Nothing is as good as a Healthy Natural Tooth

A natural tooth is an engineering marvel.  It is impossible to  construct any filling or crown that comes even close to a tooth’s performance in the mouth. 

Following on from this statement, we obviously, should do everything to protect our teeth, they are designed and capable of lasting a lifetime.  With a reasonable diet and reasonable brushing we should never suffer decay.

Any time a dentist has to place a filling in a tooth that represents a failure of the dental profession.

The primary aim of the dental team should be to protect the natural dentition.

Link to The Natural Tooth

A Tooth is made up of three different layers. 

      The outer layer is ENAMEL, this is the hardest substance within the human body

      Under the Enamel lies DENTINE, this is a softer more organic material that is flexible

     The inner part of the tooth is the pulp or nerve, this is mainly made up of blood vessels with nerve fibres that extend out into the dentine. Enamel doesn’t contain any nerve fibres

The tooth floats within the bone anchored by periodontal ligaments.  The periodontal are rich in blood vessels and nerve fibres They provide a cushioning effect, acting like shock absorbers to protect the teeth.  The nerves within the ligaments provide information on the pressure and temperature around the tooth.  And so even as enamel is the hardest substance in our body with no nerves, our teeth can still register the finest of pressures and detect thicknesses as fine as  1/4  the width of a human hair between.

The enamel is made up of interlocking prisms, that look a little like the columns at the Giants Causeway.  These enamel prisms make up the intricate shape of the crown visible in the mouth, The shape and thickness of the crown provides great strength and allows us to effectively chew food.

The real genius is in the interlocking nature of the enamel prisms, if a lot of force is placed one part of the tooth, the prisms distribute the force across a wider area and then channels it along the long axis of the tooth and into the flexible dentine.  This action decreases and dissipates the force, protecting the tooth.

Enamel by itself is incredible hard but very brittle a bit like the porcelain of a cup. Again we come across engineering genius in how the hard enamel is bonded to the softer underlying dentine,  This creates the very hard but flexible unit that is a natural tooth.  If I could create a glue or an industrial bonding process to replicate this bond I could retrieve from dentistry and quickly join the global super rich!!!

As I stated the periodontal ligament acts like a shock absorber but the tooth has one other protective trick up its sleeve.  We know that nerve fibres extend into the, if we suddenly bite too hard and the tooth is possibly going to fracture the dentine over-flexes, stretching the nerve fibres. This causes an immediate, reflex reaction cutting all power to the muscles to protect the tooth from fracture.

Even a small filling decreases the strength of the enamel crown, if a tooth is root filled we loose the reflex reaction protecting the tooth and when a tooth is crowned all the forces that would pass into the long axis of the tooth now travel around the surface of the crown creating shearing forces on the cement.

A lot of this information is new as a result of recent research.  We are now able to measure how pressure placed on a tooth is dealt with and how it differs when the tooth is filled, root filled and crowned.

For a time we were obsessed with making crowns from the hardest material possible and creating ever stronger cements and though it would lead to indestructible crowns.  But this wasn’t the case and now we area trying to create softer more flexible materials that mimic them tooth and work harmoniously within the mouth.

Through MRI Imaging we can now see the actions of the nerve, see how they fire and where they act in the central nervous system.  This new information is being used in research into the problem of habitual tooth grinding, but we also understand why teeth have nerves, the protective action of the nerve and why a root filled tooth is so compromised in the mouth.

All this new knowledge informs us on the type of restorations we should use to try to decrease how much we weaken and compromise a tooth when we restore it.

But it backs up our core fact that  “NOTHING IS AS GOOD AS A NATURAL TOOTH”

And from that our second fact “PREVENTATIVE DENTISTRY IS THE BEST AND MOST COST EFFECTIVE FORM OF DENTISTRY”