulpitis, in turn, can cause periodontitis, periodontitis, root cysts, periostitis.
The oral cavity is the initial part of the gastrointestinal tract, dental diseases lead to a deterioration in the chopping of food, which negatively affects the entire process of digestion, and therefore affects the body as a whole.
Forecast
If measures are not taken, the wedge-shaped defect progresses steadily and ultimately becomes the cause of the loss of the affected tooth.
Treatment methods for the disease are imperfect. Seals should be replaced as needed. Veneers and crowns provide a good cosmetic effect, but they are not able to prevent damage to adjacent teeth. Therefore, even a cured wedge-shaped defect requires medical supervision.
With regular dental checkups and timely treatment, the prognosis is good.
Prevention
- Regular preventive examinations by the dentist.
- Timely correction of the wrong bite.
- Refusal to use sugary carbonated drinks.
- Mastering the correct method of (vertical) brushing your teeth.
- Correct selection of toothpastes and brushes.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
