The Anatomy of a Tooth: Teeth are the most important components of the oral cavity. They are composed of 4 major components: enamel, dentin, pulp, and periodontium. ENAMEL: Enamel is the outermost component of tooth structure that is exposed to the oral cavity. All the chewing of food and contact with food occurs with enamel. It is the hardest structure in the human body, harder than bone. Enamel is formed in fetal stages and early stages of life, and it cannot be regenerated. Thus it is the most precious structure of the tooth protecting underlying structures like dentin and pulp, which are very sensitive. But ironically, the enamel is the only component of tooth structure that is subjected to wear and decay due to continuous contact with the food.  Dental issues that can be seen in ENAMEL: Dental caries or tooth decay is the most common problem among individuals. It is characterized by the destruction of enamel which leads to the seepage of bacteria, bacterial enzymes, food, and saliva directly into the most sensitive parts of tooth structure like dentin and pulp. It all starts with the sugars and sticky foods that you consume. The sugars consumed will be stuck on the teeth. Nonetheless, saliva does its best to wash away some of the food that’s stuck. But it’s the carbohydrates or sugars or sticky foods that stay on the teeth even after saliva tries to wash. This retained food slowly attracts bacteria that are present in saliva and forms a hub of bacteria. The bacterial group thus formed into groups starts feeding off the food that is stuck on your teeth, and in the process of digesting the food, bacteria starts releasing the acids onto the tooth surface. These acids are the main reason for the destruction and demineralization of the hard shell of tooth structure, i.e., enamel and dentin, forming a hole. This is how a “CAVITY” is formed. Thus the bacteria enter into the tooth through that hole, enters the pulp, or in simple terms, blood vessels and nerves in the tooth, causing the pain which you experience. Many conditions like enamel hypoplasia and amelogenesis imperfecta lead to malformation of enamel, as a result of which caries incidence and wear of teeth are more in such patients. Hence immediate attention is required in these patients. Treatment options: *Dental restorations or fillings- if tooth destruction is less *Crowns- if the majority of tooth structure is damaged

DENTIN: The layer lying beneath the enamel is called dentin. It is not as hard as enamel. It is slightly yellowish in color, giving the tooth its yellow hue.  Dental issues that can be seen in DENTIN: Due to wear of overlying enamel, there may be exposure of underlying dentin, which may lead to dentinal hypersensitivity. During active caries, bacterial enzymes destroy enamel as well as dentin. Dentin is easily destroyed, and seepage of saliva and bacteria is very fast in dentin compared to enamel. Cervical abrasions caused due to excessive tooth brushing or brushing in a wrong technique or by using a hard toothbrush might lead to exposure of dentin to the oral environment. Hence immediate action is required if any of the above observations are recorded. Treatment: *Desensitizing toothpaste can be used if hypersensitivity or sensitive teeth are observed. They form a layer on dentin and prevent hypersensitivity. *Fillings or restoration can be advised if caries are seen *Dental crowns can be advised if tooth destruction is more. PULP: All the blood vessels and nerves that nourish the tooth structure and make it a vital structure are called “pulp.” It is the most sensitive part of the tooth.  Dental issues that can be seen in PULP: Bacterial destruction is the main reason for exposure of pulp to the oral cavity. Other reasons can be severe tooth attrition, in cases like dentinal dysplasia where tooth wear is more, and in case of tooth fracture and trauma. Treatment: *Root canal treatment can be advised if bacteria reach the pulp. *A dental crown is placed on the tooth following the root canal treatment.

PERIODONTIUM: The structures surrounding the tooth, like gums, periodontal ligament or PDL, and alveolar bone comprise periodontium. It is the supporting structure of a tooth that holds the tooth in place in the socket. When any of the components of the periodontium is compromised, it leads to bacterial seepage and loosens the teeth.  Dental issues that can be seen in PERIODONTIUM: Food accumulation around the tooth leads to swelling of gums. There can be bleeding and pus oozing from gums. If this continues, PDL will be destroyed, which leads to the loosening of teeth. If the disease of gums further progresses, it reaches the bone, leading to the destruction of the bone, and the tooth eventually falls out. Treatment: Regular visits to the dentist and having teeth professionally cleaned every 6 months. Using only soft-bristled toothbrushes helps avoid further damage to gums. Using mouthwashes helps control gum bleeding. Gum surgery might be required if bone destruction is more. Brushing twice daily and flossing once at night helps keep periodontal problems in check. It is good oral hygiene maintenance that helps keep tooth structure intact, and periodic dental visits help assess the problems at the earliest. Dentistry is not expensive, but neglect is.