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Chapter: Medical Physiology: Parathyroid Hormone, Calcitonin, Calcium and Phosphate Metabolism, Vitamin D, Bone, and Teeth

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Dentition

Dentition
Humans and most other mammals develop two sets of teeth during a lifetime.

Dentition

Humans and most other mammals develop two sets of teeth during a lifetime. The first teeth are called the deciduous teeth, or milk teeth, and they number 20 inhumans. They erupt between the 7th month and the 2nd year of life, and they last until the 6th to the 13th year. After each deciduous tooth is lost, a permanent tooth replaces it, and an additional 8 to 12 molars appear posteriorly in the jaws, making the total number of permanent teeth 28 to 32, depending on whether the four wisdom teeth finally appear, which does not occur in everyone.

Formation of the Teeth. Figure 79–13 shows the forma-tion and eruption of teeth. Figure 79–13A shows invagination of the oral epithelium into the dentallamina; this is followed by the development of a tooth-producing organ. The epithelial cells above form ameloblasts, which form the enamel on the outside of the tooth. The epithelial cells below invaginate upward into the middle of the tooth to form the pulp cavity and the odontoblasts that secrete dentin. Thus, enamel is formed on the outside of the tooth, and dentin is formed on the inside, giving rise to an early tooth, as shown in Figure 79–13B.


Eruption of Teeth. During early childhood, the teethbegin to protrude outward from the bone through the oral epithelium into the mouth. The cause of “erup-tion” is unknown, although several theories have been offered in an attempt to explain this phenomenon. The most likely theory is that growth of the tooth root as well as of the bone underneath the tooth progressively shoves the tooth forward.

Development of the Permanent Teeth. During embry-onic life, a tooth-forming organ also develops in the deeper dental lamina for each permanent tooth that will be needed after the deciduous teeth are gone. These tooth-producing organs slowly form the perma-nent teeth throughout the first 6 to 20 years of life. When each permanent tooth becomes fully formed, it, like the deciduous tooth, pushes outward through the bone. In so doing, it erodes the root of the deciduous tooth and eventually causes it to loosen and fall out. Soon thereafter, the permanent tooth erupts to take the place of the original one.


Metabolic Factors Influence Development of the Teeth.

The rate of development and the speed of eruption of teeth can be accelerated by both thyroid and growth hormones. Also, the deposition of salts in the early-forming teeth is affected considerably by various factors of metabolism, such as the availability of calcium and phosphate in the diet, the amount of vitamin D present, and the rate of PTH secretion.When all these factors are normal, the dentin and enamel will be correspondingly healthy, but when they are defi-cient, the calcification of the teeth also may be defec-tive, so that the teeth will be abnormal throughout life.


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