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 Tooth Anatomy

Bone: Hard tissue that roots are attached to.

Root: Joins the tooth to the bone.  Canines, incisors, and premolars have one root; molars of the upper jaw have three roots and molars of the lower jaw have two roots.

Gum: The soft tissue surrounding the base of the tooth.

Pulp: Soft center of the tooth surrounding the nerves and the blood vessels. 

Nerves and Blood vessels: Blood vessels carry food and oxygen to the tooth and collect the waste from the tooth.  Nerves carry signals to and from the brain.

Enamel: The white outer surface of the tooth.

Dentin:  Located under the enamel of the tooth.

Crown: The visible part of the tooth. 

The permanent teeth replace the primary teeth.  The primary teeth are twenty and are usually replaced by the age of twelve to thirteen.  Permanent teeth in adults are thirty two. 

1. Canine- Adults have four canines, two in upper jaw and two in lower jaw between the incisors and the premolars.
2.  Incisors- Adults have eight incisors (the front teeth), four in upper jaw and four in lower jaw.
3. Premolars- Adults have eight premolars, four in upper jaw and four in lower jaw located between the canine and the molars.
4. Molars – Adults have twelve molars, six in the upper jaw and six in the lower jaw located towards the back of the mouth which is used for grinding food. 

What is Plaque?
Plaque is the sticky, colorless film of bacteria that forms on teeth.  Plaque forms when foods containing carbohydrates (sugars and starches) such as milk, yogurt, soft drinks, raisins, cake, candy or other sweets are deposited on the teeth.  Favorable mouth bacteria that live in the mouth survive on food containing carbohydrates and produce acids as a waste product.  As time goes by, these acids damage the tooth enamel, resulting in tooth decay.  Plaque can also penetrate under the gum and develop on the tooth roots and cause breakdown of the bone supporting the tooth.

How to prevent plaque formation and tooth decay?

• Brush your teeth with a soft toothbrush in a circular motion at least twice a day. Make sure to use fluoride-containing toothpaste. 
• To remove food and bacteria, floss between teeth at least once a day.
• Brush your tongue every night with a soft tooth brush or special tongue brush.
• See your dentist for a check-up and teeth cleaning twice a year.
• Eat healthy foods.  Avoid candy (especially sticky ones) and junk food, which can remain on the tooth surface until washed.  Brush your teeth after eating junk foods and/or candies.
• Eat a balanced diet.  Snack, on nutritious foods such as plain yogurt, cheese, vegetables (preferably raw) and fruit (preferably hard once hard like apples.)  Raw vegetables, such as celery and carrots, help remove food from between the teeth and help in saliva production, which neutralizes plaque-causing acids.

Factors that lead to the development of tooth sensitivity:

1.      Plaque:  Plaque can penetrate from the surface to the root of the tooth and cause sensitivity especially to sweet, sour (acidic), cold and hot foods or even using mouth wash for a long period of time.

2.      Using a hard tooth brush:  Using a hard brush will cause gum recession and destroy tooth enamel.  Brushing hard has also the same effect. 

3.      Gingivitis:  Gingivitis causes loss of gum tissue, which can cause irradiation and exposure of the root leading to the tooth nerves, destruction of tissues around the tooth, and eventually tooth loss.

4.      Broken teeth:  Chipped, cracked, decayed or broken teeth may collect plague (bacteria) and enter the soft tissue causing swelling of the gum.  Teeth grinding or clinching hard may break, grind down or crack the tooth.  

5.      Tooth Bleaching:  Tooth bleaching can cause the tooth enamel to wear down causing tooth sensitivity.   Toothpastes with baking soda and peroxide have the same types of effects.

Following suggestions will help you to reduce tooth sensitivity.

1.      Proper Brushing:  Properly brush and floss to keep your teeth as clean as possible.

2.      Use a soft tooth brush: To prevent gum recession and preserve tooth enamels. 

3.      Use toothpastes that reduce sensitivity:  Make sure to brush and floss before you go to bed every night.  Fluoride- containing tooth pastes will be useful.

4.      Avoid grinding your teeth:  Especially at night.  You can use mouth guard to protect your teeth.

5.      Make sure to go to your dentist:  See your dentist for a regular check up and teeth cleaning twice a year.

Toothache

Symptoms of toothache include:

1.      Sharp constant pain that if it lasts longer than 1-2 days, see the dentist.

2.      Pain when pressure is applied to the tooth.

3.      Swelling and infection of the tooth. It is important to avoid spreading the infection to other parts of the mouth such as gums, jaw, throat, sinuses, ears, nose, and even the skull.  Infection can travel through the blood stream to other parts of the body. Infection can be treated by antibiotic

4.      Fever, earache, and headache.

It’s very important to see your dentist if you have any of the above symptoms.  Never medicate yourself.  

Cavities
Cavities occur as a result of tooth decay. When the tooth structure is damaged and tooth enamel is destroyed, tooth decay is formed.   Cavities can occur at any age from children to adults, but adult decay is usually is more or less around the tooth fillings.  As the time goes by, the fillings will become week, cracked, and chipped, thus bacteria can penetrate in and cause cavities, resulting in tooth decay.  Advanced tooth decay is sensitive to sweet, sour, cold and hot foods, or you may experience pain.    

Filling Tooth  

A filling is used when the decay is not wide spread over the tooth.  The decayed segment is removed and is replaced by a filling silver, gold, or porcelain.    

Crown   

A crown is used when the majority of the tooth is covered by decay.  In this case, the decayed portion is removed and a crown is placed over the remainder of the tooth.  A crown is a cap in the shape of tooth that covers the damaged tooth to re-establish the original shape and the look of the tooth.  The crowns are also made of silver, gold, or porcelain.  To take care of your crown you should avoid eating chewy and sticky foods, avoid hard foods, and be gentle in flossing to avoid lifting the crown.  If you feel the crown is loose, see your dentist as soon as possible.  If you delay seeing your dentist bacteria may penetrate under the crown and cause decay of your healthy tooth.  If you take care of your crown it can last up to 15 years. 

Root Canal 

When internal parts of the tooth are covered by decay and cause the death of the tooth, a root canal is performed.  In this procedure, the inside of the tooth is cleaned and only the shell of the tooth remains.  Then the tooth is filled with sealing materials and covered by a crown. 

Bridge

A bridge is connected by metal framework that holds the denture in place between two natural teeth.  Some are removable some others are permanent.  Crowns are placed on the missing teeth and on the natural teeth on either side of the missing tooth to form a permanent bridge. If you take care of your bridge properly it can last as long as 10 years.  Make sure to clean between the teeth, brushing daily, and see your dentist regularly to add to the life of the bridge. 

Dentures 

A denture is a removable tooth.   There are two types of dentures complete dentures and partial dentures.  Complete dentures are used when all the teeth are missing.  Partial dentures are used when some teeth are missing and some natural teeth are remaining.

Eating and talking with a new denture will take time and requires practice, patience and a positive attitude.  In the beginning, you should start with soft foods or small pieces of food then work it up to more solid foods. You will be back to your normal eating in few weeks. Avoid hard foods such as nuts, candies and sticky foods such as caramel, gum, and chocolate.  Use denture adhesive only to enhance stability of a well fitted denture.  Do not use it on broken or poorly fitted dentures that as this will cause gum irritation.  Also do not use if you have any allergies to the adhesive materials.
If your new denture is painful, you should see your dentist to find the source of irritation. You should wear your denture all day or if it is comfortable you can wear it while you sleep too.  The new denture makes you look better, smile more often, it helps in the pronunciation of certain words, regaining your confidence, and helps in your overall appearance. You should take care of your denture to last for a long time. 

• Avoid dropping them on a hard surface
• Brush and cleaning them daily or after every meal.  Use a special brush for denture or a soft bristle brush.  You can also use denture cleaner or ultrasonic cleaners, which are used to clean dentures overnight.  In the morning, rinse and wear your denture.

Complete Dentures

Since bones and gums contract especially following the tooth removal, complete dentures are recommended after the healing period.

Dental Implants

Dental implants eliminate the need for a denture, and it looks and feels like natural teeth.  This a more expensive option than dentures. 

Tips to keep your teeth healthy

These tips apply to people of all ages. 

·      Eat lots of fruits and vegetables especially fruits that  hold a high amount of water, such as pears, melons, celery, apples, citrus and cucumbers.

·     Brush your teeth after eating sticky and chewy foods such as cookies, peanut butter, candies, lollipops, etc.  Buy sugar free foods or naturally sweetened candies.

·     Make sure to wash your teeth with fluoride toothpaste before going to bed and after waking up in the morning.  For small children and infants, make them drink plain water     before going to bed and after having cough syrups. Floss your teeth after each meal.

·     Limit snacks to one fruit, cup of milk or yogurt between each meal (breakfast, lunch, and dinner).  Milk and yogurt are good source of calcium.

Gum Disease

Gum disease is a silent and painless disease with no obvious symptoms, it does but have  warning signs, such as, sensitive gums, swelling, bleeding at the time of brushing, receding gums, and loose teeth.

Factors contributing to gum disease include:

1.      Family history of dental and gum disease.     

2.      Smoking which damages the gum tissue and makes it difficult to heal.

3.      Not cleaning your teeth regularly leads to development of gingivitis.

4.      Hormonal changes during teenage years, menopause, pregnancy, and monthly menstruation will makes the gums sensitive and makes it easier for growth of gingivitis.

5.      Some diseases such as cancer, AIDS, diabetes, and other immune system diseases weaken the immune system and can cause gum disease. 

To prevent gum disease: 

1.      Maintain a healthy diet.

2.      Avoid sweets as much as possible.

3.      Avoid junk foods.

4.      Quit smoking and using chewing tobaccos.

5.      The daily vitamins and minerals.

6.      Decrease your stress and avoid grinding your teeth.

7.      Maintain good oral hygiene.

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