Sometimes are in the eye of the beholder. The photo above shows teeth that look truly nice. The problem is, that the patient was in my office because she HATED her teeth. What you see in this picture is a woman with natural lower teeth and a full upper denture. In other words, she had NO upper teeth at all. She was seeing me because this was her third denture in two years, and she could not successfully wear any of them. They made her gag, would not stay in her mouth, and made her gums sore! These are, in fact, NOT "nice teeth".
Actually, nice teeth are not always straight. They are not always pearly white. They sometimes have fillings, and sometimes, some of the teeth may even be missing. One thing that nice teeth have in common is that they are HEALTHY! If the teeth and supporting structures (Periodontium--i.e. gums) are in a state of good health, all other defects are easily and usually quite affordablly corrected.
Crooked teeth can be straightened with orthodontics (braces) or sometimes, bonding. Discolored teeth can be bleached, or bonded. Deformed teeth can be repaired inexpensively with tooth colored fillings or (more expensively) with crowns or veneers. Missing teeth can be replaced with removable partial dentures, bridges or implants.
The teeth on the left below may look awful, but within a single forty minute appointment, the two middle teeth were repaired to look like the ones on the right. This is ORDINARY dentistry. The results may not be perfect, but they surpassed the patient's expectations. These are just plain fillings, not crowns or anything especially expensive. You will note that the two central teeth are not the exact same width. These teeth were originally overlapped and crooked, but since they were so badly decayed, I took the liberty of straightening them at the expense of making one slightly wider than the other. It didn't take me any extra time or energy to do this, so it cost the patient nothing over the cost of the two fillings. This is after only one appointment. After five or six appointments, the patient's whole mouth will contain nothing but "nice teeth"!
In other words, once the teeth are in a state of health, all their deficiencies can be overcome by the purchase of dental services which, even in the absence of dental insurance, are quite affordable by anyone, especially if the treatments are performed over the course of a year. When the teeth and gums are in a state of good health, any money spent replacing missing teeth or placing bonded veneers on discolored or malformed teeth is money well spent.
The image on the right shows how serious decay can be. You may be surprised to learn that this case is actually quite repairable. It is a case in progress. Click on the image and on the linked page, you will learn just how the case was treatment planned and treated.
Dental professionals and students of dental technologies who want a more detailed understanding of the anatomy of the teeth and their supporting structures may wish to proceed to the two pages I have written and illustrated especially for them. Click the icon on the right.
The image on the right is a schematic of a tooth as it sits in the gums. The tooth consists of a crown (which is that part of the tooth that is visible above the gums), and the root(s) (7). In a state of health the roots are surrounded by the gingiva (4), and the bone (5). Deep inside of the tooth is the nerve (3) (also called the dental pulp) which is composed of soft tissue like that in your finger tip. It contains blood vessels and connective tissue as well as nerve tissue. (For more on the structure of nerves as they relate to the teeth, click here.) The nerve is surrounded by a yellow, bony substance called dentin (2). The dentin contains millions of parallel microscopic tubules which hold tiny projections of living nerve tissue. The dentin is covered above the gum line by a hard white shell called enamel (1). The enamel acts like armor, protecting the sensitive dentin underneath. If the integrity of the enamel is breached by decay or traumatic injury, the dentinal tubules become exposed to the air and caustic chemical attack. This causes movement of fluid in the dentinal tubules and is the reason that broken or decayed teeth are sensitive when touched or dried out. If the decay actually penetrates to the level of the nerve itself, then the nerve becomes inflamed and becomes extremely sensitive or painful even if there is no immediate stimulus. For more information on the anatomy of the oral cavity, click on the diagram or here to visit my page on oral/dental anatomy.
Notice that the gingiva (4) not only covers the bone, but also narrows down to a very thin soft tissue sheath which attaches to and surrounds the entire root of the tooth, separating it from the surrounding bone like a sock separates a foot from its shoe. This thin soft tissue sheath is called the periodontal ligament (6) and is an extremely important part of the structure of the dental apparatus. It acts as both a biological barrier separating the germ filled oral cavity from the sterile bone and blood supply underneath, as well as a shock absorber allowing a small amount of movement of the tooth in response to forces from above.
The whole tooth
The image to the right shows an extracted tooth. The roots and the crown are clearly visible. The inside of the tooth is made of dentin (2 in diagram above). The roots are actually covered with a thin layer of yellow, bony material called cementum (8). The crown is covered with white, translucent enamel (1). Teeth in your mouth look yellow because the yellow dentin underneath shows through the white translucent enamel. The place where the enamel ends and the roots begin is clearly demarcated on this diagram. This line is called the CementoEnamel junction (CEJ).