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Abstract: This article introduces a young patient who came to the hospital with “painful ingrown food in the left lower posterior tooth after eating”. 3 days ago, the patient suddenly developed severe pain in the left lower posterior tooth after eating, and the pain was relieved automatically after a while, and was sensitive to external stimuli. Outpatient perfected the relevant examination, removed the decay and softened the cavity of carious tissue, ground the sockets, cleaned and dried them, and filled them with composite resin. And then the discomfort symptoms disappeared, the patient was satisfied.
Basic information】Female, 18 years old
Disease Type】36 maxillary caries (moderate)
Hospital】The Second Affiliated Hospital of Nanchang University
Consultation time】September 2021
Treatment plan] Decay removal + composite resin filling + follow up
Treatment period】Composite resin filling + 3-6 months follow-up
Treatment effect】Complete removal of decayed tissue, restoration of defective tooth tissue, disappearance of symptoms, patient satisfaction
I. Initial consultation
In September 2021, an 18-year-old female patient came to our hospital because of “pain of food imbedded in the left lower posterior tooth after eating”, and inquired about the medical history. The affected tooth reacts painfully to external stimuli (such as cold, hot, sour and sweet), and the pain disappears immediately after the stimulus is removed, without spontaneous pain. Today, the patient came to the hospital because the pain reappeared in the left lower posterior tooth when eating. Physical and dental examination: 36 cavities were seen on the jaw surface, brown-black in color, with food residue, softened dentin and other decaying matter inside the cavity. The probe was sore and did not penetrate the pulp, and there was a small amount of soft tartar and tartar around the gingival edge of the tooth, which was red in color, soft in texture and bleeding when touched. The intraoral small tooth film showed that the bottom of 36 maxillary cavities was far from the pulp cavity, and the rest did not show any abnormalities.
Treatment process
After perfecting the relevant examination to assess the condition, the patient was diagnosed as 36 maxillary caries (moderate) according to the patient’s clinical manifestation and auxiliary examination, and the patient had no special contraindication. Treatment: Communicate with the patient and explain the situation of the affected teeth, treatment plan and related cost, the patient agreed to the treatment plan, took intra-oral preoperative photos of the patient and signed the informed consent form. 36 maxillary caries remove the decay and soften the cavity of the decayed tissue, grind the fossa well, clean it, put on the rubber barrier, acid etching, cleaning, drying, use the composite resin filling, restore the natural state, shape and occlusal function of the tooth itself after filling. The filling restores the natural state, shape and occlusal function of the tooth. Conventional treatment is applied to terminate the lesion and preserve the tooth. The patient is advised to come to the hospital for follow-up if discomfort is evident. Oral hygiene education, good patient follow-up, strict compliance with medical advice and follow-up time.
Treatment effect
The patient’s pain symptoms disappeared and was satisfied with the treatment and restoration effect, as the attending doctor, I also felt very pleased. I dictated the medical advice to the patient and followed up when there were uncomfortable symptoms.
IV. Precautions
1.After the composite resin filling treatment, it is suggested that the patient should try not to eat too hard food in the near future, and avoid too strong hot and cold stimulation to prevent the caries near the pulp and stimulate the pulp, and the cold and hot stimulation pain may occur. If the tooth has severe pain or even spontaneous pain after the composite resin filling, it is necessary to go to the hospital for follow-up consultation in time.
2.Because of the insidiousness and destructive nature of this disease, it often leads to chronic progressive irreversible destruction of patient’s teeth, so early prevention and early and thorough treatment are significant. Because of the occurrence of secondary caries, patients should strengthen the regular review and maintenance of dental caries.
V. Personal insight
Caries is a chronic progressive irreversible destruction of dental hard tissues caused by many factors, and the susceptible host, oral bacteria, acid-producing food and sufficient time are four important factors of caries, which interact with each other and are indispensable. Therefore, special attention should be paid to grasp these four important factors to realize early prevention, early diagnosis and early treatment of dental caries. When making the diagnosis of dental caries, it should be distinguished from the diseases such as tooth sensitivity and chronic pulpitis. In addition, the prevention of secondary caries and how to improve the aesthetic restoration effect of caries in anterior tooth area are also the difficult problems that need to be explored in this disease.