5In the next group of slides these normal oral structures are presented.
6Primary dentition, baby teeth, with normal spaces between the teeth Healthy oral structures visible in this slide:Primary dentition, baby teeth, with normal spaces between the teethHealthy mucous membrane or the soft tissue inside the lips and cheeksAttached gingiva or gum tissueMucosaGingiva
7The labial frenum is fibrous tissue between the the lip and the mucous membrane above the gum tissue.
10The "ugly duckling" stage is often mistaken by parents as an orthodontic problem because there is a space between the top central incisors. This may be the norm between ages 7 through 12 years of age, and usually is not connected with a permanent space between the teeth. In this stage baby teeth are being lost and permanent teeth have not completely erupted.
11A panoramic x-ray of a 7 year-old child A panoramic x-ray of a 7 year-old child. One can notice the complex mix of the permanent and the primary teeth at this stage.
14(the underside of the tongue) The ventral surface of the tongue is the underside of the tongue, or that part you see when you lift your tongue up.The lingual frenum is the fold of tissue between the undersurface of the tongue and the floor of the mouth.Lingual frenum
16(Gums)Healthy gingiva, gum tissue, is coral pink in color and has a stippled or orange peel surface texture.Healthy gingiva, gum tissue, is coral pink in color and has a stippled or orange peel surface texture.
17Pigmentation in the gum tissue is normal in African Americans.
18The front part of the hard palate is covered by irregular ridges
19The hard palate is the bony “roof” of the mouth. The soft palate partially separates the mouth from the throat
20The uvula is the fleshy lobe hanging down from the back of the soft palate.
23When the fungus, Candida Albicans, causes an infection in the mouth it is known as thrush. White patches on a red inflamed surface is the characteristic look of this infection.An infection in the mouth by the fungus, Candida Albicans, is known as thrush, and it is characterized by white patches on a red surface.
25An inflammation of the tongue Glossitis is an inflammation of the tongue. The condition assumes variations in shapes giving a map-like appearance to the tongue.
26Primary herpetic gingivostomatitis is the initial outbreak of an infection with the virus, Herpes Simplex. In this picture painful sores can be observed outside (extraoral) the mouth on the lips, and inside the mouth on the gums. Note the gums are very red and swollen.This is the initial outbreak of an infection with the virus, Herpes Simplex. In this picture painful sores can be observed on the lips and gums. The gums are very red and swollen.
27In this picture with the mouth open sores can be seen inside the mouth (intraoral) on the tongue. In addition to the gums and tongue sores can occur inside the mouth on the throat, floor of the mouth and lining of the cheeks. The sores seen on the tip of the tongue are blisters that rupture or break open, loose their covering and become ulcers.Sores can also be inside the mouth on the tongue, floor of the mouth, throat and cheeks.
28Feeling run down and tired (Symptoms)Feeling run down and tiredEnlarged lymph nodes in the neckSymptoms of primary herpetic gingivostomatitis are listed in the slide. Here are the meanings of some of the terms:Malaise - an indefinite feeling of debility or lack of health often indicative of or accompanying the onset of an illnessCervical lymphadenopathy - abnormal enlargement of the lymph nodes in the neckVesicle - a small abnormal elevation of the outer layer of skin enclosing a watery liquidUlcer - a break in skin or mucous membrane with loss of surface tissue
29Take medication for fever and pain Soothing mouthrinseThis is a listing of things that can be done for someone who has the condition and precautions about dehydration, contagion, and use of antibiotics or steroids.
30Minor (most common) Major Herpetiform Generally located on the lining of the lips, cheeks, soft palate and floor of the mouthTend to be small and shallow ulcerationMajorLarger and deeper ulcerationHerpetiformMore numerous and look like blistersMinor aphthae are generally located on the lining of the lips and cheeks, the soft palate and the floor of the mouth. They can be singular or multiple, and tend to be small (less than 1 cm in diameter) and shallowMajor aphthae are larger and involve deeper ulceration.Herpetiform aphthae frequently are more numerous and look like blisters.
32Treat to relieve symptoms Healing Cause is unknownTreat to relieve symptomsHealingMinor – 7 to 10 days, without scarringMajor – 2 to 4 weeks, may scarThe etiology or cause of aphthous ulcers is unknown.Palliative treatments reduce symptoms and give some relief but do not cure. Over-the-counter benzocaine preparations (e.g., Anbesol and Oragel) are examples of palliative treatments.
33Discolorations inside the tooth Fluorosis – enamel color change and irregularitiesTetracycline – dark bandsDiscolorations on the tooth surfaceIron stain - accumulation of Iron from supplementsIntrinsic stains are inside the tooth structure and cannot be removed by cleaning. Ingestion of certain susbstances during the development of the teeth can cause intrinsic stains.Fluorosis is a disruption of enamel formation caused by ingestion of more than the optimal amount of fluoride during childhood when the tooth enamel is forming. This can only happen when the enamel is forming. Once it is formed dental fluorosis cannot develop even if excessive fluoride is ingested.Tetracycline stain is caused by ingestion of tetracycline while the teeth are forming. The tetracycline is taken up into the inner layer of the tooth, dentin, resulting in the appearance of dark bands.Extrinsic stains are on the outiside of the tooth and come from the accumulation of some substances on the tooth surface like coffee or tea. These stains can be removed by professional cleaning.iron stains from iron drop supplements taken by children can accumulate on the teeth
34White flecking of the enamel in mild fluorosis Mild fluorosis is not considered to be a clinical nor public health problem. The white flecking in the teeth is not a cosmetic problem and the teeth benefit from fluoride in the enamel structure and a reduced risk of tooth decay.White flecking of the enamel in mild fluorosis
35(Moderate)Moderate and severe forms of fluorosis have cosmetically objectionable changes in tooth color and surface irregularities.Moderate and severe forms of fluorosis have changes in the enamel surface and color that are easier to see.
36Tetracycline taken up into the inner layer of the tooth, dentin, results in the appearance of dark bands.
37The bands appear darker in moderate tetracycline staining.
38In the severe form the bands are darker than in the moderate form and cover more of the tooth.
42Fluid trapped beneath a thin layer of mucous membrane A mucous cyst is a painless, bluish, transparent structure consisting of clear fluid trapped beneath a thin layer of mucous membrane. These cysts are thought to be caused by a sucking action drawing the mucous membranes between the teeth.A mucous cyst often can be left alone; it usually will rupture spontaneously. It may need to be removed or excised if it comes back.Fluid trapped beneath a thin layer of mucous membrane
43The same as a mucocele but located on the floor of the mouth A ranula is the same as a mucocele but is located on the floor of the mouth.The same as a mucocele but located on the floor of the mouth
45The lingual frenum is too short resulting in a tongue-tied condition In ankyloglossia the lingual frenum is too short resulting in a tongue-tied condition.The lingual frenum is too short resulting in a tongue-tied condition
52Hemangioma is a usually benign tumor made up of blood vessels that typically occurs as a purplish or reddish slightly elevated area.
53These are the approximate eruption times of the primary and permanent teeth. All 20 of the primary teeth have usually erupted by 29 months or 2 years and 5 months. The permanent teeth begin to erupt at approximately 6 years of age. The first permanent teeth in the mouth are the “six” year molars and the central and lateral incisors. Eruption of the permanent dentition is usually complete by the 21st year.
68Caries (tooth decay or cavities) is a disease that involves many factors and the disease process is started by bacteria (primarily Streptococcus Mutans). When food is eaten, bacteria break down carbohydrates (sugar is a carbohydrate), producing acids that cause minerals to be lost from the teeth. This mineral loss results in cavities when the teeth are exposed to this acid for long periods of time and it overcomes the individual’s resistance and ability to heal.The slide demonstrates the required factors that cause tooth decay (dental caries): a tooth, substrate (particularly sugar) and flora (bacteria or germs). All three must be present for tooth decay to occur. The terms listed under each element and written in black can increase or decrease the risk of developing tooth decay.
69Caries (tooth decay or cavities) a disease that involves many factorsthe disease process is started by bacteria (Streptococcus Mutans).bacteria break down carbohydrates (sugar is a carbohydrate)acids are produced that cause minerals to be lost from the teethmineral loss results in cavitiesThree things must be present for tooth decay to occur:a toothbacteria (flora)sugar (substrate)
70The germs that cause tooth decay are transmitted from the mouth of the primary caregiver who is usually the mother to the baby.The germs that cause tooth decay are transmitted from the mouth of the mother to the baby.
72Early Childhood Caries Early childhood caries (ECC) is an infectious disease that can start as soon as an infant’s teeth erupt. In a child age 71 months (less than 6 years old) or younger, the presence of one or more decayed teeth, missing teeth (lost because of decay), or filled tooth surfaces in any primary tooth is know as ECC. This condition used to be called “baby bottle tooth decay” but this name is misleading because tooth decay has many factors and poor feeding and eating habits alone do not cause tooth decay. ECC is a term that better reflects the many factors involved in the disease process.One or more decayed, missing, or filled primary teeth in a child less than 6 years old is ECC.
73Early Childhood Caries Notice the cavities (holes in the tooth surface) between the front teeth and on the facial surfaces.
74Early Childhood Caries Most of the enamel is gone on the top four front teeth.
75Early Childhood Caries AbscessThree of the four front teeth and the primary first molars on the bottom have decayed down to the gum tissue. Only the roots of these teeth remain. The abscess above the upper front teeth means the infection has spread to pulp tissue inside the tooth.An abscess means the infection has spread to the inside of a tooth.
76Decay in the crevices on the chewing surfaces of back teeth
78Cellulitis is a diffuse inflammatory process within solid tissues, characterized by edema, redness, pain and interference with function.It may be caused by infection with streptococci, staphylococci, or other organisms.Cellulitis usually occurs in the loose tissues beneath the skin, but may also occur in tissues beneath mucous membranes.
80Fluoride reduces the risk of developing tooth decay. Fluoride that is eaten or ingested from food or water is also called systemic fluoride. Systemic fluoride is important for the formation of caries-resistant enamel when the teeth are developing. If the optimal level of fluoride for the reduction of tooth decay is not present in the water supply, then supplements may be necessary.
81A dentist or physician must prescribe fluoride supplements. A dentist or physician must prescribe fluoride supplements. Fluoride supplementation should only be used if the water supply has a less than an optimal level of fluoride.A dentist or physician must prescribe fluoride supplements.
82Topical fluoride is applied to the surface of the tooth and is recommended to be used in addition to systemic fluoride.
83Children under six may not know how to rinse and spit out adequately Children under six may not know how to rinse and spit out adequately. Instead of spitting it out they swallow it and this can lead to ingesting too much fluoride. Ingesting too much fluoride can lead to dental fluorosis.
84Supervise small children when brushing their teeth with fluoridated toothpastes to make sure they are not swallowing the toothpaste. Consuming too much fluoride when the teeth are forming can result in dental fluorosis.
98Teeth are jammed into the gum A tooth that has been jammed into the gum (intruded) may look like it has been knocked out. An X-ray may be needed to tell the difference between an intruded and a knocked-out tooth.Teeth are jammed into the gum
99Teeth that are pushed out of the gum tissue and bone
107Wear a mouthguard or mouth protector when playing sports to protect the teeth, lips, tongue, face and jaw.Wear a mouth guard or mouth protector when playing sports to protect the teeth, lips, tongue, face and jaw.
108Most injuries that occur with children can be prevented by taking precautions such as using child safety seats.
109Information in this program was adapted from a series on oral health for healthcare professionals by the American Academy of Pediatric Dentistry, and Proctor and Gamble Oral Health Products. The information has been revised to be useful to general audiences.Information in this program was adapted from a series on oral health for healthcare professionals by the American Academy of Pediatric Dentistry and Proctor and Gamble Oral Health Products. The information has been revised to be useful to general audiences.