Tooth Brushing

Brushing your teeth is one of the most effective ways of removing plaque from the exposed surfaces of your teeth and to make your teeth healthy.

Why Healthy Teeth Are Important?

Taking care of your teeth helps prevent plaque , which is a clear film of bacteria  that sticks to your teeth.After you eat, bacteria go crazy over the sugar on your teeth, like ants at a picnic. The bacteria break it down into acids that eat away tooth enamel, causing holes called cavities. Plaque also causes gingivitis , which is gum disease that can make your gums red, swollen, and sore. Your gums are those soft pink tissues in your mouth that hold your teeth in place.If you don't take care of your teeth, cavities and unhealthy gums will make your mouth very, very sore. Eating meals will be difficult. And you won't feel like smiling so much.

If teeth are not brushed correctly and frequently, it could lead to the calcification of saliva minerals, forming tartar. Poor dental health has been associated with heart disease and shortened life expectancy.

In the past:

3000 BC ancient Egyptians constructed crude toothbrushes from twigs and leaves to clean their teeth. Similarly, other cultures such as the Greeks, Romans, and Indians cleaned their teeth with twigs. Some would fray one end of the twig so that it could penetrate between the teeth more effectively.

Long ago, as people got older, their teeth would rot away and be very painful. To get rid of a toothache, they had their teeth pulled out. Finally people learned that cleaning their teeth was important, but they didn't have toothpaste right away. While you're swishing that minty-fresh paste around your mouth, think about what people used long ago to clean teeth:

• ground-up chalk or charcoal


• lemon juice


• ashes (you know, the stuff that's left over after a fire)


• tobacco and honey mixed together

It was only about 100 years ago that someone finally created a minty cream to clean teeth. Not long after that, the toothpaste tube was invented, so people could squeeze the paste right onto the toothbrush! Tooth brushing became popular during World War II. The U.S. Army gave brushes and toothpaste to all soldiers, and they learned to brush twice a day. Back then, toothpaste tubes were made of metal; today they're made of soft plastic and are much easier to squeeze!

Today there are plenty of toothpaste and brushes choices: lots of colors and flavors to choose from, and some are made just for kids. People with great-looking teeth advertise toothpaste on TV commercials and in magazines. When you're choosing a toothpaste, make sure it contains fluoride . Fluoride makes your teeth strong and protects them from cavities.

How to brush your teeth?

1- prepare your tooth brush:

After flossing, moisten your toothbrush with water and apply a thin strip of toothpaste. Try to choose one that contains fluoride.

2- start in the  back:

Start with your upper molars (back teeth) on your left side and work in a clockwise direction.

Point the bristles toward the gumline, in a 45-degree angle. Use a short circular motion for approximately 20 seconds.

3-Roll Away:

After 20 seconds, roll the brush head away from the gumline, so the bristles sweep the surface of the tooth, removing the food and plaque.

4-Work in a Clockwise Direction:

Continue working in a clockwise direction, ending with the lower molars on your left side. Repeat step two and three for the inside surface of the upper and lower molars.

5-Brushing the Back Surface of the Upper Front Teeth:

Brush the lingual (back) surface of the upper-front teeth by using the tip of the toothbrush head. Direct the bristles toward the gumline, and use a flicking motion down the surface of the tooth. Do this 2 to 3 times.

6-Brushing the Back of the Lower Front Teeth:

Point the bristles of the tip of the toothbrush toward the gumline. Flick the bristles up, away from the gumline in a sweeping motion. Do this 2 to 3 times.

 

7-Brush the Biting Surface:

Brush the biting surface of the upper and lower premolars and molars, using a circular motion.

8-Brush Your Tongue and the Inside of Your Cheeks:

Using a gentle circular motion, brush your tongue for 30 seconds and the inside of your cheeks for 30 seconds.

 9-Finish Up With a Rinse:

Finish by rinsing with either water or your choice of mouthwash. Don't forget to smile!

Remember to replace your toothbrush every three to four months. Researchers have established that thousands of microbes grow on toothbrush bristles and handles. Most are harmless, but others can cause cold and flu viruses, the herpes virus that causes cold sores, and bacteria that can cause periodontal infections.

Physiology of teeth

Mouth Divisions:

   The mouth can be divided into sections:

• Arches (there are 2 arches present)- an arch will divide the mouth into top and

bottom

• Quadrants (there are 4 quadrants present)- a quadrant divides an arch into right

and left

These divisions refer to both the primary and permanent dentitions.

Maxillary Arch

• This is the top arch or jaw.

• The maxillary arch contains 16 permanent teeth.

• The maxillary arch contains 10 primary teeth.

• The maxillary arch contains 2 quadrants.

Mandibular Arch:

• This is the bottom arch or jaw.

• The mandibular arch contains 16 permanent teeth.

• The mandibular arch contains 10 primary teeth.

• The mandibular arch contains 2 quadrants.

The mouth will have 4 Quadrants:

• MX right (quadrant 1) MX left (quadrant 2)

• MD right (quadrant 3) MD left (quadrant 4)

 

divided by a midline (the midline refers to an imaginary line that divides the mouth into right and left halves)

Names of Teeth:

  If you look in your mouth, you will notice that the teeth in the front of the mouth

look different than the teeth in the back of the mouth. This is because there are

different types of teeth in the mouth.

1 -Anterior teeth

• These are the teeth in the front of the mouth

Names of the anterior teeth:

      central incisors

      lateral incisors

      canines

2 - Posterior teeth

• These are the teeth in the back of the mouth

Names of the posterior teeth:

       premolars

       molars

Tooth Numbers:

tooth numbers help the patient and the dentist to diagnose the case correctly.

• Teeth are given numbers as a way to identify them

Permanent dentition- Maxillary or top arch contains tooth numbers 1 - 16

Mandibular arch contains tooth numbers 17 – 32

Primary dentition- Maxillary arch contains tooth letters A - J

Mandibular arch contains tooth letters K - T

Permanent Tooth Numbers:

Maxillary Tooth Numbers:

• Tooth #1 MX Right 3rd Molar

• Tooth #2 MX Right 2nd Molar

• Tooth #3 MX Right 1st Molar

• Tooth #4 MX Right 2nd Premolar

• Tooth #5 MX Right 1st Premolar

• Tooth #6 MX Right Canine

• Tooth #7 MX Right Lateral Incisor

• Tooth #8 MX Right Central Incisor

• Tooth #9 MX Left Central Incisor

• Tooth #10 MX Left Lateral Incisor

• Tooth #11 MX Left Canine

• Tooth #12 MX Left 1st Premolar

• Tooth #13 MX Left 2nd Premolar

• Tooth #14 MX Left 1st Molar

• Tooth #15 MX Left 2nd Molar

• Tooth #16 MX Left 3rd Molar

Mandibular Tooth Numbers:

• Tooth #17 MD Left 3rd Molar

• Tooth #18 MD Left 2nd Molar

• Tooth #19 MD Left 1st Molar

• Tooth #20 MD Left 2nd Premolar

• Tooth #21 MD Left 1st Premolar

• Tooth #22 MD Left Canine

• Tooth #23 MD Left Lateral Incisor

• Tooth #24 MD Left Central Incisor

• Tooth #25 MD Right Central Incisor

• Tooth #26 MD Right Lateral Incisor

• Tooth #27 MD Right Canine

• Tooth #28 MD Right 1st Premolar

• Tooth #29 MD Right 2nd Premolar

• Tooth #30 MD Right 1st Molar

• Tooth #31 MD Right 2nd Molar

• Tooth #32 MD Right 3rd Molar

Primary Tooth Letters:

Maxillary Tooth Letters

• Letter A MX Right Primary 2nd Molar

• Letter B MX Right Primary 1st Molar

• Letter C MX Right Primary Canine

• Letter D MX Right Primary Lateral Incisor

• Letter E MX Right Primary Central Incisor

• Letter F MX Left Primary Central Incisor

• Letter G MX Left Primary Lateral Incisor

• Letter H MX Left Primary Canine

• Letter I MX Left Primary 1st Molar

• Letter J MX Left Primary 2nd Molar

• Letter K MD Left Primary 2nd Molar

• Letter L MD Left Primary 1st Molar

• Letter M MD Left Primary Canine

• Letter N MD Left Primary Lateral Incisor

• Letter O MD Left Primary Central Incisor

• Letter P MD Right Primary Central Incisor

• Letter Q MD Right Primary Lateral Incisor

• Letter R MD Right Primary Canine

• Letter S MD Right Primary 1st Molar

• Letter T MD Right Primary 2nd Molar

Tooth Surfaces:

• the crown or portion of the tooth that you can see when the mouth is open, are

divided into surfaces

• these surfaces are named according to the direction in which they face

Mesial

• this surface is closest to the midline

Distal

• this surface is farthest from the midline

Facial

• designates the outer surface of an anterior tooth

• is also called Labial

Buccal

• designates the outer surface of a posterior tooth

Lingual

• the surface of the tooth that is towards the tongue or roof of the mouth

• Palatal- term used for maxillary teeth

Occlusal

• biting or occluding surfaces of posterior teeth

Incisal

• “biting” surface of anterior teeth

kinds of Teeth “permanent teeth”

The teeth have the most important role and the hardest structure in human's jaws and many other spinescent animals. The main function of the teeth is cutting and grinding the food pieces. Further more, they help us in speaking properly.

Two kinds of teeth grow during every human's life cycle:

1-primary teeth.

2-permanent teeth .

The number of primary teeth is 20 which are distributed equally in the two jaws.

After a while, the 32 permanent teeth are replaced the primary ones gradually.

As the primary teeth are the base of the permanent teeth, having good oral hygiene is necessary.

Around the 8th week after conception, oval-shaped tooth buds start to form and harden in the embryo's mouth. Although the baby teeth aren't visible when a child is born, both the primary and permanent teeth are partially formed below the gums. The tooth crown develops first and after it is fully grown, the root begins to develop.

Then between about six months and 1 year old, the deciduous teeth begin to push through the gums. This process is called baby teeth eruption . A child gets his first complete set of primary teeth by the age of 3. The baby teeth chart shows the average age that each primary tooth is expected to erupt. But not all baby teeth follow these rules. Some infants may have their first primary tooth (usually one of the bottom middle teeth) erupted as early as 3 months.Others may reach their first birthday or more without getting their first deciduous tooth. If there is no sign of teething by this age you should ask for a pediatrician's advise. That kind of late development of primary teeth is more common in premature babies. In some rare cases (1 every 2.000) infants are born with one or more teeth (called natal teeth) or may have teeth emerge within the first month (called neonatal teeth). A dentist should evaluate the teeth's condition, as they could be loose, interfere with feeding or irritate the baby's tongue.

2- permanent (adult) teeth:

Adult teeth or permanent teeth replace the primary teeth. They aid in digestion, speech and general appearance. There are 32 permanent teeth, with the main difference from primary teeth is that there are 4 premolars and 6 molars in each arch. Permanent teeth begin erupting at 6yrs of age and end at 21yrs of age. Some people may not have some if not all their 3rd molars due to evolutionary changes leading to the lack of development of these teeth. 3rd molars may not erupt due to becoming embedded in jaw. The tooth consists of a crown and root, and the tooth is composed of different materials that aid in strengthening, preserving and maintaining its function.

Adult teeth begin to replace the front milk teeth from the age of about six. For the next six to eight years there is a gradual replacement of milk teeth by adult teeth. This stage is called mixed dentition, as both milk and adult teeth will be from the mouth at the same time. By the age of about 12-14 all adult teeth should have appeared using the exception of wisdom teeth (third molars). At this stage the mouth will contain twenty-eight teeth. These teeth have to last for life as we only get one set.

The permanent tooth begins to grow under the baby tooth.

• The root of the baby tooth begins to dissolve (reabsorb), and the baby tooth becomes loose.


• It takes three and a half years for the baby tooth to lose its roots, and for it to be replaced by the permanent tooth.


• The crown of the permanent tooth is the first part of the tooth to develop.


• It grows into the space left by the root of the baby tooth.


• The root of the permanent tooth then continues to form.


• When the crown erupts, it is covered by a cuticle or covering that protects the enamel. The cuticle is slowly worn away by chewing and tooth brushing.

During 7 years, 20 baby teeth are lost and are replaced by 28 permanent teeth.

The mixed dentition stage is the period when some baby and permanent teeth are visible in the mouth at the same time.   

In addition, 4 wisdom teeth will erupt by the age of 21 years, taking the total number of permanent teeth to 32.

The eruption of the 32 permanent teeth starts at age 6, and is completed between the ages of 20 and 23, after the wisdom teeth (3^rd molars) have arrived.

The final four adult teeth should come through during late teens totaling 32 adult teeth. The descriptions below explain the functions of each of the teeth. To view a model showing all the milk and adult teeth erupting, take a look at the timeline showing the lifetime of teeth.

third molars often are not needed for chewing and are difficult to keep clean. Your dentist may recommend their removal to prevent potential complications when third molars are erupted partially or are impacted. The chart and photograph identify the names of the permanent teeth and provide the approximate ages at which you can expect the teeth to erupt. Heredity and other factors may influence the approximate ages at which children’s primary teeth shed and their permanent teeth emerge. Thorough brushing and flossing help remove food particles and plaque (a sticky film of bacteria) from the smooth surfaces of teeth. But toothbrush bristles cannot reach into the pits and fissures (depressions and grooves) of the chewing surfaces to remove food and plaque. Dental sealants protect these vulnerable areas by sealing out debris and plaque bacteria. A sealant is a plastic material that usually is applied to the

chewing surfaces of the back teeth—premolars and molars—where decay occurs most often. The plastic resin bonds into the pits and fissures of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.

Eruption Sequence of Permanent Dentition:

• Central incisors= 6-8 yrs


• Lateral incisors= 6.5-8.5yrs


• Canine = 9-13 yrs


• 1st Premolars= 9.5-11.5yrs


• 2nd Premolars= 10-13yrs


• 1st Molars =5.5-7yrs


• 2nd Molars= 11-13yrs


• 3rd Molars= 17-21yrs

 

 

The 32 fit into the jaw space for 20 baby teeth

The bones of the face grow during the period of tooth development.

• The jawbone normally grows in size to accommodate the extra teeth.


• The jaws grow at a faster rate than the rest of the face, and eventually measure up to 1/3 of the size of the face. This is a dramatic increase from the proportion at birth.


• If the jaws do not grow sufficiently, crowding or impacted teeth will result.

Permanent incisors: These are the front teeth, and there are 8 of them altogether (four at the top and four at the bottom). They are usually the first permanent teeth to come through, and are good for cutting into food (for example biting into an apple). You can tell which are the incisors by their flat edge at the top, and because they each have only one root.

Permanent canines: These front teeth are also known as 'eye teeth', and are more pointed in shape than the incisors, but like the incisors they each have a single root. There are 4 altogether, and in animals such as dogs and cats the canines are much longer, and are used for tearing off chunks of food. In humans they are smaller in size, and are good for cutting into food similar to incisors.

Premolars: These are the new, adult back teeth which replace the first and second deciduous molars. There are eight altogether, four first premolars and four second ones. Deciduous teeth don't have premolars as back teeth, just molars.

Permanent molars: These are the larger back teeth, which are good for crushing food into smaller pieces before being swallowed. This is known as chewing. Molars usually have more than one root each, and have irregular, or 'bumpy' surfaces with grooves called 'fissures'. There are first, second and third permanent molars, which come through in that order.

First permanent molars: The four first permanent molars are similar in size to the second molars and come through at around age 6 to 8 years.

Second permanent molars: The four second permanent molars are similar in size to the first permanent molars and come through at around age 12 years.

Third permanent molars: These are the very last of the adult teeth to appear between age 18 and 21 years, and are also called 'wisdom teeth'. There are four, and they come through at the very back and sometimes cause problems if there isn't enough room for them.