Selecting an Orthodontic Method for Different Needs

Selecting an Orthodontic Method for Different Needs

Types of Malocclusions: Overview of common types such as overbite, underbite, and crossbite in pediatric patients.

When it comes to selecting an orthodontic method for different needs, traditional braces are often considered for their proven effectiveness and versatility, particularly for young children. Traditional braces, consisting of metal brackets and wires, have been a cornerstone of orthodontic treatment for decades. Braces are available in different styles and colors for kids Early orthodontic intervention health care. Their primary advantage lies in their ability to address a wide range of orthodontic issues, from mild to severe cases, making them suitable for many young patients.


For young children, traditional braces are often recommended due to their effectiveness in correcting misaligned teeth and jaw discrepancies during the critical growth phase. As children's teeth and jaws are still developing, orthodontists can leverage this period to guide teeth into their correct positions more efficiently. Traditional braces apply consistent pressure on the teeth, gradually shifting them into alignment. This method is particularly effective for addressing issues such as overcrowding, gaps, and bite problems, which are common in young children.


Moreover, traditional braces are adaptable to the changing needs of a child's mouth. As the child grows and their dental structure evolves, orthodontists can make adjustments to the braces to ensure continued progress towards the desired outcome. This flexibility is crucial for young patients, whose orthodontic needs may change as they grow.


However, while traditional braces are highly effective, they may not be suitable for every young child. Factors such as the child's age, the severity of the orthodontic issue, and the child's ability to maintain good oral hygiene must be considered. For very young children, orthodontists may recommend waiting until more permanent teeth have erupted before starting treatment with traditional braces. Additionally, some children may find the appearance of metal braces less appealing, which could impact their self-esteem and willingness to comply with treatment.


In conclusion, traditional braces are a highly effective orthodontic method for young children, capable of addressing a wide range of dental issues. Their adaptability and proven track record make them a popular choice among orthodontists. However, the suitability of traditional braces for a young child depends on individual factors, and a thorough consultation with an orthodontist is essential to determine the best treatment plan for each child's unique needs.

When considering orthodontic treatments for children, clear aligners have emerged as a popular and effective option. These virtually invisible devices offer a modern alternative to traditional braces, and they come with a range of benefits and considerations that parents should weigh.


One of the primary benefits of clear aligners for kids is their aesthetic appeal. Unlike metal braces, which can be a source of self-consciousness for children, clear aligners are nearly invisible, allowing kids to feel more confident about their smiles during treatment. This can be particularly important during the formative years when peer perceptions can significantly impact a child's self-esteem.


Another advantage is the comfort and convenience that clear aligners provide. Made from smooth plastic, they are generally more comfortable than metal braces, which can cause irritation to the cheeks and gums. Additionally, clear aligners are removable, making it easier for children to maintain good oral hygiene by brushing and flossing without the obstacles posed by fixed braces.


However, there are important considerations to keep in mind. Clear aligners require a high level of responsibility from the child. They must be worn for at least 22 hours a day and changed every one to two weeks as directed. If not worn consistently, the treatment may be less effective, and the desired results may not be achieved. Parents should assess their child's maturity and willingness to adhere to the treatment plan before opting for clear aligners.


Moreover, clear aligners may not be suitable for all orthodontic cases, particularly more complex ones. It's crucial to consult with an experienced orthodontist who can evaluate the child's specific needs and determine if clear aligners are the best approach or if traditional braces might be more appropriate.


In conclusion, clear aligners offer a discreet and comfortable option for children needing orthodontic treatment, but they require commitment and may not be suitable for every case. By carefully considering these benefits and considerations, parents can make an informed decision that aligns with their child's needs and lifestyle, ensuring the best possible outcome for their child's oral health and confidence.

Early Detection and Diagnosis: The importance of regular dental check-ups for identifying malocclusions in children.

Early orthodontic intervention, often referred to as phase-one treatment, plays a crucial role in addressing orthodontic issues in children at a younger age. This approach is typically recommended for children between the ages of 6 and 10, a period when their jaw is still growing and their baby teeth are being replaced by permanent ones. The necessity of early intervention hinges on several factors, each tailored to the unique needs of the child.


One primary reason for early orthodontic intervention is to correct issues that could worsen over time if left untreated. For instance, conditions like crossbites, overbites, and underbites can be addressed more effectively during the developmental stages. By intervening early, orthodontists can guide the growth of the jaw and the alignment of teeth, potentially preventing more invasive and costly treatments later in life.


Another significant advantage of early intervention is the potential to improve the child's oral function and overall health. Issues such as crowded teeth or misaligned jaws can lead to difficulties with chewing, speaking, and even breathing. Early treatment can mitigate these problems, enhancing the child's quality of life and preventing secondary issues, such as speech impediments or sleep apnea.


Moreover, early orthodontic intervention can have a profound psychological impact. Children at this age are often sensitive to their appearance and can be affected by teasing or self-consciousness about their teeth. By addressing these concerns early, orthodontists can boost a child's confidence and self-esteem, which is invaluable during their formative years.


In conclusion, selecting early orthodontic intervention as a method for addressing orthodontic needs is necessary for children who exhibit specific issues that can benefit from timely treatment. It not only corrects dental and jaw alignment but also enhances oral function, overall health, and psychological well-being. As such, it's a critical consideration for parents and orthodontists when choosing the most appropriate orthodontic method for different needs.

Orthodontic Treatment Options for Kids: Discussing braces, aligners, and other corrective measures suitable for young patients.

When selecting an orthodontic method for kids, one of the critical factors to consider is the cost comparison of the different options available. Orthodontic treatment can be a significant investment, and understanding the financial implications of each method is essential for making an informed decision.


Traditional metal braces are often the most affordable option for orthodontic treatment. They have been used for decades and are widely available, which contributes to their lower cost. On average, the total cost for metal braces can range from $3,000 to $7,000, depending on the complexity of the case and the location of the orthodontist.


Ceramic braces, which are similar to metal braces but use tooth-colored or clear brackets, are slightly more expensive. The cost for ceramic braces typically falls between $4,000 and $8,000. The higher price is due to the more advanced materials used and the increased difficulty in maintaining the braces during treatment.


Lingual braces, which are placed behind the teeth, are a more discreet option but come with a higher price tag. The cost for lingual braces can range from $8,000 to $10,000 or more, as they require specialized training and equipment for the orthodontist to place and adjust them.


Clear aligners, such as Invisalign, are a popular choice for many families due to their nearly invisible appearance and removable nature. However, they are also one of the more expensive options, with costs ranging from $3,000 to $8,000. The price can vary based on the complexity of the case and the number of aligners required throughout the treatment.


It's important to note that these cost ranges are estimates, and the actual cost of treatment may vary based on factors such as the orthodontist's fees, the length of treatment, and any additional procedures that may be necessary. Many orthodontists offer payment plans or financing options to help families manage the cost of treatment.


When comparing the costs of different orthodontic methods, it's essential to consider not only the upfront expenses but also the potential long-term benefits. Investing in the right orthodontic treatment can lead to improved oral health, increased self-confidence, and a lifetime of beautiful smiles for your child. By carefully weighing the costs and benefits of each option, you can make the best decision for your family's unique needs and budget.

The Role of Parents in Orthodontic Care: How parents can support their child's orthodontic treatment and encourage good oral habits.

When selecting an orthodontic method for their children, one of the key considerations for parents is the duration of treatment. This aspect can significantly influence both the choice of orthodontic approach and the family's overall experience. Understanding what to expect in terms of treatment duration can help parents plan better and set realistic expectations.


The duration of orthodontic treatment varies widely depending on the method chosen and the complexity of the dental issues being addressed. For instance, traditional metal braces, which are commonly used, typically require about 18 to 24 months to achieve the desired results. This timeframe can be influenced by factors such as the severity of misalignment, the patient's age, and their adherence to the orthodontist's instructions.


In contrast, newer options like clear aligners, such as Invisalign, might offer a slightly shorter treatment period, often ranging from 12 to 18 months. These aligners are removable and can be more comfortable for the wearer, which might contribute to better compliance and, consequently, a shorter treatment time. However, they may not be suitable for all orthodontic cases, particularly those involving complex corrections.


For very young children, early orthodontic interventions like palatal expanders might be used. These devices are typically worn for a few months to a year, depending on the child's growth and the specific needs of their treatment plan. Early intervention can sometimes reduce the need for more extensive treatment later on, potentially shortening the overall duration of orthodontic care.


Another factor that parents should consider is the potential for adjustments or additional treatments. Some cases might require phase treatments, where an initial round of orthodontics is followed by a period of monitoring and then a second phase. This approach can extend the total treatment time but may yield better results in the long run.


Ultimately, the duration of orthodontic treatment is a critical factor that parents need to weigh when selecting the right method for their child. By discussing the expected timeline with their orthodontist and understanding the variables at play, parents can make informed decisions that align with their family's needs and lifestyle. Regular communication with the orthodontist throughout the treatment process will also help manage expectations and ensure the best possible outcome for the child's dental health.

Long-term Benefits of Early Orthodontic Intervention: How treating malocclusions in childhood can prevent more serious issues in adulthood.

When it comes to selecting an orthodontic method that suits different needs, it's crucial to also consider the maintenance and care required to keep these appliances in good condition. Whether you're opting for traditional braces, clear aligners, or other orthodontic devices, proper upkeep is essential for achieving the best results and ensuring the longevity of your treatment.


For traditional braces, which consist of brackets and wires, maintaining good oral hygiene is paramount. Brushing after every meal and flossing daily can help prevent plaque buildup and reduce the risk of stains and tooth decay. It's also important to avoid hard, sticky, or chewy foods that could damage the braces. Regular check-ups with your orthodontist will ensure that any issues are addressed promptly, keeping your treatment on track.


Clear aligners, on the other hand, offer a more discreet option and require a different approach to care. These removable trays should be cleaned daily with a soft toothbrush and lukewarm water to prevent bacterial growth. It's essential to wear the aligners for the recommended 22 hours per day, only removing them to eat, drink (except water), and clean your teeth. Storing the aligners in their case when not in use will protect them from damage and loss.


Regardless of the orthodontic method you choose, adhering to your orthodontist's guidelines is key. This may include using special cleaning tools, such as interdental brushes or water flossers, to maintain optimal oral health. It's also wise to avoid habits like biting your nails or chewing on pens, as these can compromise the effectiveness of your treatment.


In conclusion, while selecting the right orthodontic method is crucial for addressing your specific dental needs, the success of your treatment largely depends on how well you care for your appliances. By following a diligent maintenance routine and working closely with your orthodontist, you can ensure that your chosen method delivers the desired results, leaving you with a healthy, beautiful smile.

A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.

Etymology

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The word patient originally meant 'one who suffers'. This English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning 'I am suffering', and akin to the Greek verb πάσχειν (paskhein 'to suffer') and its cognate noun πάθος (pathos).

This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care.[1]

 

Outpatients and inpatients

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Patients at the Red Cross Hospital in Tampere, Finland during the 1918 Finnish Civil War
Receptionist in Kenya attending to an outpatient

An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for the visit, tests, or procedure/surgery, which should include the names and titles of the participating personnel, the patient's name and date of birth, signature of informed consent, estimated pre-and post-service time for history and exam (before and after), any anesthesia, medications or future treatment plans needed, and estimated time of discharge absent any (further) complications. Treatment provided in this fashion is called ambulatory care. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is called outpatient surgery or day surgery, which has many benefits including lowered healthcare cost, reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limited urinary-tract, eye, or ear, nose, and throat procedures and procedures involving superficial skin and the extremities). More procedures are being performed in a surgeon's office, termed office-based surgery, rather than in a hospital-based operating room.

A mother spends days sitting with her son, a hospital patient in Mali

An inpatient (or in-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as with coma or persistent vegetative state, patients can stay in hospitals for years, sometimes until death. Treatment provided in this fashion is called inpatient care. The admission to the hospital involves the production of an admission note. The leaving of the hospital is officially termed discharge, and involves a corresponding discharge note, and sometimes an assessment process to consider ongoing needs. In the English National Health Service this may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home.[2]

Misdiagnosis is the leading cause of medical error in outpatient facilities. When the U.S. Institute of Medicine's groundbreaking 1999 report, To Err Is Human, found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year,[3] early efforts focused on inpatient safety.[4] While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in a doctor's office or outpatient clinic or center.[citation needed]

Day patient

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A day patient (or day-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used by psychiatric hospital services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.

Alternative terminology

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Because of concerns such as dignity, human rights and political correctness, the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used include health consumer, healthcare consumer, customer or client. However, such terminology may be offensive to those receiving public health care, as it implies a business relationship.

In veterinary medicine, the client is the owner or guardian of the patient. These may be used by governmental agencies, insurance companies, patient groups, or health care facilities. Individuals who use or have used psychiatric services may alternatively refer to themselves as consumers, users, or survivors.

In nursing homes and assisted living facilities, the term resident is generally used in lieu of patient.[5] Similarly, those receiving home health care are called clients.

Patient-centered healthcare

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The doctor–patient relationship has sometimes been characterized as silencing the voice of patients.[6] It is now widely agreed that putting patients at the centre of healthcare[7] by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction.[8]

When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible.[9] Incidents, such as the Stafford Hospital scandal, Winterbourne View hospital abuse scandal and the Veterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience.[10] Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services.[11]

There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct.[12] Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect',[9] that are difficult to capture with institutional monitoring.[13]

One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints.[14] Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn about and improve patient experience.[15]

See also

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  • Casualty
  • e-Patient
  • Mature minor doctrine
  • Nurse-client relationship
  • Patient abuse
  • Patient advocacy
  • Patient empowerment
  • Patients' Bill of Rights
  • Radiological protection of patients
  • Therapeutic inertia
  • Virtual patient
  • Patient UK

References

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  1. ^ Neuberger, J. (1999-06-26). "Do we need a new word for patients?". BMJ: British Medical Journal. 318 (7200): 1756–1758. doi:10.1136/bmj.318.7200.1756. ISSN 0959-8138. PMC 1116090. PMID 10381717.
  2. ^ "Unpaid carers' rights are overlooked in hospital discharge". Health Service Journal. 8 September 2021. Retrieved 16 October 2021.
  3. ^ Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn, L. T.; Corrigan, J. M.; Donaldson, M. S. (2000). Kohn, Linda T.; Corrigan, Janet M.; Donaldson, Molla S. (eds.). To Err Is Human: Building a Safer Health System. Washington D.C.: National Academy Press. doi:10.17226/9728. ISBN 0-309-06837-1. PMID 25077248.
  4. ^ Bates, David W.; Singh, Hardeep (November 2018). "Two Decades Since: An Assessment Of Progress And Emerging Priorities In Patient Safety". Health Affairs. 37 (11): 1736–1743. doi:10.1377/hlthaff.2018.0738. PMID 30395508.
  5. ^ American Red Cross (1993). Foundations for Caregiving. St. Louis: Mosby Lifeline. ISBN 978-0801665158.
  6. ^ Clark, Jack A.; Mishler, Elliot G. (September 1992). "Attending to patients' stories: reframing the clinical task". Sociology of Health and Illness. 14 (3): 344–372. doi:10.1111/1467-9566.ep11357498.
  7. ^ Stewart, M (24 February 2001). "Towards a Global Definition of Patient Centred Care". BMJ. 322 (7284): 444–5. doi:10.1136/bmj.322.7284.444. PMC 1119673. PMID 11222407.
  8. ^ Frampton, Susan B.; Guastello, Sara; Hoy, Libby; Naylor, Mary; Sheridan, Sue; Johnston-Fleece, Michelle (31 January 2017). "Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care". NAM Perspectives. 7 (1). doi:10.31478/201701f.
  9. ^ a b Reader, TW; Gillespie, A (30 April 2013). "Patient Neglect in Healthcare Institutions: A Systematic Review and Conceptual Model". BMC Health Serv Res. 13: 156. doi:10.1186/1472-6963-13-156. PMC 3660245. PMID 23631468.
  10. ^ Bloche, MG (17 March 2016). "Scandal as a Sentinel Event--Recognizing Hidden Cost-Quality Trade-offs". N Engl J Med. 374 (11): 1001–3. doi:10.1056/NEJMp1502629. PMID 26981930.
  11. ^ Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. London: Stationery Office. 6 February 2013. ISBN 9780102981476. Retrieved 23 June 2020.
  12. ^ Weingart, SN; Pagovich, O; Sands, DZ; Li, JM; Aronson, MD; Davis, RB; Phillips, RS; Bates, DW (April 2006). "Patient-reported Service Quality on a Medicine Unit". Int J Qual Health Care. 18 (2): 95–101. doi:10.1093/intqhc/mzi087. PMID 16282334.
  13. ^ Levtzion-Korach, O; Frankel, A; Alcalai, H; Keohane, C; Orav, J; Graydon-Baker, E; Barnes, J; Gordon, K; Puopulo, AL; Tomov, EI; Sato, L; Bates, DW (September 2010). "Integrating Incident Data From Five Reporting Systems to Assess Patient Safety: Making Sense of the Elephant". Jt Comm J Qual Patient Saf. 36 (9): 402–10. doi:10.1016/s1553-7250(10)36059-4. PMID 20873673.
  14. ^ Berwick, Donald M. (January 2009). "What 'Patient-Centered' Should Mean: Confessions Of An Extremist". Health Affairs. 28 (Supplement 1): w555 – w565. doi:10.1377/hlthaff.28.4.w555. PMID 19454528.
  15. ^ Reader, TW; Gillespie, A; Roberts, J (August 2014). "Patient Complaints in Healthcare Systems: A Systematic Review and Coding Taxonomy". BMJ Qual Saf. 23 (8): 678–89. doi:10.1136/bmjqs-2013-002437. PMC 4112446. PMID 24876289.
[edit]
  • Jadad AR, Rizo CA, Enkin MW (June 2003). "I am a good patient, believe it or not". BMJ. 326 (7402): 1293–5. doi:10.1136/bmj.326.7402.1293. PMC 1126181. PMID 12805157.
    a peer-reviewed article published in the British Medical Journal's (BMJ) first issue dedicated to patients in its 160-year history
  • Sokol DK (21 February 2004). "How (not) to be a good patient". BMJ. 328 (7437): 471. doi:10.1136/bmj.328.7437.471. PMC 344286.
    review article with views on the meaning of the words "good doctor" vs. "good patient"
  • "Time Magazine's Dr. Scott Haig Proves that Patients Need to Be Googlers!" – Mary Shomons response to the Time Magazine article "When the Patient is a Googler"

 

 

Tooth
A chimpanzee displaying his teeth
Details
Identifiers
Latin dens
MeSH D014070
FMA 12516
Anatomical terminology
[edit on Wikidata]

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]

Etymology

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The word tooth comes from Proto-Germanic *tanþs, derived from the Proto-Indo-European *h₁dent-, which was composed of the root *h₁ed- '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 /œÃƒâ€¹Ã‚/, and later unrounded to /eː/, resulting in the tōþ/tÄ“þ alternation attested from Old English. Cf. also Old English bōc/bēċ 'book/books' and 'mÅ«s/mȳs' 'mouse/mice', from Proto-Germanic *bōks/bōkiz and *mÅ«s/mÅ«siz respectively.

Cognate with Latin dÄ“ns, Greek á½€δούς (odous), and Sanskrit dát.

Origin

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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]

Mammals

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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.

Aardvark

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In aardvarks, teeth lack enamel and have many pulp tubules, hence the name of the order Tubulidentata.[11]

Canines

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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]

Cetaceans

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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.

Primates

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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.

Horse

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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 (18 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.

Proboscideans

[edit]
Section through the ivory tusk of a mammoth

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]

Rabbit

[edit]

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.

Buccal view of top incisor from Rattus rattus. Top incisor outlined in yellow. Molars circled in blue.
Buccal view of the lower incisor from the right dentary of a Rattus rattus
Lingual view of the lower incisor from the right dentary of a Rattus rattus
Midsagittal view of top incisor from Rattus rattus. Top incisor outlined in yellow. Molars circled in blue.

Rodents

[edit]

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]

Lingual view of top incisor from Rattus rattus. Top incisor outlined in yellow. Molars circled in blue.

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.

Manatee

[edit]

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

[edit]

Walrus tusks are canine teeth that grow continuously throughout life.[32]

Fish

[edit]
Teeth of a great white shark

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].

Amphibians

[edit]

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]

Reptiles

[edit]

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]

Birds

[edit]

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]

Invertebrates

[edit]
The European medicinal leech has three jaws with numerous sharp teeth which function like little saws for incising a host.

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]

The limpet rasps algae from rocks using teeth with the strongest known tensile strength of any biological material.

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]

 

Fossilization and taphonomy

[edit]

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]

See also

[edit]
  • Animal tooth development
  • Dragon's teeth (mythology)

References

[edit]
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