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Human Teeth
Human Teeth
Who wants to know more about HISTORY OF DENTISTRY

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Edit section: The Teeth and Their Parts: The Teeth and Their Parts:

 Teeth (singular, tooth) are small white structures found in the jaws (or mouths) of many vertebrates that are used to tear, scrape, milk and chew food. Some animals, particularly carnivores, also use teeth for hunting or defense. The roots of teeth are covered by gums.

Teeth are among the most distinctive (and long-lasting) features of mammal species. Paleontologists use teeth to identify fossil species and determine their relationships. The shape of the animal's teeth are related to its diet. For example, plant matter is hard to digest, so herbivores have many molars for chewing. Carnivores, on the other hand, need canines to kill and tear meat.

Mammals are diphyodont, meaning that they develop two sets of teeth. In humans, the first set (the "baby," "milk," "primary" or "deciduous" set) normally starts to appear at about six months of age, although some babies are born with one or more visible teeth, known as Neonatal teeth. Normal tooth eruption at about six months is known as teething and can be painful.

Some animals develop only one set of teeth (monophyodont) while others develop many sets (polyphyodont). Sharks, for example, grow a new set of teeth every two weeks to replace worn teeth. Rodent incisors grow and wear away continually through gnawing, maintaining relatively constant length. Some rodent species, such as the sibling vole and the guinea pig, have continuously growing molars in addition to incisors.[1][2]

Edit section: Anatomy Anatomy

A third molar.
A third molar.

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Dental anatomy is a field of anatomy dedicated to the study of tooth structures. The development, appearance, and classification of teeth fall within its field of study, though dental occlusion, or contact among teeth, does not. Dental anatomy is also a taxonomical 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 teeth and structures during treatment.

The anatomic crown of a tooth is the area covered in enamel above the cementoenamel junction (CEJ).[3] The majority of the crown is composed of dentin with the pulp chamber in the center.[4] The crown is within bone before eruption.[5] After eruption, it is almost always visible. The anatomic root is found below the cementoenamel junction and is covered with cementum. As with the crown, dentin composes most of the root, which normally have pulp canals. A tooth may have multiple roots or just one root. Canines and most premolars, except for maxillary (upper) 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 teeth (also called deciduous, baby, or milk teeth) and 32 permanent teeth. Among primary teeth, 10 are found in the (upper) maxilla and the other 10 in the (lower) mandible. Teeth are classified as incisors, canines, and molars. In the primary set of teeth, there are two types of incisors, centrals and laterals, and two types of molars, first and second. All primary teeth are replaced with permanent counterparts except for molars, which are replaced by permanent premolars. Among permanent teeth, 16 are found in the maxilla with the other 16 in the mandible. The maxillary teeth are the maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar, maxillary second premolar, maxillary first molar, maxillary second molar, and maxillary third molar. The mandibular teeth are the mandibular central incisor, mandibular lateral incisor, mandibular canine, mandibular first premolar, mandibular second premolar, mandibular first molar, mandibular second molar, and mandibular third molar. Third molars are commonly called "wisdom teeth" and may never erupt into the mouth or form at all. If any additional teeth form, for example, fourth and fifth molars, which are rare, they are referred to as supernumerary teeth.[6]

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 commons systems are the FDI World Dental Federation notation, the universal numbering system, and Palmer notation method. The FDI system is used worldwide, and the universal is used widely in the United States.

Edit section: Parts Parts

Section of a human molar
Section of a human molar

Edit section: Enamel Enamel

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Enamel is the hardest and most highly mineralized substance of the body and is one of the four major tissues which make up the tooth, along with dentin, cementum, and dental pulp.[7] It is normally visible and must be supported by underlying dentin. Ninety-six percent of enamel consists of mineral, with water and organic material composing the rest.[8] 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 2.5 mm, and thinnest at its border, which is seen clinically as the cementoenamel junction (CEJ).[9]

Enamel's primary mineral is hydroxyapatite, which is a crystalline calcium phosphate.[10] The large amount of minerals in enamel accounts not only for its strength but also for its brittleness.[11] Dentin, which is less mineralized and less brittle, compensates for enamel and is necessary as a support.[10] Unlike dentin and bone, enamel does not contain collagen. Instead, it has two unique classes of proteins called amelogenins and enamelins. While the role of these proteins is not fully understood, it is believed that they aid in the development of enamel by serving as framework support among other functions.[12]

Edit section: Dentin Dentin

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Dentin is the substance between enamel or cementum and the pulp chamber. It is secreted by the odontoblasts of the dental pulp.[13] 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.[14] 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 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.[15] 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.[16] 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.

Edit section: Cementum Cementum

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Cementum is a specialized bony substance covering the root of a tooth.[13] It is approximately 45% inorganic material (mainly hydroxyapatite), 33% organic material (mainly collagen) 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 either dentin or enamel. The principal role of cementum is to serve as a medium by which the periodontal ligaments can attach to the tooth for stability. At the cementoenamel junction, the cementum is acellular due to its lack of cellular components, and this acellular type covers at least ⅔ of the root.[17] The more permeable form of cementum, cellular cementum, covers about ⅓ of the root apex.[18]

Edit section: Pulp Pulp

Template:Main The dental pulp is the central part of the tooth filled with soft connective tissue.[14] This tissue contains blood vessels and nerves that enter the tooth from a hole at the apex of the root.[19] Along the border between the dentin and the pulp are odontoblasts, which initiate the formation of dentin.[14] Other cells in the pulp include fibroblasts, preodontoblasts, macrophages and T lymphocytes.[20] The pulp is commonly called "the nerve" of the tooth.

Edit section: Development Development

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Radiograph of lower right third, second, and first molars in different stages of development.
Radiograph of lower right third, second, and first molars in different stages of development.

Tooth development is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. Although many diverse species have teeth, non-human tooth development is largely the same as in humans. For human teeth to have a healthy oral environment, enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth weeks in utero, and permanent teeth begin to form in the twentieth week in utero.[21] 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 branchial arch that is necessary for the development of teeth.[22]

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.[22] 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 (sometimes called the tooth germ) is an aggregation of cells that eventually forms a tooth. It is organized into three parts: the enamel organ, the dental papilla and the dental follicle.[23] The enamel organ is composed of the outer enamel epithelium, inner enamel epithelium, stellate reticulum and stratum intermedium.[23] 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.[23] Additionally, the junction between the dental papilla and inner enamel epithelium determines the crown shape of a tooth.[24] The dental follicle gives rise to three important entities: cementoblasts, osteoblasts, and fibroblasts. Cementoblasts form the cementum of a tooth. Osteoblasts give rise to the alveolar bone around the roots of teeth. Fibroblasts develop the periodontal ligaments which connect teeth to the alveolar bone through cementum.[25]

Edit section: Eruption Eruption

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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.[26] Another, known as the cushioned hammock theory, resulted from microscopic study of teeth, which was thought to show a ligament around the root. It was later discovered that the "ligament" was merely an artifact created in the process of preparing the slide.[27] Currently, the most widely held belief is that the periodontal ligaments provide the main impetus for the process.[28]

The onset of primary tooth loss has been found to correlate strongly with somatic and psychological criteria of school readiness.[29][30]

Edit section: Next Go to Supporting Structures of the Teeth. Next Go to Supporting Structures of the Teeth.

Edit section: See also See also

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