Protecting All Childrens Teeth

Basic Oral
Anatomy

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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:

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:

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.

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

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.
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.
The ventral surface (underside)
Used with permission from shutterstock.com
is
smooth. The dorsal surface (top)
The dorsal surface includes the fungiform, foliate, and circumvallate
is
papillae, which are associated with the sense of taste.
most visible on examination.
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Floor of the Mouth

Permission from Rocio B. Quinonez, DMD, MS, MPH; Clinical
Assistant Professor Department of Pediatric Dentistry, School of
Dentistry University of North Carolina

Beneath the tongue is the floor

of
the mouth.
The frenulum connects the floor
of the mouth to the tongue.
In some infants, the frenulum is thick and severely limits the
movement of the tongue. This disorder 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 Whartons ducts.
There are 2 large salivary glands, known as the Parotid glands.
These glands empty through tiny holes called Stensons 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
commonly the site of dental caries.
Used with permission from the American Dental

Association
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Sides of the Tooth

These terms describe the sides of the tooth:
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.

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.
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
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ct

Question #1
Which of the following can lead to xerostomia?
A. Antihistamines.
B. Medical conditions such as lupus or sarcoidosis.
C. Crystal Meth.
D. All of the above.
E. None of the above.

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Answer
Which of the following can lead to xerostomia?
A. Antihistamines.
B. Medical conditions such as lupus or sarcoidosis.
C. Crystal Meth.
D. All of the above.
E. None of the above.

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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
How many types of teeth are there?
A. 2.
B. 3.
C. 4.
D. 5.
E. 6.

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Answer
How many types of teeth are there?
A. 2.
B. 3.
C. 4.
D. 5.
E. 6.

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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. Saunder
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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