teeth (human)
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The human teeth function to mechanically break down items of
food Food is any substance consumed by an organism for nutritional support. Food is usually of plant, animal, or fungal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals. The substance is inge ...
by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines,
premolar The premolars, also called premolar teeth, or bicuspids, are transitional teeth located between the canine and molar teeth. In humans, there are two premolars per quadrant in the permanent set of teeth, making eight premolars total in the mouth ...
s, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla (upper jaw) or the mandible (lower jaw) and are covered by gums. Teeth are made of multiple tissues of varying density and hardness. Humans, like most other mammals, are
diphyodont A diphyodont is any animal with two ss of tooth (animal), teeth, initially the ''deciduous teeth, deciduous'' set and consecutively the ''permanent teeth, permanent'' set. Most mammals are diphyodonts—as to chew their food they need a strong, dura ...
, meaning that they develop two sets of teeth. The first set,
deciduous teeth Deciduous teeth or primary teeth, also informally known as baby teeth, milk teeth, or temporary teeth,Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 255 are the first set of teeth in the ...
, also called "primary teeth", "baby teeth", or "milk teeth", normally eventually contains 20 teeth. Primary teeth typically start to appear (" erupt") around six months of age and this may be distracting and/or painful for the infant. However, some babies are born with one or more visible teeth, known as
neonatal teeth Natal teeth are teeth that are present above the gumline (have already erupted) at birth, and neonatal teeth are teeth that emerge through the gingiva during the first month of life (the neonatal period). The incidence of neonatal teeth varies c ...
or "natal teeth".


Anatomy

Dental anatomy is a field of anatomy dedicated to the study of tooth structure. The development, appearance, and classification of teeth fall within its field of study, though
dental occlusion Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the maxillary (upper) and mandibular (lower) teeth when they approach each other, as occurs during chewing or at rest. Stati ...
, or contact between teeth, does not. Dental anatomy is also a
taxonomic Taxonomy is the practice and science of categorization or classification. A taxonomy (or taxonomical classification) is a scheme of classification, especially a hierarchical classification, in which things are organized into groups or types. ...
science as it is concerned with the naming of teeth and their structures. This information serves a practical purpose for dentists, enabling them to easily identify and describe teeth and structures during treatment. The anatomic crown of a tooth is the area covered in enamel above the cementoenamel junction (CEJ) or "neck" of the tooth. Most of the crown is composed of
dentin Dentin () (American English) or dentine ( or ) (British English) ( la, substantia eburnea) is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by ena ...
("dentine" in British English) with the pulp chamber inside. The crown is within bone before eruption. After eruption, it is almost always visible. The anatomic root is found below the CEJ and is covered with cementum. As with the crown, dentin composes most of the root, which normally has pulp canals. Canines and most premolars, except for
maxillary Maxillary means "related to the maxilla (upper jaw bone)". Terms containing "maxillary" include: * Maxillary artery *Maxillary nerve In neuroanatomy, the maxillary nerve (V) is one of the three branches or divisions of the trigeminal nerve, ...
first premolars, usually have one root. Maxillary first premolars and mandibular molars usually have two roots. Maxillary molars usually have three roots. Additional roots are referred to as supernumerary roots. Humans usually have 20 primary (deciduous, "baby" or "milk") teeth and 32 permanent (adult) teeth. Teeth are classified as incisors, canines,
premolar The premolars, also called premolar teeth, or bicuspids, are transitional teeth located between the canine and molar teeth. In humans, there are two premolars per quadrant in the permanent set of teeth, making eight premolars total in the mouth ...
s (also called ''bicuspids''), and molars. Incisors are primarily used for cutting, canines are for tearing, and molars serve for grinding. Most teeth have identifiable features that distinguish them from others. There are several different notation systems to refer to a specific tooth. The three most common systems are the
FDI World Dental Federation notation FDI World Dental Federation notation (also "FDI notation" or "ISO 3950 notation") is the world's most commonly used dental notation (tooth numbering system). It is designated by the International Organization for Standardization as standard ISO 3 ...
(ISO 3950), the Universal Numbering System, and the Palmer notation. The FDI system is used worldwide, the Universal only in the United States, while the older Palmer notation still has some adherents only in the United Kingdom.


Primary teeth

Among deciduous (primary) teeth, ten are found in the maxilla (upper jaw) and ten in the mandible (lower jaw), for a total of 20. The dental formula for primary teeth in humans is . In the primary set of teeth, in addition to the canines, there are two types of incisors—centrals and laterals—and two types of molars—first and second. All primary teeth are normally later replaced with their permanent counterparts.


Permanent teeth

Among permanent teeth, 16 are found in the maxilla and 16 in the mandible, for a total of 32. The dental formula is . Permanent human teeth are numbered in a boustrophedonic sequence. The maxillary teeth are the maxillary central incisors (teeth 8 and 9 in the diagram),
maxillary lateral incisor The maxillary lateral incisors are a pair of upper (maxillary) teeth that are located laterally (away from the midline of the face) from both maxillary central incisors of the mouth and medially (toward the midline of the face) from both maxillary ...
s (7 and 10),
maxillary canine In human dentistry, the maxillary canine is the tooth located laterally (away from the midline of the face) from both maxillary lateral incisors of the mouth but mesial (toward the midline of the face) from both maxillary first premolars. Both the ...
s (6 and 11), maxillary first premolars (5 and 12), maxillary second premolars (4 and 13), maxillary first molars (3 and 14), maxillary second molars (2 and 15), and maxillary third molars (1 and 16). The mandibular teeth are the mandibular central incisors (24 and 25), mandibular lateral incisors (23 and 26), mandibular canines (22 and 27), mandibular first premolars (21 and 28), mandibular second premolars (20 and 29), mandibular first molars (19 and 30), mandibular second molars (18 and 31), and mandibular third molars (17 and 32). Third molars are commonly called " wisdom teeth" usually emerge at ages 17 to 25. These molars may never erupt into the mouth or form at all. When they do form, they often must be removed. If any additional teeth form—for example, fourth and fifth molars, which are rare—they are referred to as supernumerary teeth (hyperdontia). Development of fewer than the usual number of teeth is called hypodontia. There are small differences between the teeth of males and females, with male teeth along with the male jaw tending to be larger on average than female teeth and jaw. There are also differences in the internal dental tissue proportions, with male teeth consisting of proportionately more dentine while female teeth have proportionately more enamel.


Parts


Enamel

Enamel is the hardest and most highly mineralized substance of the body. It has its origin from oral
ectoderm The ectoderm is one of the three primary germ layers formed in early embryonic development. It is the outermost layer, and is superficial to the mesoderm (the middle layer) and endoderm (the innermost layer). It emerges and originates from t ...
. It is one of the four major tissues which make up the tooth, along with
dentin Dentin () (American English) or dentine ( or ) (British English) ( la, substantia eburnea) is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by ena ...
, cementum, and dental pulp. It is normally visible and must be supported by underlying dentin. 96% of enamel consists of mineral, with water and organic material comprising the rest. The normal color of enamel varies from light yellow to grayish white. At the edges of teeth where there is no dentin underlying the enamel, the color sometimes has a slightly blue tone. Since enamel is semitranslucent, the color of dentin and any restorative dental material underneath the enamel strongly affects the appearance of a tooth. Enamel varies in thickness over the surface of the tooth and is often thickest at the cusp, up to 2.5mm, and thinnest at its border, which is seen clinically as the CEJ. The wear rate of enamel, called attrition, is 8 micrometers a year from normal factors. Enamel's primary mineral is
hydroxyapatite Hydroxyapatite, also called hydroxylapatite (HA), is a naturally occurring mineral form of calcium apatite with the formula Ca5(PO4)3(OH), but it is usually written Ca10(PO4)6(OH)2 to denote that the crystal unit cell comprises two entities. ...
, which is a crystalline calcium phosphate. The large amount of minerals in enamel accounts not only for its strength but also for its brittleness. Dentin, which is less mineralized and less brittle, compensates for enamel and is necessary as a support.Johnson, Clarke (1998).
Biology of the Human Dentition
". uic.edu.
Unlike dentin and bone, enamel does not contain
collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
. Proteins of note in the development of enamel are ameloblastins, amelogenins, enamelins and tuftelins. It is believed that they aid in the development of enamel by serving as framework support, among other functions. In rare circumstances enamel can fail to form, leaving the underlying dentine exposed on the surface.


Dentin

Dentin is the substance between enamel or cementum and the pulp chamber. It is secreted by the odontoblasts of the dental pulp. The formation of dentin is known as dentinogenesis. The porous, yellow-hued material is made up of 70% inorganic materials, 20% organic materials, and 10% water by weight. Because it is softer than enamel, it decays more rapidly and is subject to severe cavities if not properly treated, but dentin still acts as a protective layer and supports the crown of the tooth. Dentin is a mineralized
connective tissue Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...
with an organic matrix of collagenous proteins. Dentin has microscopic channels, called dentinal tubules, which radiate outward through the dentin from the pulp cavity to the exterior cementum or enamel border. The diameter of these tubules range from 2.5 μm near the pulp, to 1.2 μm in the midportion, and 900 nm near the dentino-enamel junction. Although they may have tiny side-branches, the tubules do not intersect with each other. Their length is dictated by the radius of the tooth. The three dimensional configuration of the dentinal tubules is genetically determined. There are three types of dentin, primary, secondary and tertiary. Secondary dentin is a layer of dentin produced after root formation and continues to form with age. Tertiary dentin is created in response to stimulus, such as cavities and tooth wear.


Cementum

Cementum is a specialized bone like substance covering the root of a tooth. It is approximately 45% inorganic material (mainly
hydroxyapatite Hydroxyapatite, also called hydroxylapatite (HA), is a naturally occurring mineral form of calcium apatite with the formula Ca5(PO4)3(OH), but it is usually written Ca10(PO4)6(OH)2 to denote that the crystal unit cell comprises two entities. ...
), 33% organic material (mainly
collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
) and 22% water. Cementum is excreted by cementoblasts within the root of the tooth and is thickest at the root apex. Its coloration is yellowish and it is softer than dentin and enamel. The principal role of cementum is to serve as a medium by which the
periodontal ligament The periodontal ligament, commonly abbreviated as the PDL, is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits. It inserts into root cementum one side and onto alveolar b ...
s can attach to the tooth for stability. At the cement to enamel junction, the cementum is acellular due to its lack of cellular components, and this acellular type covers at least ⅔ of the root. The more permeable form of cementum, cellular cementum, covers about ⅓ of the root apex.


Dental pulp

The dental pulp is the central part of the tooth filled with soft connective tissue. This tissue contains blood vessels and nerves that enter the tooth from a hole at the apex of the root. Along the border between the dentin and the pulp are odontoblasts, which initiate the formation of dentin. Other cells in the pulp include fibroblasts, preodontoblasts,
macrophage Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer cel ...
s and T lymphocytes.Walton, Richard E. and Mahmoud Torabinejad. ''Principles and Practice of Endodontics.'' 3rd ed. 2002. pp. 11–13. . The pulp is commonly called "the nerve" of the tooth.


Development

Tooth development is the complex process by which teeth form from
embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
nic
cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...
,
grow Grow or GROW may refer to: * Growth (disambiguation), an increase in some quantity over time or a measure of some principal * GROW model, a technique for problem solving or goal setting * Graphical ROMable Object Windows, a windowing system that w ...
, and erupt into the
mouth In animal anatomy, the mouth, also known as the oral cavity, or in Latin cavum oris, is the opening through which many animals take in food and issue vocal sounds. It is also the cavity lying at the upper end of the alimentary canal, bounded on ...
. Although many diverse species have teeth, their development is largely the same as in humans. For human teeth to have a healthy oral environment, enamel,
dentin Dentin () (American English) or dentine ( or ) (British English) ( la, substantia eburnea) is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by ena ...
, cementum, and the periodontium must all develop during appropriate stages of fetal development.
Primary teeth Deciduous teeth or primary teeth, also informally known as baby teeth, milk teeth, or temporary teeth,Illustrated Dental Embryology, Histology, and Anatomy, Bath-Balogh and Fehrenbach, Elsevier, 2011, page 255 are the first set of teeth in the ...
start to form in the development of the embryo between the sixth and eighth weeks, and permanent teeth begin to form in the twentieth week. If teeth do not start to develop at or near these times, they will not develop at all. A significant amount of research has focused on determining the processes that initiate tooth development. It is widely accepted that there is a factor within the tissues of the first pharyngeal arch that is necessary for the development of teeth. Tooth development is commonly divided into the following stages: the bud stage, the cap, the bell, and finally maturation. The staging of tooth development is an attempt to categorize changes that take place along a continuum; frequently it is difficult to decide what stage should be assigned to a particular developing tooth. This determination is further complicated by the varying appearance of different histologic sections of the same developing tooth, which can appear to be different stages. The
tooth bud Tooth development or odontogenesis is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. For human teeth to have a healthy oral environment, all parts of the tooth must develop during appropriate stage ...
(sometimes called the tooth germ) is an aggregation of
cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...
that eventually forms a tooth. It is organized into three parts: the enamel organ, the dental papilla and the dental follicle. The ''enamel organ'' is composed of the
outer enamel epithelium The outer enamel epithelium, also known as the external enamel epithelium, is a layer of cuboidal cells located on the periphery of the enamel organ in a developing tooth. This layer is first seen during the bell stage. The rim of the enamel org ...
, inner enamel epithelium, stellate reticulum and stratum intermedium. These cells give rise to ameloblasts, which produce enamel and the reduced enamel epithelium. The growth of cervical loop cells into the deeper tissues forms Hertwig's Epithelial Root Sheath, which determines a tooth's root shape. The ''dental papilla'' contains cells that develop into odontoblasts, which are dentin-forming cells.Lab Exercises: Tooth development
University of Texas Medical Branch.
Additionally, the junction between the dental papilla and inner enamel epithelium determines the crown shape of a tooth.. The ''dental follicle'' gives rise to three important
cells Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery w ...
: cementoblasts,
osteoblast Osteoblasts (from the Greek language, Greek combining forms for "bone", ὀστέο-, ''osteo-'' and βλαστάνω, ''blastanō'' "germinate") are cell (biology), cells with a single Cell nucleus, nucleus that synthesize bone. However, in the p ...
s, and
fibroblast A fibroblast is a type of cell (biology), biological cell that synthesizes the extracellular matrix and collagen, produces the structural framework (Stroma (tissue), stroma) for animal Tissue (biology), tissues, and plays a critical role in wound ...
s. Cementoblasts form the cementum of a tooth. Osteoblasts give rise to the alveolar bone around the roots of teeth. Fibroblasts develop the
periodontal ligament The periodontal ligament, commonly abbreviated as the PDL, is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits. It inserts into root cementum one side and onto alveolar b ...
s which connect teeth to the alveolar bone through cementum.


Eruption

Tooth eruption in humans is a process in tooth development in which the teeth enter the mouth and become visible. Current research indicates that the periodontal ligaments play an important role in tooth eruption. Primary teeth erupt into the mouth from around six months until two years of age. These teeth are the only ones in the mouth until a person is about six years old. At that time, the first permanent tooth erupts. This stage, during which a person has a combination of primary and permanent teeth, is known as the mixed stage. The mixed stage lasts until the last primary tooth is lost and the remaining permanent teeth erupt into the mouth. There have been many theories about the cause of tooth eruption. One theory proposes that the developing root of a tooth pushes it into the mouth. Another, known as the cushioned hammock theory, resulted from microscopic study of teeth, which was thought to show a
ligament A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal li ...
around the root. It was later discovered that the "ligament" was merely an
artifact Artifact, or artefact, may refer to: Science and technology * Artifact (error), misleading or confusing alteration in data or observation, commonly in experimental science, resulting from flaws in technique or equipment ** Compression artifact, a ...
created in the process of preparing the slide. Currently, the most widely held belief is that the periodontal ligaments provide the main impetus for the process. The onset of primary tooth loss has been found to correlate strongly with somatic and psychological criteria of school readiness.


Supporting structures

The periodontium is the supporting structure of a tooth, helping to attach the tooth to surrounding tissues and to allow sensations of touch and pressure. It consists of the cementum, periodontal ligaments, alveolar bone, and gingiva. Of these, cementum is the only one that is a part of a tooth. Periodontal ligaments connect the alveolar bone to the cementum. Alveolar bone surrounds the roots of teeth to provide support and creates what is commonly called an
alveolus Alveolus (; pl. alveoli, adj. alveolar) is a general anatomical term for a concave cavity or pit. Uses in anatomy and zoology * Pulmonary alveolus, an air sac in the lungs ** Alveolar cell or pneumocyte ** Alveolar duct ** Alveolar macrophage * Mam ...
, or "socket". Lying over the bone is the gingiva or gum, which is readily visible in the mouth.


Periodontal ligaments

The
periodontal ligament The periodontal ligament, commonly abbreviated as the PDL, is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits. It inserts into root cementum one side and onto alveolar b ...
is a specialized
connective tissue Connective tissue is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tiss ...
that attaches the cementum of a tooth to the alveolar bone. This tissue covers the root of the tooth within the bone. Each ligament has a width of 0.15–0.38mm, but this size decreases over time. The functions of the periodontal ligaments include attachment of the tooth to the bone, support for the tooth, formation and resorption of bone during tooth movement, sensation, and eruption. The cells of the periodontal ligaments include osteoblasts, osteoclasts, fibroblasts, macrophages, cementoblasts, and epithelial cell rests of Malassez. Consisting of mostly Type I and III
collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
, the fibers are grouped in bundles and named according to their location. The groups of fibers are named alveolar crest, horizontal, oblique, periapical, and interradicular fibers. The nerve supply generally enters from the bone apical to the tooth and forms a network around the tooth toward the crest of the gingiva. When pressure is exerted on a tooth, such as during chewing or biting, the tooth moves slightly in its socket and puts tension on the periodontal ligaments. The nerve fibers can then send the information to the central nervous system for interpretation.


Alveolar bone

The alveolar bone is the bone of the jaw which forms the alveolus around teeth. Like any other bone in the human body, alveolar bone is modified throughout life.
Osteoblast Osteoblasts (from the Greek language, Greek combining forms for "bone", ὀστέο-, ''osteo-'' and βλαστάνω, ''blastanō'' "germinate") are cell (biology), cells with a single Cell nucleus, nucleus that synthesize bone. However, in the p ...
s create bone and osteoclasts destroy it, especially if force is placed on a tooth. As is the case when movement of teeth is attempted through orthodontics, an area of bone under
compressive In continuum mechanics, stress is a physical quantity. It is a quantity that describes the magnitude of forces that cause deformation. Stress is defined as ''force per unit area''. When an object is pulled apart by a force it will cause elonga ...
force In physics, a force is an influence that can change the motion of an object. A force can cause an object with mass to change its velocity (e.g. moving from a state of rest), i.e., to accelerate. Force can also be described intuitively as a p ...
from a tooth moving toward it has a high osteoclast level, resulting in bone resorption. An area of bone receiving tension from periodontal ligaments attached to a tooth moving away from it has a high number of osteoblasts, resulting in bone formation.


Gingiva

The gingiva ("gums") is the
mucosal A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
tissue that overlays the jaws. There are three different types of epithelium associated with the gingiva: gingival, junctional, and sulcular epithelium. These three types form from a mass of epithelial cells known as the epithelial cuff between the tooth and the mouth. The gingival epithelium is not associated directly with tooth attachment and is visible in the mouth. The junctional epithelium, composed of the
basal lamina The basal lamina is a layer of extracellular matrix secreted by the epithelial cells, on which the epithelium sits. It is often incorrectly referred to as the basement membrane, though it does constitute a portion of the basement membrane. The ba ...
and hemidesmosomes, forms an attachment to the tooth. The sulcular epithelium is nonkeratinized
stratified squamous A stratified squamous epithelium consists of squamous (flattened) epithelial cells arranged in layers upon a basal membrane. Only one layer is in contact with the basement membrane; the other layers adhere to one another to maintain structural in ...
tissue on the gingiva which touches but is not attached to the tooth.


Tooth decay


Plaque

Plaque is a biofilm consisting of large quantities of various bacteria that form on teeth. If not removed regularly, plaque buildup can lead to periodontal problems such as gingivitis. Given time, plaque can mineralize along the gingiva, forming ''
tartar Tartar may refer to: Places * Tartar (river), a river in Azerbaijan * Tartar, Switzerland, a village in the Grisons * Tərtər, capital of Tartar District, Azerbaijan * Tartar District, Azerbaijan * Tartar Island, South Shetland Islands, Ant ...
''. The microorganisms that form the biofilm are almost entirely bacteria (mainly streptococcus and
anaerobes An anaerobic organism or anaerobe is any organism that does not require molecular oxygen for growth. It may react negatively or even die if free oxygen is present. In contrast, an aerobic organism (aerobe) is an organism that requires an oxygenate ...
), with the composition varying by location in the mouth. ''
Streptococcus mutans ''Streptococcus mutans'' is a facultatively anaerobic, gram-positive coccus (round bacterium) commonly found in the human oral cavity and is a significant contributor to tooth decay. It is part of the " streptococci" (plural, non-italic lowercase ...
'' is the most important bacterium associated with dental caries. Certain bacteria in the mouth live off the remains of foods, especially
sugar Sugar is the generic name for sweet-tasting, soluble carbohydrates, many of which are used in food. Simple sugars, also called monosaccharides, include glucose, fructose, and galactose. Compound sugars, also called disaccharides or double ...
s and starches. In the absence of oxygen they produce lactic acid, which dissolves the calcium and phosphorus in the enamel. This process, known as "demineralisation", leads to tooth destruction.
Saliva Saliva (commonly referred to as spit) is an extracellular fluid produced and secreted by salivary glands in the mouth. In humans, saliva is around 99% water, plus electrolytes, mucus, white blood cells, epithelial cells (from which DNA can be ...
gradually neutralises the
acid In computer science, ACID ( atomicity, consistency, isolation, durability) is a set of properties of database transactions intended to guarantee data validity despite errors, power failures, and other mishaps. In the context of databases, a sequ ...
s, which causes the pH of the tooth surface to rise above the critical pH, typically considered to be 5.5. This causes remineralisation, the return of the dissolved minerals to the enamel. If there is sufficient time between the intake of foods then the impact is limited and the teeth can repair themselves. Saliva is unable to penetrate through plaque, however, to neutralize the acid produced by the bacteria.


Caries (cavities)

Dental caries (cavities), described as "tooth decay", is an infectious disease which damages the structures of teeth.Dental Cavities
''MedlinePlus Medical Encyclopedia''.
The disease can lead to
pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
, tooth loss, and infection. Dental caries has a long history, with evidence showing the disease was present in the
Bronze Bronze is an alloy consisting primarily of copper, commonly with about 12–12.5% tin and often with the addition of other metals (including aluminium, manganese, nickel, or zinc) and sometimes non-metals, such as phosphorus, or metalloids such ...
, Iron, and Middle ages but also prior to the neolithic period. The largest increases in the prevalence of caries have been associated with diet changes. Today, caries remains one of the most common diseases throughout the world. In the United States, dental caries is the most common chronic childhood disease, being at least five times more common than asthma. Countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease.Dental caries
, from the Disease Control Priorities Project.
Among children in the United States and Europe, 60–80% of cases of dental caries occur in 20% of the population. Tooth decay is caused by certain types of acid-producing bacteria which cause the most damage in the presence of fermentable carbohydrates such as
sucrose Sucrose, a disaccharide, is a sugar composed of glucose and fructose subunits. It is produced naturally in plants and is the main constituent of white sugar. It has the molecular formula . For human consumption, sucrose is extracted and refined ...
,
fructose Fructose, or fruit sugar, is a Ketose, ketonic monosaccharide, simple sugar found in many plants, where it is often bonded to glucose to form the disaccharide sucrose. It is one of the three dietary monosaccharides, along with glucose and galacto ...
, and glucose. The resulting acidic levels in the mouth affect teeth because a tooth's special mineral content causes it to be sensitive to low pH. Depending on the extent of tooth destruction, various treatments can be used to
restore Restore may refer to: * ReStore - Retail building supply stores run by local Habitat for Humanity affiliates *"Restore", a single by Chris August Christopher August Megert (born March 20, 1982) is an American Contemporary Christian musician who ...
teeth to proper form, function, and aesthetics, but there is no known method to regenerate large amounts of tooth structure. Instead, dental health organizations advocate preventive and prophylactic measures, such as regular oral hygiene and dietary modifications, to avoid dental caries.


Tooth care


Oral hygiene

Oral hygiene is the practice of keeping the mouth clean and is a means of preventing dental caries, gingivitis, periodontal disease, bad breath, and other dental disorders. It consists of both professional and personal care. Regular cleanings, usually done by dentists and dental hygienists, remove
tartar Tartar may refer to: Places * Tartar (river), a river in Azerbaijan * Tartar, Switzerland, a village in the Grisons * Tərtər, capital of Tartar District, Azerbaijan * Tartar District, Azerbaijan * Tartar Island, South Shetland Islands, Ant ...
(mineralized plaque) that may develop even with careful brushing and
flossing Dental floss is a cord of thin filaments used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is designed t ...
. Professional cleaning includes
tooth scaling Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning, is a procedure involving removal of dental plaque and calculus (scaling or debridement) and then smoothing, or planing, o ...
, using various instruments or devices to loosen and remove deposits from teeth. The purpose of cleaning teeth is to remove plaque, which consists mostly of bacteria. Healthcare professionals recommend regular brushing twice a day (in the morning and in the evening, or after meals) in order to prevent formation of plaque and tartar.Oral Health Topics: Cleaning your teeth and gums
American Dental Association.
A toothbrush is able to remove most plaque, except in areas between teeth. As a result, flossing is also considered a necessity to maintain oral hygiene. When used correctly, dental floss removes plaque from between teeth and at the
gum line The gums or gingiva (plural: ''gingivae'') consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health. Structure The gums are part of the soft tissue linin ...
, where periodontal disease often begins and could develop caries. Electric toothbrushes are a popular aid to oral hygiene. A user without disabilities, with proper training in manual brushing, and with good motivation, can achieve standards of oral hygiene at least as satisfactory as the best electric brushes, but untrained users rarely achieve anything of the kind. Not all electric toothbrushes are equally effective and even a good design needs to be used properly for best effect, but: "Electric toothbrushes tend to help people who are not as good at cleaning teeth and as a result have had oral hygiene problems." The most important advantage of electric toothbrushes is their ability to aid people with dexterity difficulties, such as those associated with rheumatoid arthritis.


Protective treatments

Fluoride therapy is often recommended to protect against dental caries. Water fluoridation and
fluoride Fluoride (). According to this source, is a possible pronunciation in British English. is an inorganic, monatomic anion of fluorine, with the chemical formula (also written ), whose salts are typically white or colorless. Fluoride salts typ ...
supplements decrease the incidence of dental caries. Fluoride helps prevent dental decay by binding to the hydroxyapatite crystals in enamel. The incorporated fluoride makes enamel more resistant to demineralization and thus more resistant to decay. Topical fluoride, such as a fluoride toothpaste or mouthwash, is also recommended to protect teeth surfaces. Many dentists include application of topical fluoride solutions as part of routine cleanings.
Dental sealant Dental sealants (also termed pit and fissure sealants, or simply fissure sealants) are a dental treatment intended to prevent tooth decay. Teeth have recesses on their biting surfaces; the back teeth have fissures (grooves) and some front teeth h ...
s are another preventive therapy often used to provide a barrier to bacteria and decay on the surface of teeth. Sealants can last up to ten years and are primarily used on the biting surfaces of molars of children and young adults, especially those who may have difficulty brushing and flossing effectively. Sealants are applied in a dentist's office, sometimes by a dental hygienist, in a procedure similar in technique and cost to a fluoride application.


Restorations

After a tooth has been damaged or destroyed,
restoration Restoration is the act of restoring something to its original state and may refer to: * Conservation and restoration of cultural heritage ** Audio restoration ** Film restoration ** Image restoration ** Textile restoration * Restoration ecology ...
of the missing structure can be achieved with a variety of treatments. Restorations may be created from a variety of materials, including
glass ionomer Glass is a non-crystalline, often transparent, amorphous solid that has widespread practical, technological, and decorative use in, for example, window panes, tableware, and optics. Glass is most often formed by rapid cooling (quenching) of ...
,
amalgam Amalgam most commonly refers to: * Amalgam (chemistry), mercury alloy * Amalgam (dentistry), material of silver tooth fillings ** Bonded amalgam, used in dentistry Amalgam may also refer to: * Amalgam Comics, a publisher * Amalgam Digital, an in ...
, gold, porcelain, and composite. Small restorations placed inside a tooth are referred to as "intracoronal restorations". These restorations may be formed directly in the mouth or may be cast using the lost-wax technique, such as for some inlays and onlays. When larger portions of a tooth are lost, an "extracoronal restoration" may be fabricated, such as an artificial crown or a
veneer Veneer may refer to: Materials * Veneer (dentistry), a cosmetic treatment for teeth * Masonry veneer, a thin facing layer of brick * Stone veneer, a thin facing layer of stone * Wood veneer, a thin facing layer of wood Arts and entertainment * ' ...
, to restore the involved tooth. When a tooth is lost, dentures, bridges, or
implants Implant can refer to: Medicine *Implant (medicine), or specifically: **Brain implant **Breast implant **Buttock implant **Cochlear implant **Contraceptive implant **Dental implant **Fetal tissue implant **Implantable cardioverter-defibrillator ** ...
may be used as replacements.Prosthodontic Procedures
, The American College of Prosthodontists.
Dentures are usually the least costly whereas implants are usually the most expensive. Dentures may replace complete arches of the mouth or only a
partial Partial may refer to: Mathematics * Partial derivative, derivative with respect to one of several variables of a function, with the other variables held constant ** ∂, a symbol that can denote a partial derivative, sometimes pronounced "partial ...
number of teeth. Bridges replace smaller spaces of missing teeth and use adjacent teeth to support the restoration. Dental implants may be used to replace a single tooth or a series of teeth. Though implants are the most expensive treatment option, they are often the most desirable restoration because of their aesthetics and function. To improve the function of dentures, implants may be used as support.Dental Implants
, American Association of Oral and Maxillofacial Surgeons.


Abnormalities

Tooth abnormalities may be categorized according to whether they have environmental or developmental causes. While environmental abnormalities may appear to have an obvious cause, there may not appear to be any known cause for some developmental abnormalities. Environmental forces may affect teeth during development, destroy tooth structure after development, discolor teeth at any stage of development, or alter the course of tooth eruption. Developmental abnormalities most commonly affect the number, size, shape, and structure of teeth.


Environmental


Alteration during tooth development

Tooth abnormalities caused by environmental factors during tooth development have long-lasting effects. Enamel and dentin do not regenerate after they mineralize initially.
Enamel hypoplasia Enamel hypoplasia is a defect of the teeth in which the enamel is deficient in quantity, caused by defective enamel matrix formation during enamel development, as a result of inherited and acquired systemic condition(s). It can be identified as m ...
is a condition in which the amount of enamel formed is inadequate. This results either in pits and grooves in areas of the tooth or in widespread absence of enamel. Diffuse opacities of enamel does not affect the amount of enamel but changes its appearance. Affected enamel has a different translucency than the rest of the tooth. Demarcated opacities of enamel have sharp boundaries where the translucency decreases and manifest a white, cream, yellow, or brown color. All these may be caused by nutritional factors, an
exanthem An exanthem is a widespread rash occurring on the outside of the body and usually occurring in children. An exanthem can be caused by toxins, drugs, or microorganisms, or can result from autoimmune disease. The term exanthem is from the Greek ...
atous disease ( chicken pox, congenital syphilis), undiagnosed and untreated celiac disease,Dental Enamel Defects and Celiac Disease
National Institute of Health (NIH)
hypocalcemia, dental fluorosis, birth injury, preterm birth, infection or trauma from a deciduous tooth. Dental fluorosis is a condition which results from ingesting excessive amounts of
fluoride Fluoride (). According to this source, is a possible pronunciation in British English. is an inorganic, monatomic anion of fluorine, with the chemical formula (also written ), whose salts are typically white or colorless. Fluoride salts typ ...
and leads to teeth which are spotted, yellow, brown, black or sometimes pitted. In most cases, the enamel defects caused by celiac disease, which may be the only manifestation of this disease in the absence of any other symptoms or signs, are not recognized and mistakenly attributed to other causes, such as fluorosis. Enamel hypoplasia resulting from
syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
is frequently referred to as Hutchinson's teeth, which is considered one part of Hutchinson's triad.
Turner's hypoplasia Enamel hypoplasia is a defect of the teeth in which the enamel is deficient in quantity, caused by defective enamel matrix formation during enamel development, as a result of inherited and acquired systemic condition(s). It can be identified as m ...
is a portion of missing or diminished enamel on a permanent tooth usually from a prior infection of a nearby primary tooth. Hypoplasia may also result from antineoplastic therapy.


Destruction after development

Tooth destruction from processes other than dental caries is considered a normal physiologic process but may become severe enough to become a pathologic condition. Attrition is the loss of tooth structure by mechanical forces from opposing teeth. Attrition initially affects the enamel and, if unchecked, may proceed to the underlying dentin. Abrasion is the loss of tooth structure by mechanical forces from a foreign element. If this force begins at the cementoenamel junction, then progression of tooth loss can be rapid since enamel is very thin in this region of the tooth. A common source of this type of tooth wear is excessive force when using a toothbrush. Erosion is the loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Signs of tooth destruction from erosion is a common characteristic in the mouths of people with bulimia since vomiting results in exposure of the teeth to gastric acids. Another important source of erosive acids are from frequent sucking of lemon juice. Abfraction is the loss of tooth structure from flexural forces. As teeth flex under pressure, the arrangement of teeth touching each other, known as occlusion, causes tension on one side of the tooth and compression on the other side of the tooth. This is believed to cause V-shaped depressions on the side under tension and C-shaped depressions on the side under compression. When tooth destruction occurs at the roots of teeth, the process is referred to as
internal resorption Resorption of the root of the tooth, or root resorption, is the progressive loss of dentin and cementum by the action of odontoclasts. Root resorption is a normal physiological process that occurs in the exfoliation of the primary dentition. Howev ...
, when caused by cells within the pulp, or
external resorption Resorption of the root of the tooth, or root resorption, is the progressive loss of dentin and cementum by the action of odontoclasts. Root resorption is a normal physiological process that occurs in the exfoliation of the primary dentition. Howev ...
, when caused by cells in the periodontal ligament.


Discoloration

Discoloration of teeth may result from bacteria stains, tobacco, tea, coffee, foods with an abundance of
chlorophyll Chlorophyll (also chlorophyl) is any of several related green pigments found in cyanobacteria and in the chloroplasts of algae and plants. Its name is derived from the Greek words , ("pale green") and , ("leaf"). Chlorophyll allow plants to a ...
, restorative materials, and medications. Stains from bacteria may cause colors varying from green to black to orange. Green stains also result from foods with chlorophyll or excessive exposure to copper or nickel. Amalgam, a common dental restorative material, may turn adjacent areas of teeth black or gray. Long term use of chlorhexidine, a mouthwash, may encourage extrinsic stain formation near the gingiva on teeth. This is usually easy for a hygienist to remove. Systemic disorders also can cause tooth discoloration. Congenital erythropoietic porphyria causes porphyrins to be deposited in teeth, causing a red-brown coloration. Blue discoloration may occur with alkaptonuria and rarely with Parkinson's disease.
Erythroblastosis fetalis Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis foetalis, is an alloimmune condition that develops in a fetus at or around birth, when the IgG molecules (one of the five ...
and
biliary atresia Biliary atresia, also known as extrahepatic ductopenia and progressive obliterative cholangiopathy, is a childhood disease of the liver in which one or more bile ducts are abnormally narrow, blocked, or absent. It can be congenital or acquired. I ...
are diseases which may cause teeth to appear green from the deposition of
biliverdin Biliverdin (latin for green bile) is a green tetrapyrrolic bile pigment, and is a product of heme catabolism.Boron W, Boulpaep E. Medical Physiology: a cellular and molecular approach, 2005. 984-986. Elsevier Saunders, United States. It is the pi ...
. Also, trauma may change a tooth to a pink, yellow, or dark gray color. Pink and red discolorations are also associated in patients with
lepromatous leprosy Lepromatous leprosy is a form of leprosy characterized by pale macules in the skin. It results from the failure of Th1 cell activation which is necessary to eradicate the mycobacteria (Th1 response is required to activate macrophages that engulf ...
. Some medications, such as tetracycline antibiotics, may become incorporated into the structure of a tooth, causing intrinsic staining of the teeth.


Alteration of eruption

Tooth eruption may be altered by some environmental factors. When eruption is prematurely stopped, the tooth is said to be impacted. The most common cause of tooth impaction is lack of space in the mouth for the tooth. Other causes may be tumors, cysts, trauma, and thickened bone or soft tissue.
Tooth ankylosis Tooth ankylosis is the pathological fusion between alveolar bone and the cementum of teeth, which is a rare phenomenon in the deciduous dentition and even more uncommon in permanent teeth. Ankylosis occurs when partial root resorption is followed b ...
occurs when the tooth has already erupted into the mouth but the cementum or dentin has fused with the alveolar bone. This may cause a person to retain their primary tooth instead of having it replaced by a permanent one. A technique for altering the natural progression of eruption is employed by orthodontists who wish to delay or speed up the eruption of certain teeth for reasons of space maintenance or otherwise preventing crowding and/or spacing. If a primary tooth is extracted before its succeeding permanent tooth's root reaches ⅓ of its total growth, the eruption of the permanent tooth will be delayed. Conversely, if the roots of the permanent tooth are more than ⅔ complete, the eruption of the permanent tooth will be accelerated. Between ⅓ and ⅔, it is unknown exactly what will occur to the speed of eruption.


Developmental


Abnormality in number

*
Anodontia Anodontia is a rare genetic disorder characterized by the congenital absence of all primary or permanent teeth. It is divided into two subsections, complete absence of teeth or only some absence of teeth. It is associated with the group of skin ...
is the total lack of tooth development. * Hyperdontia is the presence of a higher-than-normal number of teeth. * Hypodontia is the lack of development of one or more teeth. ** Oligodontia may be used to describe the absence of 6 or more teeth. Some systemic disorders which may result in hyperdontia include Apert syndrome,
cleidocranial dysostosis Cleidocranial dysostosis (CCD), also called cleidocranial dysplasia, is a birth defect that mostly affects the bones and teeth. The collarbones are typically either poorly developed or absent, which allows the shoulders to be brought close togethe ...
,
Crouzon syndrome Crouzon syndrome is an autosomal dominant genetic disorder known as a branchial arch syndrome. Specifically, this syndrome affects the first branchial (or pharyngeal) arch, which is the precursor of the maxilla and mandible. Since the branchial ...
, Ehlers–Danlos syndrome, Gardner's syndrome, and Sturge–Weber syndrome. Some systemic disorders which may result in hypodontia include Crouzon syndrome, Ectodermal dysplasia, Ehlers–Danlos syndrome, and Gorlin syndrome.


Abnormality in size

*
Microdontia Microdontia is a condition in which one or more teeth appear smaller than normal. In the generalized form, all teeth are involved. In the localized form, only a few teeth are involved. The most common teeth affected are the upper lateral incisors ...
is a condition where teeth are smaller than the usual size. * Macrodontia is where teeth are larger than the usual size. Microdontia of a single tooth is more likely to occur in a
maxillary lateral incisor The maxillary lateral incisors are a pair of upper (maxillary) teeth that are located laterally (away from the midline of the face) from both maxillary central incisors of the mouth and medially (toward the midline of the face) from both maxillary ...
. The second most likely tooth to have microdontia are third molars. Macrodontia of all the teeth is known to occur in
pituitary gigantism Gigantism ( el, γίγας, ''gígas'', "giant", plural γίγαντες, ''gígantes''), also known as giantism, is a condition characterized by excessive growth and height significantly above average. In humans, this condition is caused by ove ...
and pineal
hyperplasia Hyperplasia (from ancient Greek ὑπέρ ''huper'' 'over' + πλάσις ''plasis'' 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferati ...
. It may also occur on one side of the face in cases of hemifacial hyperplasia.


Abnormality in shape

* Gemination occurs when a developing tooth incompletely splits into the formation of two teeth. * Fusion is the union of two adjacent teeth during development. *
Concrescence Concrescence is a condition of teeth where the cementum overlying the roots of at least two teeth join together. It usually involves only two teeth. The most commonly involved teeth are upper second and third molars. The prevalence rate is 0.04%. ...
is the fusion of two separate teeth only in their cementum. * Accessory cusps are additional cusps on a tooth and may manifest as a
Talon cusp Talon cusp is a rare dental anomaly resulting in an extra cusp or cusp-like projection on an anterior tooth, located on the inside surface of the affected tooth. Sometimes it can also be found on the facial surface of the anterior tooth. The ter ...
,
Cusp of Carabelli The cusp of Carabelli, or Carabelli's tubercle, or ''tuberculum anomale'' of Georg Carabelli is a small additional cusp at the mesiopalatal line angle of maxillary first molars. This extra cusp is usually found on the secondary maxillary first m ...
, or
Dens evaginatus Dens evaginatus is a rare odontogenic developmental anomaly that is found in teeth where the outer surface appears to form an extra bump or cusp. Premolars are more likely to be affected than any other tooth. It could occur unilaterally or bilat ...
. *
Dens invaginatus Dens invaginatus (DI), also known as tooth within a tooth, is a rare dental malformation where there is an infolding of enamel into dentine. The prevalence of condition is 0.3 - 10%, affecting more males than females. The condition is presented in ...
, also called Dens in dente, is a deep invagination in a tooth causing the appearance of a tooth within a tooth. *
Ectopic enamel Ectopic enamel is an abnormality in the shape of teeth. It is tooth enamel that is found in an unusual location, such as at the root In vascular plants, the roots are the organs of a plant that are modified to provide anchorage for the plan ...
is enamel found in an unusual location, such as the root of a tooth. *
Taurodontism Taurodontism is defined as the enlargement of pulp chambers with the furcation area being displaced toward the apex of the root. It cannot be diagnosed clinically and requires radiographic visualization since the crown of a taurodontic tooth ap ...
is a condition where the body of the tooth and pulp chamber is enlarged, and is associated with Klinefelter syndrome, Tricho-dento-osseous syndrome, Triple X syndrome, and XYY syndrome. * Hypercementosis is excessive formation of cementum, which may result from trauma, inflammation,
acromegaly Acromegaly is a disorder that results from excess growth hormone (GH) after the growth plates have closed. The initial symptom is typically enlargement of the hands and feet. There may also be an enlargement of the forehead, jaw, and nose. Other ...
,
rheumatic fever Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful jo ...
, and Paget's disease of bone. * A
dilaceration Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. This disturbance is more likely to affect the maxillary incisors and occurs in permanent ...
is a bend in the root which may have been caused by trauma to the tooth during formation. * Supernumerary roots is the presence of a greater number of roots on a tooth than expected


Cleft lip and palate and their association with dental anomalies

There are many types of dental anomalies seen in cleft lip and palate (CLP) patients. Both sets of dentition may be affected; however, they are commonly seen in the affected side. Most frequently, missing teeth, supernumerary or discoloured teeth can be seen; however, enamel dysplasia, discolouration and delayed root development are also common. In children with cleft lip and palate, the lateral incisor in the alveolar cleft region has the highest prevalence of dental developmental disorders; this condition may be a cause of tooth crowding. This is important to consider in order to correctly plan treatment keeping in mind considerations for function and aesthetics. By correctly coordinating management invasive treatment procedures can be prevented resulting in successful and conservative treatment. There have been a plethora of research studies to calculate prevalence of certain dental anomalies in CLP populations however a variety of results have been obtained. In a study evaluating dental anomalies in Brazilian cleft patients, male patients had a higher incidence of CLP, agenesis, and supernumerary teeth than did female patients. In cases of complete CLP, the left maxillary lateral incisor was the most commonly absent tooth. Supernumerary teeth were typically located distal to the cleft. In a study of Jordanian subjects, the prevalence of dental anomaly was higher in CLP patients than in normal subjects. Missing teeth were observed in 66.7% of patients, with maxillary lateral incisor as the most frequently affected tooth. Supernumerary teeth were observed in 16.7% of patients; other findings included microdontia (37%), taurodontism (70.5%), transposition or ectopic teeth (30.8%), dilacerations (19.2%), and hypoplasia (30.8%). The incidence of microdontia, dilaceration, and hypoplasia was significantly higher in bilateral CLP patients than in unilateral CLP patients, and none of the anomalies showed any significant sexual dimorphism. It is therefore evident that patients with cleft lip and palate may present with a variety of dental anomalies. It is essential to assess the patient both clinically and radiographically in order to correctly treat and prevent progression of any dental problems. It is also useful to note that patients with a cleft lip and palate automatically score a 5 on the IOTN ( index for orthodontic need) and therefore are eligible for orthodontic treatment, liaising with an orthodontist is vital in order coordinate and plan treatment successfully.


Abnormality in structure

* Amelogenesis imperfecta is a condition in which enamel does not form properly or at all. * Dentinogenesis imperfecta is a condition in which dentin does not form properly and is sometimes associated with osteogenesis imperfecta. *
Dentin dysplasia Dentin dysplasia (DD) is a rare genetic developmental disorder affecting dentine production of the teeth, commonly exhibiting an autosomal dominant inheritance that causes malformation of the root. It affects both primary and permanent dentitions ...
is a disorder in which the roots and pulp of teeth may be affected. *
Regional odontodysplasia Regional odontodysplasia is an uncommon developmental abnormality of teeth, usually localized to a certain area of the mouth. The condition is nonhereditary. There is no predilection for race, but females are more likely to get regional odontody ...
is a disorder affecting enamel, dentin, and pulp and causes the teeth to appear "ghostly" on radiographs. * Diastema is a condition in which there is a gap between two teeth caused by the imbalance in the relationship between the jaw and the size of teeth.''ASDC Journal of Dentistry for Children, Volume 48''. American Society of Dentistry for Children, 1980. p. 266


See also

* Barodontalgia *
Dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions o ...
*
Dental auxiliary A dental auxiliary is any oral health practitioner other than a dentist & dental hygienist, including the supporting team assisting in dental treatment. They include dental assistants (known as dental nurses in the United Kingdom and Ireland), de ...
** Dental assistant ** Dental hygienist ** Dental technician * Dental braces * Dental notation *
Dental tourism Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable a ...
* Head and neck anatomy * Regenerative endodontics * Socket preservation * Tongue *
Tooth fairy The Tooth Fairy is a fantasy figure of early childhood in Western and Western-influenced cultures. The folklore states that when children lose one of their baby teeth, they should place it underneath their pillow or on their bedside table and ...
* Tooth painting *
Tooth regeneration Tooth regeneration is a stem cell based regenerative medicine procedure in the field of tissue engineering and stem cell biology to replace damaged or lost teeth by regrowing them from autologous stem cells. As a source of the new bioengineered tee ...


Lists

*
List of basic dentistry topics The following outline is provided as an overview of and topical guide to dentistry and oral health: Dentistry – branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions ...
*
List of oral health and dental topics Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include: __NOTOC__ A :Abfraction  •  Abrasion  •  :Academy of General Dentistry  •  :Acin ...


References


Notes


Sources

* * * *


External links


An article on the use of human tooth used as a neolithic pendant


{{DEFAULTSORT:Tooth (Human) Human Human anatomy de:Zahn