The idea of a tooth worm is a theory of the cause of dental caries, periodontitis and toothaches. Once widespread, the belief is now obsolete, having been superseded by more scientific rationales. It was supposed that the disease was caused by small worms resident within the tooth, eating it away. [1]
The origins of the belief are wrapped in obscurity. [2] A prominent early mention, a Babylonian cuneiform tablet titled "The Legend of the Worm" (sometimes erroneously dated to Sumerian times [3] ), recounts how the tooth worm drinks the blood and eats the roots of the teeth – causing caries and periodontitis:
"After Anu [had created heaven],
Heaven had created [the earth],
The earth had created the rivers,
The rivers had created the canals,
The canals had created the marsh,
(And) the marsh had created the worm—
The worm went, weeping, before Shamash, his tears flowing before Ea: "What wilt thou give for my food? What wilt thou give me for my sucking?"
"I shall give thee the ripe fig, (and) the apricot."
"Of what use are they to me, the ripe fig and the apricot? Lift me up and among the teeth and the gums cause me to dwell! The blood of the tooth I will suck, and of the gum I will gnaw its roots!" [4]
Accounts are also found in the Central American legends of Popol Vuh. The belief persisted into the 18th century, only being disproven by the microscopical endeavors of M. Pierre Fauchard. [5] Modern veterinary practice shows that when removed intact, the necrotic or partially necrotic tooth pulp can have an appearance like that of a worm. [6]
Sinhalese Charm for toothache:
Ira deyené asyā!
Sanda deyené aeyā!
Passé Buduné acyā!
Daté nositoo dat aeyā!
Worm of the sun-god!
Worm of the moon god!
Worm of the Passé Buddha!
Stay not in the tooth, tou tooth-worm! [7]
Although no rigorous evidence was ever found, some practitioners believed the pulpal tissue within the root of the tooth to be a worm. Most however admitted to have never encountered a worm in vivo, but nonetheless encouraged the belief among the general public.
A 2009 study by the University of Maryland Baltimore using micro imaging revealed worm-like structures within a dissected molar. While not worms or caused by worms, these structures may have given rise to the tooth worm belief. [8] It is unclear what these structures are or what caused them.
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
The human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.
Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss and infection or abscess formation.
A root canal is the naturally occurring anatomic space within the root of a tooth. It consists of the pulp chamber, the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.
Toothache, also known as dental pain, is pain in the teeth or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases. When severe it may impact sleep, eating, and other daily activities.
The pulp is the connective tissue, nerves, blood vessels, and odontoblasts that comprise the innermost layer of a tooth. The pulp's activity and signalling processes regulate its behaviour.
Deciduous teeth or primary teeth, also informally known as baby teeth, milk teeth, or temporary teeth, are the first set of teeth in the growth and development of humans and other diphyodonts, which include most mammals but not elephants, kangaroos, or manatees, which are polyphyodonts. Deciduous teeth develop during the embryonic stage of development and erupt during infancy. They are usually lost and replaced by permanent teeth, but in the absence of their permanent replacements, they can remain functional for many years into adulthood.
Pulpitis is inflammation of dental pulp tissue. The pulp contains the blood vessels, the nerves, and connective tissue inside a tooth and provides the tooth's blood and nutrients. Pulpitis is mainly caused by bacterial infection which itself is a secondary development of caries. It manifests itself in the form of a toothache.
Dental plaque is a biofilm of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline (supragingival), or below the gumline cervical margins (subgingival). Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.
A dental emergency is an issue involving the teeth and supporting tissues that are of high importance to be treated by the relevant professional. Dental emergencies do not always involve pain, although this is a common signal that something needs to be looked at. Pain can originate from the tooth, surrounding tissues or can have the sensation of originating in the teeth but be caused by an independent source. Depending on the type of pain experienced an experienced clinician can determine the likely cause and can treat the issue as each tissue type gives different messages in a dental emergency.
Commonly known as a dental cyst, the periapical cyst is the most common odontogenic cyst. It may develop rapidly from a periapical granuloma, as a consequence of untreated chronic periapical periodontitis.
An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch. The wisdom teeth are frequently impacted because they are the last teeth to erupt in the oral cavity. Mandibular third molars are more commonly impacted than their maxillary counterparts.
Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include:
Pulp necrosis is a clinical diagnostic category indicating the death of the pulp and nerves of the pulp chamber and root canal of a tooth which may be due to bacterial sequelae, trauma and chemical or mechanical irritation. It is often the end result of many cases of dental trauma, caries and irreversible pulpitis.
Pulp stones are nodular, calcified masses appearing in either or both the coronal and root portion of the pulp organ in teeth. Pulp stones are not painful unless they impinge on nerves.
Periapical periodontitis or apical periodontitis (AP) is an acute or chronic inflammatory lesion around the apex of a tooth root, most commonly caused by bacterial invasion of the pulp of the tooth. It is a likely outcome of untreated dental caries, and in such cases it can be considered a sequela in the natural history of tooth decay, irreversible pulpitis and pulpal necrosis. Other causes can include occlusal trauma due to 'high spots' after restoration work, extrusion from the tooth of root filling material, or bacterial invasion and infection from the gums. Periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp, or into a periapical cyst, where an epithelial lined, fluid-filled structure forms.
Impacted wisdom teeth is a condition where the third molars are prevented from erupting into the mouth. This can be caused by a physical barrier, such as other teeth, or when the tooth is angled away from a vertical position. Completely unerupted wisdom teeth usually result in no symptoms, although they can sometimes develop cysts or neoplasms. Partially erupted wisdom teeth can develop cavities or pericoronitis. Removal of impacted wisdom teeth is advised in the case of certain pathologies, such as nonrestorable caries or cysts.
The Hall Technique is a non-invasive treatment for decayed baby back (molar) teeth. Decay is sealed under preformed crowns, avoiding injections and drilling. It is one of a number of biologically orientated strategies for managing dental decay.
Tooth transplantation is mainly divided into two types:
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