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Tooth issues can occur no matter what age you are. From the littlest child to the oldest adult, having good education when tooth issues arise is paramount. Have you ever wondered what parts make up your teeth? Why they are so strong?

Anatomy Of A Tooth

The anatomy of a tooth is actually quite simple. A tooth is made up of various layers that work together to give us our beautiful smiles. Every tooth is made up of multiple parts. These parts are as follows:

-Crown. This is the part of the tooth that you see when smiling. The crown is covered in a white colored material called enamel. Enamel is the hardest substance found in the human body. Even though enamel is very strong, it can easily be broken down by the acids produced by oral bacteria and the acids found is many popular drinks like soda.

-Dentin. Dentin is the layer right beneath the enamel.  Although not as hard as enamel, it’s hardness rating is comparable to that of bone.  Another great quality of dentin is it’s flexibility.  For example, if you bite down on a very hard food, the dentin is able to flex a little bit and can keep your tooth from cracking like it might if teeth were just made of enamel.

-Pulp. This is the inner most layer of the tooth.  The pulp provides bloodflow and nutrition to the tooth. The pulp also allows for the nerves to enter the tooth. Without proper bloodflow and innervation of the nerves a tooth will die. The pulp of a tooth is removed during root canal therapy. This procedure allows your dentist to save the tooth for form and function. Once the pulp is removed from a tooth it becomes more brittle with an increased risk of breaking. This is why dentists often recommend placing a dental crown over a tooth that has received root canal therapy.

-Root. This part of the tooth is hidden under the gum tissues. This can be visible when the gums recede as can happen during periodontal disease. The root is what anchors the tooth inside the bone allowing for support during chewing of food. One other portion of the root is called cementum. The cementum is a thin layer that anchors the tooth to the bone thru the periodontal ligament.

Periodontal Ligament (PDL). The main function of the periodontal ligament is to attach the teeth to the bone.  The peridontal ligament also sends sensory information to the brain.  For example, if you are eating some popcorn and bite down hard on a popcorn kernel, your jaw suddenly opens to alleviate the pressure.  The periodontal ligament sends that pressure signal to your brain, causing that reflex. The tooth doesn’t feel the pressure since the tooth is only capable of sending pain messages to your brain.

-Gingiva (GumTissue). The gums form a collar or sheath around the teeth that protects the underlying bone.  When you stop brushing your teeth for an extended period of time, the gingiva become red and puffy as the body begins the inflammatory process. This is the body’s way of defending against the plaque that has built up.  If you completely stop brushing, the gingiva will eventually start to lose the war against plaque and recede from around the teeth resulting in periodontal disease that can eventually loosen your teeth.

-Bone. The bone holds the whole tooth in its place.  The bone is constantly remodeling itself. This is in response to various forces it experiences in the mouth.  For example, if you have braces on, there are forces pushing on the teeth.  The bone remodels itself to help the tooth move to the position in which it is being pushed.

Different Types Of Teeth

Every tooth in the mouth has a specific function. The teeth in your mouth are as follows:

-Incisors. These are the sharp, chisel-shaped front teeth (four upper, four lower). They are used for cutting foods.

-Canines. These are sometimes called cuspids, these teeth are shaped like points and are used for tearing foods.

-Premolars. These teeth have two pointed cusps on their biting surface and are sometimes also called bicuspids. The premolars are used for crushing and tearing.

-Molars. These teeth are used for grinding, these teeth have several cusps on the biting surface.

Conclusion

An educated patient is an informed patient who can make smart decisions regarding their dental and health care. Our teeth are quite strong but they are under constant bombardment from outside forces at all times. If you are experiencing any tooth issues see your dentist immediately to put your mind and dental health at ease.



Most kids tend to have accidents that cause some sort of injury while growing up. The injuries usually range from a scraped knee to a broken bone. Most of us don’t make it into adulthood without a scar, or chipped tooth. When a child falls and loses a tooth, what can be done?

Dentists generally refer to a tooth that has been knocked out as an avulsed tooth. The accidental loss of a tooth through trauma is considered a very serious dental emergency for a permanent tooth (occurs in about 10% of the population). When a primary tooth is avulsed, re-implantation is generally not successful. The remaining space is usually left open for the permanent tooth to arrive. When a permanent tooth is avulsed, if you act quickly enough, there is a chance the avulsed tooth can be saved and maintained for many years. Even the best techniques and intentions do not always lead to a successful outcome for an avulsed tooth.

The usual cause of an avulsed tooth is a  force sufficient to break the bond between the tooth and the connection (periodontal ligament) to the bone. An avulsed tooth has no oxygen or blood flow and will die quickly if not re implanted. The primary goal of quick reimplementation is to maintain the periodontal ligament, so that the tooth is not rejected. The avulsed tooth will always need to be splinted to the other teeth, and usually, but not always, require a root canal. The speed in which the tooth is re implanted, the cleanliness of it, and how hydrated or wet it has been, all play key roles in whether or not re-implantation of the avulsed tooth will be successful.

My Child Lost A Tooth Too Early…What Now?

So what if the tooth is lost…..Can my child get dental implants?

Unfortunately, for children, the answer is no. Dental implants can only be placed after the bones of the jaw are finished growing. Dental implants placed during growth will impede jaw growth as well as proper movement of teeth into their natural places in the mouth.

The earliest recommended ages for dental implants  are as follows:

-Males – At least 17 years old.

-Females – At least 15 years old.

The determining factor for males and females is completion of growth. Females generally complete growth at an earlier age and thus can receive dental implants sooner to replace lost teeth.

Alternate Treatment Options To Dental Implants

Few children and most teenagers are going to want to replace their missing tooth as soon as possible. The options are quite limited and include the following:

-Flipper -This is a removable appliance that is able to fill the space of the missing tooth with an artificial tooth. This can create a cosmetic appearance that would be undetectable by others. It can appear very natural looking, but may affect speech and taste.

Dental Bonding – While very rare, there are instances where a “fake” tooth can be bonded to a natural tooth.

-Braces (Orthodontics) – Sometimes the missing tooth space can be closed with braces, or a false tooth can be placed on an orthodontic wire while the bite is restored.

Conclusion

Accidents happen. Fortunately, most tooth loss is short-lived for a child, as permanent teeth will soon come in to replace the baby teeth. For many, the cosmetics are not much of an issue, and can be left alone to fill in naturally. For others, there are options to help with the space maintenance and cosmetics after tooth loss. No matter what, you should discuss options with your dentist. While some teeth may be replaced by permanent teeth in a few months, others may be several years. Choose what works best for you and your child. If a permanent tooth is lost, your child will most likely need replacement after growth has ended.  Once a child matures and completes growing, dental implants can replace the lost tooth and give a lifetime of smiles.

Avulsed Tooth is the complete displacement of a tooth from its socket in alveolar bone from trauma.

Dentists generally refer to a tooth that has been knocked out as an avulsed tooth. The accidental loss of a tooth through trauma ( avulsed tooth ) is considered a very serious dental emergency for a permanent tooth (occurs in about 1/10th of the population). For an avulsed primary tooth re-implantation is generally not successful, and is usually left alone. For a permanent tooth if you act quickly enough there is a chance the avulsed tooth can be saved and maintained for many years. Even the best techniques and intentions do not always lead to a successful outcome for an avulsed tooth.

The usual cause of an avulsed tooth is a  force sufficient to break the bond between the tooth and the connection (periodontal ligament ) to the bone. An avulsed tooth has no oxygen or blood flow and will die quickly if not re implanted. The primary goal of quick reimplementation is to maintain the periodontal ligament, so that the tooth is not rejected. The avulsed tooth will always need to be splinted to the other teeth, and usually, but not always, require a root canal. The speed in which the tooth is re implanted, the cleanliness of it, and how hydrated or wet it has been all play key roles in whether or not re-implantation of the avulsed tooth will be successful.

Instructions for an Avulsed Tooth

If a tooth has avulsed due to trauma it must be re implanted in its socket within 60 minutes (or sooner if possible) of the accident for the best chance of a positive result (i.e. tooth remains in position). It is important to keep the root surface of the avulsed tooth moist. This is the reason for the need for speed when re implanting the tooth.

An avulsed tooth, whose structure is maintained without any major fracture, must be re-implanted in its socket within an hour after the accident for best chances for it to remain in position. The best option is to attempt re-implantation within the first few minutes at the site where the accident occurred. The avulsed tooth should be attempted to be cleaned and placed back into the socket ( hole in jaw ) by an adult. This can be either the person who lost his or her tooth or by an adult if a child has suffered the trauma. If the avulsed tooth goes back into its socket where it was originally then it would be considered to be a successful re-implantation.

smileIf the avulsed tooth is dirty, it is vitally important that it is cleaned, the best way is with the patient’s own saliva by putting it in their mouth. Once the avulsed tooth is cleaned in this manner the patient should spit out any blood and dirt in mouth. While spitting, you probably will remove the blood clot forming in the avulsed tooth socket. This will allow an easier re-implantation of the avulsed tooth into the socket. the tooth can also be rinsed with cold water or milk. When the avulsed tooth is as clean as you can get it, it should be placed back in the socket as soon as possible. The quicker it is done, the better the chance for success. There are also “tooth saver” kits made to hold and keep the avulsed tooth wet for transport to a dentist.

If the avulsed tooth cannot be repositioned in its socket for any reason, then it should be brought to the dentist as soon as possible. There are a few ways to accomplish this:

1) The avulsed tooth should be rinsed and cleaned as explained above. The person who had the accident must then keep the avulsed tooth in their mouth. They should keep the avulsed tooth under the tongue or between the cheek and back teeth or lip and front teeth. If the trauma happened to a young child the previous advice should be disregarded as they can swallow the tooth. In such a case, the avulsed tooth should be rinsed and placed in milk, or in water with salt. Go to your dentist as soon as possible.

2) After cleaning with saliva, the avulsed tooth can be put in a solution of water and salt. A half a teaspoon of salt should be mixed in a cup of water. It is best to use bottled water if it is  available, but tap water can also be used in a pinch.

3) The avulsed tooth can also be placed in fresh room temperature milk. The patient and avulsed tooth in solution should be brought to the dentist as soon as possibleSave-a-tooth avulsed tooth kit

4) There is a commercial product available for the storage of an avulsed tooth. It is called Save-A-Tooth. This is a small container containing fluid to help preserve the avulsed tooth  for easy transport and re-implantation.

Exceptions to the Rule

The instructions above are recommended for adult teeth only. If a primary tooth (also called baby tooth) has avulsed following an accident, the re-implantation will not really work.

-If the adult avulsed tooth is broken or has visible fractures following the trauma, and or its root remained in the socket, the re-implantation will not be successful. This is because the tooth will not reattach to its root, and a fractured tooth will continue to break down.

Prognosis of Avulsed Tooth following Re-Implantation

It should be remembered that even if you follow all of these recommendations precisely, the tooth in question may eventually need to be extracted. If the instructions are followed correctly, chances are better that the tooth may remain in position.  An immediate splinting to the other teeth is optimal to take stress off the tooth and allow for healing. It may eventually need root canal treatment and possibly a crown to restore the avulsed tooth to its full form and function.

The re implanted  tooth can also seem to be fine for a few months or even a few years before it eventually becomes a problem.

At the Dentist Office

Putting the avulsed tooth back in its socket sometimes can be quite easy. And sometimes it can be very complicated, such as when the tooth or bone is fractured or broken. Your dentist may use water to flush debris from the socket. Then they will attempt to slide the avulsed tooth back into place. As mentioned earlier, it is most important to re implant the tooth as soon as possible. Ideally, this should occur within the hour of the accident.

The best course to take will depend upon how long the tooth was out of the mouth and amount of trauma. In either case, the dentist will splint the avulsed tooth to the teeth on either side with a soft wire and/or a resin material. This will be used to maintain the tooth in place for days-weeks.

If the bone around the tooth was not fractured, the root usually will reattach firmly to the bone in about three to four weeks. More extensive damage to the area may need 6-8 weeks of healing time.

Your dentist should examine the tooth again in three to six months to ensure the tooth is doing fine with no evidence of infection occurring. If there are no signs of infection, the next visit will be at your yearly dental examination. The dentist will then continue to monitor the tooth for the next 2-3 years to ensure that the tooth re implanted successfully.