Cervical caries: what it is, causes and stages of damage

You have noticed a spot or a depression right at the gumline and do not understand how serious it is. Cervical caries is the destruction of the hard tissues of the tooth in the area where the crown transitions into the neck, at the edge of the gum. At first, caries may cause no symptoms, so it is often found during a routine examination.

What cervical caries is and where it occurs

Caries is a chronic disease of the teeth in which acids produced by bacteria destroy the hard tissues. The enamel is affected first: focal demineralization begins, then its organic matrix is destroyed, and a cavity forms in the dentin. The cervical form means that the lesion is located at the neck of the tooth, near the gum. Dental plaque most often accumulates on the posterior molars, slightly above the gumline on all teeth, and along the edges of fillings.

Causes of cervical caries

Bacteria in the mouth convert sugars and starch into acids. Together with food particles and saliva, they form a sticky plaque that begins to accumulate as early as 20 minutes after eating. If plaque is not removed, it hardens and turns into tartar. Acids damage the enamel, and enamel hydroxyapatites are sensitive to acids at a pH of 4.5. The risk is increased by frequent snacking, sticky food that stays on the teeth longer, lack of fluoride, and irregular hygiene. Smoking and excess alcohol are also considered unfavorable factors.

How cervical caries manifests and what it looks like

At first, there may be no symptoms at all. Later, white, brown, or black spots appear on the tooth, along with visible pits and cavities. Pain or a aching sensation occurs, especially after sweets, hot or cold foods, and sharp pain when eating and drinking. Cavities themselves usually do not hurt until they become very large and affect the nerves or cause a crack in the tooth.

• spots near the gum — white, brown, or black
• a visible pit or cavity on the tooth surface
• sharp pain from hot, cold, or sweet
• aching toothache after eating

Deep, advanced, and complex cervical caries: how they differ

Caries develops sequentially: first acids damage the enamel, then a cavity forms in the dentin, and without treatment the inner part of the tooth (the pulp) is destroyed and inflammatory complications arise, including abscess. In terms of "deep," "advanced," or "complex," dentists assess the depth and extent of the lesion. The more extensive the destruction, the more extensive the restoration: with a significant defect, a crown, root canal treatment, or tooth extraction may be needed.

How a dentist detects cervical caries

Most cavities are found at an early stage during a routine examination. The doctor may feel that the tooth surface is soft. X-rays show some cavities earlier than they are visible to the eye. Additionally, caries susceptibility is assessed: the oral cavity is examined and tests are performed — enamel staining, determination of plaque and bacterial traces, and tissue resistance to acids. This way the doctor understands how high the teeth's susceptibility is.

When to see a dentist

See a dentist if there is pain or discomfort in a tooth, sharp pain when eating and drinking, dark spots, and also if the gums hurt, swell, or bleed when brushing. Regular check-ups are needed even without complaints: if there has been no check-up for 2 years, make an appointment, and if under 18 years of age — after 1 year. Early treatment is less painful and less costly.

This alone is not a reason to call an ambulance; 103 or 112 — if the condition sharply worsens and signs of a life-threatening situation appear.

This material is for reference: it helps to understand the situation but does not replace a dentist's consultation — the decision on diagnosis and treatment is made by the doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer