The extraction of permanent teeth is something that your cosmetic dentist in Glendale, AZ will try to avoid if at all possible,

but sometimes it must be done. Here are some of the most common reasons why a tooth extraction might be necessary: 1. Trauma Trauma to the face sometimes causes problems with the teeth. If your tooth is knocked completely out of your mouth with the root still attached and you get to the dentist within an hour, the tooth can often be re-implanted. However, if you cant get there fast enough or if not all of the tooth came off, the dentist will have to resort to other measures to fix the tooth. In some cases, the dentist can simply add some bonding material to whats left of the tooth to create the appearance and function of an intact tooth. In other cases, whatever is left of the tooth will have to be extracted and you will need to undergo a dental implant procedure.

2. Disease Usually, fixing a tooth thats suffering from periodontal disease is a simple matter of removing the infected material and adding a filling. Sometimes, however, the infection has progressed too far for such measures, reaching the pulp of the tooth, the root, or the bone of the jaw. In cases such as this, the tooth will need to be extracted. 3. Crowding If theres not enough room in the mouth to complete cosmetic or orthodontic work, the dentist may extract a tooth to make the necessary room. In most cases, your orthodontist will attempt to avoid this procedure as best he can.

Implants

If you're missing a tooth or more, you may find that there are other things you miss. You may miss your natural smile. You may miss the ability to chew apples, crackers and other food you desire. Maybe you feel self-conscious about your teeth and mouth, or discomfort as remaining teeth shift. And perhaps you've experienced muscle strains, an inability to speak clearly, headaches or unease in familiar situations at work, with friends or at home. Naturally, the effect of tooth loss varies from person to person and depends on what exactly has been lost. If you've lost the crown, you've lost the visible part of your tooth. But if you've lost the root as well, you've lost the unseen part of your tooth. The root anchors the tooth in your jawbone, providing stable support for the crown. Without the root, the bone around the lost tooth may gradually recede, remaining teeth may shift and chewing may become more difficult with time. You can choose from a number of ways to replace your tooth crowns. But if you're interested in replacing your entire tooth - crown and root - your only option is dental implants.

Improved Appearance
There are two parts to every tooth. The crown and the root. The crown is the visible part and the root is the unseen part which anchors the tooth in your jawbone, providing stable support for your crown. When an entire tooth is lost - crown and root - shrinkage of the jawbone may occur making the face look older. Dental implants can stop this process. There are many ways to replace tooth crowns, but only dental implants can replace the entire tooth including both crown and root. Dental implants look, feel and function like your own natural teeth.

Before the Implant

After the Implant - a perfect smile!

Improved Comfort
Dental implants eliminate the pain and discomfort of removable full or partial dentures. Since dentures sit on top of the jawbone and gums, continuous shrinkage of the jaw bone alters the fit of the denture resulting in slipping or rocking of the dentures. Exposed nerves and irritation of the gum tissue may add to the discomfort. Implant supported replacement teeth are like natural teeth because they are anchored securely to your jawbone. Gum irritation and the pain of exposed nerves associated with conventional full or partial dentures are eliminated.

Eat Better
The average denture patient with an excellent fitting denture eats at 15-20% efficiency when compared to a person with natural teeth. As the jawbone shrinks, your chewing efficiency is reduced even more, making it difficult to eat certain foods. Dental implants, on the other hand, can restore chewing efficiency comparable to that of natural teeth. This allows you to eat your favorite foods with confidence and without pain. You can enjoy what everyone is eating and you don't have to think twice about it. A full upper denture covers the palate of the mouth and reduces the ability to taste foods. With dental implants, you can have the palate removed from your upper denture so you can taste and enjoy your food.

Great Value
Although dental implant treatment may initially be more expensive than other treatment methods it often turns out to be the best investment from a long term perspective since most patients can expect them to last a life time. Other treatment methods like bridges and dentures often requires regular alterations and adjustments over time.

How to Recover a Swallowed Dental Crown

Dental crowns are not only necessary for a beautiful smile, if they are on a back tooth they provide a surface with which to chew food. Dental crowns are expensive. There are two types of crowns, temporary and permanent. Dental patients more often tend to swallow a temporary crown, since the adhesive used to hold it in place is more likely to fail and the crown may be dislodged while chewing a mouthful of food and swallowed before you know it's missing. Less frequently, this happens with permanent crowns but when it does, you can recover the crown and have it reattached.

Read more: How to Recover a Swallowed Dental Crown | eHow.com http://www.ehow.com/how_5004249_recover-swallowed-dental-crown.html#ixzz1q85ahQ5M

children
Fluoride Another important topic is figuring out if your child is getting enough fluoride. Children begin to need supplemental fluoride by the age of six months. If your child is drinking tap water (either alone, or mixed with baby formula or 100% fruit juice), and you live in an area with the water is fluoridated, then he should be getting an adequate amount of fluoride. If your child doesn't drink water, or drinks well water, unfluoridated bottled water (most brands of bottled water don't have fluoride in them unless the label specifically states that they do), or filtered water, then he may not be getting enough fluoride to keep his teeth healthy. Talk with your pediatrician or dentist about fluoride supplements.

Water filters are a special concern, because some of them do filter out fluoride. Counter top filters and the pitcher type filters usually don't remove fluoride, but more sophisticated, point of use filters can. If in doubt, check with the manufacturer to see if the filter removes fluoride.
Sealants You should also talk with your dentist about using sealants in your school age child. A sealant is a plastic material that is applied to the teeth, hardens, and provides a barrier against plaque and other harmful substances. Sealants can be applied to the 1st and 2nd permanent molars to help protect the grooves and pits of these teeth that can be hard to clean and are prone to developing cavities, and appropriate premolars as soon as possible after they erupt (usually after 6 years of age). Flossing What about flossing? Flossing is an important part of good dental hygiene.

You can usually begin flossing once your child's teeth are touching each other, but they likely won't be able to floss on their own until they are 8 to 10 years old.
Habits for Healthy Teeth In addition to teaching your children the importance of regular brushing and flossing, routine visits to the dentist and a healthy diet, it is important that you set a good example by also practicing good dental hygiene.

If you do not brush and floss each day or regularly see a dentist, then it is unlikely that your children will either.

Dental Health Guide

Your child's first teeth will begin coming in between three and sixteen months (usually around six months). The two bottom front teeth will be the first to come in and this will be followed by the four upper teeth in four to eight weeks. The timing of the eruption of the first tooth is largely influenced by genetics, so if there is a family history of getting the first tooth late, then your child will probably also get his first tooth late. Related Articles

Dental Sealants Teething Brushing Teeth Dental Emergencies

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Your child will continue to get new teeth until he has all twenty of his primary teeth when he is three years old, with most children getting about four new teeth every four months. Children begin shedding their first teeth when they are around 6-7 years old, and this process is complete with the loss of the 2nd molars when he is about 11-13 years old.

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Permanent teeth begin erupting at around 6-7 years of age and continues until your child gets his third molars (or wisdom teeth) when he is about 17-22 years old.
Does teething cause...

In most children, teething only causes increased drooling and a desire to chew on hard things, but in some it does cause mild pain and irritability and the gums may become swollen and tender. To help this you can vigorously massage the area for a few minutes or let him chew on a smooth, hard teething ring. Teething should not cause fever, diarrhea, sleeping problems or diaper rashes. While most children do not need teething gels or treatment with Tylenol for pain, you can use these products if necessary.
When should I begin cleaning my child's teeth?

Once your child's teeth begin erupting, you can begin cleaning them by wiping them with a moist washcloth. As your child gets more teeth, you can begin to use a soft child's toothbrush. You should use just a pea-size amount of a fluoride toothpaste or a non-fluoride toothpaste (like Baby OraGel) until your child is able to spit it out (too much fluoride can stain their teeth).
When should I take my child to the dentist?

According to the recommendations of the American Academy of Pediatric Dentistry, the first visit to the dentist should be 'when the first tooth comes in, usually between six and twelve months of age.' The American Academy of Pediatrics used to recommend that the first visit to the dentist be at three years of age. Now, because so many children have cavities by the time they start kindergarten, the AAP states that high risk children should see a dentist six months after their first tooth erupts or before they are 12 months old.

In addition to looking for and preventing problems, an early visit to the dentist can help educate you about your child's oral health and proper hygeine. If your child is not high risk, your Pediatrician should begin oral health evaluations by six months of age. So when should the first visit be? If your child doesn't have any risk factors for developing cavities, such as sleeping with a cup or bottle or walking around all day with a cup of juice, and if his teeth seem to be developing normally, then you can probably wait until your child is older and just ask your Pediatrician to check his teeth at each well child visit. Another risk factor for getting a lot of cavities can include having a mother with a lot of cavities. Also, kids with special health care needs, later order offspring, and children from families of low socioeconomic status, are considered to be at risk for cavities and should likely see a dentist early. If your child has any problems, such as staining of his teeth, crowding or abnomal tooth development, or if he has any risk factors for developing cavities, then he should see a dentist earlier. You may also want to see a dentist if your child has any persistent habits, such as sucking his thumb or using a pacifier as a toddler or grinding his teeth at night (bruxism). If your family dentist tells you that your first visit should be delayed until he is four or five years old, then you may want to see a Pediatric dentist for the first few years.
Does my child need fluoride supplements?

In general, yes. All children need supplemental fluoride after they are six months old to help prevent cavities. For most children, they can get this fluoride from the water they drink, if they are in an area where the city water supply has an adequate amount of fluoride in it (greater than 0.6 ppm), and they are drinking tap water. Sources of water that generally don't have enough fluoride include well water and filtered or bottled water, although some brands of bottled water (or nursery water) do have fluoride added to it. Also, commercially prepared pre-mixed infant formulas do not contain an adaquate amount of fluoride, so consider using a powder or concentrated formula and mixing it with tap water, supplement your infant with extra tap water, or talk to your Pediatrician about giving fluoride supplements. If you only use a water filter pitcher or a counter top filter, it likely doesn't remove the fluoride from the water. Other types of water filters might though. If you have any doubt, check with the filter's manufacturer. It is in general better to have your child drink water that is supplemented with fluoride instead of giving extra fluoride drops or supplements. Too much fluoride can cause fluorosis, which is permanent white to brown discoloration of the enamel of the teeth. It is easier to get fluorosis if you are giving your child fluoride drops and he is still getting fluoride from his diet.

Talk with your Pediatrician or Pediatric Dentist if you think that your child may need fluoride supplements.
Why are my child's teeth stained?

In addition to intrinsic staining, that can be caused by fluorosis, blood and bile pigments, inherited defects of dentin and enamel, medications (especially tetracycline), and trauma, teeth can also be extrinsically stained from bacteria and food stains.
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Dental Conservation Dental restorations are used to restore damaged or decayed teeth. They can frequently save teeth that would otherwise need to be extracted. Restorations include fillings, inlays and onlays, veneers, crowns, implants, bridges, and dentures. Dental restorations can be described as direct and indirect restorations. Some restorations require multiple visits to the dentist (e.g., crowns, bridges). Restorations can be made from a number of different materials, including amalgam, composite resin, ionomers, metal alloys, porcelain and porcelain fused to metal.

Before the dental restoration procedure begins, patients need to see a dentist for a dental examination to determine what type of restoration is right for them. The dentist may also evaluate the patient's medical and dental history. The general process for dental restorations is similar for all types of restoration. The tooth is first prepared for the restoration. Any tooth decay is removed and the tooth may be reshaped. If an indirect restoration is to be used, the dentist will take an impression to make the restoration. The restoration can then be placed and adjusted as needed. Once placed, restorations do not usually cause discomfort.

The longevity of a dental restoration depends on many factors, including the patient's health, dental hygiene, type of restoration, material and the location in the mouth. In general, dental restorations require the same care as natural teeth. However, it is typically recommended that patients with restorations avoid placing unnecessary stress on the restoration. Dental restorations can chip, fracture, break, come loose, fall off or become stained.
Types and differences of dental restoration Dental restorations include direct and indirect restorations. Direct restorations are made in the dental office directly in the patient's mouth. Indirect restorations are created in a dental laboratory using impressions made of the patient's teeth. These usually require multiple visits to the dental office. Typically, a temporary restoration is placed in the patient's mouth between these visits. Indirect restorations tend to be more expensive than direct restorations, even when they are made from similar materials. Only a dentist can decide what type of dental restoration is right for a particular patient. The different types of restorations include: Fillings. These direct restorations are used to repair teeth that have been damaged by tooth decay and cavities. They can be used for the repair of very small or moderately sized areas of decay in primary or permanent teeth. Fillings can be made from amalgam, composite resin, or glass or resin ionomers. The longevity of a filling depends on several factors, such as the material, location, patient circumstances and skill of the dentist placing it.

 Inlays and onlays. These indirect restorations can cover some or all of the chewing surface of molars or premolars. They are larger than fillings, but do not cover as much of the tooth as a crown. Inlays lie entirely within the contours of the tooth, between the cusps. Onlays cover at least one cusp. Both inlays and onlays can restore a tooth too badly damaged for a filling. The choice depends on how much of the tooth needs to be restored. For example, onlays are generally preferred when more than half of the chewing surface needs restoration. Inlays and onlays can be made from gold or other metal alloys, composite resin or porcelain and usually last for decades. Veneers. Indirect restorations that are extremely thin shells placed on the front side of teeth. They are primarily used for cosmetic purposes (e.g., stained teeth, chipped teeth, gaps between teeth) and may be crafted from porcelain or composite resin. The lifespan of veneers is similar to crowns but depends on patient maintenance.

Crowns. These indirect restorations cover the entire visible portion of a tooth. Crowns can restore severely damaged teeth that other restorations cannot. They are also frequently used with bridges and implants. Crowns may be made from gold or other metal alloys, porcelain, porcelain fused to metal or composite resin. Crowns will usually last seven years or longer. Implants. An implant is an indirect restoration made of an artificial tooth root that supports an artificial tooth or teeth (e.g., crown, bridge, dentures) surgically placed in the jaw. Implants are used to replace missing or lost teeth with stable, well-anchored, natural-looking artificial teeth. Implants are usually made of titanium metal alloy. Dentures. A type of indirect restoration made of a removable dental appliance to replace missing teeth with artificial teeth attached to a gum-like denture base. Preparation and placement requires multiple visits to the dental office. impressions of the mouth and gums are taken and the materials are designed to look like natural teeth. They are usually made of porcelain or acrylic resin. Surgical restoration. Teeth and gums damaged by accidental injury or disease may be repaired using different types of restorations depending on the damage. Surgery to repair the initial trauma and to restore and maintain teeth and gums may be necessary.

Types of Dental Restoration There are two types of dental restorations: direct and indirect. Direct restorations are fillings placed immediately into a prepared cavity in a single visit. They include dental amalgam, glass ionomers, resin ionomers and some resin composite fillings. The dentist prepares the tooth, places the filling and adjusts it during one appointment.

Indirect restorations generally require two or more visits. They include inlays, onlays, veneers, crowns and bridges fabricated with gold, base metal alloys, ceramics or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The impression is sent to a dental laboratory, which creates the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed. Amalgam Fillings Used by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients. Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and possibly other metallic elements. Although dental amalgam continues to be a safe, commonly used restorative material, some concern has been raised because of its mercury content. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth. While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material. Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. They are also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line. Amalgam fillings, like other filling materials, are considered biocompatible-they are well tolerated by patients with only rare occurrences of allergic response. Disadvantages of amalgam include possible short-term sensitivity to hot or cold after the filling is placed. The silver-colored filling is not as natural looking as one that is tooth-colored,

especially when the restoration is near the front of the mouth, and shows when the patient laughs or speaks. And to prepare the tooth, the dentist may need to remove more tooth structure to accommodate an amalgam filling than for other types of fillings. Composite Fillings Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth. The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. It generally takes longer to place a composite filling than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling and they are subject to stain and discoloration over time. Ionomers
Glass ionomers are translucent, tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride that may be beneficial for patients who are at high risk for decay. When the dentist prepares the tooth for a glass ionomer, less tooth structure can be removed; this may result in a smaller filling than that of an amalgam. Glass ionomers are primarily used in areas not subject to heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small non-load bearing fillings (those between the teeth) or on the roots of teeth.

Resin ionomers also are made from glass filler with acrylic acids and acrylic resin. They also are used for very small, non-load bearing fillings (between the teeth), on the root surfaces of teeth, and they have low to moderate resistance to fracture. Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients with only rare occurrences of allergic response. Indirect Restorative Dental Merials (Two or more visits) Sometimes the best dental treatment for a tooth is to use a restoration that is made in a laboratory from a mold. These custom-made restorations, which require two or more visits, can be a crown, an inlay or an onlay. A crown covers the entire chewing surface and sides of the

tooth. An inlay is smaller and fits within the contours of the tooth. An onlay is similar to an inlay, but it is larger and covers some or all chewing surfaces of the tooth. The cost of indirect restorations is generally higher due to the number and length of visits required, and the additional cost of having the restoration made in a dental laboratory. Materials used to fabricate these restorations are porcelain (ceramic), porcelain fused to a metal-supporting structure, gold alloys and base metal alloys. All-Porcelain (Ceramic) Dental Materials
All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns. They are used as inlays, onlays, crowns and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. Allporcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel.

All-porcelain restorations require a minimum of two visits and possibly more. The restorations are prone to fracture when placed under tension or on impact. The strength of this type of restoration depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough. Porcelain-fused-to-Metal Another type of restoration is porcelain-fused-to-metal, which provides strength to a crown or bridge. These restorations are very strong and durable. The combination of porcelain bonded to a supporting structure of metal creates a stronger restoration than porcelain used alone. More of the existing tooth must be removed to accommodate the restoration. Although they are highly resistant to wear, porcelain restorations can wear opposing natural teeth if the porcelain becomes rough. There may be some initial discomfort to hot and cold. While porcelain-fused-to-metal restorations are highly biocompatible, some patients may show an allergic sensitivity to some types of metals used in the restoration. Gold Alloys Gold alloys contain gold, copper and other metals that result in a strong, effective filling, crown or a bridge. They are primarily used for inlays, onlays, crowns and fixed bridges. They are highly resistant to corrosion and tarnishing. Gold alloys exhibit high strength and toughness that resists fracture and wear. This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration. Gold alloys are also gentle to opposing teeth and are

well tolerated by patients. However, their metal colors do not look like natural teeth. Base Metal Alloys Base metal alloys are non-noble metals with a silver appearance. They are used in crowns, fixed bridges and partial dentures. They can be resistant to corrosion and tarnishing. They also have high strength and toughness and are very resistant to fracture and wear. Some patients may show allergic sensitivity to base metals and there may be some initial discomfort from hot and cold. However, due to their metal color, gold alloys do not look like natural teeth. Indirect Composites
Crowns, inlays and onlays can be made in the laboratory from dental composites. These materials are similar to those used in direct fillings and are tooth colored. One advantage to indirect composites is that they do not excessively wear opposing teeth. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration.

Handling Dental Emergencies Any dental emergency like an injury to the teeth or gums can be potentially serious and should not be ignored. Ignoring a dental problem can increase the risk of permanent damage as well as the need for more extensive and expensive treatment down the road. Here's a quick summary of what to do for some common dental problems.

Toothaches . First, thoroughly rinse your mouth with warm water. Use dental floss to remove any lodged food. If your mouth is swollen, apply a cold compress to the outside of your mouth or cheek. Never put aspirin or any other painkiller against the gums near the aching tooth because it may burn the gum tissue. See your dentist as soon as possible. Chipped or broken teeth. Save any pieces. Rinse the mouth using warm water; rinse any broken pieces. If there's bleeding, apply a piece of gauze to the area for about 10 minutes or until the bleeding stops. Apply a cold compress to the outside of the mouth, cheek, or lip near the broken/chipped tooth to keep any swelling down and relieve pain. See your dentist as soon as possible. Knocked-out tooth. Retrieve the tooth, hold it by the crown (the part that is usually exposed in the mouth), and rinse off the tooth root with water if it's dirty. Do not scrub it or remove any attached tissue fragments. If possible, try to put the tooth back in place. Make sure it's facing the right way. Never force it into the socket. If it's not possible to reinsert the tooth in the socket, put the tooth in a small container of milk (or cup of water that contains a pinch of table salt, if milk is not available) or a product containing cell growth medium, such as Save-a-Tooth. In all cases, see your dentist as quickly as possible. Knocked out teeth with the highest chances of being saved are those seen by the dentist and returned to their socket within 1 hour of being knocked out. Extruded (partially dislodged) tooth. See your dentist right away. Until you reach your dentist's office, to relieve pain, apply a cold compress to the outside of the mouth or cheek in the affected area. Take an over-the-counter pain reliever (such as Tylenol or Advil) if needed. Objects caught between teeth. First, try using dental floss to very gently and carefully remove the object. If you can't get the object out, see your dentist. Never use a pin or other sharp object to poke at the stuck object. These instruments can cut your gums or scratch your tooth surface. Lost filling. As a temporary measure, stick a piece of sugarless gum into the cavity (sugar-filled gum will cause pain) or use an over-the-counter dental cement. See your dentist as soon as possible. Lost crown. If the crown falls off, make an appointment to see your dentist as soon as possible and bring the crown with you. If you can't get to the dentist right away and the tooth is causing pain, use a cotton swab to apply a little clove oil to the sensitive area (clove oil can be purchased at your local drug store or in the spice aisle of your grocery store). If possible, slip the crown back over the tooth. Before doing so, coat the inner surface with an over-the-counter dental cement, toothpaste, or denture adhesive, to help hold the crown in place. Do not use super glue!

Broken braces wires. If a wire breaks or sticks out of a bracket or band and is poking your cheek, tongue, or gum, try using the eraser end of a pencil to push the wire into a more comfortable position. If you can't reposition the wire, cover the end with orthodontic wax, a small cotton ball, or piece of gauze until you can get to your orthodontist's office. Never cut the wire, as you could end up swallowing it or breathing it into your lungs. Loose brackets and bands. Temporarily reattach loose braces with a small piece of orthodontic wax. Alternatively, place the wax over the braces to provide a cushion. See your orthodontist as soon as possible. If the problem is a loose band, save it and call your orthodontist for an appointment to have it recemented or replaced (and to have missing spacers replaced). Abscess . Abscesses are infections that occur around the root of a tooth or in the space between the teeth and gums. Abscesses are a serious condition that can damage tissue and surrounding teeth, with the infection possibly spreading to other parts of the body if left untreated. Because of the serious oral health and general health problems that can result from an abscess, see your dentist as soon as possible if you discover a pimple-like swelling on your gum that usually is painful. In the meantime, to ease the pain and draw the pus toward the surface, try rinsing your mouth with a mild salt water solution (1/2 teaspoon of table salt in 8 ounces of water) several times a day.

Soft-tissue injuries. Injuries to the soft tissues, which include the tongue, cheeks, gums, and lips, can result in bleeding. To control the bleeding, here's what to do: 1. Rinse your mouth with a mild salt-water solution. 2. Use a moistened piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes. 3. To both control bleeding and relieve pain, hold a cold compress to the outside of the mouth or cheek in the affected area for 5 to 10 minutes. 4. If the bleeding doesn't stop, see your dentist right away or go to a hospital emergency room. Continue to apply pressure on the bleeding site with the gauze until you can be seen and treated.

Knocked-Out Tooth

A permanent tooth that has been knocked out should be rinsed gently to remove dirt and debris (do not scrub) and stored in the mouth, where saliva will help preserve it; take care not to swallow the tooth. (Do not store the tooth in the mouth of a young child or someone who may become unconscious.) Alternately, place the tooth or teeth in a cup of milk and immediately see a dentist or an oral surgeon. Do not attempt to place the tooth back in its socket because this could cause further damage. Seek immediate medical attention. (After two hours, the tooth usually cannot be saved.)

Broken Tooth

If the tooth is broken, rinse the mouth out with warm water and place cold compresses over the face in the area of the injury. Locate and save any broken tooth fragments. Seek immediate medical attention. Long-term dental problems can result from broken teeth.

Loose Tooth

If a tooth is moved slightly forwards or backwards, gently use light pressure with your finger to reposition the tooth to its normal alignment. Do not try to force the tooth back into its socket. Hold the tooth in place with a moist tissue or gauze. Seek medical attention within 30 minutes of the injury, if possible.

Toothache

Toothaches can be extremely painful and cause headaches, fever and sleeplessness. If you have a toothache, do not place aspirin on the aching tooth or gum. Rinse the mouth with warm water. Floss to remove food that may be trapped.

Cut or Bitten Tongue, Lip or Cheek Lining

These wounds should be cleaned gently with a clean cloth. Apply cold compresses to reduce swelling and bleeding. If bleeding does not stop, seek immediate medical attention. Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, go to a hospital emergency department.

preventive Dentistry: Care Today, Savings Tomorrow If you don't take care of your teeth and properly manage your oral health, you may find yourself forking over thousands of dollars in restorative dental care. Did you know that a full mouth reconstruction can cost between $45,000 and $80,000? By practicing preventive dentistry, you can safeguard yourself from these exorbitant dental costs. Preventive dentistry emphasizes the importance of ongoing hygiene procedures and daily practices to prevent tooth decay and other dental diseases and conditions. Effective preventive dentistry combines at-home oral care by patients with chairside treatments and counseling by dental professionals. At Home Whitening How does it compare with professional whitening?

For example, the American Dental Association (ADA) recommends a minimum of two dental checkups each year for professional cleaning and management of any developing conditions. Adhering to this recommendation can help your dentist stop dental disease in its earliest stages, protecting your smile and limiting your expense. Early Prevention Begin daily tooth cleaning as soon as your child's first tooth erupts. Visit a pediatric dentist when the first tooth erupts, or no later than 12 months of age, to establish a comprehensive oral health prevention program for your child. Preventive Dentistry Strategies Preventive oral care strategies for children and adults include a number of inoffice and home care activities, including: At-home oral hygiene. The most important prevention technique is brushing and flossing at least twice a day (or after every meal) to remove dental plaque, a filmlike coating that forms on your teeth. If not removed, plaque can build up and

produce dental tartar, a hardened, sticky substance with acid-producing bacteria that cause tooth decay and lead to gum disease. Fluoride use. Fluoride strengthens teeth and prevents tooth decay. Fluoride treatments are provided in dental offices, and dentists recommend using fluoride toothpastes and mouth rinses at home. Public water fluoridation ranked as one of the 20th century's 10 great public health achievements provides a major source of fluoride. Diet. A balanced diet is a dental health essential. Foods with sugars and carbohydrates feed the bacteria that produce dental plaque, while calcium-poor diets increase your chances of developing gum (periodontal) disease and jaw deterioration. Regular dental visits. Since most dental conditions are painless at first, if you don't regularly visit your dentist, you may not be aware of dental problems until they cause significant damage. For best results, schedule regular dental check-ups every six months; more often if you're at higher risk for oral diseases. Your dentist should also perform oral cancer screenings to check for signs of abnormal tissues. Especially for children, checking oral growth and development (including an assessment for caries development) should be part of dental evaluations. Dental cleanings and screenings. A dental cleaning (prophylaxis) is recommended every six months to remove dental plaque and stains you're unable to remove yourself, as well as to check for signs of tooth decay. X-rays. X-rays enable dentists to look for signs of dental problems that are not visible to the naked eye, such as cavities between teeth and problems below the gum line. Dry Mouth Is your dry mouth temporary or a chronic problem?

Mouth guards. Mouth guards particularly a custom-made mouth guard prescribed by your dentist to provide a better fit can be worn during sports activities to protect against broken teeth. Mouth guards also are used to treat

teeth grinding (bruxism), which can wear down teeth and contribute to temporomandibular joint (TMJ) disorder. Orthodontics. A bad bite (malocclusion) can impair eating and speaking, and crooked teeth are hard to keep clean. Correcting an improper bite with orthodontics that may include the use of dental braces or clear teeth aligners (invisible braces), such as Invisalign or Invisalign Teen, limits the possibility of future dental problems. Sealants. Sealants are thin composite coatings placed on the chewing surfaces of back permanent teeth to protect your child from tooth decay. Avoid smoking and drinking. Smoking, chewing tobacco and alcohol consumption can negatively affect your oral health. Apart from dry mouth, tooth discoloration and plaque buildup, smoking causes gum disease, tooth loss and even oral cancer. Oral health management. Consistent dental care for chronic dental diseases/conditions is essential for arresting or reversing their harmful effects. Patient education. Patients who understand the outcome of poor dental health are likelier to see their dentist for preventive dentistry treatments. Instilling excellent oral hygiene habits significantly helps ensure a lifetime of dental health. Importance of Fluoride Fluoride is absorbed easily into tooth enamel, especially in children's growing teeth. Once teeth are developed, fluoride strengthens tooth structure, making teeth more resistant to decay. Fluoride also repairs or remineralizes areas in which decay has already begun, thus reversing the process and creating a decayresistant tooth surface. Types of Fluoride Fluoride is available in two forms: topical and systemic. Topical fluorides strengthen existing teeth, making them more decay-resistant. Topical fluorides include toothpastes, mouth rinses and professionally applied fluoride therapies (gels, foams, rinses or varnishes). Many dentists give topical fluoride treatment to children up to age 18. For people with rampant cavities or

predispositions to decay such as people wearing orthodontic appliances and those with dry mouth dentists may prescribe a special gel for daily home use. Systemic fluorides are ingested into the body and incorporate into forming tooth structures. Systemic fluorides also can give topical protection because fluoride is present in saliva, which constantly moistens teeth. Systemic fluorides include public water fluoridation or dietary fluoride supplements in the form of tablets, drops or lozenges. However, keep in mind that the type of naturally occurring and added fluoride in the water supply can vary from area to area. Consult with your child's pedodontist to learn which form will be best for your child based on your area. The ADA recommends that adults and children two years and older use a fluoride toothpaste bearing the ADA Seal of Acceptance. Consult with your child's dentist if considering the use of toothpaste before age two. The ADA also recommends the use of fluoride mouth rinses, but not for children under six years old, since they may swallow the rinse. Other Preventive Dental Substances Used as a dental treatment, amorphous calcium phosphate (ACP) might help in restoring the necessary mineral balance of calcium and phosphate natural building blocks of teeth in the mouth. When applied to tooth surfaces, ACP strengthens tooth enamel before and after bleaching, and can protect dentin after professional dental cleaning and during orthodontic treatment, helping to prevent dentin hypersensitivity. ACP is currently found in toothpaste (Arm & Hammer's Enamel Care Toothpaste) and bleaching gels (Discus Dental's Nite White), as well as professional sealants (Aegis Pit and Fissure Sealant) available in dental offices. Dental Insurance Is your cosmetic dental care covered?

Many dentists also recommend xylitol, a natural sweetener made from birch trees, which has been clinically shown to reduce cavities and help prevent tooth decay and gum disease. Xylitol can be used as a sugar substitute in cooking and baking,

or beverages. It also is included in toothpastes, mouth rinses, chewing gums and candies. Technology for Dental Disease Prevention Intraoral cameras, which can be used in conjunction with computers or television monitors, take pictures of the outside of the tooth. Digital radiography is a form of X-ray imaging where digital X-ray sensors are used instead of traditional photographic film X-ray images. Faster and easier than conventional X-rays, they offer the ability to digitally transfer and enhance images of problem areas on a computer screen next to the patient's chair, allowing for better detection and patient education. Most importantly, they emit up to 90 percent less radiation than conventional radiography. Air abrasion is a drill-less technique used to remove tooth decay, superficial stains and discolorations, or to prepare a tooth surface for composite bonding or sealants. During air abrasion, a fine stream of particles (silica, aluminum oxide or a baking soda mixture) is aimed at the decayed portion of the tooth, and propelled toward the tooth surface by compressed air or a gas that runs through the handpiece of an instrument that works similar to a mini sandblaster. When the particle stream strikes the tooth, small particles of stain and decay are removed and suctioned off. Diagnostic tools such as Caries I.D. and Diagnodent help detect dental caries at the earliest stage before they progress further. Caries I.D. uses Light Emitting Diode (LED) and fiber optic technologies to detect caries. The Diagnodent is a fluorescent laser that finds cavities beneath the tooth's surface that are typically not visible with X-rays. Importance of Caries Risk Assessment Your dentist can customize a prevention program based on your individual caries risk assessment profile. Caries risk assessment, which involves observing the patient's clinical appearance, also takes into account the following: Tooth Implant Your functional and esthetic solution to missing teeth.

Number of existing carious lesions (someone with two or more may be considered at high risk of developing future caries) Fluoride exposure Salivary flow rate Diet Medication use. Some medicines can contribute to cavities since many contain high amounts of sugar or may decrease saliva flow. Age. Each age group children, teens, adults and seniors has its own set of associated risks. Income, education and oral health attitude. Research shows that those who have low incomes or lower education and achievement are likelier to have severe and untreated dental decay. Clinical variables such as number of filled/restored or missing teeth Laboratory factors such as salivary calcium levels

Benefits of Preventive Dentistry Considering that oral health is linked to overall health, preventive dentistry is important to your overall well being. Oral diseases can interfere with eating, speaking, daily activities and self-esteem. In children, severe decay can affect growth and development. Preventive dentistry can result in less extensive and less expensive treatment for any dental conditions that may develop, and help you keep your natural teeth for a lifetime. Dental caries, also known as tooth decay, is the destruction of the outer surface (enamel) of a tooth. Decay results from the action of bacteria that live in plaque, which is a sticky, whitish film formed by a protein in saliva (mucin) and sugary substances in the mouth. The plaque bacteria sticking to tooth enamel use the sugar and starch from food particles in the mouth to produce acid. Tooth decay can result in tooth loss. Description Thanks to the benefits of fluoride and fluoridated water, dental caries, also called dental cavities, are not as prevalent as in the years before and including the 1980s. While the majority of senior citizens a generation ago lost all their teeth, the vast majority of the elderly today have some or all of their natural teeth.

Although anyone can have a problem with tooth decay, children and senior citizens are the two high-risk groups. While both groups experience a diminishing caries rate, senior citizens are getting more cavities than children. Since older adults are keeping their teeth longer, they have become more prone to root caries, or root decay. Other high-risk groups include people who eat a lot of starchy and sugary foods, people living in areas without a fluoridated water supply, and people who already have numerous dental restorations (fillings and crowns). Dental caries charting: classification of cavities Classification and location Method of examination

SOURCE: Alvarez, K.H. Williams & Wilkins' Dental Hygiene Handbook. Baltimore: Williams & Wilkins, 1998. Class I Cavities in pits or fissures Direct or indirect visual Occlusal surfaces of premolars and Exploration molars Radiographs are not useful Facial and lingual surfaces of molars Lingual surfaces of maxillary incisors Early caries: by radiographs only Moderate caries not broken through from proximal to occlusal: Visual by color changes in tooth and loss of translucency Exploration from proximal Extensive caries involving occlusal: direct visual Early caries: by radiographs or transillumination Moderate caries not broken through to

Class II Cavities in proximal surfaces of premolars and molars

Class III Cavities in proximal surfaces of incisors and canines that do not

Dental caries charting: classification of cavities Classification and location involve the incisal angle Method of examination lingual or facial: Visual by tooth color change Exploration Radiograph Extensive caries: direct visual

Class IV Cavities in proximal surfaces of Visual Transillumination involve the incisal incisors or canines that angle Direct visual: dry surface for vision Class V Exploration to distinguish demineralization: Cavities in the cervical 1/3 of facial whether rough or hard and unbroken Areas or lingual surfaces (not pit or fissure) may be sensitive to touch Class VI Cavities on incisal edges of anterior Direct visual teeth and cusp tips of posterior May be discolored teeth Baby bottle tooth decay Baby bottle tooth decay is a dental problem that frequently develops in infants who are put to bed with a bottle containing a sweet liquid. Baby bottle tooth decay is also called nursing-bottle caries and bottle-mouth syndrome. Bottles containing liquids such as milk, formula, fruit juices, sweetened drink mixes, and sugar water continuously bathe an infant's mouth with sugar during naps or at night. The bacteria in the mouth use this sugar to produce acid that destroys the child's teeth. The upper front teeth are typically the ones most severely damaged, the lower front teeth receiving some protection from the tongue. Pacifiers dipped in sugar, honey, corn syrup, or other sweetened liquids also contribute to bottle-

mouth syndrome. The first signs of damage are chalky white spots or lines across the teeth. As decay progresses, the damage to the child's teeth becomes obvious. Causes and symptoms Tooth decay requires the simultaneous presence of three factors: plaque bacteria, sugar, and a vulnerable tooth surface. Although several microorganisms found in the mouth can cause tooth decay, the primary disease agent appears to be Streptococcus mutans. The sugars used by the bacteria are simple sugars such as glucose, sucrose, and lactose. They are converted primarily into lactic acid. When this acid builds up on an unprotected tooth surface, it dissolves the minerals in the enamel, creating holes and weak spots (cavities). As the decay spreads inward into the middle layer (the dentin), the tooth becomes more sensitive to temperature and touch. When the decay reaches the center of the tooth (the pulp), the resulting inflammation (pulpitis) produces a toothache. The elderly are more prone to dental caries because more than 95% of senior citizens have lost some of the gum tissue that protects the tooth roots, exposing the roots to plaque and decay. It also is common to see decay around filling margins. Over time, fillings tend to weaken, fracture, and leak around the edges, which fosters the accumulation of bacteria. Another reason that the elderly get more cavities is that many take medications that reduce saliva, which naturally protects the teeth from caries. Chewing tobacco is another culprit that increases the risk of tooth decay. A study showed that men who use chewing tobacco are four times more likely to have one or more decayed or filled root surfaces, compared to those who had never chewed tobacco. Diagnosis Tooth decay develops at varying rates. It may be found during a routine six-month dental checkup before the patient is even aware of a problem. In other cases, the patient may experience common early symptoms, such as sensitivity to hot and cold liquids or localized discomfort after eating very sweet foods. The dentist or dental hygienist may suspect tooth decay if a dark spot or pit is seen during a visual examination. Front teeth may be inspected for decay by shining a light from behind the tooth. This method is called transillumination. Areas of decay,

especially between the teeth, will appear as noticeable shadows when teeth are transilluminated. X rays may be taken to confirm the presence and extent of the

Development of dental caries. (Photograph by Biophoto Associates. Science Source/Photo Researchers, .Inc. Reproduced by permission.) decay. The dentist then makes the final clinical diagnosis by probing the enamel with a sharp instrument. Tooth decay in pits and fissures may be differentiated from dark shadows in the crevices of the chewing surfaces by a dye that selectively stains parts of the tooth that have lost mineral content. A dentist can also use this dye to tell whether all tooth decay has been removed from a cavity before placing a filling. Diagnosis in children Damage caused by baby bottle tooth decay is often not diagnosed until the child has a severe problem, because parents seldom take their infants and toddlers for dental check-ups. Dentists want to initially examine primary teeth between 12 and 24 months. Children still drinking from a bottle anytime after their first birthday are likely to have tooth decay. Treatment To treat most cases of tooth decay in adults, the dentist removes all decayed tooth structure, shapes the sides of the cavity, and fills the cavity with an appropriate material, such as silver amalgam or composite resin. The filling is put in to restore and protect the tooth. If decay has attacked the pulp, the dentist or a

specialist called an endodontist may perform root canal treatment and cover the tooth with a crown. In cases of baby bottle tooth decay, the dentist must assess the extent of the damage before deciding on the treatment method. If the problem is caught early, the teeth involved can be treated with fluoride, followed by changes in the infant's feeding habits and better oral hygiene. Primary teeth with obvious decay in the enamel that has not yet progressed to the pulp need to be protected with stainless steel crowns. Fillings are not usually an option in small children because of the small size of their teeth and the concern of recurrent decay. When the decay has advanced to the pulp, pulling the tooth is often the treatment of choice. Unfortunately, loss of primary teeth at this age may hinder the young child's ability to eat and speak. It may also have a bad effect on the alignment and spacing of the permanent teeth when they arrive. Prognosis With timely diagnosis and treatment, the progression of tooth decay can be stopped without extended pain. If the pulp of the tooth is infected, the infection may be treated with antibiotics prior to root canal treatment or extraction. The longer decay goes untreated, however, the more destructive it becomes and the longer and more intensive the necessary treatment will be. In addition, a patient with two or more areas of tooth decay is at increased risk of developing additional cavities in the future. Scientists are working on several advances in the reversal and prevention of tooth decay. The advances under development include: Smart fillings to prevent further tooth decay, toothpaste to strengthen and restore tooth minerals, and mouthwashes and chewing gums that reverse early decay. Scientists are studying the use of calcium phosphate cements (CPC), used to repair cranial defects, for fractures and bone loss from gum disease. CPC might provide a successful drug delivery system in Smart fillings to prevent tooth decay from recurring around existing fillings and surrounding teeth. Other calcium phosphate-based technologies used in chewing gum and mouth rinses are being tested to remineralize hard tooth tissues or slow demineralization produced by caries. Scientists are researching controlled-release fluoride systems, placed between the teeth or in tooth pits and fissures, that deliver high fluoride concentrations to localized areas. Research is also being done on the use of filling materials to repair

exposures of the tooth pulp, which could eliminate the need for root canal therapy. Health care team roles Dental assistants can provide patients and their families with education in caries prevention. This often includes instructions for home care and fluoride information. Dental assistants often participate in the treatment of dental caries, performing such tasks as taking x rays, assisting with materials during treatment, and setting up and maintaining treatment rooms. In some dental practices, dental hygienists assist with patient charting and taking x rays. Dental hygienists interpret findings and are often the first to see the decay during routine cleanings. Prevention It is easier and less expensive to prevent tooth decay than to treat it. The four major prevention strategies include: proper oral hygiene, fluoride, sealants, and attention to diet. Oral hygiene GENERAL CARE OF THE MOUTH. The best way to prevent tooth decay is to brush the teeth at least twice a day, preferably after every meal and snack, and to floss daily. Cavities develop most easily in spaces that are hard to clean. These areas include surface grooves, spaces between teeth, and the area below the gum line. Effective brushing cleans each outer tooth surface, inner tooth surface, and the horizontal chewing surfaces of the back teeth, as well as the tongue. Flossing once a day also helps prevent gum disease by removing food particles and plaque at and below the gum line, as well as between teeth. Patients should visit their dentist every six months for an oral examination and professional cleaning. MOUTH CARE IN OLDER ADULTS. Older adults who have lost teeth or had them removed still need to maintain a clean mouth. Bridges and dentures must be kept clean to prevent gum disease. Dentures should be relined and adjusted by a dentist whenever necessary to maintain a proper fit. These adjustments help to keep the gums from becoming red, swollen, and tender. MOUTH CARE IN CHILDREN. Parents can easily prevent baby bottle tooth decay by not allowing a child to fall asleep with a bottle containing sweetened liquid.

Bottles should be filled with plain, unsweetened water. A child should be starting to drink from a cup at around six months of age, and weaned from bottles at 12 months. If an infant seems to need oral comfort between feedings, a pacifier specially designed for the mouth may be used. Pacifiers, however, should never be dipped in honey, corn syrup, or other sweet liquids. After the eruption of the first tooth, parents should begin routinely wiping an infant's teeth and gums with a moist piece of gauze or soft cloth, especially before bedtime. Parents may begin brushing a child's teeth with a small, soft toothbrush at about two years of age, when most of the primary teeth have come in. They should apply only a very small amount (the size of a pea) of toothpaste containing fluoride. Too much fluoride may cause spotting (fluorosis) of the tooth enamel. As the child grows, he or she will learn to handle the toothbrush, but parents should control the application of toothpaste and do the follow-up brushing until the child is about seven years old. Fluoride application Fluoride is a natural substance that slows the destruction of enamel and helps to repair minor tooth decay damage by remineralizing tooth structure. Toothpaste, mouthwash, fluoridated public drinking water, and vitamin supplements are all possible sources of fluoride. It is important to note that bottled water and water from home purifiers often does not contain fluoride, so people who drink from these sources may have to supplement their fluoride use. Children living in areas without fluoridated water should receive 0.5 mg/day of fluoride (0.25 mg/day if using a toothpaste containing fluoride), from three to five years of age, and 1 mg/day from 6-12 years. While fluoride is important for protecting children's developing teeth, it is also of benefit to older adults with receding gums. It helps to protect the newly exposed tooth surfaces from decay. Older adults can be treated by a dentist with a fluoride solution that is painted onto selected portions of the teeth or poured into a fitted tray and held against all the teeth. Sealants Because fluoride is most beneficial on the smooth surfaces of teeth, sealants were developed to protect the irregular surfaces of teeth. A sealant is a thin plastic coating that is painted over the grooves of chewing surfaces to prevent food and

plaque from being trapped there. Sealant treatment is painless because none of the tooth is removed, although the tooth surface is etched with acid so that the plastic will adhere to the rough surface. Sealants are usually clear or toothcolored, making them less noticeable than silver fillings. They cost less than fillings and can last up to 10 years, although they should be checked for wear at every dental visit. Children should get sealants on their first permanent "6-year" molars, which come in between the ages of 5 and 7, and on the second permanent "12-year" molars, which come in between the ages of 11 and 14. Sealants should be applied to the teeth shortly after they erupt, before decay can set in. Although sealants have been used in the United States for about 25 years, one survey by the National Institute of Dental Research reported that fewer than 8% of American children have them. Diet Choosing foods wisely and eating less often can lower the risk of tooth decay. Foods high in sugar and starch, especially when eaten between meals, increase the risk of cavities. The bacteria in the mouth use sugar and starch to produce the acid that destroys the enamel. The damage increases with more frequent and longer periods of eating. For better dental health, people should eat a variety of foods, limit the number of snacks, avoid sticky and overly sweetened foods, and brush often after eating. Drinking water is also beneficial by rinsing food particles from the mouth. Children can be taught to "swish and swallow" if they are unable to brush after lunch at school. Similarly, saliva stimulated during eating makes it more difficult for food and bacteria to stick to tooth surfaces. Saliva also appears to have a buffering effect on the acid produced by the plaque bacteria and to act as a remineralizing agent. Older people should be made aware that some prescription medications may decrease salivary flow. Less saliva tends to increase the activity of plaque bacteria and encourage further tooth decay. Chewing sugarless gum increases salivation and thus helps to lower the risk of tooth decay.

KEY TERMS

Amalgam mixture (alloy) of silver and several other metals, used by dentists to make fillings for cavities. Carieshe medical term for tooth decay. Cavity hole or weak spot in the tooth surface caused by decay. Dentinhe middle layer of a tooth, which makes up most of the tooth's mass. Enamelhe hard, outermost surface of a tooth. Fluoride chemical compound containing fluorine that is used to treat water or applied directly to teeth to prevent decay. Mucin protein in saliva that combines with sugars in the mouth to form plaque. Plaque thin, sticky, colorless film that forms on teeth. Plaque is composed of mucin, sugars from food, and bacteria that live in the plaque. Pulphe soft, innermost layer of a tooth containing blood vessels and nerves. Sealant thin plastic substance that is painted over teeth as an anti-cavity measure to seal out food particles and acids produced by bacteria. Transillumination technique of checking for tooth decay by shining a light behind the patient's teeth. Decayed areas show up as spots or shadows.