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Oral Anatomy - American Academy of Pediatrics

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•
Referral
to dentist
for
Protecting
All
Children’s
Teeth
evaluation of enamel
o
Of esthetic concern, bleaching
can be performed
•
Recommend meticulous
hygiene
•
Prevention : Keep toothpaste
away from small children, adults
should supervise brushing and
fluoride mouth-rinsing.
Basic Oral Anatomy
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www.aap.org/oralhealth/pact
Introduction
Paper permission on file by Diona Reeves
Knowledge of the structures of the mouth, their locations, and
nomenclature is important in helping children maintain good oral
health.
The ability to recognize normal from abnormal and to communicate
that information to families and other health professionals will aid in
education and provision of care.
This PowerPoint will review key anatomic structures in the mouth
and typical and atypical development of these structures.
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Learner Objectives
Paper permission on file by Diona Reeves
Upon completion of this presentation, participants will be able to:
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Recognize and properly label oral anatomic sites.
Describe the location of a tooth lesion using the correct
tooth name, letter or number designation, and surface label.
Recall the layers of a tooth and their basic functions.
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Lips
The lips form the entryway of the mouth.
The following structures underlie the epithelium of the skin of
the lips:
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Vasculature
Sweat glands
Hair follicles
Muscles that function to move the lips
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Lips, continued
The mucous membrane of the lips is non-keratinized with many capillary
vessels close to the surface, giving it the pinkish/red color.
Examination of the lips is
valuable in recognizing signs
of illness, such as cyanosis,
herpetic lesions, or trauma.
Used with permission from Martha Ann Keels, DDS, PhD; Division Head of Duke Pediatric
Dentistry, Duke Children's Hospital
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Cheeks
The cheeks form the sides of the mouth.
Like the lips, the cheeks are muscles covered with skin on the
outside and mucous membranes on the inside.
Examination of the oral mucosa is especially important in
adolescents who chew tobacco to screen for oral cancer.
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Cheeks, continued
Along with trauma, you may also note the following:
Permission from Martha Ann Keels, DDS, PhD; Division Head of
Duke Pediatric Dentistry, Duke Children's Hospital
Aphthous ulcers
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Permission from Martha Ann Keels, DDS, PhD; Division
Head of Duke Pediatric Dentistry, Duke Children's Hospital
Mucoceles
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Gums
The gingiva (gums) is the mucosal membrane that covers the
periodontal ligaments, the alveolar sockets, bones of the jaw,
and borders the teeth at their neck.
The periodontal ligament is made up of bundles of connective
tissue fibers that anchor the teeth within the jaws.
As the teeth erupt, ridges of bone called alveolar processes
develop around the teeth to provide support.
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Gums, continued
Examination of the gingiva can
help reveal gingivitis.
If untreated, gingivitis can
progress to bone involvement,
or periodontitis.
Severe periodontitis can lead to
tooth loss.
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Permission from Noel Childers, DDS, MS, PhD; Department of Pediatric
Dentistry, University of Alabama at Birmingham
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Palate
The palate is the area in the roof of the mouth that starts
behind the upper teeth and extends to the uvula.
A normal hard palate consists of the fusion of bones in the
upper jaw and the palatine bones.
The soft palate is mostly muscle and has an important role in
swallowing and speech.
Examination of the hard and soft palate may uncover thrush.
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Tongue
The tongue is composed entirely
of muscle and connective tissue
and has ventral and dorsal
surfaces.
Used with permission from shutterstock.com
The ventral surface (underside) is
smooth. The dorsal surface (top)
is most visible on examination.
The dorsal surface includes the fungiform, foliate, and circumvallate
papillae, which are associated with the sense of taste.
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Floor of the Mouth
Beneath the tongue is the floor
of the mouth.
The frenulum connects the floor
of the mouth to the tongue.
Used with permission from Rocio B. Quinonez, DMD, MS, MPH; Associate Professor Department
of Pediatric Dentistry, School of Dentistry University of North Carolina
A thick frenulum that limits the movement is called ankyloglossia.
In cases where breastfeeding is inhibited, a frenectomy may be
done to release the tongue.
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Salivary Glands
Near the frenulum are the tiny openings of the
submandibular salivary glands. These openings are called
Wharton’s ducts.
There are 2 large salivary glands, known as the Parotid
glands. These glands empty through tiny holes called
Stenson’s ducts.
Failure of the Parotid glands to produce saliva leads to
xerostomia, an abnormal dryness of the mouth.
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Teeth
There are 4 kinds
of teeth:
1.
2.
3.
4.
Incisors
Canines
Premolars
Molars
Used with permission from the American Dental Association
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Teeth, continued
The 4 front teeth are the central
and lateral incisors. Next to the
incisors are the cuspids.
Next to the cuspids are the
8 premolars, or bicuspids.
The final 12 teeth are the molars.
The molars have pits and fissures
that can harbor cariogenic bacteria
and are a common site of dental
caries.
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Used with permission from the American Dental Association
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Sides of the Tooth
These terms describe the sides of the tooth:
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Buccal/labial/facial – Side that faces outward, toward the cheeks
or lips
Lingual/palatal – Inside surface facing the tongue or the palate
Mesial - Sides of the teeth that face the front of the mouth
Distal - Surfaces of the teeth that face the back of the mouth
Occlusal - Surface of the back teeth where biting and chewing
takes place
Incisal - Biting surface of the front teeth
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Anatomy of a Tooth
The tooth consists of a crown and a
root.
The crown is visible above the gums.
The root is covered with cementum,
which anchors it to the periodontal
membrane.
17
Used with permission from Miller Medical Illustration & Design
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Anatomy of a Tooth, continued
The hard, outer surface of the crown is the enamel.
The enamel is mostly composed of hydroxyapatite.
Binding of fluoride to the hydroxyapatite leads to the
formation of fluoroapatite, which makes the enamel
harder and more resistant to decay.
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Anatomy of a Tooth, continued
The enamel protects the dentin, a
hard, thick substance containing
thousands of tubules that surround
the nerve.
These tubules contain tiny
projections of the nerve and are
sensitive to exposure to air, acid, and
touch.
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The pulp is the soft core of the
tooth that contains blood vessels,
connective tissue, and the
nerve itself.
Used with permission from the American Dental Association
Question #1
The most common indication to perform a
frenectomy (ankyloglossia release) is:
A. Prematurity
B. Inability to handle introduction of solid foods
C. Interference with breastfeeding
D. Dysarticulation/speech impediment
E. Development of cavities
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Answer
The most common indication to perform a
frenectomy (ankyloglossia release) is:
A. Prematurity
B. Inability to handle introduction of solid foods
C. Interference with breastfeeding
D. Dysarticulation/speech impediment
E. Development of cavities
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Question #2
Which teeth are the most common site for caries?
A. Pre-molars
B. Incisors
C. Molars
D. Canines
E. None of the above
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Answer
Which teeth are the most common site for caries?
A. Pre-molars
B. Incisors
C. Molars
D. Canines
E. None of the above
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Question #3
The hard, thick substance of the tooth that surrounds
the nerve is known as the:
A. Enamel
B. Dentin
C. Hydroxyapatite
D. Cementum
E. Pulp
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Answer
The hard, thick substance of the tooth that surrounds
the
nerve is known as the:
A. Enamel
B. Dentin
C. Hydroxyapatite
D. Cementum
E. Pulp
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Question #4
Which term describes the sides of the teeth that
face the front of the mouth?
A. Mesial
B. Distal
C. Buccal
D. Occlusal
E. Incisal
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Answer
Which term describes the sides of the teeth that
face the front of the mouth?
A. Mesial
B. Distal
C. Buccal
D. Occlusal
E. Incisal
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Question #5
Which type of papillae is responsible for the sense
of taste?
A. Fungiform
B. Conventrial
C. Circumvallate
D. Foliate
E. Flavial
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Answer
Which type of papillae is responsible for the
sense of taste?
A. Fungiform
B. Conventrial
C. Circumvallate
D. Foliate
E. Flavial
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References
1. Anatomy of orofacial structures. 7th edition. RW Brand
and DE Isselhard eds. St Louis. Mosby. 2003.
2. Netter's head and neck anatomy for dentistry. NS
Norton. Philadelphia. Saunders Elsevier. 2007.
3. Wheeler's dental anatomy, physiology and occlusion, 8th
Edition. MM Ash and SJ Nelson eds. Philadelphia. Saunders.
2003.
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