What Is Taurodontism?

Even though all teeth may seem similar to the unsuspecting onlooker, they differ vastly from person and person as well as within the same person.

Many variations are found in the teeth and this includes the shape, size, number of roots, the way in which they take their position in the mouth and even the color. Some variations, though, are clinically recognizable due to the presence of some particular features.

One of the most important of these is Taurodontism. The word comes from the Greek word for "bull", "tauro", and "odontos", meaning "tooth". This is why teeth affected by this condition are also called "bull teeth".

Taurodontism affects the lifespan of the teeth as well as the treatment options that are available for the affected teeth.

Characteristic Features Of Taurodontism

In normal conditions, the back teeth comprise the crown, or the part of the tooth you can see in the mouth and the roots, which may be two or more in number. The length of the crown and the length of the roots underneath is almost similar, providing a strong support to the tooth.

In taurodontism, this ratio is altered because of an abnormally large crown. The center of the tooth, the pulp chamber, where all the nerves and blood vessels of the tooth reside is like a blown up version of itself.

As a consequence, other layers of the teeth like the dentin and enamel, which are responsible for the protection of this sensitive portion are much thinner and weaker than normal.

These characteristic features of a tooth affected by taurodontism can only be seen in a radiograph since they appear to be the same as any other tooth on appearance.

Why Are Some Teeth Affected By This Condition?

The exact reason behind the development of this condition is debated. There was a belief in earlier times that taurodontism is associated with certain chromosomal disorders such as Down’s Syndrome, Klinefelter's Syndrome, had a predilection in certain races, or  was a sign of an underlying genetic abnormality.

One of the reasons why racial predilection was thought to be a factor because a high number of cases were found in Eskimo populations that were used to using their teeth in preparing tough Whale skin for protection from the cold.

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The researchers presumed that taurodontism could be a morphologic adaptation to the increased amount of forces the teeth were subjected to, however, similar forces were subjected on the teeth by Neanderthals and their skull did not show evidence of widespread taurodontism, thus bringing up the flaw in this theory.

These theories are no longer accepted and the current research into the cause behind taurodontism is focused on localized alterations during the development of the tooth.

Researchers have identified that the group of cells that form the roots of the teeth do not follow the same path as they do in normal teeth and this could be the basic reason behind the occurrence of taurodontism.

Clinical Implications Of Taurodontism

Why Is Taurodontism Clinically Important?

Teeth that are affected by taurodontism will behave as any other tooth as long as everything is fine. Theoretically, a person would never even come to know that one or more of the teeth are different than the other one if they remain disease free throughout life.

Unfortunately, that is rarely the case. The thin covering of enamel and dentin means that the tooth is less insulated from the temperature changes that take place in the mouth. Patients will often complain of increased sensitivity with those teeth even though they look perfectly okay on visual inspection.

The molars are the most common teeth affected by taurodontism. They are also the most common teeth to suffer from tooth decay due the presence of grooves on their surface as well as having the largest surface area of all the teeth.

This combination is a not good one since even a small amount of tooth decay will lead to the pulp exposure. Some of the symptoms associated with such an occurrence will include severe pain, an inability to bite from that tooth, the increased possibility of fracture and referred pain to the nearby areas.

Since the crown of the teeth is increased greatly in size at the expense of the roots, they are at a disadvantage in being resistant to gum disease. The nature of gum disease is such that it does not cause pain and is often ignored by the patient until the disease has progressed to an advanced stage.

Often in the case of taurodontism affected teeth, the disease progresses so quickly that by the time the patient realizes there is a problem, nothing can be done to save the tooth.

It is also much more difficult to provide root canal treatment to the affected teeth. It has been fond that the roots of taurodontism affected teeth are often partially obliterated or calcified making access to all parts of the pulp very difficult. Even the openings of the roots into the canal are located at positions different from the normal and thus require the removal of a lot more tooth structure to uncover all the canal openings.

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Gum surgeries that can be used to try and save the tooth are also much more limited in scope. Thus, extraction becomes the only choice.

This too can be a slightly more complicated procedure since the tooth is likely to crack under the force exerted during extraction, however, that is a minor concern and something that the doctor needs to worry about rather than the patient.

Conclusion

 Taurodontism is a relatively rare condition which will be diagnosed in most cases when the tooth needs some form of treatment. It is important to know why some of the treatment options are not available to you or why they may not have the same success rate as in other cases.

The maintenance of oral hygiene for patients with taurodontism becomes even more important and a stricter follow-up protocol should be followed in case the teeth are diagnosed during a routine examination.