Teeth: From dental anatomy to diseases and dental treatments

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The tooth is one of the most vital parts of the human body that is easily exposed to damage and infection, but its care is practical and straightforward.

These organs are the most challenging part of the human body, and in addition to chewing food, they also play a crucial role in speech. At the same time, the appearance of people can affect the beauty of teeth at a glance. This member can also represent a person’s social class! Having a few visible decaying teeth makes one judge that one is not in a good financial position or is careless about one’s appearance. However, a better understanding of such a member will not be unimportant. 

Each tooth consists of the following parts.

 

Enamel

Enamel is the outermost and most challenging part of the tooth. This part of the tooth is made of calcium phosphate, which is a hard mineral. Because the enamel is transparent, it transmits light.

However, the primary color of your teeth is determined by the dentin, which is covered by enamel. Occasionally, beverages such as tea, soft drinks, fruit juices, and cigarettes can cause enamel staining. Therefore, regular visits to the dentist and daily cleaning of the teeth can help clean the surface stains to ensure your teeth’ health.

Dentin

Ivory is located in the lower part of the enamel. Dentin has hard tissues that include thin microscopic tubes. If the enamel is damaged, heat or cold can enter these tubular pathways and cause pain or tenderness. About 45% of the dentin structure comprises the mineral hydroxylapatite, 33% organic matter, and 22% water. Due to the enamel’s transparency, ivory jaundice can significantly affect the overall color of the tooth. Because dentin has a lower mineral content than enamel, it is less brittle and can protect tooth enamel. Two principal characteristics distinguish dentin from enamel: first, dentin is formed over a lifetime, and second, it is more sensitive to the enamel.

Tooth pulp

The pulp or tooth marrow is the soft, inner part of the tooth. The blood vessels and nerves are inside the tooth pulp. Usually, the tooth’s brain is alive and active, but caries and damage to the arteries and nerves can lead to the pulp’s death. In these cases, endodontic treatment or neurosurgery is required.

Cement

The cementum is a connective tissue layer that firmly connects the teeth’ roots to the jaws and gums. Cement is slightly softer than dentin, and 45 to 50 percent of its structure is made of the mineral hydroxylapatite, and 50 to 55 percent of it is made of organic matter and water.

The organic composition of this part is composed of proteoglycans and collagen. The cementum has no blood vessels and feeds its internal cells through the surrounding vascular tissues. This part of the tooth is yellow and lighter in color than dentin. It also has the highest amount of fluoride compared to other mineral tissues.

Periodontal ligament

The periodontal ligament is a collagenous tissue that helps hold teeth in the jaw. The periodontal ligament is attached to the cementum on one side and the other’s alveolar bone.

The function of this tissue is independent of this organ. It may be a completely healthy tooth, but this supporting tissue is loose and loses its efficiency due to the disease.

Types of teeth

Every average adult has 32 teeth in his mouth, all of which have already disappeared by 13. These teeth include the following:

* Anterior 

The anterior teeth include the eight middle teeth of the upper and lower jaws. These teeth are responsible for cutting and slicing food.

* Fangs

These four canines are located right next to the anterior teeth. The surface of this organ is sharp and causes food to decompose. There are four canines in both deciduous and permanent teeth.

* Small mill 

This organ is located between the canines and the large mill of this organ, and unlike the anterior teeth and canines, their surface is smooth and even. The milk of this organ is responsible for crushing food. In total, we have eight small mill teeth in our mouths.

* Large mill 

Although the large mill’s teeth are located at the back of the mouth, they are the best food mills. This type of organ is the largest type of organ and has a large surface area for breaking down food. Primary deciduous teeth have eight large molar teeth, and permanent teeth have 12 large molar teeth.

*Wisdom 

This organ type begins to grow at the age of 18 but is often pulled out because it causes other teeth to move. Some doctors recommend removing this type of tooth even if it is healthy!

Dental problems and diseases

The space inside the mouth is home to a variety of bacteria. Therefore, these organs of our body are easily exposed to all kinds of problems and diseases.

Problems and diseases include:

Caries

Some bacteria are not killed by toothbrushes and saliva and can damage the enamel and its deep parts. The incisors are more damaged than other teeth. A cavity called tooth decay is a cavity that forms in this organ. The cavities are small at first and gradually get bigger and bigger. Also, cavities do not cause any pain in the early stages. Therefore, people do not treat them promptly. Regular visits to the dentist can diagnose caries promptly.

According to published statistics, caries is one of the most common health problems in the world. Also, babies’ teeth are not safe from this problem and can rot.

Symptoms of tooth decay:

The symptoms of tooth decay depending on the severity of caries. These symptoms include the following:

  • Tooth sensitivity
  • toothache
  • Visible holes in the teeth
  • White or black spots On this organ
  • Causes of tooth decay
  • Plaque is a sticky substance that sticks to teeth and causes decay. Dental plaque is a combination of the following:
  • bacterias
  • Saliva
  • acid
  • Food particles

Everyone has bacteria in their mouth. After eating or drinking sugary foods, the bacteria in your mouth convert sugar into acid. In this case, plaque starts on the tooth. For this reason, it is necessary to use a toothbrush after eating sugary foods and drinks.

The plaque destroys the enamel after it sticks to the tooth. Everyone is prone to tooth decay. But some people suffer more from caries than others:

  • People who consume a lot of sour and sweet foods and drinks
  • People who do not insist on brushing and flossing
  • People who do not get enough fluoride
  • People with dry mouth
  • People who suffer from overeating or anorexia
  • For people who suffer from gastroesophageal reflux disease and acidic fluid that returns from their stomach, enamel.

The grooves of the mill teeth allow food particles to be easily trapped inside them. Flossing is more difficult in the case of mill teeth. Therefore, these teeth are more prone to decay.

Periodontal

Periodontal is a type of gum disease that occurs due to swelling of deep tooth structures and is mostly due to poor oral hygiene. In acute gum infections, the soft, damaged tissue and bones that support the teeth are destroyed. Because of this, periodontitis can lead to the loss of this organ. However, this infection is preventable. Brushing at least twice a day and regular dental checkups can significantly reduce the risk of disease. (Pneumonia; Symptoms, Causes, And Treatment Methods)

Periodontal symptoms:

Healthy gums are firm and pale pink. At the same time, fitting into the surrounding teeth. Periodontal signs and symptoms can include the following:

  • Swollen or swollen gums
  • Pale red, dull, or reddish gums
  • Gums that feel tingling when touched
  • Bleeding gums
  • The gums are behind the teeth and make your teeth longer than normal.
  • New spaces between teeth
  • Wounds between the gums and teeth
  • Bad Breath
  • Loosening of teeth
  • Painful chewing
  • Change the position of your teeth when biting.

There are several different types of periodontitis. Common types of periodontitis include the following:

  • Chronic periodontitis is the most common type of gum disease that affects most adults. However, it can also occur in children. Periodontal occurs as a result of plaque formation and progresses slowly. Of course, the situation may improve or worsen.
  • Invasive periodontitis begins in childhood or early adulthood and affects only a small number of people.
  • Necrotizing periodontal disease is associated with gum tissue death, tooth ligaments, and abutment bones that result from severe infections. This type of periodontitis generally occurs in people whose immune systems are suppressed. People with cancer, as well as HIV, are in this category.

Gingivitis

In this case, the surface of the gums and around the crown of the tooth swells. Plaque and tartar can cause gingivitis. Gingivitis means inflammation of the gums and is usually caused by forming a film of plaque or accumulating bacteria on the teeth. It is a non-destructive periodontal condition but can lead to periodontal disease if left untreated.

Symptoms of gingivitis include redness and inflammation of the gums. Also, in these conditions, the patient’s gums bleed easily from brushing. Like many dental diseases, gingivitis is caused by inadequate oral hygiene and can be treated with regular brushing and regular flossing. Also, an antiseptic mouthwash may help treat it.

In milder cases, the person may have gingivitis but may not be aware of the disease. However, if symptoms are observed, they should be taken seriously and treated promptly.

Types of gingivitis:
  • Gingivitis due to dental plaque: This condition can be caused by plaque, systemic factors, medication, or malnutrition.
  • Non-plaque gingivitis: This type of gingivitis can be caused by a specific bacterium, virus, or fungus. Also, genetic factors, allergic reactions, wounds, or the body’s reaction to foreign factors such as prostheses can cause this particular type of gingivitis.
Causes of gingivitis:

 The most common cause of gingivitis is bacterial plaque accumulation between and around the teeth. The presence of plaques stimulates immune responses that can lead to the destruction of gums or gum tissue. It can also eventually lead to more severe complications such as tooth loss.

Dental plaque is a biofilm that accumulates naturally on teeth. These plaques are usually caused by the accumulation of bacteria that try to stick to the tooth’s smooth surface. Bacteria may protect teeth against the accumulation of harmful microorganisms, But plaque can cause tooth decay and cause periodontal problems such as gingivitis and chronic periodontitis.

If dental plaque is not adequately removed from the tooth surface, it can become plaque or tartar near the gums. The mass and tartar are both yellow and should be cleaned professionally by a doctor. Finally, the presence of plaque and tartar causes the gums to swell and bleed immediately.

Other causes and factors of oral diseases

Some conditions can lead to oral problems and increase the risk of developing them:

  • Hormonal changes: Puberty and pregnancy can cause sensitive gums and increase the risk of inflammation.
  • Diabetes and HIV: Other diseases, such as diabetes and HIV, also increase the risk of gingivitis.
  • Medication: Some medications can adversely affect oral health; Especially if they reduce the flow of saliva. For example, Dilantin, an anticonvulsant, and some antianginal drugs can cause abnormal gum tissue growth.
  • Smoking: People who smoke regularly are more prone to oral disease than non-smokers.
  • Age: With age, the risk of gingivitis increases.
  • Improper diet: Diets that do not have enough vitamin C are more likely to develop gum disease.
  • Family history: People whose parents have had gingivitis have a higher risk of developing the disease. This may be because some of the body’s bacteria are formed at birth.

Tooth tartar

If plaque is not removed from the tooth surface, it mixes with minerals and turns into tartar, a more rigid material than plaque. Tartar removal is not your job and requires professional cleaning. You need to know that no matter how well you take care of your teeth, there are still bacteria in your mouth. These bacteria mix with proteins and food products to form plaque. These plaques stick to the gum line’s bottom on the teeth, dental fillings, and other items. Plaque carries bacteria that can damage tooth enamel and lead to cavities.

If plaque remains on the tooth, a more significant problem called tartar occurs—Tartar, also called tooth mass, forms below and above the gums. Toothpaste is rough and porous and will cause gum disease and should be removed with special dental tools.

How does tartar affect teeth and gums?

Tartar can make the process of brushing and flossing more difficult than usual. Also, plaque or tartar will cause cavities as well as tooth decay.

Any tartar that is above your gum line can have adverse consequences for you. Because of this, bacteria in toothpaste can irritate and damage your gums. Over time, gum disease will worsen.

Plaque removal solutions

As mentioned, plaque is a sticky film formed by bacteria inside the mouth on the teeth. When plaque stays on your teeth for a long time, unpleasant consequences will befall you.

Plaque weakens teeth and leads to tooth decay and gum disease. Of course, it is not possible to get all the bacteria out of the mouth; But there are steps you can take to prevent them from accumulating on your teeth:

1-Brush at least twice a day

Everyone knows that brushing is necessary. But how many times a day is it necessary? Ideally, it would help if you brushed after each meal to remove plaque as soon as it forms. Brushing before bed is very important; Because if you do not brush at this time, the plaque has a chance to settle on your teeth all night long!

Try to choose your toothbrush soft. Hard toothbrushes may irritate your gums. Change your toothbrush every 3 to 4 months. If your toothbrush is old, it will not work correctly. Follow these tips when brushing:

  1. When brushing, hold your toothbrush at a 45-degree angle to your gums.
  2. Brush your bristles in a soft, circular motion
  3.  Brush your tongue to kill bacteria and freshen your breath.
  4. Try to increase your brushing time to 2 minutes
  5. Meanwhile, electronic toothbrushes are more effective at removing plaque than regular toothbrushes.
2- Clean between your teeth

Plaque does not just accumulate in your teeth. They can also be located between the teeth. Therefore, flossing or other tools will be appropriate. Therefore, it is essential to know that brushing alone does not remove plaque, and flossing is necessary at least once. If you have trouble flossing around your fingers, there are other alternatives to flossing:

  • Toothpick
  • Floss equipped with a holder
  • Small toothbrushes with brushes placed between the teeth
  • Floss with mouthwash (a device)

Remember that there is no right or wrong time to clean between your teeth. You can floss before or after brushing; make sure you do!

3- Rinse with mouthwash

For many people, using antibacterial mouthwash can be an excellent option to prevent plaque because mouthwash helps to remove plaque more efficiently. Some mouthwashes contain alcohol and cause dry mouth. At the same time, dry mouth is not suitable to prevent plaque from closing the teeth. Because your saliva helps keep your mouth healthy. In a dry mouth, more sticky plaques form that is harder to remove. So choose a mouthwash that does not contain alcohol.

4- Reduce consumption of sour and sweet foods

After you stop eating, the bacteria go to the sugar left in your mouth and feed on it. The sweeter your food, the more bacteria will accumulate in your mouth.

On the other hand, sugary and acidic foods cause tooth decay. Therefore, eat less of these foods to prevent further problems.

5-Tooth overbite

 In the overbite mode, the upper teeth are shorter than the mandibular teeth. Overbite is a common dental disease that occurs if your teeth do not fit properly. It can be caused in the early childhood stages by habits such as thumb sucking, tongue pressing on teeth, or prolonged use of a pacifier. When the arch and roof of the mouth become narrow, the mandible has no choice but to retreat, and the upper teeth can not overlap with the mandibular teeth. Overbite is more likely in patients who have lost their mill teeth. Although overbite is usually treated between the ages of 10 and 12, it can be treated at other ages.

Home overbite detection:

Close your mouth normally. Put your teeth together naturally to make sure your jaw is comfortable without tooth pressure. This movement can indicate that your teeth are in a normal position or not overlapping.

  • Look in the mirror and smile. To be able to detect an overbite, you need a mirror to help you show your teeth. Smile and show your teeth while standing in front of the mirror.
  • Get as close to the mirror as possible and smile so that your lips are away from your teeth.
  • Check if the upper teeth are in front of the lower teeth.
  • If the upper teeth are more than 3.5 mm from the lower teeth, you have an overbite.
  • You may also feel that the lower row teeth are close to the mouth’s roof in overbite mode.
6-Tooth underbite

In this case, the lower teeth protrude significantly from the upper teeth. Some underbites are severe and cause the mandibular teeth to protrude. Other cases are milder and almost unnoticeable. However, the problem of underbite teeth is more than just a cosmetic discussion. An underbite is not a problem; But in severe cases, it can cause oral health problems. These include biting and chewing food, difficulty speaking, and jaw and face paint due to the jaws’ misalignment.

Reasons for underbite teeth

How your teeth align can be influenced by several factors. Typically, teeth grow so that the upper teeth are slightly ahead of the lower teeth. Your mill teeth, which have a flat, flat surface at the back of the mouth, should align with other teeth. Proper tooth alignment helps you not to bite your jaw or tongue when eating accidentally.

In the meantime, some factors can lead to an underbite problem. These factors include the following:

1.Childhood habits: Some childhood habits can lead to underbite or other dental malformations.

  • Thumb sucking
  • Pressing the tongue on the teeth
  • Use of pacifiers in children over three years old
  • Long-term feeding from a glass of milk after childhood

2.Genetics: Genes have a more significant impact on our lives than we think! Most of the time, the underbite or front of the mandible is an inherited condition. Genetics can decide the shape and size of our jaws and teeth. Therefore, if a family member has this problem, there is a possibility that it will occur in other people as well.

3.Injury: Severe injuries can cause permanent damage to the jaw. Of course, most of the time, a broken jaw can be repaired, but after surgery, the jaws do not necessarily fit together, and eventually, an underbite problem develops.

4.Tumors: Tumors of the jaw or mouth can cause the jaw and underbite to protrude.

Underbite treatment:

Most people are not born with perfectly aligned teeth. There are usually a few people whose teeth do not need medical treatment. However, there are many benefits to treating underbite. After treatment, teeth will be easier to clean, and the risk of tooth decay and gum disease will be reduced. You will also feel less pressure on your teeth, jaws, and facial muscles.

8.Bruxism or gnashing

Bruxism is a condition in which a person involuntarily or involuntarily presses their teeth together, and the teeth erode. Internal stress is the most common cause of bruxism. Bruxism does not necessarily cause a particular problem, but in some people, it is associated with pain in the head and face area and tearing and deformation of the teeth.

Symptoms of bruxism include:
  • Facial pain
  • Headache
  • Ear pain
  • The feeling of pain and stiffness in the jaw area and surrounding muscles
  • Sleep disorder
  • Tooth decay can lead to tooth loss.
  • Broken teeth or their filling materials
  • Usually, in acute cases of bruxism, the teeth are damaged.

When to see a doctor for bruxism?

In these cases, see a dentist:

  • Your teeth are worn, damaged, or sensitive.
  • You feel pain in the jaw, face, or ears.
  • Others inform you that you gnash your teeth in your sleep.

You may need dental care to prevent problems such as infection or dental abscess. If gnashing of teeth is caused by stress, a neurologist can help you control it. In the meantime, the use of mouthguards reduces the wear and tear of the teeth. Also, muscle relaxation exercises before bed can help prevent gritted teeth.

Treatment of tooth decay:

Dental fillings are the least common dental problems that occur to most of us several times in a lifetime. The dentist fills the decayed part of the tooth with one of two materials, amalgam or composite, to prevent caries from progressing. Each of these materials has its advantages and disadvantages:

Advantages and disadvantages of amalgam:

Amalgam fillers are made from various metals such as silver, mercury, zinc, and copper; Compared to composite, this type of filling is more cost-effective and has longer strength and durability. Adequately covered, it will withstand a lot of adverse conditions for up to 15 years. Because the metal alloy is used to make amalgam, it is more resistant to impact or possible damage and is a preferred option for deeper decay.

In recent years, however, the mercury element in amalgam has led to its notoriety. Mercury is a heavy metal, and some patients are allergic to it. Another negative point is its appearance. Silver fillers are very popular when laughing or smiling. Over time, amalgams can darken the appearance of filled teeth and affect the role of the smile.

Advantages and disadvantages of composite:

Composite fillings, known as toothpaste fillings, are a combination of acrylic and ceramic that can give your teeth a natural and beautiful look. Also, in composite placement, less enamel is shaved, and the tooth structure is preserved as much as possible.

Disadvantages of dental composite include its high cost and a shorter lifespan than amalgam. Hence, amalgam is more cost-effective than composite. Because the composite does not have amalgam durability, its lifespan eventually reaches 7 to 10 years.

Composite or amalgam?

Composite would be a better option if the tooth to be repaired is visible when smiling. For the back teeth of the mouth, which are more prone to decay, amalgam will be more durable.

Root canal treatment or denervation:

Neurosurgery or endodontic treatment is performed when the tooth is severely decayed and infected. In the denervation process, the nerve and pulp inside the tooth are removed and cleaned and sealed inside the tooth canals. Otherwise, the tooth becomes infected and may lead to an abscess. The tooth nerve is located inside the root canal, and the tooth acts as a cold or heat sensor; Therefore, it does not play an essential role in dental health, and its presence or absence does not affect the daily function of the tooth.

Why is a dental pulp removed during denervation?

When nerve tissue or the pulp of a tooth is damaged, bacteria multiply in the pulp chamber. Bacteria and other decaying debris can cause abscesses or tooth decay. An abscess is a pus-filled sac that forms at the end of the root. An abscess occurs when the infection spreads along the entire end of the tooth roots. Therefore, the tooth pulp is removed to prevent the infection from progressing.

How is dental denervation performed?

A dentist or endodontist can perform neurosurgery. The level of difficulty or complexity of endodontic treatment determines which one to refer to.

Usually, the first step in endodontic treatment is to take an x-ray of the tooth to determine the root canals’ shape and infection signs in the surrounding bone. Neurosurgery usually uses anesthetic injections around the damaged tooth. Of course, anesthesia is not necessary, but dentists usually inject anesthesia for the patient’s comfort. Next, it is necessary to keep the oral environment dry to perform denervation of glossy discharge. Therefore, suction rubber tubes are used for this purpose.

The dentist then makes a hole in the tooth with a special drill. In this way, the pulp and the bacteria, the decayed nerve tissue, and the corresponding debris are removed from the tooth. The cleaning process is done using special needles called files. Files come in different sizes to scrape and shred root channels. Water pressure or sodium hypochlorite is used to drain the shaved parts.

Once the tooth is completely clean, there are two ways: Some dentists postpone the final restoration to a week after denervation to remove any remaining infection with medication. Some dentists also perform final restorations immediately after denervation.

At the next visit, the dentist uses a sticky paste and a rubber compound called gata to fill the tooth’s inside and insert it into the tooth’s root canal. A filler is placed to fill the external cavity created at the beginning of the treatment.

The final stage of restoration may be associated with additional cases in some teeth. In severe caries, tools such as pins or posts are usually inserted into the canal to protect the tooth further to avoid the risk of breaking the denervated tooth.

Is denervation painful?

Due to the anesthetic effect, the denervation process is usually painless. However, in the first few days after denervation, normal tissues may become sensitive to inflammation; Especially if there was pain or infection before the denervation. Of course, this pain and discomfort can usually be cured with painkillers such as ibuprofen or naproxen. On the other hand, it is recommended that you refrain from chewing food with the treated tooth until it has been entirely denervated to prevent it from breaking.

 How successful is denervation?

Root canal treatment is usually successful in 95% of cases; Also, some denervated teeth remain healthy for the rest of their lives.

Complications of dental denervation:

Despite your dentist’s efforts to clean the canals and veneers, the denervated tooth may still become infected. Infection of a denervated tooth can be due to:

  •  The number of canals has exceeded the dentist’s diagnosis, and one of them has not been cleared.
  • Existence of unknown cracks in the root of the tooth
  • In some cases, re-denervation can be successful. In other cases, the doctor must choose another way to save the tooth. One of the most common surgical procedures is endodontic surgery or root canal resection. This method reduces inflammation or infection in the bony area around the end of the tooth. In this procedure, the gingival tissue is opened, and the infected tissue is removed, and sometimes the end of the root is removed, followed by a small filling to seal the root canal.

In some cases, after denervation, a large part of the tooth wall is shaved due to excessive decay; In these cases, the dentist suggests using dental veneers to make the teeth look better and have a longer life.

Various factors can threaten dental health; our teeth do not have many opportunities against our inattention, and we will have to spend a lot of money to maintain them. Practical and straightforward oral health care can significantly reduce dental problems and prevent many diseases.

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