Okay, so picture this: your kiddo finally gets braces. Hooray for straighter teeth in the future! But hold on a second. We're talking about a mouth full of brackets, wires, and tiny spaces just begging for food particles to stage a party. That's where the whole "critical role of oral hygiene during orthodontic treatment" comes in. It's not just a nice-to-have, it's absolutely essential.
Think of braces like little obstacle courses for brushing. Orthodontic care can improve both dental health and self-confidence Children's braces treatment physician. Suddenly, it's not just a quick once-over anymore. We're talking dedicating time to carefully clean around each bracket, getting under the wires, and making sure nothing's hiding in the nooks and crannies. Why all the fuss? Because neglected oral hygiene with braces is a recipe for disaster. We're talking about plaque buildup leading to swollen gums (gingivitis), white spots on the teeth that can become permanent (decalcification), and even cavities. Nobody wants that! All that hard work to straighten teeth, only to end up with damaged enamel.
Now, I know what you're thinking: "Balancing oral care with busy lifestyles? Easier said than done!" Kids have school, sports, homework, and a million other things going on. But trust me, a little extra effort now saves a whole lot of trouble (and dentist visits) later. Maybe it means packing an extra toothbrush and toothpaste for school, or setting a timer for two minutes to ensure a thorough cleaning. Perhaps it's about making it a family affair - everyone brushes together, making it a fun (or at least less-dreaded) activity. The important thing is to make oral hygiene a non-negotiable part of the daily routine. A little dedication to brushing and flossing while they have braces will pay off big time with a healthy, beautiful smile that lasts a lifetime. And that's a win for everyone!
Okay, so you're a busy family, right? Juggling school, sports, maybe a couple of part-time jobs for the older kids, and then just the sheer exhaustion of existing in the 21st century. And somewhere in the middle of all that, you've got a kid (or maybe more!) sporting a shiny set of braces. Suddenly, "brush your teeth" isn't just a quick reminder; it's a potential battleground, a source of guilt, and a logistical nightmare.
Honestly, the biggest challenge is time. It takes longer to brush effectively with braces, and flossing? Forget about it! It feels like an Olympic sport. Rushing through the process just doesn't cut it, leading to plaque build-up, potential cavities, and those dreaded white spots when the braces finally come off. Nobody wants that.
Then there's the food factor. Braces are like magnets for all the things kids love but shouldn't be eating constantly – sticky candies, chewy gum, crunchy chips. Trying to police every single bite is exhausting, and let's be real, sometimes you just cave to avoid a meltdown. But then the guilt kicks in because you know you're setting them up for a dentist's appointment filled with lectures and maybe even more work.
And let's not forget the motivation. It's hard to get kids excited about something that feels like a chore, especially when it's something they have to do multiple times a day. They might complain about the discomfort of brushing around the brackets, or they might just flat-out forget because, well, they're kids!
Finally, just keeping track of everything – the special flossers, the interdental brushes, the fluoride rinse – can be a challenge. It's easy to run out of something or forget to pack it for a school trip. And suddenly, that carefully crafted oral hygiene routine goes completely out the window. It's a lot to manage on top of everything else, but acknowledging these challenges is the first step toward finding solutions that work for your family. Because a healthy smile is worth the effort, even if it means a little extra juggling.
Okay, let's talk about wrangling tiny humans with braces and busy schedules into a semblance of oral hygiene. We all know the drill: braces are like tiny food magnets, and kids are, well, kids. They'd rather be anywhere else than standing in front of the mirror meticulously scrubbing their teeth for what feels like an eternity. So, how do we make it quick, effective, and, dare I say, not a complete nightmare?
First off, ditch the idea of perfection. Aim for "good enough" most of the time. A quick win is better than a drawn-out battle that ends in tears and a half-cleaned mouth. Focus on the areas that collect the most gunk: around the brackets, along the gumline, and between the teeth (if you can manage it).
Think of it like a mini-mission. Break it down. A regular toothbrush is fine for a quick overall sweep, but an interdental brush, those tiny little Christmas tree-shaped things, is your secret weapon. They can get right under the wires and around the brackets. Show your kid how to use it - gently! - and let them take the reins. Make it a game. "Let's see if we can find any monsters hiding around your brackets!"
Next, timing is everything. Right after dinner is usually a good bet, before the evening wind-down and the inevitable "I'm too tired" routine kicks in. Two minutes is the gold standard, but even one minute of focused brushing is better than nothing. Set a timer. Use a fun toothbrushing app with music. Anything to make it less of a chore.
Finally, lead by example. If your kids see you diligently brushing and flossing (even if you're just faking it sometimes!), they're more likely to follow suit. Remember, it's a marathon, not a sprint. Consistency is key. A few quick, effective brushes each day are far more valuable than one epic scrubbing session a week. Embrace the chaos, celebrate the small victories, and remember that even with braces, a little effort goes a long way in keeping those smiles healthy and happy.
Okay, so your kid's got braces. And life is already a circus of school, sports, homework, and whatever TikTok craze is currently consuming their attention. Adding "meticulous flossing after every meal" to the to-do list? That's a recipe for a dental disaster and parental burnout. But listen, it doesn't have to be a complete nightmare. We're talking about finding flossing strategies that actually work with a chaotic kid schedule, not against it.
First, ditch the guilt. Aim for progress, not perfection. If they can't floss perfectly after every single meal, it's okay. The key is consistency, even if it's just once a day, really well. Think about a strategic time – maybe right before bed when they're (supposedly) winding down anyway.
Then, make it easy! Those little floss threaders? Essential. Pre-threaded flossers? Lifesavers. Investing in a water flosser might seem like a splurge, but if it gets them actually flossing, it's worth every penny. Think of it as buying them a cool gadget that happens to clean their teeth.
And finally, involve them in the solution. Ask them what times and methods would realistically fit into their day. Maybe they can floss during a commercial break while watching TV. Maybe they prefer the water flosser because it feels less tedious. The more ownership they feel, the more likely they are to actually do it. It's not about nagging; it's about figuring out a sustainable system together. Braces are temporary, but good oral hygiene is a lifelong habit. Let's build that habit in a way that doesn't drive everyone completely bonkers.
Okay, so you're rocking braces, right? Life's already a bit of an adventure, dodging popcorn kernels and feeling that phantom bracket pain. But then you throw in a jam-packed schedule – school, work, sports, whatever your jam – and suddenly keeping your pearly whites (or at least the metal landscape occupying them) clean becomes this Herculean task.
That's where portable oral care solutions become your best friend. Forget lugging around a whole bathroom sink in your backpack. We're talking about the essentials, streamlined and ready for action. Think travel-sized toothbrushes with those pointy little interdental brushes that get right in there, dislodging the remnants of that questionable cafeteria lunch. Floss threaders become your new secret weapon, navigating the wire maze with ninja-like precision. And mouthwash? Opt for those single-use packets that are perfect for a quick swish and spit after that impromptu pizza party.
Honestly, it's all about adapting. You can't always run home for a full-blown oral hygiene routine. But you can stash a little kit in your bag, in your locker, even in your car. A quick brush after lunch, a floss session during a study break – these little things add up. It's not just about avoiding lectures from your orthodontist (although, let's be real, nobody wants that). It's about feeling confident and comfortable, knowing you're taking care of yourself, even when life's throwing curveballs. Because even with a mouthful of metal, you deserve a smile you can be proud of. And with the right portable tools, that's totally achievable, no matter how busy you are.
Okay, so the whirlwind of raising kids is real, right? Add braces to the mix, and suddenly you're not just packing lunches, you're navigating a dietary minefield. It's all about balancing that need for proper oral care with the fact that, let's face it, life is chaotic!
Braces and sticky candy? A definite no-go. Hard pretzels? Risky business. But kids are kids, and they need to eat! The key is to think smart. Soft fruits like bananas and berries are great. Yogurt, smoothies, and even cheese are brace-friendly and packed with nutrients. Think softer textures, less chewing, and definitely nothing that's going to get stuck in those brackets.
Snacking is where things can get tricky. Instead of reaching for chips or cookies, try sliced apples (without the peel if it's too tough), cheese sticks, or even a small container of applesauce. Pre-cut veggies like carrots (cooked!) and cucumbers are also good options. The goal is to avoid those sugary, sticky snacks that can wreak havoc on teeth already contending with braces.
And remember, it's not about deprivation, it's about substitution. Instead of ice cream, maybe try a frozen yogurt smoothie. Instead of hard candy, perhaps a sugar-free popsicle. Small changes can make a big difference! It's about finding a balance that keeps their teeth healthy and their tummies happy, all while fitting into the crazy schedule of family life. Plus, a little extra brushing and flossing after those sneaky snacks is always a good idea. We're all just trying to survive, right?
Okay, so picture this: you're a parent, right? Life's a whirlwind. School, soccer practice, dance class, homework, maybe even a little bit of precious downtime if you're lucky. Squeezing in a decent meal feels like a victory some days, let alone tackling the whole oral hygiene routine with your kiddo.
But here's the thing, and we all know it deep down: those little pearly whites need some love, even when time is tight. It's not about turning into a dental hygiene drill sergeant, though. It's about finding little ways to make brushing and flossing a normal, easy part of their crazy day.
Think about it. Maybe it's brushing in the shower – multi-tasking at its finest! Or having a fun, colorful timer that makes brushing a game. Maybe it's letting them pick out a cool toothbrush with their favorite character on it. Small tweaks can make a big difference.
And let's be real, kids mirror what they see. If they see you brushing and flossing, they're more likely to hop on board. Make it a family affair! Brush together, floss together, maybe even have a little "check-up" day with fun toothpaste flavors.
The key is consistency, not perfection. Miss a night of flossing? Don't sweat it. Just get back on track the next day. Positive reinforcement works wonders. Praise them for their efforts, even if their brushing isn't flawless. A little encouragement goes a long way in building good habits that will stick with them for life, even when life gets hectic. Because trust me, it only gets busier!
Okay, so you're juggling a million things, right? Work, family, maybe even trying to squeeze in a little "you" time. I get it. But amidst all the chaos, don't let your oral health fall by the wayside, especially if you've got braces or aligners. Think of your regular orthodontic check-ups and professional cleanings not as another chore, but as an investment.
Why? Well, those check-ups are like pit stops for your smile. Your orthodontist keeps an eye on things, making sure your treatment's progressing as it should. They can spot potential problems early before they become bigger, more expensive headaches (and toothaches!). Are your elastics doing their job? Is everything tracking correctly? They'll know.
And the cleanings? They're not just about a brighter smile, though that's a nice bonus. They're about getting into all those nooks and crannies around your braces that your toothbrush just can't reach. Plaque and bacteria love to hang out there, leading to cavities, gum disease, and even staining. A professional cleaning blasts away all that gunk, keeping your teeth healthy and your gums happy.
Look, I know adding another appointment to your already packed schedule sounds dreadful. But honestly, carving out that little bit of time for your orthodontic health can save you a lot of time and trouble down the road. A healthy, straight smile is worth the effort, and it's a lot easier to maintain than to fix. So, pencil it in, treat yourself afterward, and know you're doing something really good for yourself.
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This article needs additional citations for verification. (August 2016)
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Dental braces (also known as orthodontic braces, or simply braces) are devices used in orthodontics that align and straighten teeth and help position them with regard to a person's bite, while also aiming to improve dental health. They are often used to correct underbites, as well as malocclusions, overbites, open bites, gaps, deep bites, cross bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces are often used in conjunction with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws.
The application of braces moves the teeth as a result of force and pressure on the teeth. Traditionally, four basic elements are used: brackets, bonding material, arch wire, and ligature elastic (also called an "O-ring"). The teeth move when the arch wire puts pressure on the brackets and teeth. Sometimes springs or rubber bands are used to put more force in a specific direction.[1]
Braces apply constant pressure which, over time, moves teeth into the desired positions. The process loosens the tooth after which new bone grows to support the tooth in its new position. This is called bone remodelling. Bone remodelling is a biomechanical process responsible for making bones stronger in response to sustained load-bearing activity and weaker in the absence of carrying a load. Bones are made of cells called osteoclasts and osteoblasts. Two different kinds of bone resorption are possible: direct resorption, which starts from the lining cells of the alveolar bone, and indirect or retrograde resorption, which occurs when the periodontal ligament has been subjected to an excessive amount and duration of compressive stress.[2] Another important factor associated with tooth movement is bone deposition. Bone deposition occurs in the distracted periodontal ligament. Without bone deposition, the tooth will loosen, and voids will occur distal to the direction of tooth movement.[3]
Orthodontic services may be provided by any licensed dentist trained in orthodontics. In North America, most orthodontic treatment is done by orthodontists, who are dentists in the diagnosis and treatment of malocclusions—malalignments of the teeth, jaws, or both. A dentist must complete 2–3 years of additional post-doctoral training to earn a specialty certificate in orthodontics. There are many general practitioners who also provide orthodontic services.
The first step is to determine whether braces are suitable for the patient. The doctor consults with the patient and inspects the teeth visually. If braces are appropriate, a records appointment is set up where X-rays, moulds, and impressions are made. These records are analyzed to determine the problems and the proper course of action. The use of digital models is rapidly increasing in the orthodontic industry. Digital treatment starts with the creation of a three-dimensional digital model of the patient's arches. This model is produced by laser-scanning plaster models created using dental impressions. Computer-automated treatment simulation has the ability to automatically separate the gums and teeth from one another and can handle malocclusions well; this software enables clinicians to ensure, in a virtual setting, that the selected treatment will produce the optimal outcome, with minimal user input.[medical citation needed]
Typical treatment times vary from six months to two and a half years depending on the complexity and types of problems. Orthognathic surgery may be required in extreme cases. About 2 weeks before the braces are applied, orthodontic spacers may be required to spread apart back teeth in order to create enough space for the bands.
Teeth to be braced will have an adhesive applied to help the cement bond to the surface of the tooth. In most cases, the teeth will be banded and then brackets will be added. A bracket will be applied with dental cement, and then cured with light until hardened. This process usually takes a few seconds per tooth. If required, orthodontic spacers may be inserted between the molars to make room for molar bands to be placed at a later date. Molar bands are required to ensure brackets will stick. Bands are also utilized when dental fillings or other dental works make securing a bracket to a tooth infeasible. Orthodontic tubes (stainless steel tubes that allow wires to pass through them), also known as molar tubes, are directly bonded to molar teeth either by a chemical curing or a light curing adhesive. Usually, molar tubes are directly welded to bands, which is a metal ring that fits onto the molar tooth. Directly bonded molar tubes are associated with a higher failure rate when compared to molar bands cemented with glass ionomer cement. Failure of orthodontic brackets, bonded tubes or bands will increase the overall treatment time for the patient. There is evidence suggesting that there is less enamel decalcification associated with molar bands cemented with glass ionomer cement compared with orthodontic tubes directly cemented to molars using a light cured adhesive. Further evidence is needed to withdraw a more robust conclusion due to limited data.[7]
An archwire will be threaded between the brackets and affixed with elastic or metal ligatures. Ligatures are available in a wide variety of colours, and the patient can choose which colour they like. Arch wires are bent, shaped, and tightened frequently to achieve the desired results.
Modern orthodontics makes frequent use of nickel-titanium archwires and temperature-sensitive materials. When cold, the archwire is limp and flexible, easily threaded between brackets of any configuration. Once heated to body temperature, the arch wire will stiffen and seek to retain its shape, creating constant light force on the teeth.
Brackets with hooks can be placed, or hooks can be created and affixed to the arch wire to affix rubber bands. The placement and configuration of the rubber bands will depend on the course of treatment and the individual patient. Rubber bands are made in different diameters, colours, sizes, and strengths. They are also typically available in two versions: Coloured or clear/opaque.
The fitting process can vary between different types of braces, though there are similarities such as the initial steps of moulding the teeth before application. For example, with clear braces, impressions of a patient's teeth are evaluated to create a series of trays, which fit to the patient's mouth almost like a protective mouthpiece. With some forms of braces, the brackets are placed in a special form that is customized to the patient's mouth, drastically reducing the application time.
In many cases, there is insufficient space in the mouth for all the teeth to fit properly. There are two main procedures to make room in these cases. One is extraction: teeth are removed to create more space. The second is expansion, in which the palate or arch is made larger by using a palatal expander. Expanders can be used with both children and adults. Since the bones of adults are already fused, expanding the palate is not possible without surgery to separate them. An expander can be used on an adult without surgery but would be used to expand the dental arch, and not the palate.
Sometimes children and teenage patients, and occasionally adults, are required to wear a headgear appliance as part of the primary treatment phase to keep certain teeth from moving (for more detail on headgear and facemask appliances see Orthodontic headgear). When braces put pressure on one's teeth, the periodontal membrane stretches on one side and is compressed on the other. This movement needs to be done slowly or otherwise, the patient risks losing their teeth. This is why braces are worn as long as they are and adjustments are only made every so often.
Braces are typically adjusted every three to six weeks. This helps shift the teeth into the correct position. When they get adjusted, the orthodontist removes the coloured or metal ligatures keeping the arch wire in place. The arch wire is then removed and may be replaced or modified. When the archwire has been placed back into the mouth, the patient may choose a colour for the new elastic ligatures, which are then affixed to the metal brackets. The adjusting process may cause some discomfort to the patient, which is normal.
Patients may need post-orthodontic surgery, such as a fiberotomy or alternatively a gum lift, to prepare their teeth for retainer use and improve the gumline contours after the braces come off. After braces treatment, patients can use a transparent plate to keep the teeth in alignment for a certain period of time. After treatment, patients usually use transparent plates for 6 months. In patients with long and difficult treatment, a fixative wire is attached to the back of the teeth to prevent the teeth from returning to their original state.[8]
In order to prevent the teeth from moving back to their original position, retainers are worn once the treatment is complete. Retainers help in maintaining and stabilizing the position of teeth long enough to permit the reorganization of the supporting structures after the active phase of orthodontic therapy. If the patient does not wear the retainer appropriately and/or for the right amount of time, the teeth may move towards their previous position. For regular braces, Hawley retainers are used. They are made of metal hooks that surround the teeth and are enclosed by an acrylic plate shaped to fit the patient's palate. For Clear Removable braces, an Essix retainer is used. This is similar to the original aligner; it is a clear plastic tray that is firmly fitted to the teeth and stays in place without a plate fitted to the palate. There is also a bonded retainer where a wire is permanently bonded to the lingual side of the teeth, usually the lower teeth only.
Headgear needs to be worn between 12 and 22 hours each day to be effective in correcting the overbite, typically for 12 to 18 months depending on the severity of the overbite, how much it is worn and what growth stage the patient is in. Typically the prescribed daily wear time will be between 14 and 16 hours a day and is frequently used as a post-primary treatment phase to maintain the position of the jaw and arch. Headgear can be used during the night while the patient sleeps.[9][better source needed]
Orthodontic headgear usually consists of three major components:
The headgear application is one of the most useful appliances available to the orthodontist when looking to correct a Class II malocclusion. See more details in the section Orthodontic headgear.
The pre-finisher is moulded to the patient's teeth by use of extreme pressure on the appliance by the person's jaw. The product is then worn a certain amount of time with the user applying force to the appliance in their mouth for 10 to 15 seconds at a time. The goal of the process is to increase the exercise time in applying the force to the appliance. If a person's teeth are not ready for a proper retainer the orthodontist may prescribe the use of a preformed finishing appliance such as the pre-finisher. This appliance fixes gaps between the teeth, small spaces between the upper and lower jaw, and other minor problems.
A group of dental researchers, Fatma Boke, Cagri Gazioglu, Selvi Akkaya, and Murat Akkaya, conducted a study titled "Relationship between orthodontic treatment and gingival health." The results indicated that some orthodontist treatments result in gingivitis, also known as gum disease. The researchers concluded that functional appliances used to harness natural forces (such as improving the alignment of bites) do not usually have major effects on the gum after treatment.[10] However, fixed appliances such as braces, which most people get, can result in visible plaque, visible inflammation, and gum recession in a majority of the patients. The formation of plaques around the teeth of patients with braces is almost inevitable regardless of plaque control and can result in mild gingivitis. But if someone with braces does not clean their teeth carefully, plaques will form, leading to more severe gingivitis and gum recession.
Experiencing some pain following fitting and activation of fixed orthodontic braces is very common and several methods have been suggested to tackle this.[11][12] Pain associated with orthodontic treatment increases in proportion to the amount of force that is applied to the teeth. When a force is applied to a tooth via a brace, there is a reduction in the blood supply to the fibres that attach the tooth to the surrounding bone. This reduction in blood supply results in inflammation and the release of several chemical factors, which stimulate the pain response. Orthodontic pain can be managed using pharmacological interventions, which involve the use of analgesics applied locally or systemically. These analgesics are divided into four main categories, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and local anesthesia. The first three of these analgesics are commonly taken systemically to reduce orthodontic pain.[13]
A Cochrane Review in 2017 evaluated the pharmacological interventions for pain relief during orthodontic treatment. The study concluded that there was moderate-quality evidence that analgesics reduce the pain associated with orthodontic treatment. However, due to a lack of evidence, it was unclear whether systemic NSAIDs were more effective than paracetamol, and whether topical NSAIDs were more effective than local anaesthesia in the reduction of pain associated with orthodontic treatment. More high-quality research is required to investigate these particular comparisons.[13]
The dental displacement obtained with the orthodontic appliance determines in most cases some degree of root resorption. Only in a few cases is this side effect large enough to be considered real clinical damage to the tooth. In rare cases, the teeth may fall out or have to be extracted due to root resorption.[14][15]
According to scholars and historians, braces date back to ancient times. Around 400–300 BC, Hippocrates and Aristotle contemplated ways to straighten teeth and fix various dental conditions. Archaeologists have discovered numerous mummified ancient individuals with what appear to be metal bands wrapped around their teeth. Catgut, a type of cord made from the natural fibres of an animal's intestines, performed a similar role to today's orthodontic wire in closing gaps in the teeth and mouth.[16]
The Etruscans buried their dead with dental appliances in place to maintain space and prevent the collapse of the teeth during the afterlife. A Roman tomb was found with a number of teeth bound with gold wire documented as a ligature wire, a small elastic wire that is used to affix the arch wire to the bracket. Even Cleopatra wore a pair. Roman philosopher and physician Aulus Cornelius Celsus first recorded the treatment of teeth by finger pressure. Unfortunately, due to a lack of evidence, poor preservation of bodies, and primitive technology, little research was carried out on dental braces until around the 17th century, although dentistry was making great advancements as a profession by then.[citation needed]
Orthodontics truly began developing in the 18th and 19th centuries. In 1669, French dentist Pierre Fauchard, who is often credited with inventing modern orthodontics, published a book entitled "The Surgeon Dentist" on methods of straightening teeth. Fauchard, in his practice, used a device called a "Bandeau", a horseshoe-shaped piece of iron that helped expand the palate. In 1754, another French dentist, Louis Bourdet, dentist to the King of France, followed Fauchard's book with The Dentist's Art, which also dedicated a chapter to tooth alignment and application. He perfected the "Bandeau" and was the first dentist on record to recommend extraction of the premolar teeth to alleviate crowding and improve jaw growth.
Although teeth and palate straightening and/or pulling were used to improve the alignment of remaining teeth and had been practised since early times, orthodontics, as a science of its own, did not really exist until the mid-19th century. Several important dentists helped to advance dental braces with specific instruments and tools that allowed braces to be improved.
In 1819, Christophe François Delabarre introduced the wire crib, which marked the birth of contemporary orthodontics, and gum elastics were first employed by Maynard in 1843. Tucker was the first to cut rubber bands from rubber tubing in 1850. Dentist, writer, artist, and sculptor Norman William Kingsley in 1858 wrote the first article on orthodontics and in 1880, his book, Treatise on Oral Deformities, was published. A dentist named John Nutting Farrar is credited for writing two volumes entitled, A Treatise on the Irregularities of the Teeth and Their Corrections and was the first to suggest the use of mild force at timed intervals to move teeth.
In the early 20th century, Edward Angle devised the first simple classification system for malocclusions, such as Class I, Class II, and so on. His classification system is still used today as a way for dentists to describe how crooked teeth are, what way teeth are pointing, and how teeth fit together. Angle contributed greatly to the design of orthodontic and dental appliances, making many simplifications. He founded the first school and college of orthodontics, organized the American Society of Orthodontia in 1901 which became the American Association of Orthodontists (AAO) in the 1930s, and founded the first orthodontic journal in 1907. Other innovations in orthodontics in the late 19th and early 20th centuries included the first textbook on orthodontics for children, published by J.J. Guilford in 1889, and the use of rubber elastics, pioneered by Calvin S. Case, along with Henry Albert Baker.
Today, space age wires (also known as dental arch wires) are used to tighten braces. In 1959, the Naval Ordnance Laboratory created an alloy of nickel and titanium called Nitinol. NASA further studied the material's physical properties.[17] In 1979, Dr. George Andreasen developed a new method of fixing braces with the use of the Nitinol wires based on their superelasticity. Andreasen used the wire on some patients and later found out that he could use it for the entire treatment. Andreasen then began using the nitinol wires for all his treatments and as a result, dental doctor visits were reduced, the cost of dental treatment was reduced, and patients reported less discomfort.
Media related to Dental braces at Wikimedia Commons| Authority control databases: National |
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A chimpanzee displaying his teeth
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| Latin | dens |
| MeSH | D014070 |
| FMA | 12516 |
| Anatomical terminology
[edit on Wikidata]
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A tooth (pl.: teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tearing food, for defensive purposes, to intimidate other animals often including their own, or to carry prey or their young. The roots of teeth are covered by gums. Teeth are not made of bone, but rather of multiple tissues of varying density and hardness that originate from the outermost embryonic germ layer, the ectoderm.
The general structure of teeth is similar across the vertebrates, although there is considerable variation in their form and position. The teeth of mammals have deep roots, and this pattern is also found in some fish, and in crocodilians. In most teleost fish, however, the teeth are attached to the outer surface of the bone, while in lizards they are attached to the inner surface of the jaw by one side. In cartilaginous fish, such as sharks, the teeth are attached by tough ligaments to the hoops of cartilage that form the jaw.[1]
Monophyodonts are animals that develop only one set of teeth, while diphyodonts grow an early set of deciduous teeth and a later set of permanent or "adult" teeth. Polyphyodonts grow many sets of teeth. For example, sharks, grow a new set of teeth every two weeks to replace worn teeth. Most extant mammals including humans are diphyodonts, but there are exceptions including elephants, kangaroos, and manatees, all of which are polyphyodonts.
Rodent incisors grow and wear away continually through gnawing, which helps maintain relatively constant length. The industry of the beaver is due in part to this qualification. Some rodents, such as voles and guinea pigs (but not mice), as well as lagomorpha (rabbits, hares and pikas), have continuously growing molars in addition to incisors.[2][3] Also, tusks (in tusked mammals) grow almost throughout life.[4]
Teeth are not always attached to the jaw, as they are in mammals. In many reptiles and fish, teeth are attached to the palate or to the floor of the mouth, forming additional rows inside those on the jaws proper. Some teleosts even have teeth in the pharynx. While not true teeth in the usual sense, the dermal denticles of sharks are almost identical in structure and are likely to have the same evolutionary origin. Indeed, teeth appear to have first evolved in sharks, and are not found in the more primitive jawless fish – while lampreys do have tooth-like structures on the tongue, these are in fact, composed of keratin, not of dentine or enamel, and bear no relationship to true teeth.[1] Though "modern" teeth-like structures with dentine and enamel have been found in late conodonts, they are now supposed to have evolved independently of later vertebrates' teeth.[5][6]
Living amphibians typically have small teeth, or none at all, since they commonly feed only on soft foods. In reptiles, teeth are generally simple and conical in shape, although there is some variation between species, most notably the venom-injecting fangs of snakes. The pattern of incisors, canines, premolars and molars is found only in mammals, and to varying extents, in their evolutionary ancestors. The numbers of these types of teeth vary greatly between species; zoologists use a standardised dental formula to describe the precise pattern in any given group.[1]
The word tooth comes from Proto-Germanic *tanþs, derived from the Proto-Indo-European *hâ‚Âdent-, which was composed of the root *hâ‚Âed- 'to eat' plus the active participle suffix *-nt, therefore literally meaning 'that which eats'.[7]
The irregular plural form teeth is the result of Germanic umlaut whereby vowels immediately preceding a high vocalic in the following syllable were raised. As the nominative plural ending of the Proto-Germanic consonant stems (to which *tanþs belonged) was *-iz, the root vowel in the plural form *tanþiz (changed by this point to *tÄ…Ì„þi via unrelated phonological processes) was raised to /œÃ‹Â/, and later unrounded to /eËÂ/, resulting in the tÃ…Âþ/tÄ“þ alternation attested from Old English. Cf. also Old English bÃ…Âc/bÄ“Ä‹ 'book/books' and 'mÅ«s/mȳs' 'mouse/mice', from Proto-Germanic *bÃ…Âks/bÃ…Âkiz and *mÅ«s/mÅ«siz respectively.
Cognate with Latin dÄ“ns, Greek á½€δοÃÂς (odous), and Sanskrit dát.
Teeth are assumed to have evolved either from ectoderm denticles (scales, much like those on the skin of sharks) that folded and integrated into the mouth (called the "outside–in" theory), or from endoderm pharyngeal teeth (primarily formed in the pharynx of jawless vertebrates) (the "inside–out" theory). In addition, there is another theory stating that neural crest gene regulatory network, and neural crest-derived ectomesenchyme are the key to generate teeth (with any epithelium, either ectoderm or endoderm).[4][8]
The genes governing tooth development in mammals are homologous to those involved in the development of fish scales.[9] Study of a tooth plate of a fossil of the extinct fish Romundina stellina showed that the teeth and scales were made of the same tissues, also found in mammal teeth, lending support to the theory that teeth evolved as a modification of scales.[10]
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 and grinding. Carnivores, on the other hand, have canine teeth to kill prey and to tear meat.
Mammals, in general, 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. Kangaroos, elephants, and manatees are unusual among mammals because they are polyphyodonts.
In aardvarks, teeth lack enamel and have many pulp tubules, hence the name of the order Tubulidentata.[11]
In dogs, the teeth are less likely than humans to form dental cavities because of the very high pH of dog saliva, which prevents enamel from demineralizing.[12] Sometimes called cuspids, these teeth are shaped like points (cusps) and are used for tearing and grasping food.[13]
Like human teeth, whale teeth have polyp-like protrusions located on the root surface of the tooth. These polyps are made of cementum in both species, but in human teeth, the protrusions are located on the outside of the root, while in whales the nodule is located on the inside of the pulp chamber. While the roots of human teeth are made of cementum on the outer surface, whales have cementum on the entire surface of the tooth with a very small layer of enamel at the tip. This small enamel layer is only seen in older whales where the cementum has been worn away to show the underlying enamel.[14]
The toothed whale is a parvorder of the cetaceans characterized by having teeth. The teeth differ considerably among the species. They may be numerous, with some dolphins bearing over 100 teeth in their jaws. On the other hand, the narwhals have a giant unicorn-like tusk, which is a tooth containing millions of sensory pathways and used for sensing during feeding, navigation, and mating. It is the most neurologically complex tooth known. Beaked whales are almost toothless, with only bizarre teeth found in males. These teeth may be used for feeding but also for demonstrating aggression and showmanship.
In humans (and most other primates), there are usually 20 primary (also "baby" or "milk") teeth, and later up to 32 permanent teeth. Four of these 32 may be third molars or wisdom teeth, although these are not present in all adults, and may be removed surgically later in life.[15]
Among primary teeth, 10 of them are usually found in the maxilla (i.e. upper jaw) and the other 10 in the mandible (i.e. lower jaw). Among permanent teeth, 16 are found in the maxilla and the other 16 in the mandible. Most of the teeth have uniquely distinguishing features.
An adult horse has between 36 and 44 teeth. The enamel and dentin layers of horse teeth are intertwined.[16] All horses have 12 premolars, 12 molars, and 12 incisors.[17] Generally, all male equines also have four canine teeth (called tushes) between the molars and incisors. However, few female horses (less than 28%) have canines, and those that do usually have only one or two, which many times are only partially erupted.[18] A few horses have one to four wolf teeth, which are vestigial premolars, with most of those having only one or two. They are equally common in male and female horses and much more likely to be on the upper jaw. If present these can cause problems as they can interfere with the horse's bit contact. Therefore, wolf teeth are commonly removed.[17]
Horse teeth can be used to estimate the animal's age. Between birth and five years, age can be closely estimated by observing the eruption pattern on milk teeth and then permanent teeth. By age five, all permanent teeth have usually erupted. The horse is then said to have a "full" mouth. After the age of five, age can only be conjectured by studying the wear patterns on the incisors, shape, the angle at which the incisors meet, and other factors. The wear of teeth may also be affected by diet, natural abnormalities, and cribbing. Two horses of the same age may have different wear patterns.
A horse's incisors, premolars, and molars, once fully developed, continue to erupt as the grinding surface is worn down through chewing. A young adult horse will have teeth, which are 110–130 mm (4.5–5 inches) long, with the majority of the crown remaining below the gumline in the dental socket. The rest of the tooth will slowly emerge from the jaw, erupting about 3 mm (1⁄8 in) each year, as the horse ages. When the animal reaches old age, the crowns of the teeth are very short and the teeth are often lost altogether. Very old horses, if lacking molars, may need to have their fodder ground up and soaked in water to create a soft mush for them to eat in order to obtain adequate nutrition.
Elephants' tusks are specialized incisors for digging food up and fighting. Some elephant teeth are similar to those in manatees, and elephants are believed to have undergone an aquatic phase in their evolution.
At birth, elephants have a total of 28 molar plate-like grinding teeth not including the tusks. These are organized into four sets of seven successively larger teeth which the elephant will slowly wear through during its lifetime of chewing rough plant material. Only four teeth are used for chewing at a given time, and as each tooth wears out, another tooth moves forward to take its place in a process similar to a conveyor belt. The last and largest of these teeth usually becomes exposed when the animal is around 40 years of age, and will often last for an additional 20 years. When the last of these teeth has fallen out, regardless of the elephant's age, the animal will no longer be able to chew food and will die of starvation.[19][20]
Rabbits and other lagomorphs usually shed their deciduous teeth before (or very shortly after) their birth, and are usually born with their permanent teeth.[21] The teeth of rabbits complement their diet, which consists of a wide range of vegetation. Since many of the foods are abrasive enough to cause attrition, rabbit teeth grow continuously throughout life.[22] Rabbits have a total of six incisors, three upper premolars, three upper molars, two lower premolars, and two lower molars on each side. There are no canines. Dental formula is 2.0.3.31.0.2.3 = 28. Three to four millimeters of the tooth is worn away by incisors every week, whereas the cheek teeth require a month to wear away the same amount.[23]
The incisors and cheek teeth of rabbits are called aradicular hypsodont teeth. This is sometimes referred to as an elodent dentition. These teeth grow or erupt continuously. The growth or eruption is held in balance by dental abrasion from chewing a diet high in fiber.
Rodents have upper and lower hypselodont incisors that can continuously grow enamel throughout its life without having properly formed roots.[24] These teeth are also known as aradicular teeth, and unlike humans whose ameloblasts die after tooth development, rodents continually produce enamel, they must wear down their teeth by gnawing on various materials.[25] Enamel and dentin are produced by the enamel organ, and growth is dependent on the presence of stem cells, cellular amplification, and cellular maturation structures in the odontogenic region.[26] Rodent incisors are used for cutting wood, biting through the skin of fruit, or for defense. This allows for the rate of wear and tooth growth to be at equilibrium.[24] The microstructure of rodent incisor enamel has shown to be useful in studying the phylogeny and systematics of rodents because of its independent evolution from the other dental traits. The enamel on rodent incisors are composed of two layers: the inner portio interna (PI) with Hunter-Schreger bands (HSB) and an outer portio externa (PE) with radial enamel (RE).[27] It usually involves the differential regulation of the epithelial stem cell niche in the tooth of two rodent species, such as guinea pigs.[28][29]
The teeth have enamel on the outside and exposed dentin on the inside, so they self-sharpen during gnawing. On the other hand, continually growing molars are found in some rodent species, such as the sibling vole and the guinea pig.[28][29] There is variation in the dentition of the rodents, but generally, rodents lack canines and premolars, and have a space between their incisors and molars, called the diastema region.
Manatees are polyphyodont with mandibular molars developing separately from the jaw and are encased in a bony shell separated by soft tissue.[30][31]
Walrus tusks are canine teeth that grow continuously throughout life.[32]
Fish, such as sharks, may go through many teeth in their lifetime. The replacement of multiple teeth is known as polyphyodontia.
A class of prehistoric shark are called cladodonts for their strange forked teeth.
Unlike the continuous shedding of functional teeth seen in modern sharks,[33][34] the majority of stem chondrichthyan lineages retained all tooth generations developed throughout the life of the animal.[35] This replacement mechanism is exemplified by the tooth whorl-based dentitions of acanthodians,[36] which include the oldest known toothed vertebrate, Qianodus duplicis[37].
All amphibians have pedicellate teeth, which are modified to be flexible due to connective tissue and uncalcified dentine that separates the crown from the base of the tooth.[38]
Most amphibians exhibit teeth that have a slight attachment to the jaw or acrodont teeth. Acrodont teeth exhibit limited connection to the dentary and have little enervation.[39] This is ideal for organisms who mostly use their teeth for grasping, but not for crushing and allows for rapid regeneration of teeth at a low energy cost. Teeth are usually lost in the course of feeding if the prey is struggling. Additionally, amphibians that undergo a metamorphosis develop bicuspid shaped teeth.[40]
The teeth of reptiles are replaced constantly throughout their lives. Crocodilian juveniles replace teeth with larger ones at a rate as high as one new tooth per socket every month. Once mature, tooth replacement rates can slow to two years and even longer. Overall, crocodilians may use 3,000 teeth from birth to death. New teeth are created within old teeth.[41]
A skull of Ichthyornis discovered in 2014 suggests that the beak of birds may have evolved from teeth to allow chicks to escape their shells earlier, and thus avoid predators and also to penetrate protective covers such as hard earth to access underlying food.[42][43]
True teeth are unique to vertebrates,[44] although many invertebrates have analogous structures often referred to as teeth. The organisms with the simplest genome bearing such tooth-like structures are perhaps the parasitic worms of the family Ancylostomatidae.[45] For example, the hookworm Necator americanus has two dorsal and two ventral cutting plates or teeth around the anterior margin of the buccal capsule. It also has a pair of subdorsal and a pair of subventral teeth located close to the rear.[46]
Historically, the European medicinal leech, another invertebrate parasite, has been used in medicine to remove blood from patients.[47] They have three jaws (tripartite) that resemble saws in both appearance and function, and on them are about 100 sharp teeth used to incise the host. The incision leaves a mark that is an inverted Y inside of a circle. After piercing the skin and injecting anticoagulants (hirudin) and anaesthetics, they suck out blood, consuming up to ten times their body weight in a single meal.[48]
In some species of Bryozoa, the first part of the stomach forms a muscular gizzard lined with chitinous teeth that crush armoured prey such as diatoms. Wave-like peristaltic contractions then move the food through the stomach for digestion.[49]
Molluscs have a structure called a radula, which bears a ribbon of chitinous teeth. However, these teeth are histologically and developmentally different from vertebrate teeth and are unlikely to be homologous. For example, vertebrate teeth develop from a neural crest mesenchyme-derived dental papilla, and the neural crest is specific to vertebrates, as are tissues such as enamel.[44]
The radula is used by molluscs for feeding and is sometimes compared rather inaccurately to a tongue. It is a minutely toothed, chitinous ribbon, typically used for scraping or cutting food before the food enters the oesophagus. The radula is unique to molluscs, and is found in every class of mollusc apart from bivalves.
Within the gastropods, the radula is used in feeding by both herbivorous and carnivorous snails and slugs. The arrangement of teeth (also known as denticles) on the radula ribbon varies considerably from one group to another as shown in the diagram on the left.
Predatory marine snails such as the Naticidae use the radula plus an acidic secretion to bore through the shell of other molluscs. Other predatory marine snails, such as the Conidae, use a specialized radula tooth as a poisoned harpoon. Predatory pulmonate land slugs, such as the ghost slug, use elongated razor-sharp teeth on the radula to seize and devour earthworms. Predatory cephalopods, such as squid, use the radula for cutting prey.
In most of the more ancient lineages of gastropods, the radula is used to graze by scraping diatoms and other microscopic algae off rock surfaces and other substrates. Limpets scrape algae from rocks using radula equipped with exceptionally hard rasping teeth.[50] These teeth have the strongest known tensile strength of any biological material, outperforming spider silk.[50] The mineral protein of the limpet teeth can withstand a tensile stress of 4.9 GPa, compared to 4 GPa of spider silk and 0.5 GPa of human teeth.[51]
Because teeth are very resistant, often preserved when bones are not,[52] and reflect the diet of the host organism, they are very valuable to archaeologists and palaeontologists.[53] Early fish such as the thelodonts had scales composed of dentine and an enamel-like compound, suggesting that the origin of teeth was from scales which were retained in the mouth. Fish as early as the late Cambrian had dentine in their exoskeletons, which may have functioned in defense or for sensing their environments.[54] Dentine can be as hard as the rest of teeth and is composed of collagen fibres, reinforced with hydroxyapatite.[54]
Though teeth are very resistant, they also can be brittle and highly susceptible to cracking.[55] However, cracking of the tooth can be used as a diagnostic tool for predicting bite force. Additionally, enamel fractures can also give valuable insight into the diet and behaviour of archaeological and fossil samples.
Decalcification removes the enamel from teeth and leaves only the organic interior intact, which comprises dentine and cementine.[56] Enamel is quickly decalcified in acids,[57] perhaps by dissolution by plant acids or via diagenetic solutions, or in the stomachs of vertebrate predators.[56] Enamel can be lost by abrasion or spalling,[56] and is lost before dentine or bone are destroyed by the fossilisation process.[57] In such a case, the 'skeleton' of the teeth would consist of the dentine, with a hollow pulp cavity.[56] The organic part of dentine, conversely, is destroyed by alkalis.[57]
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