Tooth Anatomy

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Becky Larson, RDH

Tooth Anatomy

Sometimes when I am talking to my patients I can tell they are a bit confused!  I never want my patients to be confused.  Communication is so important when trying to give important information about oral health.  This blog is just a quick overview of the anatomy of the tooth.  Knowing a few simple terms can eliminate confusion and patient’s can better understand why their dentist and hygienist are giving specific recommendations for home care and dental treatment.

Tooth Anatomy

This diagram breaks the tooth into two parts: the crown and the root.  The root surface of the tooth is the part that is covered by gum tissue in a healthy mouth.   The crown of the tooth is that part we actually see.  Sometimes the root of the tooth is exposed due to gum recession and can be sensitive to cold or vibration.  The gums or gingival cover the jaw bone in which the teeth sit.

Teeth are composed of several layers.  The outer most layer is the enamel, which is generally white in color.  Though it is the hardest substance in the human body, it can still decay and erode if not taken care of.  Just under the enamel is the dentin which is much softer and more yellow in color.  When viewing radiographs, if the dentist sees a cavity that has progressed through the entire enamel layer and into the dentin, a filling is necessary.

Radiograph (xray) showing a cavity that has progressed through the enamel into the dentin:

Decay

Under the dentin layer is the pulp.  There are also nerves and blood vessels in the pulp chamber that extend down the roots of the tooth.  If a cavity has progressed into the pulp chamber, it’s likely that a root canal is necessary.  During the process of a root canal, the nerves and pulp inside the canals are taken out.  The inside of the tooth is cleaned and sealed to prevent further pathology.

Radiograph showing tooth roots after a root canal:

Root Canal

Understanding tooth anatomy can help patients better understand their dental needs!  Always consult your dentist or dental hygienist if you have concerns or questions about your teeth or oral health.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

https://www.humana.com/learning-center/health-and-wellbeing/healthy-living/tooth-enamel

http://www.webmd.com/oral-health/guide/dental-root-canals

What is a Dental Porcelain Veneer?

LindsayW

Lindsay Olsen, RDH

What is a Dental Porcelain Veneer?

Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made, shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance.  These shells are bonded to the front of the teeth changing their color, shape, size, or length.

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In 2011, following the removal of my braces, Dr. Jason Nelson placed two all porcelain veneers on my front upper teeth. Below are pictures of my own teeth.

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Please contact your dental office for more information regarding dental veneers!

http://www.alamedadentalaz.com/

http://www.northstapleydentalcare.com/

http://www.shalimarfamilydentistry.com/

http://www.dentistingilbert.com/

Images:

https://www.google.com/search?q=what+is+a+dental+veneer&biw=1600&bih=731&source=lnms&tbm=isch&sa=X&sqi=2&ved=0CAYQ_AUoAWoVChMIpu_Mq-y4yAIVF-1jCh2gjgyj#imgrc=-Dp20x_5-7xrrM%3A

https://www.google.com/search?q=what+is+a+dental+veneer&biw=1600&bih=731&source=lnms&tbm=isch&sa=X&ved=0CAcQ_AUoAWoVChMI0sXxp-24yAIVQ8hjCh2sSgh6#tbm=isch&q=what+is+a+dental+porcelain+veneer&imgrc=WoNzbSiOtXK1EM%3A

https://www.google.com/search?q=what+is+a+dental+veneer&biw=1600&bih=731&source=lnms&tbm=isch&sa=X&ved=0CAcQ_AUoAWoVChMI0sXxp-24yAIVQ8hjCh2sSgh6#tbm=isch&q=what+is+a+dental+porcelain+veneer&imgrc=hACaPJFsiKsG-M%3A

A little dental humor to keep you smiling

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Lora Cook, RDH

A little dental humor to keep you smiling…

Flossing

Flossing More

AirFloss

You can always air floss!

Loose Canine

For more fun, Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.sugarfixdental.com/

http://www.viralnova.com/funny-dog-faces/

http://www.buzzfeed.com/ailbhemalone/things-youll-only-know-if-your-parents-were-dentists?sub=2681816_1827186

http://themetapicture.com/must-visit-the-dentist/

Dry Socket: The Absolute Worst

AriannaM

Arianna Ritchey, RDH

DRY SOCKET: The Absolute Worst.

Last July we featured an awesome article by Becky that was all about wisdom teeth.  If you haven’t read it yet, here’s the link!  Becky touched on one of the complications following a wisdom tooth extraction, called a “dry socket.”  The technical term for a dry socket is Alveolar Osteitis, which directly translated means ‘inflammation of alveolar bone (of the jaw).’  

A dry socket is a complication which occurs after about 25% of wisdom tooth extractions, and is more common in the lower jaw than the upper jaw.  The incidence of a dry socket resulting from the extraction of any other teeth is considerably lower; only two to three percent.  The symptoms of dry socket include a bad taste in the mouth, a dry-looking socket with white-ish bone at the bottom instead of a dark red blood clot, and pain that progressively becomes more severe and can sometimes radiate to other parts of the head and neck.  Symptoms typically occur about two to three days after the extraction and are often uncontrollable with over-the-counter pain medication. If you have ever experienced a dry socket, then you already know that the pain is excrutiating.  So, what exactly is a dry socket?  Why does it happen, how can it be prevented, and most importantly, how can it be treated?

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When a tooth is pulled, what’s left behind is an empty socket site in the bone where the roots of the tooth used to be.  Following the extraction, a blot clot forms in the socket site and protects the underlying bone and nerves from exposure to the mouth.  Over time, the socket site heals and is filled in with new bone.  If this blood clot is lost prematurely, however, the underlying bone and nerves are exposed to the environment of the mouth, which is crawling with bacteria.  This exposure can lead to infection and the dreaded dry socket.  Dry socket is more prevalent in the lower jaw than the upper jaw, because the lower jaw has a poorer blood supply than the upper jaw, and food debris is more likely to become trapped in socket sites due to gravity.  

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Following an extraction, dental professionals provide post-operative instructions in the interest of preventing a dry socket.  They will advise to avoid any foods with small seeds or nuts which could get trapped in the socket site, avoid strenuous activity following surgery to prevent additional bleeding, and to avoid vigorous rinsing that could potentially dislodge the blood clot.  Instruction will be given to avoid spitting or drinking through a straw for at least two or three days.  Spitting and using a straw creates negative pressure in the mouth which could dislodge a clot.  Your dental professional will likely also tell you to avoid the use of tobacco at all costs, especially cigarette smoking.  Smoking also creates negative pressure in the mouth which could dislodge a clot, and the nicotine in the cigarette slows healing and constricts blood flow necessary for proper healing.

Besides providing helpful instructions for how a dry socket can be prevented at home, your dental health professional can also help to prevent dry socket from occurring by placing a small suture in the extraction site if necessary, and by rinsing with an antimicrobial chlorhexidine rinse immediately after the extraction.  Rinsing with chlorhexidine solution after extractions has been shown to prevent about 40% of potential dry sockets.  

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Despite dry socket being very painful, the treatment is fairly simple.  If you think you may be experiencing dry socket, call your dental provider right away.  Once they determine a dry socket is present, your dental professional will clean the socket site and apply a medicated dressing.  Your dental professional may administer a local anesthetic to the area to provide pain relief and to facilitate cleaning and medicating the site without causing further discomfort.  The medicated dressing often includes eugenol, an ingredient which is very soothing for dry socket.  Your dentist may provide a prescription for antibiotics or pain medication to assist with recovery from the dry socket.  If a dry socket is left untreated, it may resolve on its own, but the pain is likely to last for about a week.

Dry socket is a very painful complication that should be avoided with every effort.  If preventive efforts are made, and post-op instructions are adhered to, there’s a good chance you won’t experience a dry socket.  If your extraction site does start to hurt after about two or three days and over-the-counter medication isn’t controlling the pain, you may have a dry socket and should see your dentist as soon as possible!  Dry socket is easily treatable by dental professionals.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.webmd.com/oral-health/guide/dry-socket-symptoms-and-treatment

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006968.pub2/abstract;jsessionid=F0834E6C40502280912EBEE765DF99AD.f03t01?userIsAuthenticated=false&deniedAccessCustomisedMessage=

http://askthedentist.com/how-to-heal-a-dry-socket/

https://en.wikipedia.org/wiki/Alveolar_osteitis#cite_ref-Daly_2012_4-6

http://www.hayeshandpiece.com/disposable-12-cc-curved-utility-syringe-compare-to-monoject-50-box/w1/i1005997/

http://abdentalsupply.com/store/images/T/xtlchlorh.jpg

http://www.ua-dent.com/wp-content/uploads/2014/11/Alveogyl.jpg

http://images.teamsugar.com/files/upl1/1/12981/17_2008/teeth.jpg

What is an ABSCESS all about anyway?

AnnC

Ann Clark RDH

abcess

Tooth Sensitivity

KatieM

Katie Moynihan RDH

Tooth Sensitivity

Sensitive teeth is one of the most common concerns among dental patients. Tooth sensitivity occurs due to enamel loss or gum recession which exposes the underlying dentin structure of the tooth. The dentin layer of your tooth is found underneath the enamel and contains several tiny tubes which run from the nerve to the outside of the tooth. When exposed, these tubes are highly sensitive to temperature changes, sweets, or mechanical forces. Not to mention very painful!

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Tooth sensitivity can be caused by several factors. Aggressive brushing can wear away your enamel at the gumline leading to gum recession and exposed tooth root. Another cause of sensitivity can be from continuous grinding of the teeth to the point that the enamel is completely worn down to the dentin layer. Cracked teeth or worn fillings can create passageways to the nerve of the tooth. Periodontal disease, or severe gum disease, can contribute to sensitivity because the gums around the teeth break down and lead to gum loss and bone loss.

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There are several ways to help reduce tooth sensitivity either at home or at the dental office. The type of treatment will depend of what is causing the sensitivity.

At home treatments include:

  • using a soft or extra-soft toothbrush while brushing gently in order to avoid toothbrush abrasion at the gumline (take a good look at your toothbrush…if the bristles are pointing in multiple directions, you’re brushing too hard!)
  • using a toothpaste that contains potassium nitrate, which penetrates the exposed dentin and soothes the nerve endings
  • using a fluoride toothpaste to help strengthen the tooth and exposed dentin
  • using MI Paste (available at your dental office) to block dentin tubule openings
  • limit acidic foods and drinks because they can remove small amounts of enamel over time

In office treatments include:

  • application of a fluoride varnish – helps seal the tubules and rebuild exposed dentin
  • application of a fluoride foam – provides a high dose of fluoride to help strengthen teeth
  • bonding agents can be placed at the gumline if necessary to seal exposed dentin and reduce sensitivity
  • restorative treatment if needed to correct the tooth that is causing the sensitivity
  • periodontal treatment if needed to keep gums healthy around the teeth

A mix of potassium nitrate and fluoride is your best solution for desensitization. Some products which include these active ingredients include Sensodyne, Pronamel, Colgate Sensitive Pro Relief, and Colgate Prevident 5000 Sensitive. These products must be used on a regular basis for at least 30 days before any therapeutic benefit will take place. Whitening and tartar control toothpastes contain abrasive ingredients that can damage tooth enamel and may be too harsh for those with sensitive teeth. The application of a fluoride varnish is always available in-office at your request. If you suffer from tooth sensitivity, feel free to ask us which desensitizing agents will work best for you!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.ada.org/~/media/ADA/Publications/Files/patient_33.ashx

https://us.sensodyne.com/faq.aspx

http://www.colgate.com/en/us/oc/oral-health/conditions/tooth-sensitivity/article/treatment-options-for-tooth-sensitivity

http://www.mouthhealthy.org/en/az-topics/s/sensitive-teeth

What’s the Deal with Wisdom Teeth?

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Becky Larson, RDH

What’s the Deal with Wisdom Teeth?

Everyone has them, but not everybody knows what to do with them.  “Wisdom teeth” or 3rd molars can cause a number of problems in the mouth.

Wisdom teeth are believed to be evolutionary and were helpful to our distant ancestors who frequently ate rougher foods.  Wisdom teeth would erupt as replacements for worn out or missing teeth.  Nowadays modern advancements, better hygiene, and softer diets allow us to keep most of our teeth so we really don’t need wisdom teeth at all! For most people, wisdom teeth erupt in the late teen years or early 20’s, usually earlier for females.  They are the most posterior (towards the back) teeth.  Most people have 4 wisdom teeth total, but sometimes they can be congenitally missing.  Other times people may have extra (supernumerary) wisdom teeth.

Even if there is sufficient space in the mouth and the wisdom teeth are in alignment with the other teeth, they can still cause problems.  Because of their location, wisdom teeth are extremely hard to brush and floss.  If they are not kept clean, they can cause periodontal pocketing, which can lead to tooth loss in other areas of the mouth.  Unfortunately, most people don’t have enough space and when wisdom teeth erupt, they can push on the surrounding teeth.  This can cause crowding and misalignment throughout the entire mouth.  Wisdom teeth can also be impacted – meaning they are enclosed in the gum tissue or jawbone.  When this happens they can partially erupt or even try to erupt horizontally.  When teeth are only partially erupted, it allows bacteria to enter the tooth.  This can lead to infection, pain, swelling, jaw soreness, cysts, and other systemic illnesses.

X-ray showing impacted wisdom teeth:

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A dentist will usually take a panoramic x-ray to view the wisdom teeth to determine when/if they need to be extracted.  If extractions are indicated, getting them out at a younger age is preferable for recovery time.  If wisdom teeth are fully erupted and not impacted in the gums or bone, they can be extracted as easily as a regular tooth.  If they are impacted, the gums and/or bone need to be cut open in order to extract.  Wisdom teeth can be extracted with local anesthetic only, though other pain/anxiety management techniques can be used.  These include nitrous oxide, conscious sedation, and/or anti-anxiety pre-medication.

Recovering time is usually about 2 weeks.  During the recover a person may experience bleeding and facial swelling.  Pain medications and antibiotics are often prescribed as well.  Possible complications of wisdom teeth extractions include dry socket and parasthesia.  Dry socket occurs when a blood clot fails to form or falls out and is extremely painful.  A person should not drink from a straw for several days after the extractions to avoid dry socket.  During wisdom teeth extractions the nerves can sometimes become damaged or bruised.  This results in prolonged numbness or parasthesia, which can last weeks or months and can sometimes be permanent.  Parasthesia is more rare and generally the numbing sensation wears off after several hours.  Dry socket and/or parasthesia don’t always occur after wisdom teeth are extracted.

So you can see that wisdom teeth can cause many headaches (literally)!  Be wise and get your wisdom teeth extracted as soon as your dentist recommends it.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.webmd.com/oral-health/wisdom-teeth

http://crest.com/en-us/oral-care-topics/general-oral-hygiene/never-ignore-your-wisdom-teeth-symptoms

picture from: http://www.quora.com/Do-all-humans-have-wisdom-teeth

What is Xylitol?

LindsayW

Lindsay Whitlock, RDH

“Xylitol is a natural sweetener derived from the fibrous parts of plants.”

What Are The Dental Benefits of Xylitol?

Splenda (Sucralose) is a commonly used artificial sweetener that one would use to sweeten their iced tea. Once you drink your sweet tea, your teeth are splashed with the sugary beverage, and the Splenda begins to break down in your mouth. Bacteria already thriving in your mouth are immediately drawn to the sugars on your teeth. During this process, the bacteria, for lack of better words, “poop” out acid onto your teeth, and begin the cavity process.

Xylitol does not break down in the mouth like typical sugars (Splenda). Because acid-producing bacteria cannot digest Xylitol, the growth of bacteria is greatly reduced in your mouth, up to 90%. After taking xylitol, the bacteria are unable to stick to the surfaces of your teeth, and thus results in decreased plaque.

Your saliva in your mouth is naturally trying to keep your mouth at a neutral pH, as one is ingesting sugars. If sugar is only consumed a couple times per day, the saliva can protect your mouth and teeth on its own. But for most, sugar is so often consumed that your natural defenses (saliva) are not enough, in the battle of cavity prevention. Xylitol can also increase a neutral pH saliva flow, which could decrease your risk of cavities.

Other Benefits of Xylitol?

  • Xylitol serves as an effective sugar substitute for diabetics and non-diabetics
  • Delicious sweet taste… with no unpleasant aftertaste
  • Provides one third fewer calories than sugar
  • May be useful as a sugar alternative for people with diabetes (on the advice of their healthcare providers)
  • It’s 100% natural. Xylitol is not an artificial substance, but a normal part of everyday metabolism. Xylitol is widely distributed throughout nature in small amounts
  • It’s safe
  • It’s convenient to use
  • Xylitol can be conveniently delivered to your teeth via chewing gum, tablets, or even candy. You don’t need to change your normal routine to make room for Xylitol

How Much, and How Often Should I use Xylitol?

Strive For 5:

  1. Use Xylitol toothpaste, mouthwash, and nasal spray upon waking up
  2. After breakfast use Xylitol gum, mints, or candy
  3. After lunch use Xylitol gum, mints, or candy
  4. After dinner use Xylitol gum, mints, or candy
  5. Use Xylitol toothpaste, mouthwash, and nasal spray upon going to bed

For a complete this of Xylitol containing products, follow this link: http://xylitol.org/xylitol-products

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources: 

http://www.Xylitol.org

How to Care For Your Infant’s Teeth

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Lora Cook RDH 

How to Care For Your Infant’s Teeth

When to start cleaning your baby’s teeth

          You can start before your baby even has teeth, it is best to incorporate mouth cleaning at bath time.  This routine will help your baby get used to you cleaning their mouth, which can allow a smoother transition when you do begin to brushing their teeth. This will also help you to know when your babies teeth first start to push through their gum tissue.

The bacteria that lives in the mouth is not harmful to the gum tissue, but can be harmful to the teeth.  The enamel on baby teeth are 50% thinner than adult teeth.  Therefore baby teeth are more susceptible to the bacteria that causes cavities.

How to clean your infants teeth

          To clean your babies mouth before tooth eruption use a clean wet wash cloth.  Wrap wash cloth around your finger then rub it gently around your babies gums.

baby blog

When to transition to a tooth brush.

            When the teeth have started to erupt, this will be time to transition from a wash cloth to a baby tooth brush.  Look for a tooth brush specifically made for infants. This will usually start around six months old.  This will also be the time to change from bath time mouth cleaning to brushing two times daily.

It is fine to just dry brush with just tap water, or a fluoridated tooth paste can be used. When using toothpaste, use the tiniest smear.  It is never too early to help create a good brushing routine for your child.

Baby TB

 

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.myhealthunit.ca/en/livehealthyandprotectyourhealth/Caring-for-Your-Child-s-Teeth.asp

http://m.oralb.com/products/oral-b-stage-1-disney-baby-pooh-toothbrush

www.babycenter.com

Random Fun Dental Facts

KO6A3300-Edit[1]

Amanda Orvis, RDH

Random Fun Dental Fact

Did you know that George Washington’s famous dentures weren’t made from wood?  That is a popular dental myth. George Washington had several sets of teeth fabricated for him, but none of which were made from wood. His dentures included teeth that were crafted from different combinations of gold, ivory, lead and a mixture donkey and hippopotamus teeth.

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The first toothbrush was created in the late 18th century by a prisoner. The toothbrush had a carved bone handle with boar bristles inserted into drilled holes, the bristles were held in place by wire.

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The first nylon bristle toothbrush was created in 1938. It was called Doctor West’s Miracle Toothbrush.

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Have you ever heard of Supernumerary teeth? Hyperdontia is the true term for Supernumerary teeth. These are teeth that appear in addition to the normal number of teeth.

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The first known floss was made of silk and was invented in 1815 in New Orleans.

In the year 1210 Barber-Surgeons evolved. Their job duties included hygiene services such as shaving and tooth extractions. Can you imagine going to get a haircut/shave and then having your tooth pulled? Ouch!

In 1776 Paul Revere used the first known post-mortem dental forensics by identifying his deceased friend according to the dental bridge that he had previously fabricated for him.

1906- Irene Newman was the first trained Dental Hygienist. By the year 1936, thirty states had licensed dental hygienists.

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In 1931 Arm & Hammer dentifrice (toothpaste) was given the first ever ADA Seal (American Dental Association Seal).

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Braces have come a long way. Originally in order to straighten your teeth, it was required to band every single tooth. Today bands are occasionally used on molars to anchor the orthodontic wires to help achieve desired movement.

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources

http://www.history.com/news/ask-history/did-george-washington-have-wooden-teeth

https://www.google.com/search?q=18th+century+toothbrush&rlz=1T4GGNI_enUS478US479&source=lnms&tbm=isch&sa=X&ei=Yx-YVZDEBcXSoATVo7jIBw&ved=0CAcQ_AUoAQ&biw=1600&bih=714#tbm=isch&q=george+washingtons+teeth&imgrc=EAwFSfl5LOzB0M%3A

http://www.history.com/news/ask-history/who-invented-the-toothbrush

https://www.google.com/search?q=18th+century+toothbrush&rlz=1T4GGNI_enUS478US479&source=lnms&tbm=isch&sa=X&ei=Yx-YVZDEBcXSoATVo7jIBw&ved=0CAcQ_AUoAQ&biw=1600&bih=714#imgrc=Ofulh03HnKdMHM%3A

http://www.loc.gov/rr/scitech/mysteries/tooth.html

https://www.google.com/search?q=who+created+the+first+nylon+bristle+toothbrush&rlz=1T4GGNI_enUS478US479&biw=1600&bih=714&source=lnms&tbm=isch&sa=X&ei=7CGYVYfdH8PToAS7hpjIDw&ved=0CAcQ_AUoAg#imgrc=jjIA1ifoHV61UM%3A

http://www.ada.org/en/about-the-ada/ada-history-and-presidents-of-the-ada/ada-history-of-dentistry-timeline

http://www.adha.org/timeline

https://www.google.com/search?q=paul+revere&rlz=1T4GGNI_enUS478US479&source=lnms&tbm=isch&sa=X&ei=qieYVYySDM_joAT07aL4Aw&ved=0CAcQ_AUoAQ&biw=1600&bih=714#tbm=isch&q=irene+newman+dental+hygienist&imgrc=yOpwQE1mvSFJ7M%3A

https://www.google.com/search?q=first+orthodontics&rlz=1T4GGNI_enUS478US479&source=lnms&tbm=isch&sa=X&ei=nC-YVfrAPNLeoATHm52YAw&ved=0CAgQ_AUoAg&biw=1600&bih=714#imgrc=YCP08L500cD6ZM%3A

https://www.google.com/search?q=supernumerary+teeth&rlz=1T4GGNI_enUS478US479&source=lnms&tbm=isch&sa=X&ei=_jOYVeDKMImsogTw9I34Bw&ved=0CAcQ_AUoAQ&biw=1600&bih=714#imgrc=oblCbC97QOONTM%3A