The gums may then become swollen, sore, or infected; this is referred to as gingivitis. In general, gum disease can be treated or prevented by maintaining a good oral health regime. However, if it is left to develop, it can result in periodontitis, which weakens the supporting structures of the teeth.

Gum disease, which is also called periodontal disease, is widespread. According to the Centers for Disease Control and Prevention (CDC), almost half of adults in the United States have some degree of gum disease.

The mechanisms behind periodontal disease are relatively well-understood, and newer research shows that this health problem may play a role in the development of a number of other conditions, including Alzheimer’s disease, cancer, and respiratory disease. In this Spotlight, we will cover some of the surprising links between gum disease and disparate health issues.

Gums and the brain

Although spatially the gums are near the brain, one wouldn’t normally associate dental complaints with neurological conditions.

However, some studies have found a link between periodontal disease and tooth loss and cognitive function. One study looking at cognitive performance followed 597 men for up to 32 years. The authors conclude:

Risk of cognitive decline in older men increases as more teeth are lost. Periodontal disease and caries, major reasons for tooth loss, are also related to cognitive decline.

Researchers have also linked periodontal disease with an increased buildup of beta-amyloid in the brain — the neurological hallmark of Alzheimer’s.

Other experiments have produced evidence that one type of bacteria commonly found in cases of periodontitis — Porphyromonas gingivalis — can be found in the brains of individuals with Alzheimer’s.

Following on from that discovery, in a more recent study, researchers showed that P. gingivalis infection boosts the production of beta-amyloid in the brain.

Periodontal disease was associated with a small, but significant, increase in overall cancer risk.

In this study, the researchers paid particular attention to an enzyme produced by P. gingivalis called gingipain. They found that this protease was toxic to tau, another protein that plays a pivotal role in Alzheimer’s.

It is worth noting that other researchers have concluded that beta-amyloid is produced in response to a pathogen. The way we view Alzheimer’s is slowly changing.

In the future, scientists hope that targeting gingipain enzymes might help stop neurodegeneration in some people with Alzheimer’s disease. They have already designed a gingipain inhibitor, which they are testing in humans.

The number and types of teeth a person has changes as they age. Typically, people have two sets of teeth during their life — primary, or baby teeth, and permanent, or adult teeth. In this article, we look at the teeth that children and adults have, as well as their functions.

Humans have the following types of teeth:

Incisors

Incisors are the sharp teeth at the front of the mouth that bite into food and cut it into smaller pieces. They are flat with a thin edge. They are also called anterior teeth.

Both children and adults have eight incisors — four central incisors at the front of the mouth, two on each row, with one lateral incisor positioned on either side of them.

Canines

Canines are the sharp, pointed teeth that sit next to the incisors and look like fangs. Dentists also call them cuspids or eyeteeth. Canines are the longest of all the teeth, and people use them to tear food.

Both children and adults have four canines. Children usually get their first permanent canines between the ages of 9 and 12. The lower canines tend to come through slightly before those in the upper jaw.

Premolars

Premolars, or bicuspids, are bigger than the incisors and canines. They have many ridges and help chew and grind up food. Adults have eight premolars. The first and second premolars are the molars that sit next to the canines.

Young children do not have premolar teeth. These first appear as permanent teeth when children are 10–12 years old.

Molars

Molars are the biggest of all the teeth. They have a large, flat surface with ridges that allow them to chew food and grind it up. Adults have 12 permanent molars — six on the bottom and top jaw, and children have eight primary molars.

The last molars to erupt are wisdom teeth, or third molars, which usually come through between the ages of 17–21. These sit at the end of the row of teeth, in the far corners of the jaw. Some people do not have all four wisdom teeth, or the teeth may stay unerupted in the bone and never appear in the mouth.

Sometimes wisdom teeth can become impacted, which means they can become trapped under the gum and are unable to come through properly.

Wisdom teeth that only come through halfway or are in the wrong position can increase the risk for infection or damage in surrounding areas. It is essential to see a dentist if people have any issues with their wisdom teeth.

People may experience mild discomfort when their wisdom teeth start pushing through the gums, but anyone feeling a lot of pain or has swelling should see a dentist.

A dentist may need to remove wisdom teeth if a person has tooth decay, pain, or an infection. People do not need these teeth for chewing, and they are difficult to keep clean because of their position far back in the mouth.

Number of teeth

Children have 20 primary, or baby, teeth. Primary teeth first start to appear when babies are around 6 months old. Children usually get all their primary teeth by the age of 3.

These teeth gradually fall out, and 28 permanent teeth replace them. Sometimes, permanent teeth push the baby teeth out, but typically, permanent teeth come through the gums at the back of the mouth behind the last baby tooth in the jaw.

The first permanent teeth to erupt through the gums are four first, or ‘6-year’ molars, so-called because they usually come through when a child is about 6 years old.

The first baby teeth to fall out are the lower central incisors. The adult central incisors tend to erupt around the same time as the first permanent molars around age 6-7.

Usually, people have lost all of their baby teeth by around the age of 14.

Researchers have found intriguing clues about pancreatic and esophageal cancer risk in mouth bacteria, and some studies have linked poor oral hygiene with respiratory problems.

Mounting evidence is also strengthening the link between oral health and cardiovascular health.

For instance, some studies have found oral bacteria in the blood clots of people receiving emergency treatment for stroke, and experts have linked severe gum disease with a significantly higher risk of hypertension.

Conversely, destroying “friendly” oral bacteria that help maintain a healthy and balanced oral microbiome could disrupt blood pressure levels and also lead to hypertension.

Maintaining good oral health, therefore, seems to be key to cardiovascular health.

Now, a new study that appears in the European Journal of Preventive Cardiology suggests that regular toothbrushing may keep heart failure and atrial fibrillation (A-fib) — a type of arrhythmia — at bay.

Dr. Tae-Jin Song of Ewha Womans University in Seoul, Korea, is the senior author of the new study.

In their paper, Dr. Song and team explain that the motivation for the study hinges on the mediating role of inflammation. They write, “Poor oral hygiene can provoke transient bacteremia and systemic inflammation, a mediator of atrial fibrillation and heart failure.”

Studying A-fib, heart failure, and oral hygiene

In their study, Dr. Song and team examined atrial fibrillation’s associations with both heart failure and poor oral hygiene. They used data from 161,286 people who were part of the Korean National Health Insurance System-Health Screening Cohort.

A-fib is a condition affecting at least 2.7 million people in the United States. In people with A-fib, the heart cannot efficiently pump blood to the rest of the body because it does not beat regularly.

The heart also does not pump blood as it should in people with heart failure. This inefficiency results in fatigue and, sometimes, breathing difficulties, as insufficient oxygen reaches the other organs in the body.

The participants of the current study were 40–79 years old and had no history of either A-fib or heart failure. During enrollment, which took place between 2003 and 2004, the team measured the height and weight of each of the participants and asked them questions about their lifestyle, oral health, and oral hygiene habits.

The participants also underwent some laboratory tests, which included blood tests, urine tests, and blood pressure readings.

Brushing lowers heart failure risk by 12%

Over a median follow-up period of 10.5 years, 4,911 participants received a diagnosis of A-fib, and 7,971 developed heart failure.

Brushing the teeth three times or more a day was linked with a 10% lower chance of developing A-fib and a 12% lower risk of heart failure.

Confounding factors — including age, sex, socioeconomic status, physical activity, alcohol intake, body mass index, and other coexisting conditions, such as hypertension — did not influence these results, as the researchers accounted for them in their analysis.

The authors conclude:

Improved oral hygiene care was associated with decreased risk of atrial fibrillation and heart failure. Healthier oral hygiene by frequent toothbrushing and professional dental cleanings may reduce risk of atrial fibrillation and heart failure.

In this article, we look at the reasons why people might get white spots on their teeth, and provide 11 tips for treating and preventing them.

Causes

There are several possible causes of white spots on the teeth.

A common cause is dental fluorosis.

People usually get this when they are young if they consumed too much fluoride as a child. It is usually a harmless condition that only tends to develop before the teeth break through the gums.

Another common cause is enamel hypoplasia.

This condition occurs when a person’s teeth enamel does not form properly. Like fluorosis, hypoplasia only occurs during childhood when a person’s teeth are still developing. However, it can increase the risk of tooth decay.

Other causes of white spots on the teeth include poor dental hygiene, especially when someone is wearing braces, or eating too many acidic or sugary foods.

Treatments

There are several possible treatments for white spots on the teeth. The suitability of these treatments may depend on the underlying cause of the white spots and the condition of a person’s teeth.

1. Enamel microabrasion

Some people may be able to have microabrasion done to treat their white spots. During this procedure, a dentist removes a small amount of enamel from the teeth to reduce the appearance of the white spots.

This professional treatment is typically followed by teeth bleaching, which can make the teeth appear more uniform in color.

2. Teeth whitening or bleaching

Whitening or bleaching teeth can help to reduce the appearance of white spots and other stains. A variety of teeth whitening products, such as strips and paste, are available over-the-counter (OTC.) People can also buy these products online.

People with white spots can also see a dentist for professional whitening treatments. These treatments tend to use stronger bleaching solutions than those available OTC, which may make them work better.

3. Dental veneer

Dental veneers are thin, protective coverings that attach to the front surface of a person’s teeth. They can conceal white spots and other blemishes very effectively.

Dental veneers are only available from a dentist and must be professionally fitted. This can make them costly.

4. Topical fluoride

A dentist may apply topical fluoride to the teeth of people with enamel hypoplasia. This may encourage the development of enamel on the teeth and help prevent tooth decay.

5. Composite resin

For people with enamel hypoplasia, a dentist may apply composite resin to fill in cavities and to bond the outer enamel of the teeth. This may not be suitable if people have large numbers of white spots on their teeth.