There are many different problems that can affect your teeth, including

• Tooth decay - damage to a tooth's surface, which can lead to cavities
• Abscess - a pocket of pus, caused by a tooth infection
• Impacted tooth - a tooth did not erupt (break through the gum) when it should have. It is usually wisdom teeth that are impacted, but it can sometimes happen to other teeth.
• Misaligned teeth (malocclusion)
• Tooth injuries such as broken or chipped teeth

Your teeth are made of a hard, bonelike material. There are four parts:

• Enamel, your tooth's hard surface
• Dentin, the hard yellow part under the enamel
• Cementum, the hard tissue that covers the root and keeps your teeth in place
• Pulp, the soft connective tissue in the center of your tooth. It contains nerves and blood vessels.

You need your teeth for many activities that you may take for granted. These include eating, speaking and even smiling.

A tooth that is prevented from erupting by a physical barrier, usually other teeth. Impaction may also result from orientation of the tooth in an other than vertical position in the periodontal structures.

A malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other during mouth closure. Malocclusions are common, although usually not serious enough to require treatment. Severe malocclusions may involve craniofacial anomalies and require orthodontic or sometimes surgical treatment (orthognathic surgery) to correct the problem. Correction of malocclusion may reduce the risk of tooth decay and prevent damage to the temporomandibular joint. Orthodontic treatment is also used to correct minor misalignments for aesthetic reasons.

Malocclusions can involve teeth that are mispositioned, tilted, rotated, deformed extranumerary or missing, and with dozens of teeth in the mouth, diagnosis can be a complicate process. Angle (1899) produced one of the oldest and simplest way of classifying malocclusions. It focuses on the position of the teeth. Several other classification systems have been proposed later to account for the limitations of Angle's system. This includes classifications by Martin Dewey (1915), Benno Lischer (1912, 1933), Simon (1930, the first 3D system), Jacob A. Salzmann (1950, based on skeletal structures) and James L. Ackerman and William R. Proffit (1969).

What is tooth decay?

Tooth decay is damage to a tooth's surface, or enamel. It happens when bacteria in your mouth make acids that attack the enamel. Tooth decay can lead to cavities (dental caries), which are holes in your teeth. If tooth decay is not treated, it can cause pain, infection, and even tooth loss.

What causes tooth decay?

Our mouths are full of bacteria. Some bacteria are helpful. But some can be harmful, including the ones that play a role in tooth decay. These bacteria combine with food to form a soft, sticky film called plaque. The bacteria in plaque use the sugar and starch in what you eat and drink to make acids. The acids begin to eat away at the minerals on your enamel. Over time, the plaque can harden into tartar. Besides damaging your teeth, plaque and tartar can also irritate your gums and cause gum disease.

You get fluoride from toothpaste, water, and other sources. This fluoride, along with your salvia, helps the enamel repair itself by replacing the minerals. Your teeth go through this natural process of losing minerals and regaining minerals all day long. But if you don't take care of your teeth and/or you eat and drink lots of sugary or starchy things, your enamel will keep losing minerals. This leads to tooth decay.

A white spot may appear where minerals have been lost. This is an early sign of tooth decay. You may be able to stop or reverse the decay at this point. Your enamel can still repair itself, if you take better care of your teeth and limit sugary/starchy foods and drinks.

But if the tooth decay process continues, more minerals are lost. Over time, the enamel is weakened and destroyed, forming a cavity. A cavity is a hole in your tooth. It is permanent damage that a dentist has to repair with a filling.

Who is at risk for tooth decay?

The main risk factors for tooth decay are not taking care of your teeth and having too many sugary or starchy foods and drinks.

Some people have a higher risk of tooth decay, including people who:

• Don't have enough saliva, because of medicines, certain diseases, or some cancer treatments
• Don't get enough fluoride
• Are very young. Babies and toddlers who drink from bottles are at risk, especially if they are given juice or get bottles at bedtime. This exposes their teeth to sugars for long periods of time.
• Are older. Many older adults have receding gums and more wear on their teeth. These raise the risk of decay on the exposed root surfaces of their teeth.

What are the symptoms of tooth decay and cavities?

In early tooth decay, you usually don't have symptoms. As tooth decay gets worse, it can cause:

• A toothache (tooth pain)
• Tooth sensitivity to sweets, hot, or cold
• White or brown stains on the surface of a tooth
• A cavity
• An infection, which can lead to an abscess (pocket of pus) forming. The abscess can cause pain, facial swelling, and fever.

How are tooth decay and cavities diagnosed?

Dentists usually find tooth decay and cavities by looking at your teeth and probing them with dental instruments. Your dentist will also ask if you have any symptoms. Sometimes you may need a dental x-ray.

What are the treatments for tooth decay and cavities?

There are several treatments for tooth decay and cavities. Which treatment you get depends on how bad the problem is:

• Fluoride treatments. If you have early tooth decay, a fluoride treatment can help the enamel to repair itself.
• Fillings. If you have a typical cavity, your dentist will remove the decayed tooth tissue and then restore the tooth by filling it with a filling material.
• Root canal. If the damage to the tooth and/or an infection spreads to the pulp (inside of the tooth), you might need a root canal. Your dentist will remove the decayed pulp and clean inside the tooth and root. The next step is to fill the tooth with a temporary filling. Then you will need to come back to get a permanent filling or a crown (a cover on the tooth).
• Extraction (pulling the tooth). In the most severe cases, when the damage to the pulp cannot be fixed, your dentist may pull the tooth. Your dentist will suggest that you get a bridge or implant to replace the missing tooth. Otherwise, the teeth next to the gap may move over and change your bite.

Can tooth decay be prevented?

There are steps that you can take to prevent tooth decay:

• Make sure that you get enough fluoride by
  • Brushing with a fluoride toothpaste
  • Drinking tap water with fluoride. Most bottled water does not contain fluoride.
  • Using fluoride mouth rinse
• Practice good oral health by brushing your teeth twice a day with a fluoride toothpaste and regularly flossing your teeth
• Make smart food choices by limiting foods and drinks that are high in sugars and starches. Eat nutritious, balanced meals and limit snacking.
• Do not use tobacco products, including smokeless tobacco. If you currently use tobacco, consider quitting.
• See a dentist for regular check-ups and professional cleanings
• Make sure that your children get sealants on their teeth. Dental sealants are thin plastic coatings that protect the chewing surfaces of the back teeth. Children should get sealants on their back teeth as soon as they come in, before decay can attack the teeth.

Wisdom teeth: Overview

Introduction

Wisdom teeth come in at the very back of our mouth, with one at the end of each row of teeth. They usually do not develop until the ages of 17 to 24, and it is only then that they first break through, if they do at all. These teeth are commonly thought of as "trouble makers" because they usually do not fit well with the other teeth and can cause problems.

Wisdom teeth are thought to date back to our distant ancestors who had larger jaws and more teeth. Nowadays most people's jaws are too small to have enough room for these "extra" teeth. For a while they were routinely pulled, but because they do not always cause problems and there may be side effects if they are removed, dentists are now a bit more hesitant.

Effects

Often wisdom teeth will break through only partially or not at all, although they have stopped growing. This can cause pain, swelling or gum inflammation. The wisdom teeth may also damage nearby teeth and increase the likelihood of cavities. But usually wisdom teeth that do not break through do not cause any trouble.

Circumstances are similar if wisdom teeth break through: Sometimes they have no trouble fitting in at the back of the jaw. But they can push against other teeth, grow in crooked, and cause inflammation or other complications.

Diagnosis

If you are worried about your wisdom teeth it is best to talk to your dentist. They will first ask you about your symptoms and examine your mouth and jaw. An x-ray can be taken to see the position of the teeth. A thorough examination can help to find out whether the wisdom teeth will cause problems or will grow in normally.

Treatment

If one or more wisdom teeth start causing problems, they will usually need to be pulled. Depending on whether they have already broken out or are still deeper inside the jaw, surgery may be necessary.

Even wisdom teeth that were not causing any problems used to be pulled in most cases. But nowadays this is usually only recommended if problems are already occurring or are expected.

Healthy teeth are important to your child's overall health. From the time your child is born, there are things you can do to promote healthy teeth and prevent cavities. For babies, you should clean teeth with a soft, clean cloth or baby's toothbrush. Avoid putting the baby to bed with a bottle and check teeth regularly for spots or stains.

For all children, you should

• Start using a pea-sized amount of fluoride toothpaste when they are two years old. You might start sooner, if a dentist or doctor suggests it.
• Provide healthy foods and limit sweet snacks and drinks
• Schedule regular dental check-ups

Forming good habits at a young age can help your child have healthy teeth for life.

It's important to take care of your mouth and teeth starting in childhood. If you don't, you could have problems with your teeth and gums - like cavities or even tooth loss.

Here's how to keep your mouth and teeth healthy:

• Brush your teeth twice a day with a fluoride toothpaste
• Clean between your teeth every day with floss or another type of between-the-teeth cleaner
• Snack smart - limit sugary snacks
• Don't smoke or chew tobacco
• See your dentist or oral health professional regularly

If you have gum disease, you're not alone. Many U.S. adults currently have some form of the disease. It ranges from simple gum inflammation, called gingivitis, to serious damage to the tissue and bone supporting the teeth. In the worst cases, you can lose teeth.

In gingivitis, the gums become red and swollen. They can bleed easily. Gingivitis is a mild form of gum disease. You can usually reverse it with daily brushing and flossing and regular cleanings by a dentist or dental hygienist. Untreated gingivitis can lead to periodontitis. If you have periodontitis, the gums pull away from the teeth and form pockets that become infected. If not treated, the bones, gums and connective tissue that support the teeth are destroyed.

Some people have naturally straight teeth that fit together. But if you have problems with your bite or the spacing of your teeth, you may need orthodontic care. Orthodontia is the branch of dentistry that deals with abnormalities of the teeth and jaw.

Orthodontic care involves the use of devices, such as braces, to

• Straighten teeth
• Correct problems with bite
• Close gaps between teeth
• Align lips and teeth properly

Most people who receive orthodontic care are kids, but adults get braces, too. In young children, orthodontic treatment may guide proper jaw growth. This can help permanent teeth to come in properly. Straight permanent teeth can help prevent tooth problems later on.

The causes of tooth disorders varies, depending on the problem. Sometimes the cause is not taking good care of your teeth. In other cases, you may have been born with the problem or the cause is an accident.

The symptoms can vary, depending on the problem. Some of the more common symptoms include

• Abnormal color or shape of the tooth
• Tooth pain
• Worn-down teeth

Your dentist will ask about your symptoms, look at your teeth, and probe them with dental instruments. In some cases, you may need dental x-rays.

The treatment will depend on the problem. Some common treatments are

• Fillings for cavities
• Root canals for cavities or infections that affect the pulp (inside of the tooth)
• Extractions (pulling teeth) for teeth that are impacted and causing problems or are too damaged to be fixed. You may also have a tooth or teeth pulled because of overcrowding in your mouth.