Training Manual

ORAL CAVITY Oral Cavity (Mouth) includes : LIPS TONGUE TEETH GINGIVA (GUMS) HARD PALATE SOFT PALATE UVULA FLOOR OF THE MOUTH CHEEK & LIP MUCOSAL (Inner) LINING SALIVARY GLANDS & DUCTS

TEETH Maxillary (Upper) Teeth Mandibular (Lower) Teeth Primary (Milk) Teeth are defined as hard bony structures attached to jaws used for mastication(chewing). Can be described as (based on position) Maxillary (Upper) Teeth Mandibular (Lower) Teeth And also as (based on age) Primary (Milk) Approximate Age 6 mnths-2 yrs. Mixed 6 yrs. - 14 yrs. Secondary (Permanent) Teeth 6 yrs onwards

TEETH Teeth are given specific names based on the functions they perform Incisors. Incisors are the eight teeth in the front and center of your mouth (four on top and four on bottom). These are the teeth that you use to take bites of your food. Incisors are usually the first teeth to erupt, at around 6 months of age for your first set of teeth, and between 6 and 8 years of age for your adult set. Canines. Your four canines are the next type of teeth to develop. These are your sharpest teeth and are used for ripping and tearing food apart. Primary canines generally appear between 16 and 20 months of age with the upper canines coming in just ahead of the lower canines. In permanent teeth, the order is reversed. Lower canines erupt around age 9 with the uppers arriving between 11 and 12 years of age. Premolars. Premolars, or bicuspids, are used for chewing and grinding food. You have four premolars on each side of your mouth, two on the upper and two on the lower jaw. The first premolars appear around age 10 and the second premolars arrive about a year later. Molars. Primary molars are also used for chewing and grinding food. These appear between 12 and 15 months of age. These molars, also known as decidious molars, are replaced by the first and second permanent premolars (four upper and four lower). The permanent molars do not replace, but come in behind the primary teeth. The first molars erupt around 6 years of age (before the primary molars fall out) while the second molars come in between 11 and 13 years of age. Third molars. Third molars are commonly known as wisdom teeth. These are the last teeth to develop and do not typically erupt until age 18 to 20, and some people never develop third molars at all.

TEETH Teeth are important for: Chewing Smiling Speech Lip Support Maintaining Bone structure Facial Aesthetics Preventing Drooling Preservation of Self Esteem & Confidence

ANATOMY OF TOOTH A tooth is divided into two basic parts: the crown, which is the visible, white part of the tooth, and the root, which extends below the gum line and anchors the tooth into the bone. Teeth are made up of four kinds of tissues and each has a specific function. Enamel. Enamel is the visible substance that covers the tooth crown. Harder than bone, enamel protects the tooth from decay. Enamel is made up of phosphorous and calcium. Dentin. Underneath the enamel you find dentin, which is calcified and looks similar to bone. Dentin is not quite as hard as enamel, so it is at greater risk for decay should the enamel wear away.Contains dentinal tubules which transfer signals to pulp. Cementum. This tissue covers the tooth root and helps anchor it (cement it) into the bone. It is softer than enamel and dentin.Cementum has a light yellow colour and is usually covered by the gums.. Pulp. Pulp is found at the center of your tooth and contains the blood vessels, nerves, and other soft tissues that deliver nutrients and carries signals to your teeth from nerve endings in the bone.

DISEASES OF TEETH 1. Cavities (Decay) 2. Tooth Sensitivity 3. Gum Diseases –a. Gingivitis b. Periodontitis 4. Bad breadth (Halitosis) 5. Tooth Discolouration.

1. CAVITIES (Decay) Tooth decay is the damage that occurs when germs (bacteria) in your mouth produce acids that dissolve the tooth structure. It can lead to a hole in the tooth structure, called a cavity. If not treated, tooth decay can cause pain, infection, and tooth loss. A clear, sticky substance called plaque is always forming on your teeth and gums. Plaque contains bacteria that feed on the sugars in the food you eat.It is yellowish in colour and responsible for cavities and gum diseases in mouth. Plaque can be controlled by regular brushing with a toothpaste that prevents the bacteria to colonize on teeth. Signs that you may have decayed teeth: Tooth decay usually doesn't cause symptoms until you have a cavity or an infected tooth. When this happens, you may have: White, grey, brown, or black spots on your teeth.This could be the initial stage of decay. Bad breath or a bad taste in your mouth due to food lodgement. Sensitive teeth. A toothache, which is the most common symptom. Swelling or boil on the gums along with a sore tooth. This can be a sign of severe tooth decay or a tooth abscess. Fractured or broken blackish teeth stumps.

CAVITIES(Decay)

CAVITIES (Decay) Stages of decay

2. TOOTH SENSITIVITY Tooth sensitivity is tooth discomfort in one or more teeth that is triggered by hot, cold, sweet, or sour foods and drinks or even by breathing cold air. The pain can be sharp, sudden, and shoot deep into the nerve endings of your teeth.  Tooth sensitivity is due to the wasting diseases of teeth, namely attrition, abrasion and erosion. These diseases cause loss of tooth structure causing the dentinal nerve fibres to get exposed, thus triggering sensitivity. Gum recession is also another major reason for hypersensitivity.

TOOTH SENSITIVITY

3.GUM DISEASES Gingivitis Teeth are supported by the gums or gingiva. Inflammation of the gums is medically classified as gingivitis. Signs of gingivitis If you suffer from gingivitis, some of the warning signs are swelling, bleeding gums, bright red or purple appearance to gums, gums that are tender when touched, mouth sores, swollen gums and shiny appearance to gums. Gingivitis is caused by bacteria buildup in the mouth that goes untreated.

GINGIVITIS

PERIODONTITIS Periodontitis is a bacterial infection that destroys the supporting structures that hold the teeth in place. Signs of periodontitis The gums draw back and the roots of the teeth are exposed. It is in this stage of periodontitis that loss of bone due to bacterial erosion can occur, which will then cause the pocket (space between the gum and tooth) to grow deeper and wider. Pus develops between the teeth and the gums and the teeth become loose in their sockets.

4.BAD BREADTH Bad breath referred to as halitosis, is an unpleasant odour of the breadth,it can have a significant impact on a person's social and professional life.  Bad breath is caused by the decay of food particles that are not removed from the mouth by brushing and flossing. Oral bacteria use these particles as food and they produce waste that in many instances are compounds of sulfur. This is what produces the foul odour.  Other reasons for bad breath are infections of the sinus or lungs, Diabetes, kidney failure, liver malfunction, metabolism disorder, fasting (devoid of food, the body breaks down the fat and protein reserves resulting in release of bad odour from the reaction).

5.TOOTH DISCOLOURATION When the crown of the tooth reflects a darker shade or stains the tooth is said to be discoloured. Discolouration can be Intrinsic (due to systemic conditions and cannot be removed with routine prophylaxis) OR Extrinsic(due to accquired stains and can generally be removed with routine prophlaxis). Internalised discolouration is the incorporation of extrinsic stain within the tooth surface due to enamel defects and porosity of exposed dentine.

TOOTH DISCOLOURATION Brownish black extrinsic stains (Smoking) Greyish blue intrinsic stains (Tetracycline) Yellowish discolouration (Aging)

ROUTINE DENTAL TREATMENTS Prophylaxis (Cleaning & Polishing) Cavity Filling (Cements,Silver amalgam,White composite ) Root canal (Nerve Treatment) Extraction (Removal of tooth from socket) Crowns and Bridges (To cover/replace teeth) Removable Dentures (To replace missing teeth) Gum surgeries Dental Implants (To replace missing teeth-Surgical proceedure)

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