At Contemporary Dentistry, we believe in minimally invasive dentistry. That’s dentistry that acknowledges that our teeth have the ability to last forever, if we take proper care of them. Whenever possible, we avoid altering your teeth, because any time we place a restoration, we may be trying to repair but we are to some extent causing damage, because none of the restorations we place have the abilities that your natural teeth have.
Here’s how our teeth can manage to last forever.
We know it doesn’t seem like it, but your teeth are actually slightly flexible. It’s one of several cushioning mechanisms built into your tooth system that helps cushion your teeth against the repeated, damaging stresses of chewing.
Your teeth are build in several layers. The outer layer, the enamel, is very hard and brittle. But underneath that layer is the dentin, which is a little softer, more capable of flexing, though it’s still pretty hard. Underneath that is the tooth pulp, which is actually very soft tissue.
These multiple layers allow the teeth to compress and reshape under stress. The inner layers of the teeth can bend when this happens, but there’s a problem: the outer layer is so hard and brittle that it can’t bend, so it breaks. But that’s okay, it’s what it’s designed to do.
Yeah, that’s right, your teeth are designed to break. But it’s a very special kind of break. Your teeth can’t help breaking: tooth enamel is often compared to glass, because it’s also very hard and very brittle, but through a number of structural tricks, your teeth can control these breaks. That’s because of the way it’s structured.
Think of your tooth enamel as being made of a lot of thin rods of glass all standing together like blades of grass. When force comes from outside the tooth, these blades are pointing directly at the force, which is their strongest orientation.
But down at the base of these rods is a tangle not of parallel rods, but intertwined rods, like the roots of the grass. When force comes from within the tooth, from the dentin pushing back or flexing, these rods don’t present their strongest side to the force, they present the weak space between the rods. This allows cracks to form, but it only goes so far. Think about how easy it is to move your hand through the blades of grass, but how hard it is to move it through the roots.
You might have been told that our body can’t regrow enamel, and that’s partly true. Once you’ve formed your full set of teeth, your body doesn’t grow new enamel. And because tooth enamel is almost 100% mineral, there are no living cells in it to heal or repair tooth enamel once it gets decayed or broken.
But our body does have some mechanisms for healing our teeth. Inside the tooth, the pulp contains cells that can actually heal dentin and build new dentin. But the enamel is a little more difficult to repair. As our teeth get damaged, especially by acid, they lose some vital minerals from their structure. But these minerals are also floating in our saliva, along with fluoride, which speeds the chemical reaction that restores these minerals to our teeth.
As long as you have enough minerals in your saliva and the pH is right, your body is slowly rebuilding your teeth.
They’re Cushioned in the Bone
We noted that our teeth have several shock absorbers built into the system. Another one is found in the tooth socket. Your teeth aren’t directly attached to the bone. Instead, they’re attached to the periodontal ligament, a tough but stretchy membrane.
This membrane allows a small amount of flex in your teeth. That’s why even healthy teeth have just a tiny amount of give to them. This give allows your dental floss to slip in between your teeth, and it also helps your teeth respond to what would otherwise be damaging pressure.
The Bone Repairs
Your body is constantly reworking your bones. That’s what allows orthodontics to work: by putting constant pressure on your teeth, it can stimulate the growth and removal of bone around the tooth.
This process is constantly going on, so that under normal conditions your body maintains the bone around your teeth.
So Why Do Teeth Fail?
With all these miraculous protections, why do our teeth fail? Our teeth fail because we overwhelm these natural mechanisms. We damage our teeth so fast and so persistently that the body can’t respond. For example, our teeth require a neutral or slightly basic environment to heal, but we constantly bathe our teeth in acid. This includes acidic foods and drinks as well as the attacks that pathological bacteria in our mouth perform.
In a similar way, teeth can crack if they’re subjected to too much pressure. This can happen all at once, and you’ll end up with a cracked tooth. Or it can happen gradually, due to lots of teeth clenching or chewing hard materials. When this occurs, the teeth might not actually crack open. Instead, the enamel might crack more subtly and flake off at the neck of the tooth.
But these tooth failures don’t have to occur. By managing your diet, you can reduce the rate at which acid attacks your teeth to a pace that your saliva can naturally reverse. And by managing your bite, you can avoid most of the damaging stresses that crack your teeth. If you also take advantage of preventive dentistry and you’re lucky, you can completely avoid reconstructive dentistry in your life.