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 com-
mon term for the condition, “clubfoot.” The
affected foot turns in and under at the heel, such
that the top of the foot appears nearly upside-
down. All the bones, muscles, and other connec-
tive tissues are usually present though deformed
in structure.
The anomaly forms in the last part of the first
trimester of PREGNANCYwhen the muscles, bones,
and connective tissues develop. Researchers do
not know what causes talipes equinovarus though
believe it is a combination of environmental fac-
tors (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 progres-
sive casting during the first months of life, typi-
cally 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 fur-
ther 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

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 life-

time. 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 perma-

nent 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 gum-

line 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 jaw-

bone. The main health condition to affect the

teeth is DENTAL CARIES, or cavities. A cavity is a hole

through the enamel that allows BACTERIAto 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

DISEASEand traumatic injury.

See also HALITOSIS; GLOSSITIS; SIALADENITIS.

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