Why do teeth crumble and what to do?

With each year, dentistry rises one step higher, expanding the range and scale of treatment of dentoalveolar pathologies. The newest drugs are being discovered, more effective methods of treatment and prevention of dental diseases are being introduced. However, in connection with total urbanization, increased rhythm of life, lower environmental indicators, dental diseases are still a serious problem in the life of each person. One of these conditions is the destruction of hard tissues of the teeth. 

Why do your teeth crumble?

Quite often in a certain period of his life a person, noticing the problems with his teeth, starts to wonder why teeth are crumbling? This can occur against the background of systemic pathologies, pregnancy, after moving to an industrial city, entering a responsible position in a large institution. Also, serious factors are: low stress resistance of the person, excessively slow adaptation to new circumstances, complex family circumstances. Considering the versatility of the concept of "crumbling teeth", let us consider the most common causes of this problem.

Caries, pulpitis and depulpation of the tooth

Caries is one of the most common causes of tooth decay. Carious process is a demineralization of hard tissues of teeth. The causative agents of this disease are streptococci of the cariogenic group (Str. Mitis, Str. Sanguis, Str. Mutans and Str. Salivarus). After the occurrence of plaque, the above microorganisms begin to multiply in it. As a result of the active life of streptococci, various metabolic products, enzymes, toxic substances are isolated. As a result, the mineral components of the tooth "dissolve", which leads to the appearance of a spot of demineralization, then - a defect, cavity and finally total destruction of the tooth. Risk factors for carious process development are unsatisfactory hygiene of the oral cavity, reduced intake of micro- and macro elements (especially phosphorus and calcium), gastrointestinal tract, endocrine and nervous system, salivary glands, etc.

Clinically, caries can be invisible, or, on the contrary, attract all the attention of a sick person. Everything depends on the stage and type of pathological process. The first signs of caries are the appearance of a petiolar spot on the tooth. Since the enamel of the tooth normally has a natural glossy sheen, caries in the stain will be visually determined, since it has a matte surface. Of course, we are only talking about cases where the pathological process is on the visible parts of the tooth. Most often it is the labial surface of incisors, canines and small molars. In other cases, patients rarely notice focal discoloration of the tooth. This is due to the fact that the initial form of caries is not accompanied by painful sensations.

Surface caries suggest a defect in the tooth tissues. This stage of carious process is accompanied by painful sensations, but massive destruction of tooth tissues is not determined. Therefore, a visit to the dentist, careful removal of the affected tissues and the establishment of a quality seal can for many years stop the progression of the pathological process in this tooth.

Medium and deep caries are the stages of the carious process, in which the demineralization of hard tooth tissues with a noticeable loss of the tissues of the crown part of the tooth often occurs. In some cases, caries begins at the distal (posterior) portions of the tooth crown, and then spreads into the interior of the dentin. It should be noted that in dentin caries extends its boundaries faster than in enamel. Due to this, in the enamel the carious cavity can be narrow, and in the dentin - exceed the first several times. As a result of this insignificant destruction, a person at some point will come to the doctor and say that his tooth hurts and crumble without an obvious reason.

As a special form distinguish blossoming (generalized, multiple) caries - it occurs more often in children under 6 years. This is because in this period children have temporary teeth. As is known, enamel of milk teeth is thin and porous. This allows cariogenic microorganisms to easily penetrate into the tooth tissues, multiply there and provoke the emergence of a carious process. The low content of protective immunoglobulins in the saliva of the child's organism also contributes to the successful functioning of streptococci. At risk are children with pathologies of immunity, mineral metabolism, salivary glands and genetic diseases. The clinical picture of multiple caries is never left without attention. The child begins to complain of pain, which appears in several teeth. Parents often lead a child to the dentist with complaints that his baby teeth are crumbling. When examining a large number of teeth affected by caries.

Treatment of caries consists in removal of the affected tissues and in the implementation of direct restoration. Most often, composite materials are used for this, which allow achieving an aesthetic result and reliable restoration of the anatomical and functional integrity of the tooth. If there is a flowering caries or caries in pregnant women, a special approach is required, in which the general condition of the organism will be taken into account and corrected.

Prevention of caries is an important principle of maintaining healthy teeth. Since the main condition for the appearance of streptococcus accumulations is dental plaque, prevention of caries should begin with regular oral hygiene. If you do not create comfortable conditions for the life of streptococci, the risk of their occurrence is minimized. Also it is necessary to think, than to strengthen a teeth that they did not crumble. To do this, there are special pastes that contain the necessary elements (calcium, phosphorus, magnesium, zinc, etc.). Examples of toothpastes with similar compositions are: Colgate "Enamel Health", Blend-a-med "Anti-caries", etc. It should also be noted oral paste B "Biorepair", which contains substances that suppress the vital activity of cariogenic bacteria (in particular Str. Mutans). An excellent means of preventing caries is the procedure for remineralization of teeth. To do this, there is a special ROCS gel "Medical minerals" (gel ROKS "Medical Minerals"). It is applied to the teeth every day after brushing your teeth for 30-40 minutes. In the market there are many varieties of this gel, taking into account age and taste preferences. According to the manufacturer, this product is the source of the necessary mineral components, which form the structure of the tooth.

Destructive and erosive forms of fluorosis

Fluorosis is a dental disease of an endemic nature. This pathology occurs in people who live in a district with a fluoride content in drinking water of about 1.6 - 2.0 mmol / l. It should be noted that in view of the individual characteristics of the body, not all people manifest this disease. However, in the case of this disease, serious aesthetic and functional disorders are noted. The pathogenesis of fluorosis, like most non-carious lesions of teeth, has not been fully studied. At the moment it is believed that at the stage of development of the teeth rudiments excess fluoride in the body leads to the formation of a specific compound - fluorapatite. In comparison with hydroxyapatite, which normally forms tooth enamel, fluorapappatite is a more fragile substance, which leads to increased erosion of the teeth and the formation of defects. The clinical picture of erosive and destructive forms of fluorosis is quite specific. At children at eruption of a permanent teeth brown defects on enamel are defined. It is worth noting that the lesion is symmetrically located, for example, on the canines on the right and on the canines on the left. Also a feature of fluorosis is the fact that a single tooth may have several spots. The presence of fluorosis is most often noticed by the parents of their child. They complain that the child had teeth with dark spots. The child himself most often feels the consequences of the destruction of the dental tissues, which manifests itself in the form of defects, chips, abrasion, etc. Diagnosis of fluorosis does not cause difficulties. Living in an endemic zone and the nature of lesions clearly indicate the presence of the disease examined. Treatment of fluorosis is the restoration of affected teeth with the help of restoration materials or non-removable structures (crowns, veneers, etc.). To prevent this pathology, you should monitor the intake of fluoride into the body. To do this, drink defluorated water and use toothpaste without fluoride.

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Erosion of teeth

Erosion of teeth is a non-carious lesion, which manifests itself in the form of enamel and dentin defects on the outer (vestibular) surface of the tooth. The cause of this disease has not yet been fully clarified. Like some other non-carious lesions, erosion "surrounded" itself with a set of etiological theories. Interestingly, some theories contradict even the very term "erosion". For example, the chemical theory assumes that different chemical substances, for example, acids, act on hard tooth tissues. They are found in citrus fruits, confectionery, soda and other products. However, in physics, the effects of chemicals on the body are called corrosion. But, in connection with the uncertainty of the true cause of the disease, even its name can not be formulated clearly. The mechanical theory is that different abrasive substances (toothbrushes, pastes, hard food, foreign objects) affect the tooth. In considering this theory, the term "erosion" sounds more logical, since it consists in the mechanical action of a liquid or air on the surface of a physical body. However, this version of erosion as well as the previous one did not receive the necessary scientific justification. The third theory says that the cause of erosion is hyperthyroidism. It has been scientifically proven that in people with hyperthyroidism, tooth erosion occurs 2 times more often than in healthy people.

The clinical picture of this disease is reduced to the fact that a person without obvious causes first appear matte spots, and then defects on the vestibular surface of the teeth. The foci of the lesion become narrower as the depression deepens, which is why the defects are called cup-like. Subjectively, erosion occurs only after a transition from the spot stage to the defect stage. A person has an increased sensitivity to cold and acidic foods. Without clinical examination, erosion is difficult to distinguish from caries, wedge-shaped defect and other lesions of hard tooth tissues. Therefore, a person who is professionally unrelated to dentistry will complain that his teeth are crumbling.

The question "How to treat erosion?" Can not be answered clearly, as the etiology of the disease remains unclear. Therefore, the therapy consists in eliminating the symptoms of the disease, risk factors and strengthening of hard tooth tissues.

[2], [3]

Chef muscles parafunctions

The work of the chewing muscles of a person is closely related to the state of his teeth. When different parafunctions occur, the muscles contract with excessive force, which leads to increased strain on the teeth. Moreover, with some types of parafunctional activity, the jaw performs lateral and anteroposterior movements, which provokes abnormal abrasion of the teeth. There are two most common types of parafunctions of chewing muscles - bruxism and klench.

Bruxism is a parafunction of the masticatory muscles of the central genesis. During the development of dentistry, a number of risk factors for bruxism were identified, but the main reason was not so established. Scientists who study sleep and the associated limbic system of the brain, argue that the cause of bruxism is a violation of the function of sleep. Some dentists who are engaged in gnathology and the study of occlusal relationships (contact between teeth), suggest that the cause is obstruction from the teeth. The most logical was the theory, which says that bruxism is a protective reaction of the body, directed at combating stress. As the modern world is developing very dynamically, the rhythm of life is constantly accelerating, and the amount of new information is increasing. This leads to the fact that a person has many problems, the solution of which is not enough time and energy. Moreover, highly paid professions require a high level of responsibility, which supplements the stressful state. If to add to this other factors such as lack of sports, love relationships, new pleasant impressions and rest, then a person begins a state of chronic stress. As you know, stress is the most "universal" risk factor for diseases. Diabetes mellitus, oncological, cardiovascular diseases - all this can be triggered by chronic emotional stress. If the stress is reduced, then the risk of these diseases also decreases. Consequently, with bruxism, the body reduces emotional stress through muscle activity. This raises the question: "What is worth treating? Bruxism or mental state? "

The mechanism of bruxism can be characterized as follows. An impulse to the muscles comes from the central nervous system. The chewing musculature slides with a force that is 6 times stronger than the usual contraction force when chewing. In this case, the lower jaw can move forward and deviate to the sides, performing these movements throughout the whole cycle of bruxism. The duration of the attack is from 5 seconds to several minutes.

The clinical picture of bruxism is characterized by tooth erosion, enamel fissures, abrupt fractures and chipped. Some patients, observing the above signs, complain that their teeth are crumbling and aching. However, all this is not due to weakened teeth, but due to the increased strain on them.

Klench - a kind of muscular parafunctional activity, in which the clenching of teeth without lateral and anteroposterior movements of the jaw occurs. Those. The lower jaw moves only in the vertical direction. Complaints for the klenche are about the same as for bruxism, the difference is only that the tooth abrasion is less pronounced.

Diagnosis of bruxism is carried out only in clinical settings. A complete history, a study of the tone of the masticatory muscles, and their palpation are performed. On examination, attention is drawn to the erosion of the teeth and the presence of gum recessions. The analysis of diagnostic gypsum models in the articulator is also carried out. This allows you to determine occlusal relationships and identify points on the teeth that create obstacles to the movement of the lower jaw. One of the diagnostic techniques is the comparison of the facets of erasure. The method consists in setting the LF in such a position that the upper and lower incisors contact each other. From this position the LF deviates to the left or to the right and finds the maximum correspondence between the planes of the upper and lower teeth. Most often, this position is 1 to 3 cm to the left or to the right of the center position of the LF.

A more accurate technique for diagnosing bruxism is Brockers. They are special kappas that a person puts on for the night. A thin color coating of the mouthpiece allows the opposite teeth to leave prints on it, which will allow the doctor to see "unwanted contacts". Diagnosis of the klencha is also based on the study of chewing muscles and occlusal relationships.

The treatment of parafunctional activity today is quite abstract. Until the cause of the disease is established, it is considered to be polyethological. And if it is polyethological, then the effect on its cause is initially impossible. Therefore, therapy is aimed at reducing symptoms and eliminating tooth erosion. In the presence of chronic stress, a course of psychotherapy is prescribed. To protect the teeth and periodontal special cuts are used. In the presence of unwanted contact of teeth, selective teeth polishing is performed. If the patient has incorrectly positioned teeth or defects in the dentition, then necessary is orthodontic treatment and rational prosthetics.

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Abfractions

Ablation (wedge-shaped defect) is a non-carious lesion of the teeth, in which V-shaped foci of destruction of hard tissues appear in the cervical region. Many researchers believe that the nature of wedge-shaped defects is polyethological. Some scientists build their hypotheses, which are associated with mechanical and chemical stimuli. However, the most logical at the moment is the theory of lateral load on the teeth. It so happened that the anatomical shape of the teeth is carefully thought out by nature. Human teeth can easily withstand chewing. Powerful roots, the right inclination of the teeth, the optimal shape of the mounds on the chewing surfaces - all this contributes to the ideal distribution of the load on the teeth. However, if its direction is wrong, the strength and time of exposure is exceeded, then the hard tissues of the tooth begin to experience stress. Such a situation can be observed with bite pathologies, periodontal diseases (tooth mobility), dentition defects (when the chewing load is distributed to the remaining teeth), parafunctions of the masticatory muscles (bruxism), etc. All these conditions can lead to the appearance of a wedge-shaped defect. For a better understanding of pathogenesis, one can imagine how the dry branch of a tree breaks down. When you try to bend it on the outside of the bend, there is a stretching zone, and on the inside - a compression zone. If we talk about the tooth - then for him the compression zone will be the vestibular surface, and the stretching zone - oral. Since there is no space for cells in the stretching zone, the distance between them is first increased, and then decreases without visible influence on the state of the tooth tissues. In the compression zone, the situation is different: as a result of external action, the cells squeeze each other, leading to V-shaped destruction of enamel and dentin. The clinical picture of this lesion remains unnoticed for a long time. This is due to the slow progression of the disease and the absence of acute symptoms. However, at some point a person begins to complain that the tooth enamel is crumbling. Diagnosis of a wedge-shaped defect is also fairly simple: a V-shaped defect is observed, the surface of which is covered with unaltered hard tissues (enamel or dentin). Treatment of this condition should begin with the exclusion of predisposing factors of the disease, which were mentioned earlier. Only with this condition can begin restoration treatment of affected teeth. Restoration of the function and aesthetics of the teeth is performed with the help of filling materials, ceramic veneers and crowns.

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Pregnancy

The period of pregnancy for a woman is one of the most crucial stages in her life. However, it should be noted that this condition sometimes causes significant damage to the health of the future mother. This is due primarily to the restructuring of the hormonal background and the preferred direction of nutrients through the placenta to the fetus. Given the fact that the fetal bone structures are formed in the first trimester of pregnancy, the mineral components enter the placenta in a rather large amount. Thus, already in the first trimester of pregnancy a woman may have a deficit of mineral components. Most often, pregnant women complain that their hair falls out, teeth and nails crumble. In addition to calcium deficiency, the body becomes more sensitive to external stimuli and is vulnerable to pathogens of various diseases. Activation of saprophytic flora leads to the fact that even relatively harmless diseases occur in a rather aggressive form. The same tooth decay, for example, in an ordinary person can be a single phenomenon, in which one tooth is affected, while in a pregnant woman, caries can acquire the character of a multiple and rapidly progressing. Fear of medical intervention during pregnancy can force a woman to endure the pain and postpone the visit to the postpartum period. However, with this approach towards the end of the third trimester, it is possible to lose several teeth in view of their total destruction and loss. The clinical picture in each individual case is different. If tooth decay progresses not too aggressively, a pregnant woman can complain about falling out of old fillings and on getting cold, hot and sweet food into the tooth. In the case when caries progresses fairly quickly, people complain that their teeth are crumbling one by one. Immediately in several teeth appear carious spots, and then cavities. Very often, these problems are complicated by pulpitis and periodontitis, which requires anesthesia and endodontic treatment. To prevent these complications, you need to contact the dentist on time to perform the diagnosis. It consists in an instrumental examination of the teeth, in which areas of demineralization (caries) are identified. Caries detectors are often used to detect the carious process. These are special pigment solutions that stain only the affected solid tooth tissues. Treatment of caries assumes, first of all, the removal of all softened tissues. This can be done using rotating tools (boron machines) or by carrying out manual extraction of soft tissues with an excavator. Then, the cavity is filled with one of the materials (composite, cement, compomer, etc.). The choice of material depends on the depth and location of the lesion, as well as the economic and aesthetic preferences of the patient.

Conclusion

If you notice that your teeth begin to crumble, try to find the main cause of this condition (poor hygiene, stress, diseases of other organs, pregnancy, job change or the parallel existence of these factors). Analyze the latest events that have occurred in your life and try to note psychologically and physically the most difficult for you. Perhaps the fact that your teeth are crumbling is one of the symptoms of a very different disease. Unfortunately, the society has developed such a tendency that people do not consider it necessary to devote a dentist to their life and their general health. However, this will only make the patient worse. The dentist will do his job: remove plaque, perform restoration of teeth. But the further forecast remains in the hands of the patient. If he continues to work in harmful production, the teeth will continue to crumble quickly. If a person can not get out of the state of depression, then he may have other, more serious illnesses. As a result, the next time this patient will turn to the dentist with a more aggravated state of the dentoalveolar system. So do not postpone tooth problems for an uncertain future. You should look at your body in a complex way, as a single fragile mechanism, where the psychological and physical components are closely interrelated and require a trembling attitude towards themselves.

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