What is interdental caries and how to avoid it?

How did my son's tooth break when everything was fine yesterday?

This question is very frequently asked in Velez & Lozano. Parents often tell us that while brushing or brushing their children's teeth, they notice a sort of tiny hole in one of the molars. What has happened? A interproximal caries o interdental.

This type of caries forms between two teeth, usually affecting only one or both of them. The cavity starts as a small hole that is imperceptible to the naked eye. But with the passage of time, this decay is increasing in size until the enamel on the outermost part of the tooth crumbles and ends up fractured and decayed.

Sometimes caries grows so large that it not only affects the enamel and dentine, but also the enamel and dentin. continues towards the nerve. When caries reaches the nerve, it can cause pain or infection, which can lead to a fistula or a gum abscess. In these cases we will have to perform an endodoncy ("kill the nerve") if we are talking about permanent teeth, or a pulpectomy, or pulpotomywhich is the name given to the endodontics in milk teeth.

Interproximal caries with fistula in the gingiva
Interproximal caries with fistula in the gum

But there is no need to go to this extreme in all cases. When the caries is still small and remains hidden, can be localised and diagnosed by X-rays. Sometimes it can be detected directly because a shadow can be seen under the tooth enamel. It is therefore very important to have check-ups every 3 to 6 months to prevent these cavities.

The paediatric dentist will take X-rays when he/she deems it appropriate, as thanks to them we can diagnose caries when they are smaller and repair them with a simple filling before they increase in size. In the case of early caries, the dentist will remineralise with resin infiltration techniques. and will not need to be filled. This prevents more invasive treatments.

Interproximal caries without enamel breakage

How to prevent tooth decay?

Brushing your teeth with fluoride toothpaste is essential for prevent the development of cariesbut it is not enough. As the teeth come into contact with each other, the toothbrush does not reach this area and does not remove the food debris that is retained. This happens especially between the middle molars, as they are larger and have a larger contact surface, although it can happen between any teeth that are next to each other. Therefore, as soon as we see that our children's teeth have come together, we will need the help of the dental floss or dental arches (flossers).

Interdental caries in the anterior teeth

Dental arches are especially recommended for children, as they require a very simple technique that they can do themselves if they are over 6 years of age. Even so, we must help them with the later teeth until they are sufficiently skilled. You can find archwires in any supermarket or pharmacy, in all colours and shapes, and we even encourage parents to use them too!

What is the correct technique for brushing my child's teeth?

The proper technique for brushing your teeth is as follows:

  1. Pass the dental arch between all the teeth, making a back and forth movement while we exert a little controlled pressure until we reach the gum and remove it with the same movement. It is important to be careful and control the movement, otherwise we may damage the gums and discourage the child from continuing to use it. Between the different applications, we will clean the remains of food that are left on the arch wire with a piece of paper or under water.
  2. Rinse with water and spit out the remains.
  3. Brush teeth with 1000ppm or 1450ppm paste according to their age and caries risk as determined by the paediatric dentist.
  4. Spit out any remaining paste, but do not rinse afterwards. You heard it right, it's not a mistake. We should not rinse after brushing our teeth so that the fluoride in the toothpaste stays on the teeth and remineralises. This also applies to adults.

With this care, together with a good diet, we will prevent the appearance of new cavities and maintain a healthy clean and healthy mouth.

If you notice that your child has a hole in one of his or her teeth and you would like to have it checked by a professional, we invite you to contact our specialists at Velez & Lozano.

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