Encyclopedia of Health and Medicine

T
talipes equinovarus A CONGENITAL ANOMALY in
which an infant is born with one foot or both feet
deformed into the shape of a club, hence the common
term for the condition, “clubfoot.” The
affected foot turns in and under at the heel, such
that the top of the foot appears nearly upsidedown.
All the bones, muscles, and other connective
tissues are usually present though deformed
in structure.
The anomaly forms in the last part of the first
trimester of PREGNANCY when the muscles, bones,
and connective tissues develop. Researchers do
not know what causes talipes equinovarus though
believe it is a combination of environmental factors
(such as the fetus’s position in the UTERUS) and
genetic factors. The condition must be corrected
for the child to walk; treatment is most successful
when it begins shortly after birth.
The current standard of treatment is progressive
casting during the first months of life, typically
with the cast changed each week to move
the foot slightly closer to normal position and
gradually stretch the foot’s soft tissue structures
(the Ponseti casting method). Often the doctor
must cut the ACHILLES TENDON to allow it to
lengthen so the foot may completely return to its
normal position. When the foot finally reaches
normal position, the doctor removes the casts and
replaces them with a special brace that the child
wears for two months. Some children require further
bracing at night for another few months.
After treatment, the foot looks and functions as
normal.
See also BIRTH DEFECTS; BONE; GENETIC DISORDERS;
MUSCLE.
teeth Calcified formations that grow from the
gums in the MOUTH. The teeth are necessary for
358
cutting, tearing, and chewing the food as well as
for forming the sounds of language. A person
develops two sets of teeth during his or her lifetime.
The first set, the primary teeth, erupts
around six months of age and remains in place
until six or seven years of age. Then the permanent
teeth begin to push through the gum and the
primary teeth fall out. There are 20 primary teeth
and 32 permanent teeth by adulthood. The last 4
permanent teeth, molars in the back of the mouth
called the wisdom teeth, erupt through the gumline
at age 18 to 20.
When a blow to the face knocks out a
tooth, retrieve the tooth and put it in a
plastic bag with ice. The dentist often
can put the tooth back in place and the
tooth will reroot.
The outer layer of the tooth, the enamel, is the
densest, hardest substance in the body. Highly
mineralized, enamel cannot replace itself when
damaged. At the core of the tooth is one of the
softest, the pulp. The pulp encases and nourishes
the NERVE. Between the enamel and the pulp is a
layer of calcified tissue almost as hard as BONE, the
dentin. The tooth’s root extends from the jawbone.
The main health condition to affect the
teeth is DENTAL CARIES, or cavities. A cavity is a hole
through the enamel that allows BACTERIA to enter
the tooth. The bacteria eat away at the tooth’s
inner structure until reaching the pulp, at which
point the cavity causes PAIN. A dentist can plug a
cavity with a resin filler to stop the process and
preserve the tooth. Other health conditions that
can affect the teeth include GINGIVITIS, PERIODONTAL
DISEASE and traumatic injury.
See also HALITOSIS; GLOSSITIS; SIALADENITIS.