[Overview]

Shallow caries is limited to the tooth surface, enamel caries occurs in the crown, and cementum caries occurs in the neck. Shallow caries located in the crown can be divided into pit and fissure caries and glossy surface caries. Generally speaking, shallow caries have no conscious symptoms and no obvious response to external physical and chemical stimuli, so it is often found in oral examination, and a few patients go to see a doctor because of the blackening of their teeth.

[Diagnostic Points]

1. Shallow pit and fissure caries

(1) There is discoloration around the pit and fissure, which is saturated with ink and opaque.

(2) there is a sense of roughness in the exploration; Or the probe tip can be inserted with a little force, and it is not easy to take out when it feels soft (acupuncture feeling); Or a shallow hole can be hooked with the probe tip.

2. Smooth surface with shallow caries

(1) The color of enamel changes, and it is chalky in the early stage, and it can turn to yellow-brown or brown with time.

(2) There are no conscious symptoms in the early stage of adjacent caries, and cold, hot, sweet, acid and other stimulating reactions are not easy to detect. Careful examination with probe or dental floss, X-ray film for early diagnosis.

Note: When shallow caries is suspected in the early stage, regular follow-up or other diagnostic methods, such as fluorescence display examination, are helpful for early diagnosis.

[Differential diagnosis and its basis]

1. Normal pit and fissure caries can be dark brown, but the pigment of pit and fissure caries is dispersed in ink, and sometimes probes can be inserted; However, the pigment in the normal pit and fissure can be scraped off, and there is no needle feeling and soft feeling during exploration. Some pits are deep and the pigment is heavy, which is difficult to scrape off or identify. Suspected dental caries should be diagnosed and observed regularly.

2. Mild enamel hypoplasia glossy surface shallow caries and mild enamel hypoplasia can show color and morphological changes, but glossy surface shallow caries have qualitative changes at the same time, that is, the enamel is loose, rough or soft, while mild enamel hypoplasia is hard and smooth when exploring the affected area. In addition, the position and position of their prone teeth are obviously different, which is also helpful for identification.

3. The damaged tooth surface of dental fluorosis is chalky or brown plaque damage, and the affected teeth are symmetrically distributed, with a regional epidemic history; It is hard and smooth when exploring the affected area.

[therapeutic principle]

1. Early caries with smooth surface can be treated by remineralization.

2. Drug therapy can be used for early superficial caries of deciduous teeth or early caries of glossy surface in the near replacement period of permanent molars.

3. If there is a substantial defect and a shallow cavity is formed, it should be filled and repaired to prevent the development of dental caries and restore the inherent shape, beauty and function of teeth.

[Case study]

One patient, male, 17 years old. Because the upper front teeth turn black, they need treatment.

Examination: There is a long oval yellow-brown area near the upper left 1 and the upper right 1, and the quality of exploration is soft. There is a hole about 3 mm long, 2 mm wide and 65438 0 mm deep in the mesial surface of the two teeth. I want to ask about its diagnosis, treatment and treatment precautions.

1. Diagnose upper left 1 near middle and shallow caries, and upper right 1 near middle and shallow caries.

Diagnostic basis: The mesial surfaces of both teeth have typical changes in color, shape and quality of caries, and shallow cavities have been formed. In this case, because the caries damage is limited to the enamel layer, the patient has no conscious symptoms.

2. Treatment of conventional caries removal, cavity preparation, disinfection, drying, cavity lining and photosensitive resin filling.

3. Precautions: Both teeth have caries in the mesial surface and are adjacent. Therefore, when filling teeth, we should pay attention to separating them with polyester film to keep each filling body independent.

[Thinking]

1. On the diagnostic points of superficial pit and fissure caries.

2. Try to describe the main points of diagnosis of superficial caries in glossy surface.

3. Please describe the main points of distinguishing superficial pit and fissure caries from normal pit and fissure caries.

Please describe the treatment principle of superficial caries.

5. Please describe the indications of drug therapy, remineralization therapy and pit and fissure sealant therapy.