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Selasa, 23 Desember 2008

Kesehatan Gigi dan Mulut

Kesehatan Gigi dan Mulut



Kelainan atau penyakit rongga mulut dan gigi merupakan salah satu dari 10 penyakit terbanyak di Puskesmas. Hampir sekitar 60% masyarakat Indonesia pernah mengalami gangguan pada gigi. Pada tahun 1980, ditemukan bahwa hampir 90% anak sekolah mempunyai kelainan gigi atau rongga mulut. Hal ini menunjukkan bahwa kesehatan gigi dan rongga mulut perlu mendapatkan perhatian khusus.


Jaringan Rongga Mulut

Dalam rongga mulut, terdapat beberapa jaringan yang dibagi dalam 2 kelompok, yaitu :

Jaringan Keras (rahang atas, rahang bawah, dan gigi).
Jaringan Lunak (gusi, lidah, mukosa pipi, mukosa bibir, mukosa lidah, mukosa palatum, dan jaringan dasar lidah).

Fungsi Gigi

Secara histologis, jaringan gigi dan mulut berasal dari mesoderm dan ektoderm, yang memiliki 3 fungsi utama yaitu, pengunyahan (mastikasi), keindahan (estetika), dan berbicara (phonetic). Dalam mulut, gigi tertanam dalam tulang rahang dan dilindungi oleh gusi (gingiva), dengan bentuk yang berbeda – beda sesuai dengan fungsinya.


Gigi Seri (Incisivus)

Gigi ini letaknya berada di depan, dan berfungsi untuk memotong makanan (mastikasi). Jumlahnya ada 8, dengan pembagian 4 berada di rahang atas dan 4 berada di rahang bawah. Gigi seri susu mulai tumbuh pada bayi usia 4 – 6 bulan, kemudian diganti dengan gigi seri permanen pada usia 5 – 6 tahun pada rahang bawah dan pada usia 7 – 8 tahun pada rahang atas.


Gigi Taring (Caninus)

Posisi gigi ini terletak pada sudut mulut, di sebelah gigi seri, dan merupakan gigi yang paling panjang dalam rongga mulut. Fungsinya adalah untuk mengoyak makanan. Jumlahnya ada 4, dengan pembagian 2 ditiap rahang, 1 di kiri dan 1 di kanan. Gigi susu caninus ini diganti dengan gigi caninus permanen pada usia 11 – 13 tahun.


Gigi Geraham Kecil (Premolar)

Gigi ini jumlahnya 8, dengan pembagian 4 ditiap rahang, 2 di kiri dan 2 di kanan. Gigi ini hanya ada pada gigi dewasa, dan letaknya berada di belakang caninus. Tumbuh pada usia 10 – 11 tahun dan menggantikan posisi dari gigi molar susu. Bersama gigi molar, gigi ini berfungsi untuk melumatkan makanan, dan pada proses orthodontie, gigi ini sering “dikorbankan”.


Gigi Geraham (Molar)

Gigi molar susu berjumlah 8 seperti gigi premolar, kemudian lepas pada usia 10 – 11 tahun dan digantikan oleh gigi premolar. Sedangkan gigi molar permanen tumbuh di belakang gigi premolar setelah gigi molar susu lepas dan digantikan oleh gigi premolar. Jumlah dari gigi molar permanen adalah 12, dengan pembagian 6 di tiap rahang, 3 di tiap sisi kanan dan kiri. Gigi molar permanen inilah yang paling sering berlubang dan menyebabkan keluhan.


Proses Pertumbuhan Gigi

Dalam pertumbuhannya, gigi mengalami 2 fase pergantian. Diawali dari pertumbuhan gigi susu yang lengkap pada umur 3 tahun dengan jumlah 20 gigi, kemudian diganti dengan fase gigi tetap yang diawali pada usia 13 tahun keatas. Pertumbuhan gigi tetap ini menjadi lengkap setelah jumlah gigi menjadi 32 gigi, sekitar umur 17 – 21 tahun. Fase diantara awal fase gigi tetap sampai gigi tetap yang lengkap disebut fase gigi campuran, yaitu antara umur 13 – 17 tahun.

Minggu, 21 Desember 2008

Gigi bungsu kenapa sih?

Gigi bungsu kenapa sih?
Posted on Monday, April 28, 2008 comments (30)
Labels: GIGI


Dari beberapa pertanyaan yang masuk sering menanyakan mengapa sakit saat sibungsu tumbuh, apa memang harus sakit? Kebanyakan memang terasa sakit namun mengapa gigi bungsu harus tumbuh kalau hanya untuk membuat masalah. Mari kita bersama-sama menelusuri jejak langkah si bungsu yang selalau dipermasalahkan ini.

Pertumbuhan atau kemunculan gigi bungsu yang dalam dunia kedokteran gigi sering disebut dengan dens molaris inferior tertius atau molar ketiga ini memang kerap memberikan rasa sakit yang sangat menggangu aktifitas kita. Beberapa dari kita mungkin kurang paham akan gigi bungsu ini. mungkin saya dapet menjelaskan sedikit mengenai gigi bungsu ini.

Gigi bungsu adalah gigi geraham ketiga yang muncul pada usia sekitar 18-20 tahun.

Gigi bungsu termasuk dalam kategori struktur vestigial, yaitu struktur yang fungsi awalnya menjadi hilang atau berkurang sejalan dengan evolusi. Banyak ahli berpendapat bahwa perubahan jenis makanan pada manusia modern dari mentah menjadi dimasak membuat makanan lebih lunak. Selain itu, pemeliharaan gigi moderen mengalami kemajuan pesat. Akibatnya kerusakan pada gigi berkurang. Kehadiran gigi bungsu yang diperkirakan dapat membantu bila ada geraham lain yang tanggal menjadi tidak berguna, malah pada kebanyakan orang menjadi masalah.

Ada sejumlah faktor yang menyebabkan gigi mengalami impaksi. Karena jaringan sekitarnya yang terlalu padat, adanya retensi gigi susu yang berlebihan, tanggalnya gigi susu terlalu awal. Bisa juga karena tidak adanya tempat untuk erupsi. Rahang "kesempitan" gara-gara pertumbuhan tulang rahang kurang sempurna.

Ada teori lain. Pertumbuhan rahang dan gigi mempunyai tendensi bergerak maju ke arah depan. Apabila pergerakan ini terhambat oleh sesuatu yang merintangi, bisa terjadi impaksi gigi. Misalnya, karena infeksi, trauma, malposisi gigi, atau gigi susu tanggal sebelum waktunya.

Sementara, menurut teori Mendel, pertumbuhan rahang dan gigi dipengaruhi oleh faktor keturunan. Jika salah satu orang tua (ibu) mempunyai rahang kecil, dan bapak bergigi besar-besar, ada kemungkinan salah seorang anaknya berahang kecil dan bergigi besar-besar. Akibatnya, bisa terjadi kekurangan tempat erupsi gigi bungsu, dan terjadilah impaksi.

Sempitnya ruang erupsi gigi bungsu, menurut drg. Danardono, itu karena pertumbuhan rahangnya kurang sempurna. Hal ini bisa karena perubahan pola makan. Manusia sekarang cenderung menyantap makanan lunak, sehingga kurang merangsang pertumbuhan tulang rahang.

Makanan lunak yang mudah ditelan menjadikan rahang tak aktif mengunyah. Sedangkan makanan banyak serat perlu kekuatan rahang untuk mengunyah lebih lama. Proses pengunyahan lebih lama justru menjadikan rahang berkembang lebih baik. Seperti diketahui, sendi-sendi di ujung rahang merupakan titik tumbuh atau berkembangnya rahang. Kalau proses mengunyah kurang, sendi-sendi itu pun kurang aktif, sehingga rahang tidak berkembang semestinya. Rahang yang harusnya cukup untuk menampung 32 gigi menjadi sempit. Akibatnya, gigi bungsu yang selalu tumbuh terakhir itu tidak kebagian tempat untuk tumbuh normal. Ada yang tumbuh dengan posisi miring, atau bahkan "tidur" di dalam karena tidak ada tempat untuk nongol.

Maka, untuk mendukung perkembangan rahang, sebaiknya sering-sering mengkonsumsi makanan berserat supaya gigi jadi lebih aktif menggigit, memotong, dan mengunyah. Rahang pun menjadi makin aktif dan diharapkan akan tumbuh normal. Dampaknya, pertumbuhan gigi pun bisa lebih bagus. Tapi jangan lupa, periksakan gigi secara rutin untuk memantau kesehatan gigi.

Beberapa sumber memberikan definisi yang berbeda dan tanggapan yang berbeda tentang gigi bungsu ini, salah satu sumber yang membahas tentang masalah pada gigi bungu ini dapat saya kutipkan dan menurut saya lengkap menjelaskan masalah pada gigi bungsu ini dari wikipedia.

Masalah pada gigi bungsu

Gigi yang berdesakan

Karena gigi bungsu tumbuh paling akhir, terkadang rahang tidak memiliki tempat yang cukup untuk gigi bungsu tumbuh dengan wajar. Akibatnya gigi bungsu mendesak gigi geraham yang berada di depannya. Hal ini akan mengakibatkan sakit pada gigi. Masalah ini umumnya diatasi dengan mencabut gigi bungsu yang baru tumbuh. Bila gigi bungsu menempati posisi yang sulit untuk dicabut, yang dicabut adalah gigi geraham yang terdesak sehingga gigi bungsu mendapat tempat yang cukup untuk tumbuh.


Gigi yang tidak muncul sempurna pada gusi

Terkadang gigi bungsu tidak muncul dengan sempurna pada gusi. Gusi yang menutupi gigi dapat menyebabkan penumpukan sisa makanan dan bakteri yang dapat menyebabkan infeksi dan sakit pada gigi.


Pengobatan


Pencabutan

Sebelum dicabut, gigi umumnya akan difoto terlebih dahulu dengan sinar X untuk mengetahui bentuk, posisi dan kedalaman gigi. Pencabutan gigi bungsu biasanya dilakukan dengan pembiusan lokal, namun terkadang juga dilakukan dengan bius total. Walaupun tergolong operasi kecil, pencabutan gigi sebaiknya dilakukan secara profesional oleh dokter gigi, mengigat komplikasi yang mungkin timbul saat dan setelah pencabutan.


Hal yang perlu diperhatikan setelah pencabutan gigi

Untuk mempercepat proses penyembuhan:
Usahakan beristirahat sepanjang hari dan tidak mengerjakan pekerjaan berat.
Hindari merokok. Bila memungkinkan selama proses penyembuhan (3-4 hari), minimal selama 24 jam setelah operasi.
Hindari berkumur atau menggosok gigi selama 24 jam setelah operasi
Setelah 24 jam, kebersihan daerah operasi dapat dijaga dengan berkumur air hangat bergaram (1 sendok teh garam untuk 1 gelas air) minimal 4 kali sehari. Berkumurlah dengan hati-hati karena tekanan dapat menyebabkan lubang bekas operasi terbuka lagi dan terjadi pendarahan.
Setelah 24 jam, meggosok gigi dapat dilakukan dengan hati-hati, terutama di daerah operasi.
Bila diberi obat penahan sakit dan antibiotik, minumlah sesuai petunjuk dokter. Antibiotik harus dihabiskan walaupun gigi sudah tidak terasa sakit. Sebaliknya, obat penahan sakit dapat dihentikan bila sakit mereda.
Makan dan minumlah seperti biasanya. Hindari berdiet, karena makan dan minum yang cukup sangat penting untuk proses penyembuhan.
Hindari minum menggunakan sedotan karena tekanannya dapat melepaskan gumpalan darah pada lubang operasi.
Hindari minuman bersoda karena busanya diperkirakan dapat melepaskan gumpalan darah pada lubang operasi. Minuman jus buah terutama jeruk sangat disarankan.
Makan tambahan vitamin C dianjurkan.
Untuk menghindari pembengkakan, setelah operasi rahang sebaiknya dikompres dengan es atau air dingin. Tempelkan kompres dingin selama 15 menit, diseling 10 menit tanpa kompres, diulang sampai saat istirahat malam.
Pada hari-hari setelah hari operasi, rahang dapat dikompres dengan kompres hangat, untuk menstimulasi peredaran darah di daerah gigi bungsu yang dapat mempercepat penyembuhan.

Selain hal-hal di atas, pembiusan yang dilakukan sebelum operasi juga dapat berpengaruh pada kemampuan psikis dan mekanis. Jangan berkendara, melakukan pekerjaan yang membutuhkan konsentrasi tinggi, atau menandatangani dokumen penting pada hari yang sama. Bila menggunakan bius total, usahakan ada seseorang yang dapat menemani selama minimal satu hari tersebut.


Masalah yang mungkin timbul setelah pencabutan


Pendarahan

Pendarahan tidak dapat dihindari dan dapat berlangsung selama satu hari penuh. Berkumur pada saat pendarahan terjadi sangat tidak dianjurkan. Pendarahan akan berhenti saat darah mulai menggumpal di lubang pencabutan, dan berkumur dapat menyebabkan gumpalan darah terlepas. Hal ini dapat memperlambat proses penyembuhan dan menyebabkan pendarahan terjadi lebih lama.

Bila terjadi pendarahan, letakkan gulungan kecil kasa steril (umumnya diberikan oleh dokter gigi) pada lubang bekas pencabutan. Kasa harus digigit dengan baik dengan tekanan secukupnya. Cara ini akan membantu menghentikan pendarahan, tetapi jangan dilakukan telalu berlebihan sehingga menimbulkan iritasi pada lubang pencabutan. Gulungan kasa hanya boleh digigit selama sekitar 20 menit. Bila terlalu lama, darah dapat membeku pada kasa dan gumpalan darah dapat terlepas lagi saat kasa dibuang. Bila pendarahan masih terjadi setelah 20 menit, ganti dengan kasa yang baru. Demikian seterusnya hingga pedarahan berkurang atau berhenti.

Bila pendarahan terus berlanjut setelah 1 hari, segera kembali ke dokter gigi dan laporkan. Pendarahan yang terus menerus menunjukkan masalah pada proses penyembuhan.


Lubang operasi tidak tertutup sempurna (Dry socket)

Pada umumnya, setelah gigi bungsu dicabut, darah akan menggenangi lubang bekas gigi dan menggumpal. Terbentuknya gumpalan darah ini sangat penting karena berfungsi sebagai tempat gusi kemudian akan tumbuh menutupi lubang. Diperkirakan sebanyak 5-10% kasus mengalami penutupan lubang yang tidak sempurna atau terlepasnya gumpalan darah sebelum waktunya, sehingga syaraf pada gusi dan bahkan tulang rahang menjadi terbuka (dry socket). Telah diketahui bahwa umumnya penderita dry socket adalah perempuan yang minum pil kontrasepsi. Diperkirakan dry socket dapat dihindari dengan melakukan operasi pada hari ke-22 hingga ke-28 siklus, yaitu saat kadar estrogen sedang pada titik terendah.


Infeksi

Infeksi yang terjadi saat proses penyembuhan dapat dihindari dengan minum antibiotik dan menjaga kebersihan mulut. Berkumur dengan air garam setiap selesai makan dapat membantu membersihkan daerah operasi.


Semoga dapet membantu, artikel ini saya buat dengan mengkutip beberap artikel dari wikipedia dan ilmu yang saya dapatkan dibangku kuliah, semoga sehat selalu.

Kamis, 18 Desember 2008

Kaitan berus gigi dengan serangan jantung?

Friday, December 19, 2008
Kaitan berus gigi dengan serangan jantung?

Aku : Dah berus gigike belum?

Teman : Belum..

Aku : Pergilah berus.. bahaya tu.

Teman : Bahaya... apa yang bahaya?

Aku : Bahaya... nanti kau kena serangan jantung.

Teman : Serangan jantung!!! Betulke?


Aku tersenyum melihat teman terpinga-pinga. Antara percaya dengan tidak.

Aku memberikan satu artikel kepadanya. Lantas dibacanya dengan penuh minat…

Menurut Pensyarah Jabatan Periodontologi, Fakulti Pergigian Universiti Carolina Utara, Profesor Ray William, kajian klinikal membuktikan bahawa banyak kes serangan jantung juga berlaku kepada individu yang kurang memberi penjagaan pada kebersihan mulut.

Menurut Prof. Ray William, bakteria dalam mulut boleh merebak ke organ lain melalui salur darah. Kehadiran bakteria merangsang sistem imun badan untuk bertindak balas bagi menghapuskannya. Kesan tindak balas ini boleh menyebabkan keradangan, terutama pada sistem kardiovaskular (jantung) dengan menebalkan dinding salur darah. Keadaan ini lama kelamaan menyebabkan salur darah menjadi sempit dan serangan jantungpun boleh berlaku.

Malah dalam kajian lainpun terdapat para penyelidik yang turut mengaitkan kehadiran bakteria dalam mulut juga boleh menyebabkan seseorang itu terkena serangan strok, kencing manis, kelahiran tak cukup bulan dan bayi lahir tidak cukup berat.

Aku lihat teman aku itu mengerutkan dahinya...

Aku terus tersenyum… "hai teman, jangan banyak fikir. Cepat! pergi berus gigi tu.. hehe"

Posted by Rashid at 19.12.08

karies dan diet

Karies dan Diet
Posted on Thursday, August 07, 2008 comments (28)
Labels: Dunia Medis Kita

Karies merupakan salah satu penyakit gigi dan mulut yang disebabkan oleh beberapa faktor, saya rasa sudah perbah saya bahas dan dipostingan sebelumnya anda akan lebih jelas mengenai karies :). Diet salah satu trend anak muda sekarang terutama bagi para remaja putri yang ingin tampil lebih PD dan menjaga kelangsingan tubuhnya. Namun apa hubungan antara karies dan diet ya? disini saya akan coba menjelaskan sedikit.


Pada dasarnya hubungan antara karies dan diet sangat simpel dan mudah untuk dimengerti, beberapa orang yang menjalani diet sehat dan berprilaku hidup sehat akan mengalami penurunan masalah gigi. mengapa demikian, hal ini dikarenakan konsumsi gula pada tubuh dikurangi dan lebih banyak mengkonsumsi bahan atau makanan dengan pemanis alami seperti buah-buahan yang sangat baik bagi tubuh maupun bagi kesehatan gigi dan mulut. Apabila kita mengkonsumsi buah-buahan seperti apel, apel secara tidak langsung akan membantu membersihkan gigi secara alami bisa diibaratkan kita menggosok gigi, nah sangat dianjurkan untuk menu penutup menggunakan apel atau ganti snak anda dengan buah - buahan. Selain gigi dan mulut kita sehat maka badan kita tetap langsing :).

Hubungan antara diet dan karies erat sekali kaitannya dengan jumlah konsumsi pemanis atau gula yang dikonsumsi oleh tubuh kita, sebenarnya Tuhan telah menciptakan gigi dan mulut kita sebagai gerbang dan peringatan yang sangat luar biasa. bagai mana tidak, apabila makanan yang kita konsumsi tidak baik bagi tubuh atau merugikan maka gelaja yang nampak akan terlihat pada daerah disekitar rongga mulut seperti : Amandel, sariawan, bibir pecah - pecah, karies, sakit tenggorokan dan lain - lain. maka kenali makanan yang anda konsumsi. Sangat dianjurkan untuk kembali ke pola hidup sederhana dan kembali ke alam. Saran saya mulai sekarang tinggalkan makanan dengan bahan kimia dan kembalilah Natural.

Sekedar tambahan:
Ingat pengolahan masakan dengan MSG mengidikasikan pembuat makanan kurang cakap mengolah bahan masakan dengan paduan bumbu - bumbu yang tersedia. apabila seorang koki atau tukang masak bisa mengolah bahan makanan dan bumbunya tidak perlu ditambah bahan penyedap.

Rabu, 03 Desember 2008

Gosok Gigi

Wednesday, December 3, 2008
Gosok Gigi
Aku tersadar dari tidur. Hal pertama yang kuingat adalah belum gosok gigi sebelum tidur tadi. Ah terang saja, aku memang belum berniat tidur. Tadi itu ketiduran, posisiku pun masih di depan TV, bukan nonton tapi ditonton TV.

Sudah jam 1 pagi. Dan melewatkan ritual gosok gigi sebelum tidur dijamin bakal bikin runyam. Tidurku sudah pasti nyapnyap. Aku mencoba memanipulasi diri, membuat penawaran-penawaran (tak) penting.

- gosok giginya absen aja, toh seharian tadi udah dua kali
+ tapi kan, abis gosok gigi kedua aku makan lagi

tawaran pertama gagal!

- ntar lagi pagi, gosok gigi pagi2 kan bisa. sekarang tidur aja
+ aduuuh gigiku bisa rusak, masih ada sisa makanan di gigiku. sambal tempe, tumis kapri, dan biskuit coklat (menunya ga matching gini :P)

tawaran kedua gagal!

Arrrgghhh aku ngantuuuuk dan gagal memanipulasi diri. Tempat gosok gigi dua meter jaraknya dari ruang TV. Aku harus sampai di sana sesegera mungkin. Ah, apa mau dikata. Ayo bangun! Gosok gigi!

Kalau lagi begini aku langsung ingat ibu, nasehatnya yang membuatku jadi begini. Mungkin dulu ibu menyusupkan mantra-mantra sakti supaya ajarannya meresap sedalam ini pada diriku. Sampai-sampai aku tidak bisa melewatkan kebiasaan remeh macam begini, bahkan di saat ngantuuuuuk seperti ini.

Hahhh. Sudahhhh. Bereshhhh. Bersihhh. Seghhhar...

Aku harus menelepon ibu nanti. memintanya menurunkan tips dan trik menanamkan kebiasaan gosok gigi pada anak. Aku harus sesakti ibu, bikin anakku sulit berkelit dari urusan gosok-menggosok gigi. Kalau perlu biar seperti aku, mendadak bangun cuma buat gosok gigi. cape deeee.

Melihat Penyakit Melalui Gigi

Rabu, 2008 Desember 03
Melihat Penyakit Melalui Gigi
Meropong Penyakit Melalui Gigi
Tahukah Anda bahwa gejala awal penyakit diabetes, jantung, atau leukemia, bisa diketahui lewat kondisi gigi dan mulut. Jika mata bisa mengungkapkan isi hati seseorang, mulut juga bisa buka rahasia. Ketua Umum Pengurus Besar Persatuan Dokter Gigi Indonesia (PDGI), drg H Emmyr F Moeis, MARS mengatakan, kondisi gigi dan mulut bisa mengungkapkan gejala-gejala awal penyakit berbahaya bahkan sampai memprediksi kelahiran prematur.

Menurut Emmyr F Moeis, salah satu tanda gejala diabetes adalah penyakit gigi dan gusi yang berlebihan. Penderita diabetes cenderung memiliki penyakit mulut 3-4 kali lebih sering ketimbang orang yang tidak mengidap diabetes. Penderita diabetes umumnya mudah terluka saat menyikat gigi atau menggunakan benang pembersih gigi. Gigi penderita diabetes juga umumnya mengalami abses.

Hal itu bisa terjadi karena penderita diabetes umumnya mengalami kerusakan sel darah putih. Padahal sel darah putih sangat diperlukan untuk melawan bakteri penyebab infeksi di mulut. Selain masalah gusi, diabetes juga mengakibatkan mulut kering, sariawan, dan mulut panas.

Bau mulut seseorang juga bisa mengungkapkan apakah seseorang memiliki kecenderungan gula darah tinggi. Bau tersebut biasa disebut acetone breath bau manis yang dapat segera dikenali dokter gigi sebagai tanda-tanda seseorang mengidap diabetes.

Lain lagi dengan bau mulut tak sedap penderita diabetes, bau mulut yang berbeda juga dapat mengindikasikan seseorang sedang mengalami infeksi hidung, mulut, paru-paru, atau perut.

Penelitian yang dilakukan American Dental Association sebagaimana dilansir Webmd, menyebutkan, osteoporosis atau penyakit rapuh tulang dan tanggalnya gigi sangat berhubungan. Jika seseorang mengalami Osteoporosis maka ia mengalami penurunan kepadatan tulang. Akibatkan terjadi cedera pada pinggul dan beberapa bagian tubuh lainnya yang disanggah tulang. Proses ini juga mempengaruhi kokohnya rahang dan gigi.

Pada wanita, ada tiga empat momen di mana seseorang lebih berisiko terhadap penyakit mulut. Pertama, saat setelah menopause, ketika masa puber, pada saat hamil, dan sekitar masa menstruasi setiap bulannya. Pada masa-masa itu, hormon tertentu akan meningkat sehingga memicu proses-proses peradangan dan membuat mulut lebih rentan terhadap bakteri.

Ditemukannya terapi estrogen bisa membantu mengatasi masalah ini. Terapi ini bisa membantu mengurangi tingkat kerapuhan gigi dan radang gusi.

Penelitian terbaru membandingkan kesehatan mulut 256 pasien jantung dewasa dengan 250 pasien lain tanpa penyakit jantung. Hasilnya, salah satu penanda awal sakit jantung adalah pericoronitis atau infeksi gusi di sekitar gigi geraham. Biasanya gigi akan membusuk sehingga hanya menyisakan ujung kecil di akarnya. Pastinya penyakit ini juga disertai radang gusi, radang lainnya di mulut, dan tanggalnya gigi.

Hal itu diduga karena bakteri yang ditemukan di mulut merupakan bakteri yang sama sebagai penyebab atherosclerotic plaque (kelainan pada pembuluh darah yang disertai plak dan tidak elastis) yang berhubungan dengan penyakit jantung.

Penelitian lain membuktikan, wanita yang mengalami gangguan gusi selama masa kehamilan, 7 kali lebih berisiko mengalami kelahiran prematur. Tak hanya prematur, bayi yang dilahirkan juga umumnya lebih kecil dari rata-rata.

Hal itu disebabkan ketika seseorang mengalami gangguan mulut, peradangan yang terjadi menyebab beberapa zat tertentu dilepaskan ke aliran darah sehingga bisa mempengaruhi berat tubuh bayi dan proses persalinan. Studi lain menyebutkan, membersihkan plak dan tartar secara teratur bisa mengurangi risiko persalinan prematur.

Penderita Leukimia umumnya memiliki gusi yang memerah, meradang, dan lembek. Nah, dengan membuka mulut lebar-lebar setidaknya anda bisa mengantisipasi beberapa gejala awal penyakit berbahaya. Tapi, jangan tarik kesimpulan sendiri. "Segera konsultasikan ke dokter jika mengalami gejala-gejala seperti tersebut di atas," ujarnya.

Kampanye Pencegahan


Melihat pentingnya kesehatan gigi dan mulut, mendorong PB PDGI bekerja sama dengan PT Pfizer Indonesia menggelar "Kampanye pencegahan dan perawatan kesehatan gigi dan mulut" di Indonesia. Upaya yang dilakukan, antara lain, program sekolah di DKI Jakarta , dental mobile unit program, semiloka dan workshop terkait dengan profesi kedokteran gigi, dan partisipasi pada Asia Pasific Dental Congress.

"Hasil Survei Rumah Tangga 2004 menyebutkan 39 persen penduduk Indonesia menderita penyakit gigi dan mulut. Angka itu bukan merupakan angka yang dapat diabaikan karena telah terbukti bahwa penyakit gigi dan mulut dapat secara signifikan mempengaruhi produktivitas masyarakat. Karena itu, perlu dilakukan suatu kampanye yang terus menerus untuk menurunkan angka penderita penyakit gigi dan mulut," katanya.

Ada 4 anjuran pokok yang akan disampaikan kepada masyarakat, yaitu, pertama, sikat gigi 2 kali sehari dengan pasta gigi ber-flouride, terutama sesudah makan pagi dan sebelum tidur. Kedua, ganti sikat gigi 2-3 bulan sekali. Ketiga, kunjungi dokter gigi secara teratur minimal 2 kali setahu dan memiliki dental record. Keempat, kurangi makan makanan dan minuman yang mengandung gula.

Hasil studi morbiditas SKRT (Survei Kesehatan Rumah Tangga)-Surkenas (survei Kesehatan Nasional) 2001 menunjukkan, dari 10 kelompok penyakit terbanyak yang dikeluhkan masyarakat, penyakit gigi dan mulut menduduki urutan pertama (60 persen). Hasil surkenas 1998 menunjukan bahwa 62,4 persen penduduk merasa terganggu produktivitas kerja/sekolah karena sakit gigi, selama rata-rata 3,86 hari.

Secara umum penyakit gigi yang dikeluhkan masyarakat adalah karies gigi dan penyakit gusi. Hasil studi SKRT 2001, menyatakan, 52,3 persen penduduk usia 10 tahun ke atas mengalami karies gigi yang belum ditangani. Prevalensi karies umur 10 tahun ke atas adalah 71,2 persen, dengan catatan bahwa prevalensi karies lebih tinggi pada umur lebih tinggi, pada pendidikan lebih rendah, serta pada status ekonomi lebih rendah. Penduduk usia 10 tahun ke atas, 46 persen mengalami penyakit gusi, prevalensi semakin tinggi pada umur yang lebih tinggi.

Hal yang memprihatinkan dalam SKRT 2001 adalah motivasi untuk menambal gigi masih sangat rendah yaitu 4-5 persen, sementara besarnya kerusakan yang belum ditangani di mana memerlukan penambalan dan atau pencabutan mencapai 82,5 persen. Diketahui berdasarkan SKRT 2001, rata-rata 16 gigi dicabut pada umur 65 tahun ke atas.

Penyakit periodontal (radang jaringan pendukung gigi) merupakan penyakit gigi dan mulut lain yang banyak dikeluhkan (70 persen). Sementara 5 persennya dikategorikan lanjut yang dapat menyebabkan gigi goyang dan lepas, saat ini banyak ditemukan pada penduduk usia muda. Salah satu faktor penyebab penyakit ini adalah karang gigi yang dijumpai pada 46 persen penduduk.

Kondisi itu menggambarkan, pelayanan kesehatan gigi baru ditangani pada kondisi penyakit yang sudah dalam keadaan parah. Hal itu disebabkan, antara lain masih kurangnya kesadaran masyarakat mengenai arti penting menjaga kesehatan gigi dan mulut, ketidaktahuan, mahalnya biaya. "Serta yang perlu diperhatikan oleh PDGI, adalah banyaknya dokter gigi yang cenderung pasif serta masih memberikan porsi yang besar pada tindakan kuratif," ujar Emmyr.

Hal lain yang menjadi perhatian PDGI adalah rasio dokter gigi terhadap penduduk yang masih rendah, yaitu 1:21.500, masih jauh dari rasio ideal yaitu 1:2000. Untuk itu, bersama Kolegium Kedokteran Gigi Indonesia, PDGI mendorong terbentuknya Fakultas Kedokteran Gigi baru, terutama di Indonesia bagian barat, mengingat data Depkes menyatakan bahwa rasio dokter gigi terhadap puskesmas di Indonesia bagian barat lebih tinggi daripada bagian timur. Di provinsi Sumut misalnya, rasio dokter gigi terhadap puskesmas 0,82, bandingkan dengan NTT yang 0,27 atau bahkan Papua mencapai 0,21.

Dengan kondisi seperti itu, Emmyr menilai perlu didorong sikap kemandirian masyarakat, terutama tindakan preventif yang dapat dilakukan setiap individu, keluarga, serta lingkungan terkecil di masyarakat.

Sikap kemandirian itu perlu didorong terus-menerus melalui berbagi upaya dan kegiatan yang berkesinambungan. Namun, upaya itu tidak saja oleh pihak organisasi profesi tetapi akan lebih optimal jika melibatkan pihak-pihak lain yang mempunyai kompetensi dan kepentingan yang sama dalam hal peningkatan derajat kesehatan gigi dan mulut di Indonesia
Diposkan oleh Galih Gumelar Center di 10:53

Melihat Penyakit Melalui Gigi

Rabu, 2008 Desember 03
Melihat Penyakit Melalui Gigi
Meropong Penyakit Melalui Gigi
Tahukah Anda bahwa gejala awal penyakit diabetes, jantung, atau leukemia, bisa diketahui lewat kondisi gigi dan mulut. Jika mata bisa mengungkapkan isi hati seseorang, mulut juga bisa buka rahasia. Ketua Umum Pengurus Besar Persatuan Dokter Gigi Indonesia (PDGI), drg H Emmyr F Moeis, MARS mengatakan, kondisi gigi dan mulut bisa mengungkapkan gejala-gejala awal penyakit berbahaya bahkan sampai memprediksi kelahiran prematur.

Menurut Emmyr F Moeis, salah satu tanda gejala diabetes adalah penyakit gigi dan gusi yang berlebihan. Penderita diabetes cenderung memiliki penyakit mulut 3-4 kali lebih sering ketimbang orang yang tidak mengidap diabetes. Penderita diabetes umumnya mudah terluka saat menyikat gigi atau menggunakan benang pembersih gigi. Gigi penderita diabetes juga umumnya mengalami abses.

Hal itu bisa terjadi karena penderita diabetes umumnya mengalami kerusakan sel darah putih. Padahal sel darah putih sangat diperlukan untuk melawan bakteri penyebab infeksi di mulut. Selain masalah gusi, diabetes juga mengakibatkan mulut kering, sariawan, dan mulut panas.

Bau mulut seseorang juga bisa mengungkapkan apakah seseorang memiliki kecenderungan gula darah tinggi. Bau tersebut biasa disebut acetone breath bau manis yang dapat segera dikenali dokter gigi sebagai tanda-tanda seseorang mengidap diabetes.

Lain lagi dengan bau mulut tak sedap penderita diabetes, bau mulut yang berbeda juga dapat mengindikasikan seseorang sedang mengalami infeksi hidung, mulut, paru-paru, atau perut.

Penelitian yang dilakukan American Dental Association sebagaimana dilansir Webmd, menyebutkan, osteoporosis atau penyakit rapuh tulang dan tanggalnya gigi sangat berhubungan. Jika seseorang mengalami Osteoporosis maka ia mengalami penurunan kepadatan tulang. Akibatkan terjadi cedera pada pinggul dan beberapa bagian tubuh lainnya yang disanggah tulang. Proses ini juga mempengaruhi kokohnya rahang dan gigi.

Pada wanita, ada tiga empat momen di mana seseorang lebih berisiko terhadap penyakit mulut. Pertama, saat setelah menopause, ketika masa puber, pada saat hamil, dan sekitar masa menstruasi setiap bulannya. Pada masa-masa itu, hormon tertentu akan meningkat sehingga memicu proses-proses peradangan dan membuat mulut lebih rentan terhadap bakteri.

Ditemukannya terapi estrogen bisa membantu mengatasi masalah ini. Terapi ini bisa membantu mengurangi tingkat kerapuhan gigi dan radang gusi.

Penelitian terbaru membandingkan kesehatan mulut 256 pasien jantung dewasa dengan 250 pasien lain tanpa penyakit jantung. Hasilnya, salah satu penanda awal sakit jantung adalah pericoronitis atau infeksi gusi di sekitar gigi geraham. Biasanya gigi akan membusuk sehingga hanya menyisakan ujung kecil di akarnya. Pastinya penyakit ini juga disertai radang gusi, radang lainnya di mulut, dan tanggalnya gigi.

Hal itu diduga karena bakteri yang ditemukan di mulut merupakan bakteri yang sama sebagai penyebab atherosclerotic plaque (kelainan pada pembuluh darah yang disertai plak dan tidak elastis) yang berhubungan dengan penyakit jantung.

Penelitian lain membuktikan, wanita yang mengalami gangguan gusi selama masa kehamilan, 7 kali lebih berisiko mengalami kelahiran prematur. Tak hanya prematur, bayi yang dilahirkan juga umumnya lebih kecil dari rata-rata.

Hal itu disebabkan ketika seseorang mengalami gangguan mulut, peradangan yang terjadi menyebab beberapa zat tertentu dilepaskan ke aliran darah sehingga bisa mempengaruhi berat tubuh bayi dan proses persalinan. Studi lain menyebutkan, membersihkan plak dan tartar secara teratur bisa mengurangi risiko persalinan prematur.

Penderita Leukimia umumnya memiliki gusi yang memerah, meradang, dan lembek. Nah, dengan membuka mulut lebar-lebar setidaknya anda bisa mengantisipasi beberapa gejala awal penyakit berbahaya. Tapi, jangan tarik kesimpulan sendiri. "Segera konsultasikan ke dokter jika mengalami gejala-gejala seperti tersebut di atas," ujarnya.

Kampanye Pencegahan


Melihat pentingnya kesehatan gigi dan mulut, mendorong PB PDGI bekerja sama dengan PT Pfizer Indonesia menggelar "Kampanye pencegahan dan perawatan kesehatan gigi dan mulut" di Indonesia. Upaya yang dilakukan, antara lain, program sekolah di DKI Jakarta , dental mobile unit program, semiloka dan workshop terkait dengan profesi kedokteran gigi, dan partisipasi pada Asia Pasific Dental Congress.

"Hasil Survei Rumah Tangga 2004 menyebutkan 39 persen penduduk Indonesia menderita penyakit gigi dan mulut. Angka itu bukan merupakan angka yang dapat diabaikan karena telah terbukti bahwa penyakit gigi dan mulut dapat secara signifikan mempengaruhi produktivitas masyarakat. Karena itu, perlu dilakukan suatu kampanye yang terus menerus untuk menurunkan angka penderita penyakit gigi dan mulut," katanya.

Ada 4 anjuran pokok yang akan disampaikan kepada masyarakat, yaitu, pertama, sikat gigi 2 kali sehari dengan pasta gigi ber-flouride, terutama sesudah makan pagi dan sebelum tidur. Kedua, ganti sikat gigi 2-3 bulan sekali. Ketiga, kunjungi dokter gigi secara teratur minimal 2 kali setahu dan memiliki dental record. Keempat, kurangi makan makanan dan minuman yang mengandung gula.

Hasil studi morbiditas SKRT (Survei Kesehatan Rumah Tangga)-Surkenas (survei Kesehatan Nasional) 2001 menunjukkan, dari 10 kelompok penyakit terbanyak yang dikeluhkan masyarakat, penyakit gigi dan mulut menduduki urutan pertama (60 persen). Hasil surkenas 1998 menunjukan bahwa 62,4 persen penduduk merasa terganggu produktivitas kerja/sekolah karena sakit gigi, selama rata-rata 3,86 hari.

Secara umum penyakit gigi yang dikeluhkan masyarakat adalah karies gigi dan penyakit gusi. Hasil studi SKRT 2001, menyatakan, 52,3 persen penduduk usia 10 tahun ke atas mengalami karies gigi yang belum ditangani. Prevalensi karies umur 10 tahun ke atas adalah 71,2 persen, dengan catatan bahwa prevalensi karies lebih tinggi pada umur lebih tinggi, pada pendidikan lebih rendah, serta pada status ekonomi lebih rendah. Penduduk usia 10 tahun ke atas, 46 persen mengalami penyakit gusi, prevalensi semakin tinggi pada umur yang lebih tinggi.

Hal yang memprihatinkan dalam SKRT 2001 adalah motivasi untuk menambal gigi masih sangat rendah yaitu 4-5 persen, sementara besarnya kerusakan yang belum ditangani di mana memerlukan penambalan dan atau pencabutan mencapai 82,5 persen. Diketahui berdasarkan SKRT 2001, rata-rata 16 gigi dicabut pada umur 65 tahun ke atas.

Penyakit periodontal (radang jaringan pendukung gigi) merupakan penyakit gigi dan mulut lain yang banyak dikeluhkan (70 persen). Sementara 5 persennya dikategorikan lanjut yang dapat menyebabkan gigi goyang dan lepas, saat ini banyak ditemukan pada penduduk usia muda. Salah satu faktor penyebab penyakit ini adalah karang gigi yang dijumpai pada 46 persen penduduk.

Kondisi itu menggambarkan, pelayanan kesehatan gigi baru ditangani pada kondisi penyakit yang sudah dalam keadaan parah. Hal itu disebabkan, antara lain masih kurangnya kesadaran masyarakat mengenai arti penting menjaga kesehatan gigi dan mulut, ketidaktahuan, mahalnya biaya. "Serta yang perlu diperhatikan oleh PDGI, adalah banyaknya dokter gigi yang cenderung pasif serta masih memberikan porsi yang besar pada tindakan kuratif," ujar Emmyr.

Hal lain yang menjadi perhatian PDGI adalah rasio dokter gigi terhadap penduduk yang masih rendah, yaitu 1:21.500, masih jauh dari rasio ideal yaitu 1:2000. Untuk itu, bersama Kolegium Kedokteran Gigi Indonesia, PDGI mendorong terbentuknya Fakultas Kedokteran Gigi baru, terutama di Indonesia bagian barat, mengingat data Depkes menyatakan bahwa rasio dokter gigi terhadap puskesmas di Indonesia bagian barat lebih tinggi daripada bagian timur. Di provinsi Sumut misalnya, rasio dokter gigi terhadap puskesmas 0,82, bandingkan dengan NTT yang 0,27 atau bahkan Papua mencapai 0,21.

Dengan kondisi seperti itu, Emmyr menilai perlu didorong sikap kemandirian masyarakat, terutama tindakan preventif yang dapat dilakukan setiap individu, keluarga, serta lingkungan terkecil di masyarakat.

Sikap kemandirian itu perlu didorong terus-menerus melalui berbagi upaya dan kegiatan yang berkesinambungan. Namun, upaya itu tidak saja oleh pihak organisasi profesi tetapi akan lebih optimal jika melibatkan pihak-pihak lain yang mempunyai kompetensi dan kepentingan yang sama dalam hal peningkatan derajat kesehatan gigi dan mulut di Indonesia
Diposkan oleh Galih Gumelar Center di 10:53

Senin, 01 Desember 2008

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GIGI Ajak Kita Meniti “Jalan Kebenaran”
2008-08-21 08:35:30 - Ramadhan tahun 2008 ini GIGI meluncurkan “Jalan Kebenaran”, album religinya yang ke 4. Berbeda dengan 3 album sebelumnya di mana GIGI banyak membawakan lagu orang dengan aransemen ala GIGI, di album b... - selengkapnya


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Tooth

Tooth
From Wikipedia, the free encyclopedia
Jump to: navigation, search
"Teeth" redirects here. For the film, see Teeth (film).
Teeth

An adult human's teeth.

CGI posterior view of teeth taken from inside mouth
Dorlands/Elsevier Tooth
Teeth (singular, Tooth) are small whitish structures found in the jaws (or mouths) of many vertebrates that are used to tear, scrape, milk and chew food. Some animals, particularly carnivores, also use teeth for hunting or defense. The roots of teeth are covered by gums. Teeth are not made of bone, but rather of tissues of varying density and hardness.

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. Carnivores, on the other hand, need canines to kill and tear meat.

Mammals 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.

Some animals develop only one set of teeth (monophyodont) while others develop many sets (polyphyodont). Sharks, for example, grow a new set of teeth every two weeks to replace worn teeth. Rodent incisors grow and wear away continually through gnawing, maintaining relatively constant length. Many rodents, such as the sibling vole and the guinea pig[verification needed], have continuously growing molars in addition to incisors.[1][2]

Contents [hide]
1 Anatomy
2 Parts
2.1 Enamel
2.2 Dentin
2.3 Cementum
2.4 Pulp
3 Development
4 Eruption
5 Supporting structures
5.1 Periodontal ligaments
5.2 Alveolar bone
5.3 Gingiva
6 Tooth decay
6.1 Plaque
6.2 Caries (Cavities)
7 Tooth care
8 Restorations
9 Abnormalities
9.1 Digestive
9.1.1 Alteration during tooth development
9.1.2 Destruction after development
9.1.3 Discoloration
9.1.4 Alteration of eruption
9.2 Developmental
9.2.1 Abnormality in number
9.2.2 Abnormality in size
9.2.3 Abnormality in shape
9.2.4 Abnormality in structure
10 Non-human animals
11 See also
11.1 Lists
12 References
13 External links



Anatomy

A third molar.Main article: Dental anatomy
The bottom teeth are used more for the grinding of food and the top front teeth are mainly used for biting.

Dental anatomy is a field of anatomy dedicated to the study of tooth structures. The development, appearance, and classification of teeth fall within its field of study, though dental occlusion, or contact among teeth, does not. Dental anatomy is also a taxonomical science as it is concerned with the naming of teeth and their structures. This information serves a practical purpose for dentists, enabling them to easily identify teeth and structures during treatment.

The anatomic crown of a tooth is the area covered in enamel above the cementoenamel junction (CEJ).[3] The majority of the crown is composed of dentin with the pulp chamber in the center.[4] The crown is within bone before eruption.[5] After eruption, it is almost always visible. The anatomic root is found below the cementoenamel junction and is covered with cementum. As with the crown, dentin composes most of the root, which normally have pulp canals. A tooth may have multiple roots or just one root. Canines and most premolars, except for maxillary (upper) first premolars, usually have one root. Maxillary first premolars and mandibular molars usually have two roots. Maxillary molars usually have three roots. Additional roots are referred to as supernumerary roots.


Models of human teeth as they exist within the alveolar bone.Humans usually have 20 primary teeth (also called deciduous, baby, or milk teeth) and 32 permanent teeth. Among primary teeth, 10 are found in the (upper) maxilla and the other 10 in the (lower) mandible. Teeth are classified as incisors, canines, and molars. In the primary set of teeth, there are two types of incisors, centrals and laterals, and two types of molars, first and second. All primary teeth are replaced with permanent counterparts except for molars, which are replaced by permanent premolars. Among permanent teeth, 16 are found in the maxilla with the other 16 in the mandible. The maxillary teeth are the maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar, maxillary second premolar, maxillary first molar, maxillary second molar, and maxillary third molar. The mandibular teeth are the mandibular central incisor, mandibular lateral incisor, mandibular canine, mandibular first premolar, mandibular second premolar, mandibular first molar, mandibular second molar, and mandibular third molar. Third molars are commonly called "wisdom teeth" and may never erupt into the mouth or form at all. If any additional teeth form, for example, fourth and fifth molars, which are rare, they are referred to as supernumerary teeth.[6]

Most teeth have identifiable features that distinguish them from others. There are several different notation systems to refer to a specific tooth. The three most commons systems are the FDI World Dental Federation notation, the universal numbering system, and Palmer notation method. The FDI system is used worldwide, and the universal is used widely in the United States.


Parts

Section of a human molar
Enamel
Main article: Tooth enamel
Enamel is the hardest and most highly mineralized substance of the body and is one of the four major tissues which make up the tooth, along with dentin, cementum, and dental pulp.[7] It is normally visible and must be supported by underlying dentin. Ninety-six percent of enamel consists of mineral, with water and organic material composing the rest.[8] The normal color of enamel varies from light yellow to grayish white. At the edges of teeth where there is no dentin underlying the enamel, the color sometimes has a slightly blue tone. Since enamel is semitranslucent, the color of dentin and any restorative dental material underneath the enamel strongly affects the appearance of a tooth. Enamel varies in thickness over the surface of the tooth and is often thickest at the cusp, up to 2.5 mm, and thinnest at its border, which is seen clinically as the cementoenamel junction (CEJ).[9]

Enamel's primary mineral is hydroxyapatite, which is a crystalline calcium phosphate.[10] The large amount of minerals in enamel accounts not only for its strength but also for its brittleness.[11] Dentin, which is less mineralized and less brittle, compensates for enamel and is necessary as a support.[10] Unlike dentin and bone, enamel does not contain collagen. Instead, it has two unique classes of proteins called amelogenins and enamelins. While the role of these proteins is not fully understood, it is believed that they aid in the development of enamel by serving as framework support among other functions.[12]


Dentin
Main article: Dentin
Dentin is the substance between enamel or cementum and the pulp chamber. It is secreted by the odontoblasts of the dental pulp.[13] The formation of dentin is known as dentinogenesis. The porous, yellow-hued material is made up of 70% inorganic materials, 20% organic materials, and 10% water by weight.[14] Because it is softer than enamel, it decays more rapidly and is subject to severe cavities if not properly treated, but dentin still acts as a protective layer and supports the crown of the tooth.

Dentin is a mineralized connective tissue with an organic matrix of collagenous proteins. Dentin has microscopic channels, called dentinal tubules, which radiate outward through the dentin from the pulp cavity to the exterior cementum or enamel border.[15] The diameter of these tubules range from 2.5 μm near the pulp, to 1.2 μm in the midportion, and 900 nm near the dentino-enamel junction.[16] Although they may have tiny side-branches, the tubules do not intersect with each other. Their length is dictated by the radius of the tooth. The three dimensional configuration of the dentinal tubules is genetically determined.


Cementum
Main article: Cementum
Cementum is a specialized bony substance covering the root of a tooth.[13] It is approximately 45% inorganic material (mainly hydroxyapatite), 33% organic material (mainly collagen) and 22% water. Cementum is excreted by cementoblasts within the root of the tooth and is thickest at the root apex. Its coloration is yellowish and it is softer than either dentin or enamel. The principal role of cementum is to serve as a medium by which the periodontal ligaments can attach to the tooth for stability. At the cementoenamel junction, the cementum is acellular due to its lack of cellular components, and this acellular type covers at least ⅔ of the root.[17] The more permeable form of cementum, cellular cementum, covers about ⅓ of the root apex.[18]


Pulp
Main article: Pulp (tooth)
The dental pulp is the central part of the tooth filled with soft connective tissue.[14] This tissue contains blood vessels and nerves that enter the tooth from a hole at the apex of the root.[19] Along the border between the dentin and the pulp are odontoblasts, which initiate the formation of dentin.[14] Other cells in the pulp include fibroblasts, preodontoblasts, macrophages and T lymphocytes.[20] The pulp is commonly called "the nerve" of the tooth.


Development
Main article: Tooth development

Radiograph of lower right third, second, and first molars in different stages of development.Tooth development is the complex process by which teeth form from embryonic cells, grow, and erupt into the mouth. Although many diverse species have teeth, non-human tooth development is largely the same as in humans. For human teeth to have a healthy oral environment, enamel, dentin, cementum, and the periodontium must all develop during appropriate stages of fetal development. Primary (baby) teeth start to form between the sixth and eighth weeks in utero, and permanent teeth begin to form in the twentieth week in utero.[21] If teeth do not start to develop at or near these times, they will not develop at all.

A significant amount of research has focused on determining the processes that initiate tooth development. It is widely accepted that there is a factor within the tissues of the first branchial arch that is necessary for the development of teeth.[22]

Tooth development is commonly divided into the following stages: the bud stage, the cap, the bell, and finally maturation. The staging of tooth development is an attempt to categorize changes that take place along a continuum; frequently it is difficult to decide what stage should be assigned to a particular developing tooth.[22] This determination is further complicated by the varying appearance of different histologic sections of the same developing tooth, which can appear to be different stages.

The tooth bud (sometimes called the tooth germ) is an aggregation of cells that eventually forms a tooth. It is organized into three parts: the enamel organ, the dental papilla and the dental follicle.[23] The enamel organ is composed of the outer enamel epithelium, inner enamel epithelium, stellate reticulum and stratum intermedium.[23] These cells give rise to ameloblasts, which produce enamel and the reduced enamel epithelium. The growth of cervical loop cells into the deeper tissues forms Hertwig's Epithelial Root Sheath, which determines a tooth's root shape. The dental papilla contains cells that develop into odontoblasts, which are dentin-forming cells.[23] Additionally, the junction between the dental papilla and inner enamel epithelium determines the crown shape of a tooth.[24] The dental follicle gives rise to three important entities: cementoblasts, osteoblasts, and fibroblasts. Cementoblasts form the cementum of a tooth. Osteoblasts give rise to the alveolar bone around the roots of teeth. Fibroblasts develop the periodontal ligaments which connect teeth to the alveolar bone through cementum.[25]


Eruption
Main article: Tooth eruption
Tooth eruption in humans is a process in tooth development in which the teeth enter the mouth and become visible. Current research indicates that the periodontal ligaments play an important role in tooth eruption. Primary teeth erupt into the mouth from around six months until two years of age. These teeth are the only ones in the mouth until a person is about six years old. At that time, the first permanent tooth erupts. This stage, during which a person has a combination of primary and permanent teeth, is known as the mixed stage. The mixed stage lasts until the last primary tooth is lost and the remaining permanent teeth erupt into the mouth.

There have been many theories about the cause of tooth eruption. One theory proposes that the developing root of a tooth pushes it into the mouth.[26] Another, known as the cushioned hammock theory, resulted from microscopic study of teeth, which was thought to show a ligament around the root. It was later discovered that the "ligament" was merely an artifact created in the process of preparing the slide.[27] Currently, the most widely held belief is that the periodontal ligaments provide the main impetus for the process.[28]

The onset of primary tooth loss has been found to correlate strongly with somatic and psychological criteria of school readiness.[29][30]


Supporting structures

Histologic slide of tooth erupting into the mouth.
A: tooth
B: gingiva
C: bone
D: periodontal ligamentsThe periodontium is the supporting structure of a tooth, helping to attach the tooth to surrounding tissues and to allow sensations of touch and pressure.[31] It consists of the cementum, periodontal ligaments, alveolar bone, and gingiva. Of these, cementum is the only one that is a part of a tooth. Periodontal ligaments connect the alveolar bone to the cementum. Alveolar bone surrounds the roots of teeth to provide support and creates what is commonly called an alveolus, or "socket". Lying over the bone is the gingiva or gum, which is readily visible in the mouth.


Periodontal ligaments
The periodontal ligament is a specialized connective tissue that attaches the cementum of a tooth to the alveolar bone. This tissue covers the root of the tooth within the bone. Each ligament has a width of 0.15 - 0.38 mm, but this size decreases over time.[32] The functions of the periodontal ligaments include attachment of the tooth to the bone, support for the tooth, formation and resorption of bone during tooth movement, sensation, and eruption.[33] The cells of the periodontal ligaments include osteoblasts, osteoclasts, fibroblasts, macrophages, cementoblasts, and epithelial cell rests of Malassez.[34] Consisting of mostly Type I and III collagen, the fibers are grouped in bundles and named according to their location. The groups of fibers are named alveolar crest, horizontal, oblique, periapical, and interradicular fibers.[35] The nerve supply generally enters from the bone apical to the tooth and forms a network around the tooth toward the crest of the gingiva.[36] When pressure is exerted on a tooth, such as during chewing or biting, the tooth moves slightly in its socket and puts tension on the periodontal ligaments. The nerve fibers can then send the information to the central nervous system for interpretation.


Alveolar bone
The alveolar bone is the bone of the jaw which forms the alveolus around teeth.[37] Like any other bone in the human body, alveolar bone is modified throughout life. Osteoblasts create bone and osteoclasts destroy it, especially if force is placed on a tooth.[31] As is the case when movement of teeth is attempted through orthodontics, an area of bone under compressive force from a tooth moving toward it has a high osteoclast level, resulting in bone resorption. An area of bone receiving tension from periodontal ligaments attached to a tooth moving away from it has a high number of osteoblasts, resulting in bone formation.


Gingiva
The gingiva ("gums") is the mucosal tissue that overlays the jaws. There are three different types of epithelium associated with the gingiva: gingival, junctional, and sulcular epithelium. These three types form from a mass of epithelial cells known as the epithelial cuff between the tooth and the mouth.[38] The gingival epithelium is not associated directly with tooth attachment and is visible in the mouth. The junctional epithelium, composed of the basal lamina and hemidesmosomes, forms an attachment to the tooth.[33] The sulcular epithelium is nonkeratinized stratified squamous tissue on the gingiva which touches but is not attached to the tooth.[39] This leaves a small potential space between the gingiva and tooth which can collect bacteria, plaque, and calculus.


Tooth decay

Plaque
Main article: Dental plaque
Plaque is a biofilm consisting of large quantities of various bacteria that form on teeth.[40] If not removed regularly, plaque buildup can lead to dental cavities (caries) or periodontal problems such as gingivitis. Given time, plaque can mineralize along the gingiva, forming tartar. The microorganisms that form the biofilm are almost entirely bacteria (mainly streptococcus and anaerobes), with the composition varying by location in the mouth.[41] Streptococcus mutans is the most important bacteria associated with dental caries.

Certain bacteria in the mouth live off the remains of foods, especially sugars and starches. In the absence of oxygen they produce lactic acid, which dissolves the calcium and phosphorus in the enamel.[13][42] This process, known as "demineralisation", leads to tooth destruction. Saliva gradually neutralises the acids which cause the pH of the tooth surface to rise above the critical pH. This causes 'remineralisation', the return of the dissolved minerals to the enamel. If there is sufficient time between the intake of foods then the impact is limited and the teeth can repair themselves. Saliva is unable to penetrate through plaque, however, to neutralize the acid produced by the bacteria.


Caries (Cavities)

Advanced tooth decay on a premolar.Main article: Dental caries
Dental caries, also described as "tooth decay" or "dental cavities", is an infectious disease which damages the structures of teeth.[43] The disease can lead to pain, tooth loss, infection, and, in severe cases, death. Dental caries has a long history, with evidence showing the disease was present in the Bronze, Iron, and Middle ages but also prior to the neolithic period.[44] The largest increases in the prevalence of caries have been associated with diet changes.[44][45] Today, caries remains one of the most common diseases throughout the world. In the United States, dental caries is the most common chronic childhood disease, being at least five times more common than asthma.[46] Countries that have experienced an overall decrease in cases of tooth decay continue to have a disparity in the distribution of the disease.[47] Among children in the United States and Europe, 60-80% of cases of dental caries occur in 20% of the population.[48]

Tooth decay is caused by certain types of acid-producing bacteria which cause the most damage in the presence of fermentable carbohydrates such as sucrose, fructose, and glucose.[49][50] The resulting acidic levels in the mouth affect teeth because a tooth's special mineral content causes it to be sensitive to low pH. Depending on the extent of tooth destruction, various treatments can be used to restore teeth to proper form, function, and aesthetics, but there is no known method to regenerate large amounts of tooth structure. Instead, dental health organizations advocate preventative and prophylactic measures, such as regular oral hygiene and dietary modifications, to avoid dental caries.[51]


Tooth care

Toothbrushes are commonly used to clean teeth.Main article: Oral hygiene
Oral hygiene is the practice of keeping the mouth clean and is a means of preventing dental caries, gingivitis, periodontal disease, bad breath, and other dental disorders. It consists of both professional and personal care. Regular cleanings, usually done by dentists and dental hygienists, remove tartar (mineralized plaque) that may develop even with careful brushing and flossing. Professional cleaning includes tooth scaling, using various instruments or devices to loosen and remove deposits from teeth.

The purpose of cleaning teeth is to remove plaque, which consists mostly of bacteria.[52] Healthcare professionals recommend regular brushing twice a day (in the morning and in the evening, or after meals) in order to prevent formation of plaque and tartar.[51] A toothbrush is able to remove most plaque, excepting areas between teeth. As a result, flossing is also considered a necessity to maintain oral hygiene. When used correctly, dental floss removes plaque from between teeth and at the gum line, where periodontal disease often begins and could develop caries. Electric toothbrushes are not considered more effective than manual brushes for most people.[53] The most important advantage of electric toothbrushes is their ability to aid people with dexterity difficulties, such as those associated with rheumatoid arthritis.

In addition, fluoride therapy is often recommended to protect against dental caries, water fluoridation and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent dental decay by binding to the hydroxyapatite crystals in enamel.[54] The incorporated fluoride makes enamel more resistant to demineralization and thus more resistant to decay.[55] Topical fluoride, such as a fluoride toothpaste or mouthwash, is also recommended to protect teeth surfaces. Many dentists include application of topical fluoride solutions as part of routine cleanings.


Restorations
After a tooth has been damaged or destroyed, restoration of the missing structure can be achieved with a variety of treatments. Restorations may be created from a variety of materials, including glass ionomer, amalgam, gold, porcelain, and composite.[56] Small restorations placed inside a tooth are referred to as "intracoronal restorations". These restorations may be formed directly in the mouth or may be cast using the lost-wax technique, such as for some inlays and onlays. When larger portions of a tooth are lost, an "extracoronal restoration" may be fabricated, such as a crown or a veneer, to restore the involved tooth.


Picture of a restored premolar.When a tooth is lost, dentures, bridges, or implants may be used as replacements.[57] Dentures are usually the least costly whereas implants are usually the most expensive. Dentures may replace complete arches of the mouth or only a partial number of teeth. Bridges replace smaller spaces of missing teeth and use adjacent teeth to support the restoration. Dental implants may be used to replace a single tooth or a series of teeth. Though implants are the most expensive treatment option, they are often the most desirable restoration because of their aesthetics and function. To improve the function of dentures, implants may be used as support.[58]


Abnormalities
Tooth abnormalities may be categorized according to whether they have environmental or developmental causes.[59] While environmental abnormalities may appear to have an obvious cause, there may not appear to be any known cause for some developmental abnormalities. Environmental forces may affect teeth during development, destroy tooth structure after development, discolor teeth at any stage of development, or alter the course of tooth eruption. Developmental abnormalities most commonly affect the number, size, shape, and structure of teeth.


Digestive

Alteration during tooth development
Tooth abnormalities caused by environmental factors during tooth development have long-lasting effects. Enamel and dentin do not regenerate after they mineralize initially. Enamel hypoplasia is a condition in which the amount of enamel formed is inadequate.[60] This results either in pits and grooves in areas of the tooth or in widespread absence of enamel. Diffuse opacities of enamel does not affect the amount of enamel but changes its appearance. Affected enamel has a different translucency than the rest of the tooth. Demarcated opacities of enamel have sharp boundaries where the translucency decreases and manifest a white, cream, yellow, or brown color. All these may be caused by a systemic event, such as an exanthematous fever.[61] Turner's hypoplasia is a portion of missing or diminished enamel on a permanent tooth usually from a prior infection of a nearby primary tooth. Hypoplasia may also result from antineoplastic therapy. Dental fluorosis is condition which results from ingesting excessive amounts of fluoride and leads to teeth which are spotted, yellow, brown, black or sometimes pitted. Enamel hypoplasia resulting from syphilis is frequently referred to as Hutchinson's teeth, which is considered one part of Hutchinson's triad.[62]


Destruction after development
Tooth destruction from processes other than dental caries is considered a normal physiologic process but may become severe enough to become a pathologic condition. Attrition is the loss of tooth structure by mechanical forces from opposing teeth.[63] Attrition initially affects the enamel and, if unchecked, may proceed to the underlying dentin. Abrasion is the loss of tooth structure by mechanical forces from a foreign element.[64] If this force begins at the cementoenamel junction, then progression of tooth loss can be rapid since enamel is very thin in this region of the tooth. A common source of this type of tooth wear is excessive force when using a toothbrush. Erosion is the loss of tooth structure due to chemical dissolution by acids not of bacterial origin.[65][66] Signs of tooth destruction from erosion is a common characteristic in the mouths of people with bulimia since vomiting results in exposure of the teeth to gastric acids. Another important source of erosive acids are from frequent sucking of lemon juice. Abfraction is the loss of tooth structure from flexural forces. As teeth flex under pressure, the arrangement of teeth touching each other, known as occlusion, causes tension on one side of the tooth and compression on the other side of the tooth. This is believed to cause V-shaped depressions on the side under tension and C-shaped depressions on the side under compression. When tooth destruction occurs at the roots of teeth, the process is referred to as internal resorption, when caused by cells within the pulp, or external resorption, when caused by cells in the periodontal ligament.


Discoloration
Discoloration of teeth may result from bacteria stains, tobacco, tea, coffee, foods with an abundance of chlorophyll, restorative materials, and medications.[67] Stains from bacteria may cause colors varying from green to black to orange. Green stains also result from foods with chlorophyll or excessive exposure to copper or nickel. Amalgam, a common dental restorative material, may turn adjacent areas of teeth black or gray. Chlorhexidine, a mouthwash, is associated with causing yellow-brown stains near the gingiva on teeth. Systemic disorders also can cause tooth discoloration. Congenital erythropoietic porphyria causes porphyrins to be deposited in teeth, causing a red-brown coloration. Blue discoloration may occur with alkaptonuria and rarely with Parkinson's disease. Erythroblastosis fetalis and biliary atresia are diseases which may cause teeth to appear green from the deposition of biliverdin. Also, trauma may change a tooth to a pink, yellow, or dark gray color. Pink and red discolorations are also associated in patients with lepromatous leprosy. Some medications, such as tetracycline antibiotics, may become incorporated into the structure of a tooth, causing intrinsic staining of the teeth.


Alteration of eruption
Tooth eruption may be altered by some environmental factors. When eruption is prematurely stopped, the tooth is said to be impacted. The most common cause of tooth impaction is lack of space in the mouth for the tooth.[68] Other causes may be tumors, cysts, trauma, and thickened bone or soft tissue. Ankylosis of a tooth occurs when the tooth has already erupted into the mouth but the cementum or dentin has fused with the alveolar bone. This may cause a person to retain their primary tooth instead of having it replaced by a permanent one.

A technique for altering the natural progression of eruption is employed by orthodontists who wish to delay or speed up the eruption of certain teeth for reasons of space maintenance or otherwise preventing crowding and/or spacing. If a primary tooth is extracted prior to the root of its succeeding permanent tooth reaching ⅓ of its total growth, the eruption of the permanent tooth will be delayed. Conversely, if the roots of the permanent tooth are more than ⅔ complete, the eruption of the permanent tooth will be accelerated. Between ⅓ and ⅔, it is unknown exactly what will occur to the speed of eruption.


Developmental

Abnormality in number
Anodontia is the total lack of tooth development. Hyperdontia is the presence of a higher-than-normal number of teeth, where as Hypodontia is the lack of some teeth. Usually, hypodontia refers to the lack of development of one or more teeth, and oligodontia may be used to describe the absence of 6 or more teeth. Some systemic disorders which may result in hyperdontia include Apert syndrome, Cleidocranial dysostosis, Crouzon syndrome, Ehlers-Danlos syndrome, Gardner syndrome, and Sturge-Weber syndrome.[69] Some systemic disorders which may result in hypodontia include Crouzon syndrome, Ectodermal dysplasia, Ehlers-Danlos syndrome, and Gorlin syndrome.[70]


Abnormality in size
Microdontia is a condition where teeth are smaller than the usual size, and macrodontia is where teeth are larger than the usual size. Microdontia of a single tooth is more likely to occur in a maxillary lateral incisor. The second most likely tooth to have microdontia are third molars. Macrodontia of all the teeth is known to occur in pituitary gigantism and pineal hyperplasia. It may also occur on one side of the face in cases of hemifacial hyperplasia.


Abnormality in shape

The fusion of two deciduous teeth.Gemination occurs when a developing tooth incompletely splits into the formation of two teeth. Fusion is the union of two adjacent teeth during development. Concrescence is the fusion of two separate teeth only in their cementum. Accessory cusps are additional cusps on a tooth and may manifest as a Talon cusp, Cusp of Carabelli, or Dens evaginatus. Dens invaginatus, also called Dens in dente, is a deep invagination in a tooth causing the appearance of a tooth within a tooth. Ectopic enamel is enamel found in an unusual location, such as the root of a tooth. Taurodontism is a condition where the body of the tooth and pulp chamber is enlarged, and is associated with Klinefelter syndrome, Tricho-dento-osseous syndrome, Triple X syndrome, and XYY syndrome.[71] Hypercementosis is excessive formation of cementum, which may result from trauma, inflammation, acromegaly, rheumatic fever, and Paget's disease of bone.[71] A dilaceration is a bend in the root which may have been caused by trauma to the tooth during formation. Supernumerary roots is the presence of a greater number of roots on a tooth than expected.


Abnormality in structure
Amelogenesis imperfecta is a condition in which enamel does not form properly or at all.[72] Dentinogenesis imperfecta is a condition in which dentin does not form properly and is sometimes associated with osteogenesis imperfecta.[73] Dentin dysplasia is a disorder in which the roots and pulp of teeth may be affected. Regional odontodysplasia is a disorder affecting enamel, dentin, and pulp and causes the teeth to appear "ghostly" on radiographs.[74]


Non-human animals

Section through the ivory tusk of a mammothMain article: Tooth (animal)

Teeth of Great White SharkTeeth vary greatly among animals. Some animals, such as turtles and tortoises, are toothless. Others, such as sharks, may go through many teeth in their lifetime. Walrus tusks are canine teeth that grow continuously throughout life.[75] Dog teeth are less likely than human teeth to form dental caries because of the very high pH of dog saliva, which prevents enamel from demineralizing.[76] Unlike humans whose ameloblasts die after tooth development, rodents continually produce enamel and must wear down their teeth by gnawing on various materials.[77] Horse teeth include twelve premolars, twelve molars, and twelve incisors. Whale teeth have some similarities and differences from human teeth. 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 to protrusions are located on the outside of the root, while in whales the nodule is located on the inside of the pulp chamber. As mentioned, the roots of human teeth are made of cementum on the outer surface. Whale teeth have cementum on the entire surface of the tooth with a very small layer of enamel at its tip. This small enamel layer is only seen in older whales where the cementum has been worn away to show the underlying enamel.[78] The structure of horse teeth is different from human teeth as the enamel and dentin layers are intertwined.[79]


See also
Look up tooth in Wiktionary, the free dictionary.Wikimedia Commons has media related to:
teethBarodontalgia
Braces
Dental auxiliary
Dental assistant
Dental hygienist
Dental technician
Dental notation
Dental tourism
Dentistry
Dragon's teeth (mythology)
Head and neck anatomy
Language
Tooth Fairy
Tooth painting
Vocal tract

Lists
List of basic dentistry topics
List of oral health and dental topics

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^ Gandara B.K., Truelove E.L. "Diagnosis and Management of Dental Erosion", online version hosted on the The Journal of Contemporary Dental Practice website. Journal of Contemporary Dental Practice, 1999 October; (1)1, pages 16-23. Page accessed April 25, 2007.
^ Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 63. ISBN 0-7216-9003-3.
^ Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 66. ISBN 0-7216-9003-3.
^ Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 70. ISBN 0-7216-9003-3.
^ Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 69. ISBN 0-7216-9003-3.
^ a b Neville, B.W., D. Damm, C. Allen, J. Bouquot. Oral & Maxillofacial Pathology. Second edition. 2002. Page 85. ISBN 0-7216-9003-3.
^ Amelogenesis imperfecta, hosted on the Genetics Home Reference website, a service of the U.S. National Library of Medicine. Page accessed April 1, 2007.
^ Dentinogenesis imperfecta, hosted on the Genetics Home Reference website, a service of the U.S. National Library of Medicine. Page accessed April 1, 2007.
^ Cho, Shiu-yin, Conservative Management of Regional Odontodysplasia: Case Report, hosted on the Canadian Dental Association website. Issue 72(8): pp. 735–8. Page accessed April 1, 2007.
^ The Permanent Canine Teeth, hosted on the University of Illinois at Chicago website. Page accessed February 5, 2007.
^ Chris C. Pinney, The Illustrated Veterinary Guide for Dogs, Cats, Birds, and Exotic Pets (Blue Ridge Summit, PA: TAB Books, 1992), p. 187.
^ Caceci, Thomas. Veterinary Histology with subtitle "Digestive System: Oral Cavity" found here.
^ "Common Characteristics of Whale Teeth" here
^ Encarta article found here and Randall-Bowman, whose link can be found here

External links
An article on the use of human tooth used as a neolithic pendant
An overview of dental anatomy
"Broke a tooth? Grow it back", University of Alberta
Straight Teeth
Tooth eruption chart

Ramus of the mandible

Ramus of the mandible
From Wikipedia, the free encyclopedia
(Redirected from Mandibular ramus) Please help improve this article or section by expanding it. Further information might be found on the talk page. (January 2007)
Bone: Ramus of the mandible

Mandible. Outer surface. Side view

Mandible. Inner surface. Side view
Latin ramus mandibulae
Gray's subject #44 173


The ramus of the mandible (perpendicular portion) is quadrilateral in shape, and has two surfaces, four borders, and two processes.Contents [hide]
1 Surfaces
2 Borders
3 Processes
4 Additional images
5 External links


[edit]
Surfaces

The lateral surface is flat and marked by oblique ridges at its lower part; it gives attachment throughout nearly the whole of its extent to the masseter.

The medial surface presents about its center the oblique mandibular foramen, for the entrance of the inferior alveolar vessels and nerve.

The margin of this opening is irregular; it presents in front a prominent ridge, surmounted by a sharp spine, the lingula mandibulae, which gives attachment to the sphenomandibular ligament; at its lower and back part is a notch from which the mylohyoid groove runs obliquely downward and forward, and lodges the mylohyoid vessels and nerve.

Behind this groove is a rough surface, for the insertion of the internal pterygoid muscle (Pterygoideus internus). The mandibular canal runs obliquely downward and forward in the ramus, and then horizontally forward in the body, where it is placed under the alveoli and communicates with them by small openings.

On arriving at the incisor teeth, it turns back to communicate with the mental foramen, giving off two small canals which run to the cavities containing the incisor teeth.

In the posterior two-thirds of the bone the canal is situated nearer the internal surface of the mandible; and in the anterior third, nearer its external surface.

It contains the inferior alveolar vessels and nerve, from which branches are distributed to the teeth.

[edit]
Borders

The lower border of the ramus is thick, straight, and continuous with the inferior border of the body of the bone. At its junction with the posterior border is the angle of the mandible, which may be either inverted or everted and is marked by rough, oblique ridges on each side, for the attachment of the Masseter laterally, and the Pterygoideus internus medially; the stylomandibular ligament is attached to the angle between these muscles. The anterior border is thin above, thicker below, and continuous with the oblique line.

The posterior border is thick, smooth, rounded, and covered by the parotid gland. The upper border is thin, and is surmounted by two processes, the coronoid in front and the condyloid behind, separated by a deep concavity, the mandibular notch.

[edit]
Processes

The coronoid process is a thin, triangular eminence, which is flattened from side to side and varies in shape and size.

The condyloid process is thicker than the coronoid, and consists of two portions: the condyle, and the constricted portion which supports it, the neck.

The mandibular notch, separating the two processes, is a deep semilunar depression, and is crossed by the masseteric vessels and nerve.

[edit]
Additional images

The skull from the front.

The Temporalis; the zygomatic arch and Masseter have been removed.

The Pterygoidei; the zygomatic arch and a portion of the ramus of the mandible have been removed.


[edit]
External links
Norman/Georgetown lesson1
Roche Lexicon - illustrated navigator, at Elsevier 25420.000-1
Anatomy at PSU skel/mandible2
Roche Lexicon - illustrated navigator, at Elsevier 34256.000-1

Salivary gland

From Wikipedia, the free encyclopedia This article needs additional citations for verification.
Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (December 2007)
Salivary gland

Salivary glands: #1 is Parotid gland, #2 is Submandibular gland, #3 is Sublingual gland

Salivary+Glands
Latin glandulae salivariae


The salivary glands in mammals are exocrine glands that produce saliva. They also secrete amylase, an enzyme that breaks down starch into glucose. In other organisms such as insects, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been useful in genetic research.Contents [hide]
1 Histology
1.1 Ducts
2 Anatomy
2.1 Parotid Glands
2.2 Submandibular Glands
2.3 Sublingual Gland
2.4 Minor Salivary Glands
2.4.1 Von Ebner's Glands
3 Innervation
4 Role in disease
5 Diagnostic investigation
6 References
7 External links


[edit]
Histology

Parotid gland (green) in relation to the skull.

The glands are enclosed in a capsule of connective tissue and internally divided into lobules. Blood vessels and nerves enter the glands at the hilum and gradually branch out into the lobules.

[edit]
Ducts

In the duct system, the lumens formed by intercalated ducts, which in turn join to form striated ducts. These drain into ducts situated between the lobes of the gland (called interlobar ducts or excretory ducts).

All of the human salivary glands terminate in the mouth, where the saliva proceeds to aid in digestion. The saliva that salivary glands release is quickly inactivated in the stomach by the acid that is present there.

[edit]
Anatomy

The salivary glands are situated at the entrance to the gastrointestinal system to help begin the process of digestion.

[edit]
Parotid Glands
Main article: Parotid gland

The parotid glands are a pair of glands located in the subcutaneous tissues of the face overlying the mandibular ramus and anterior and inferior to the external ear. The secretion produced by the parotid glands is serous in nature, and enters the oral cavity through the Stensen's duct after passing through the intercalated ducts which are prominent in the gland. Despite being the largest pair of glands, only approximately 25% of saliva is produced by the glands. another type of salivary gland is the sublingual salivary gland.

[edit]
Submandibular Glands
Main article: Submandibular gland

The submandibular glands are a pair of glands located beneath the floor of the mouth, superior to the digastric muscles. The secretion produced is a mixture of both serous and mucous and enters the oral cavity via Wharton's ducts. Approximately 70% of saliva in the oral cavity is produced by the submandibular glands, even though they are much smaller than the parotid glands.

[edit]
Sublingual Gland
Main article: Sublingual gland

The sublingual glands are a pair of glands located beneath the floor of the mouth anterior to the submandibular glands. The secretion produced is mainly mucous in nature, however it is categorized as a mixed gland. Unlike the other two major glands, the ductal system of the sublingual glands do not have striated ducts, and exit from 8-20 excretory ducts. Approximately 5% of saliva entering the oral cavity come from these glands.

[edit]
Minor Salivary Glands

There are over 600 minor salivary glands located throughout the oral cavity within the lamina propria of the oral mucosa. They are 1-2mm in diameter and unlike the other glands, they are not encapsulated by connective tissue only surrounded by it. The gland is usually a number of acini connected in a tiny lobule. A minor salivary gland may have a common excretory duct with another gland, or may have its own excretory duct. Their secretion is mainly mucous in nature (except for Von Ebner's glands) and have many functions such as coating the oral cavity with saliva. Problems with dentures are usually associated with minor salivary glands.[1]

[edit]
Von Ebner's Glands
Main article: Von Ebner's glands

Von Ebner's glands are glands found in circumvallate papillae of the tongue. They secrete a serous fluid that begin lipid hydrolysis. They are an essential component of taste.

[edit]
Innervation

Salivary glands are innervated, either directly or indirectly, by the parasympathetic and sympathetic arms of the autonomic nervous system.
Parasympathetic innervation to the salivary glands is carried via cranial nerves. The parotid gland receives its parasympathetic input from the glossopharyngeal nerve (CN IX) via the otic ganglion, while the submandibular and sublingual glands receive their parasympathetic input from the facial nerve (CN VII) via the submandibular ganglion.
Direct sympathetic innervation of the salivary glands takes place via preganglionic nerves in the thoracic segments T1-T3 which synapse in the superior cervical ganglion with postganglionic neurons that release norepinephrine, which is then received by β-adrenergic receptors on the acinar and ductal cells of the salivary glands, leading to an increase in cyclic adenosine monophosphate (cAMP) levels and the corresponding increase of saliva secretion. Note that in this regard both parasympathetic and sympathetic stimuli result in an increase in salivary gland secretions.[2] The sympathetic nervous system also affects salivary gland secretions indirectly by innervating the blood vessels that supply the glands.

[edit]
Role in disease
See mumps (parotiditis epidemica), Sjögren's syndrome, Mucocele, and Salivary gland neoplasm.

Salivary duct calculus may cause blockage of the ducts, causing pain and swelling of the gland.

Tumors of the salivary glands may occur.

[edit]
Diagnostic investigation

A sialogram is a radiocontrast study of a salivary duct.

[edit]
References
^ Cate, A.R. Ten. Oral Histology: development, structure, and function. 5th ed. 1998. Page 3. ISBN 0-8151-2952-1.
^ Costanzo, L. (2006). Physiology, 3rd ed.. Saunders Elsevier. ISBN 10:1-4160-2320-8.

[edit]
External links
Salivary Gland Disorders at intelihealth.com
Illustration at merck.com
Illustration at .washington.edu
Photo at mgccc.cc.ms.us

Saliva

From Wikipedia, the free encyclopedia
For the band, see Saliva (band); for the village in Azerbaijan, see Səliva.
Not to be confused with Salvia.

Look up saliva in
Wiktionary, the free dictionary.

Saliva is the watery and usually frothy substance produced in the mouths of humans and most other animals. Saliva is produced in and secreted from the salivary glands. Human saliva is composed mostly of water, but also includes electrolytes, mucus, antibacterial compounds, and various enzymes. [1] As part of the initial process of food digestion, the enzymes in the saliva break down some of the starch and fat in the food at the molecular level. Saliva also breaks down food caught in the teeth, protecting them from bacteria that cause decay. Furthermore, saliva lubricates and protects the teeth, the tongue, and the tender tissues inside the mouth. Saliva also plays an important role in tasting food by trapping thiols produced from odourless food compounds by anaerobic bacteria living in the mouth. [2]

Various species have evolved special uses for saliva that go beyond predigestion. Some swifts use their gummy saliva to build their nests. Some Aerodramus swiftlet nests are made only from saliva and used to make bird's nest soup.[3] Cobras, vipers, and certain other members of the venom clade hunt with venomous saliva injected by fangs. Some arthropods, such as spiders and caterpillars, create thread from salivary glands.

Taking a saliva sample for testingContents [hide]
1 Functions
1.1 Digestion
1.2 Disinfectants
1.3 Cleaning
2 Stimulation
3 Daily salivary output
4 Contents
5 References


[edit]
Functions

[edit]
Digestion

The digestive functions of saliva include moistening food, and helping to create a food bolus, so it can be swallowed easily. Saliva contains the enzyme amylase that breaks some starches down into maltose and dextrin. Thus, digestion of food occurs within the mouth, even before food reaches the stomach. Salivary glands also secrete enzymes (salivary lipase) to start fat digestion.[4]

[edit]
Disinfectants

A common belief is that saliva contained in the mouth has natural disinfectants, which leads people to believe it is beneficial to "lick their wounds". Researchers at the University of Florida at Gainesville have discovered a protein called nerve growth factor (NGF) in the saliva of mice. Wounds doused with NGF healed twice as fast as untreated and unlicked wounds; therefore, saliva can help to heal wounds in some species. NGF has not been found in human saliva; however, researchers find human saliva contains such antibacterial agents as secretory IgA, lactoferrin, and lactoperoxidase. It has not been shown that human licking of wounds disinfects them, but licking is likely to help clean the wound by removing larger contaminants such as dirt and may help to directly remove infective bodies by brushing them away. Therefore, licking would be a way of wiping off pathogens, useful if clean water is not available to the animal or person.

The mouth of animals is the habitat of many bacteria, some pathogenic. Some diseases, such as herpes, can be transmitted through the mouth. Animal (including human) bites are routinely treated with systemic antibiotics because of the risk of septicemia.

Recent research suggests that the saliva of birds is a better indicator of avian influenza than are faecal samples. [5]

[edit]
Cleaning

Saliva is an effective cleaning agent used in art conservation. Cotton swabs coated with saliva are rolled across a paintings surface to delicately remove thin layers of dirt that may accumulate.[6]

[edit]
Stimulation

The production of saliva is stimulated both by the sympathetic nervous system and the parasympathetic.[7]

The saliva stimulated by sympathetic innervation is thicker, and saliva stimulated parasympathetically is more watery.

Parasympathetic stimulation leads to acetylcholine (ACh) release onto the salivary acinar cells. ACh binds to muscarinic receptors and causes an increased intracellular calcium ion concentration (through the IP3/DAG second messenger system). Increased calcium causes vesicles within the cells to fuse with the apical cell membrane leading to secretion formation. ACh also causes the salivary gland to release kallikrein, an enzyme that converts kininogen to lysyl-bradykinin. Lysyl-bradykinin acts upons blood vessels and capillaries of the salivary gland to generate vasodilation and increased capillary permeability respectively. The resulting increased blood flow to the acinar allows production of more saliva. Lastly, both parasympathetic and sympathetic nervous stimulation can lead to myoepitheilium contraction which causes the expulsion of secretions from the secretory acinus into the ducts and eventually to the oral cavity.

[edit]
Daily salivary output

There is much debate about the amount of saliva that is produced in a healthy person per day. The estimates range from 0.75 liters per day to 1.5 liters per day.This suggests that the amount produced varies from person to person. It is generally accepted though that while sleeping the amount usually drops to almost zero.

[edit]
Contents

Produced in salivary glands, human saliva is 98% water, but it contains many important substances, including electrolytes, mucus, antibacterial compounds and various enzymes. [8]

It is a fluid containing:
Water
Electrolytes:
2-21 mmol/L sodium (lower than blood plasma)
10-36 mmol/L potassium (higher than plasma)
1.2-2.8 mmol/L calcium
0.08-0.5 mmol/L magnesium
5-40 mmol/L chloride (lower than plasma)
25 mmol/L bicarbonate (higher than plasma)
1.4-39 mmol/L phosphate
Mucus. Mucus in saliva mainly consists of mucopolysaccharides and glycoproteins;
Antibacterial compounds (thiocyanate, hydrogen peroxide, and secretory immunoglobulin A)
Various enzymes. There are three major enzymes found in saliva.
α-amylase (EC3.2.1.1). Amylase starts the digestion of starch and lipase fat before the food is even swallowed. It has a pH optima of 7.4.
lysozyme (EC3.2.1.17). Lysozyme acts to cause lysis in bacteria.
lingual lipase (EC3.1.1.3). Lingual lipase has a pH optimum ~4.0 so it is not activated until entering the acidic environment of the stomach.
Minor enzymes include salivary acid phosphatases A+B (EC3.1.3.2), N-acetylmuramyl-L-alanine amidase (EC3.5.1.28), NAD(P)H dehydrogenase-quinone (EC1.6.99.2), salivary lactoperoxidase (EC1.11.1.7), superoxide dismutase (EC1.15.1.1), glutathione transferase (EC2.5.1.18), class 3 aldehyde dehydrogenase (EC1.2.1.3), glucose-6-phosphate isomerase (EC5.3.1.9), and tissue kallikrein (EC3.4.21.35).
Cells: Possibly as much as 8 million human and 500 million bacterial cells per mL. The presence of bacterial products (small organic acids, amines, and thiols) causes saliva to sometimes exhibit foul odor.
Opiorphin, a newly researched pain-killing substance found in human saliva.

Different reagents used to determine the content of saliva \1. Molisch test gives a positive result of purple color that is costituent to the presence of carbohydrates

[edit]
References
^ Physiology at MCG 6/6ch4/s6ch4_6
^ Christian Starkenmann, Benedicte Le Calvé, Yvan Niclass, Isabelle Cayeux, Sabine Beccucci, and Myriam Troccaz. Olfactory Perception of Cysteine−S-Conjugates from Fruits and Vegetables. J. Agric. Food Chem., 2008; 56 (20): 9575-9580 DOI: 10.1021/jf801873h
^ Marcone, M. F. (2005). "Characterization of the edible bird's nest the Caviar of the East." Food Research International 38:1125–1134. doi:10.1016/j.foodres.2005.02.008 Abstract retrieved 12 Nov 2007
^ Maton, Anthea; Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright (1993). Human Biology and Health. Englewood Cliffs, New Jersey, USA: Prentice Hall. ISBN 0-13-981176-1.
^ "Saliva swabs for bird flu virus more effective than faecal samples" German Press Agency December 11, 2006 Retrieved 13 November 2007
^ "Techniques for Cleaning Acrylic". Golden Artist Colors. Retrieved on 2008-09-12.
^ Physiology at MCG 6/6ch4/s6ch4_7
^ Physiology at MCG 6/6ch4/s6ch4_6

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