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This is the oral photograph of a 9-10 year old girl who has not used her left side teeth for chewing for a long time. When I enquired about the exact duration , she was unable to recollect.

She had come to me for painful gums on the upper left side. At this age, it is quite rare to find teeth with calculus (tartar) deposits – the “dirt” that is visible on girl’s left upper teeth.

Her father pointed to the first permanent molar. The surrounding gum of that particular tooth had chronic inflammation and perhaps that it is the reason she was not using her left side for mastication. The two milk teeth (“deciduous molar”) lying infront of the permanent molar are also shaky. That is quite normal at this age because this is the age for their natural “shedding” for making room for erupting permanent teeth.

Even in the lower jaw, it was noticed that two premolars were erupting and the surrounding gums appear swollen.  All said and done, the net result of all her problems is that she is not using her left side for chewing.

When I told her to bring her toothbrush next day, i found her brush is just a bunch of frayed bristles. She was instructed to take proper care of cleanliness of her teeth. Her condition is quite easy to manage- she would be alright in just 3-4 days of thorough oral prophylaxis in which all those tartar deposits will be removed.

This small case report highlights the importance of bilateral chewing. If a person stops using one side (due to any reason) permanently, she is bound to have some problems. Mastication is also a nature’s cleansing mechanism for mouth because rubbing of food items, fibrous foods tend to clean teeth surfaces to some extent.