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Hypoplasia of the enamel. Cervical caries

Enamel hypoplasia and cervical caries in children: causes, symptoms, treatment

Enamel hypoplasia in children is manifested as a violation of the development of hard tissues of one or more teeth, both temporary and permanent. This disease is not carious.

Hypoplasia is manifested by:

  • non-uniform enamel color (from white or yellow to dark brown),
  • changes in relief (depressions, grooves) are more common on the vestibular surface (facing the vestibule of the oral cavity).

Forms of hypoplasia

  • Systemic, when groups of milk and permanent teeth are affected. The defect appears on the cutting edges of the incisors and on the tubercles of the chewing teeth. Most often, parents notice an unsightly appearance of teeth in children, and the child, in turn, may complain of pain in the upper and lower jaw when eating sweet or cold food.
  • Local hypoplasia, in which one or more teeth are more often affected (a speck or depression appears on the enamel). The cause of the defect on the permanent tooth is an inflammatory process in the area of the roots of the baby tooth in the past, which affected the formation of the rudiment of the permanent tooth. That is why it is so important to take care of baby teeth and visit a pediatric dentist twice a year.
Hypoplasia

Causes of hypoplasia

The main reason for the development of hypoplasia on the teeth is a metabolic disorder at the time of the formation of the rudiments of teeth.

Pathological factors during intrauterine development include: Rhesus conflict between mother and child, toxicosis, infections (rubella, toxoplasmosis), taking antibiotics (tetracycline).

Factors related to the child's diseases: Down syndrome, cerebral palsy and other CNS lesions; rickets and childhood infections (measles, scarlet fever), hypo- and vitamin deficiency.

Patients with hypoplasia are most susceptible to the development of caries and its complications, especially with poor oral hygiene. It is necessary to visit a pediatric dentist regularly for preventive examinations and professional oral hygiene, identify defects in time and treat them in a timely manner.

Methods of treatment of hypoplasia

  • Restoration of the defect using composite material;
  • For deeper and more extensive defects, restoration with a crown.

The most insidious process in children with a milky bite is the so-called neck or bottle caries. Circular caries, in scientific terms.

The main causes of cervical caries in children

  • Poor oral hygiene. A large amount of soft plaque leads to a violation of the acid-base balance and demineralization (destruction) of the enamel occurs, as a result – the formation of a carious cavity.
  • Prolonged breastfeeding or bottle feeding with formula and juices. All these products are characterized by a high concentration of fermentable carbohydrates, including sucrose, which leads to active bacterial reproduction.
  • Vitamin A deficiency also leads to the development of circular caries in children, as the enamel becomes brittle and vulnerable to the effects of bacteria.

Symptoms of cervical caries

At the initial stages, cervical caries in children is asymptomatic. Further, as the disease progresses, symptoms such as enamel spots (yellow or brown), sensitivity when brushing teeth, and reactions to temperature and chemical stimuli appear. If symptoms appear, it is necessary to consult a dentist. During the examination, the doctor will determine the degree of disease activity, the number of affected teeth and the depth of the lesion, and suggest treatment options.

Depending on the degree of activity, cervical caries is divided into three types:

Compensated. Tooth damage occurs slowly, and examination reveals isolated enamel lesions. It is necessary to visit the dentist every 3 months and regularly remineralize (strengthen) the enamel at the reception and at home.

Subcompensated. Enamel lesions develop over several months. It is also necessary to regularly carry out hygiene and strengthen the enamel with fluorinated compounds. A single restoration of teeth with a composite material is possible, depending on the depth of the lesion.

Decompensated. Severe course, the carious process develops rapidly and spreads to neighboring teeth, is accompanied by acute pain and requires immediate treatment. Most often, with this type of lesion, dental treatment is performed under general anesthesia and the destroyed teeth are restored with crowns.

Cervical caries also develops on permanent teeth, especially during the eruption of the second molars. The reason is poor oral hygiene, an unbalanced diet, and the consumption of large amounts of carbohydrates. This process is detected during preventive examinations and, depending on the depth of the lesion, treatment is performed (restoration with composite material, fluoroapplicationHypoplasiaand).

EMC pediatric dentists perform all types of treatment for hypoplasia and cervical caries in children. With large amounts of damage, treatment under anesthesia is possible. If the baby is still small or very afraid, we offer nitrous oxide therapy.


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Questions and answers

Dermoid cyst and pregnancy
An ultrasound revealed a mass in my left ovary during the first pregnancy. I was told that it is a dermoid cyst. Five years have passed since then. I gave birth to a second child. An ultrasound was performed annually. There were differences in size, but not significant. Since I’m going to have the 3rd child, another
ultrasound was done today. The doctor said that the cyst had increased. I am concerned about it. Don't know where to start. What tests are needed? Thank you.
...more
Surgical treatment is strictly indicated in your case given the long history of the mass in the ovary and its rapid growth in recent times. In our clinic, we perform such an intervention laparoscopically through 3 small punctures. Patients go home next morning after the surgery and may return to work after 3 days.
This surgery must be as delicate to preserve healthy ovarian tissue (considering your reproductive plans) as radical at the same time to remove the mass together with the capsule. At the preoperative stage an expert level ultrasound with Doppler is required, as well as blood tests for Ca-125 and НЕ-4 tumor markers. The decision concerning the necessity of FEGDS and colonoscopy is taken based on the results of these tests.
...more
Total knee replacement
My mom suffers from gonarthrosis for the past three years. Despite treatment by injections the pain is still present. MRI revealed a meniscal tear in the posterior horn, the presence of small bony osteophytes on the patella, a small amount of fluid in the joint cavity (signs of exudative synovitis were detected)
joint space is asymmetrically narrowed in the medial segment. The pain is ongoing but the knee remains flexible. Tell me, please, whether the surgery is contraindicated for meniscal tear in case of arthrosis? Is it possible to do an arthroscopic surgery on the meniscus in our case or it should be «major» surgery? And what would you advice concerning knee replacement for the patient in the age of 57? What is the life time of the artificial joint?
...more
It is necessary to make an X-ray of the knee in direct projection in standing position. If it turns out that there is no medial cartilage in the medial area, then the knee replacement is the only solution. The age of 57 is normal for the prosthetics. Modern artificial knee joint (when properly placed of course) will
serve for a lifetime. You can make an appointment via phone +7 (495) 933-66-44.
...more
Kardanov Andrey
07 September 2016
Pain
I am 19 years old, professionally engaged in weightlifting. I did an arthroscopy of both knee joint a year ago, now feel pain in them and it prevents me from training at full capacity. I visited a traumatologist, and «osteoarthritis of 1 degree» was diagnosed. Could you advise me some medicines or anything else to
relief the pain? Thank you very much for the answer!
...more
First of all you should undergo an MRI and find out what was done at arthroscopy; if it’s really an arthrosis of 1 degree, hyaluronic acid injections are possible and physiotherapy is not required. Anyway, you are always welcome to consultation for thorough examination.
Question to Dr. Yakobashvili
Tell me, please, at which age child's hearing should be checked-up if we were informed at the hospital before discharge that one ear does not hear. At the moment the child’s age is 1.5 months. Thank you.
These tests done in the hospital are often false negative. Hearing can be tested now, it is necessary to make an appointment to the audiologist.
Cought
A child of 11 years old, suffers from cough for more than six months. The cough is dry, sometimes attack-like, mainly begins during the day, and often occurs before sleep. There is no cough at night. CBC is normal, glucose is 4.16, total IgE 111.80, Toxocara, Ascaride are negative, Cytomegalovirus, Mycoplasma are
negative, PPD test is negative as well. A chest x-ray is normal. We have already consulted with a therapist, otolaryngologist, pulmonologist, neurologist, gastroenterologist... the cough is still present. What should we do?
...more
First of all, there are no results of whooping cough testing among the results provided above. The disease cannot be ruled out, even if your child was vaccinated. The blood test for antibodies against the whooping cough germ is required (blood test for class M and G antibodies against Bordetella pertussis). Second,
even a slight increase in class E antibodies is a reason to visit an allergist and to perform an evaluation of respiratory function with bronchodilator. This method will detect a latent bronchial spasm in your child. Even if the results of the test will be normal, allergologist mast rule out the allergic nature of the cough even if it's not obstructive syndrome. Third, this cough can be due to gastroesophageal reflux. It is difficult to draw any conclusions having no data of gastroenterologist’s consultation. 24-hour acidity monitoring of the stomach and esophagus is carried out to confirm or exclude the presence of reflux. Fourth, you didn’t mention whether x-ray of nasopharynx and paranasal sinuses was done. Perhaps, after all, the pathology is associated with ENT organs.
...more

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