Although dental hygiene habits have been improving over the years and certain campaigns and programs have helped to make people more aware, the fact is that the number of people with caries problems is still high. In addition, it should be taken into account that there are different types and that some of them are more unknown because they are difficult to detect, such as interdental or interproximal caries.
What is interdental caries?
Interdental caries are caries found in the area between the teeth and usually affect two adjacent teeth at the same time. This is because this area between the teeth is more prone to the accumulation of dental plaque and tartar and its cleaning is more complex than other parts of the tooth, especially in people with severe crowding or who wear fixed orthodontic appliances that make dental hygiene difficult.
These cavities reach the pulp area earlier because, in the interproximal areas, the tooth enamel becomes thinner as we get closer to the root of the tooth, so cavities that start in the middle and lower part of the tooth are more susceptible to decay. Progress more rapidly as they have less enamel surface area to go through.
The symptoms of this type of caries are the same as those of any other caries. These are dental sensitivity to cold, heat or sweets and as it advances towards the dental pulp, the pain becomes more intense and can even infect and necrotize the nerve of the tooth.
How do you know if you have interdental caries?
To make a good diagnosis of this type of caries, it is necessary to take radiographs where we can perfectly see the point of contact of the affected pieces, since we cannot see the dental surface with the naked eye except when we have a great affectation of the dental structure.
To avoid the appearance of these cavities, prevention is the first step. The use of dental floss and interproximal brushes, fluoride mouthwashes, with particular emphasis on cases of crowding dental, prosthesis wearers and fixed orthodontics that may favour the retention of food between the teeth.
What is the treatment of interproximal caries?
Once interdental caries has been detected, it is advisable to treat it as soon as possible, since the affected surface is much thinner and the possibility of suffering an infection in the nerve is greater. When reconstructing the interproximal walls of teeth due to caries, it is necessary to take into account whether caries affect one or two adjacent teeth, which is quite common, since food debris retained between the two teeth ends up producing caries between them.
If the lesion is very small, remineralization treatment with fluoride can be attempted. If the caries are more advanced, we will proceed to remove them and reconstruct the teeth with composite.
When two teeth are affected, the ideal is to reconstruct both teeth in the same session. In this way, in addition to being more comfortable for the patient, we can better reconstruct the point of contact and prevent food debris from continuing to be impacted, thus facilitating interdental hygiene and making it easier for dental floss or interdental brushes to pass through.
When it comes to reconstructing the parts, we use common layering techniques with composites. In order to achieve a correct joint between the two parts, we use different die and wedge systems designed to achieve natural contact points predictably.
Once caries reconstruction has been performed, it is very important to remember the importance of proper dental hygiene, using electric toothbrushes, dental floss and interdental brushes, as well as a mouthwash to avoid bacterial recontamination of the interproximal surface.
Finally, it is also very important to insist on periodic maintenance check-ups to verify the perfect condition of the reconstructions, to rule out their appearance and to verify that the hygiene techniques are adequate.