Dental Glossary
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A
Abscess
An abscess is a localized collection of pus in an enclosed area or space,
somewhere within the body. Abscesses may occur around the teeth and jaws,
and are often associated with an infection. They are commonly divided into
ACUTE or CHRONIC types.
An ACUTE abscess is one which is very active and often painful, and which
you will want to seek help for quickly as it will cause you some problems.
It may also be associated with some SWELLING and INFLAMMATION.
A CHRONIC abscess may or may not be painful, and is generally a slower
abscess to form and to heal. It may also be associated with swelling and
inflammation, but is often not so painful as the pus finds a route to drain
away in the form of a SINUS.
All abscesses should be treated, as they are a sign of PATHOLOGY, and your
dentist may recommend all or one of the following: OPENING surgically and
DRAINING the abscess, ANTIBIOTIC treatment, ENDODONTIC treatment,
PERIODONTAL treatment with surgery or ROOT PLANING, other SURGICAL
treatment.
You should not try to treat an abscess at home, as you might exacerbate the
problem and spread infection. Seek treatment from a dentist as soon as
possible, and do not use hot or warm compresses in the area unless told to,
as this may also alter the way the infection spreads.
Abutment
Usually a tooth or root used for support, stabilization or anchorage for
either a fixed or removable denture PROSTHESIS or other device e.g. an
IMPLANT, to support against lateral or horizontal thrust.
Acid Etching
Acid etching is the selective dissolution of a surface (usually the tooth
enamel) by a dilute acid. In the case of the tooth surface, this causes
demineralization of the enamel leaving a clean and more mechanically
retentive surface layer, thereby improving the bonding to filling materials.
The acid used is generally 30 to 50% Phosphoric acid.
Aesthetic / Esthetic dentistry
This term describes the treatments, skills, and techniques used to improve
the position and symmetry of the teeth, jaws and face in order to improve
the appearance, as well as the function, of these structures. Importance is
placed especially on color and form.
Amalgam
Also called SILVER FILLING RESTORATION or ALLOY RESTORATION. Dental amalgam
is a mixture or ALLOY of metals, including mercury, which is combined to
form a soft and silvery looking paste which hardens on setting. It is used
for the restoration of the form and function of teeth, and is made up of
various metals such as silver, tin, copper, and sometimes zinc.
Dental amalgam has been used extensively for many years in dentistry as the
material of choice for fillings. In recent years there has, however, been
much debate both within the profession and amongst the general public, about
the safety of the material, and more specifically, the safety of the MERCURY
used in the mixture. Mercury and mercury vapor are toxic, and may produce
acute or chronic poisoning, and damage mainly to the nervous system. Once
combined with other metals, however, mercury alloy becomes quite safe, so
the mixing and handling procedures are the most important as far as safety
is concerned. There are very strict guidelines in almost all countries
relating to the handling of mercury in dental practice.
Over the years, amalgam has provided a stable and extremely useful
restorative material. There are literally billions of amalgam restorations
that have been carried out, and the reports of side effects, symptoms, and
reactions to the material have been almost negligible in comparison to the
number of teeth treated. There is however, an ever more vocal and well
documented lobby against the use of amalgam, and many recorded cases now of
patients who appear to have had symptoms which have been attributed to
amalgam, and which have been reduced or have disappeared after the removal
of amalgam from their teeth. Some countries, most notably in Scandinavia,
have either banned the use of amalgam, or are no longer recommending it's
use as a filling material of choice, especially in the treatment of children
and pregnant women.
Your dentist will advise you on whether or not she still recommends the use
of amalgam as a filling material. The improvement in the structure and
techniques of other materials in recent years has meant that patient and
dentist have more of a choice in the alternative materials available.
Angle's Classification of Occlusion
To help dentists quickly describe a patient's teeth and the way they come
together, certain normal and abnormal situations have been described and
classified, and these are used for communication and defining the case. The
man who invented this system was an American ORTHODONTIST called Edward
Angle.( 1855- 1930 )
Apicectomy / Apicoectomy
This procedure may also called ROOT END RESECTION, or ROOT END AMPUTATION,
APICOTOMY, or APECTOMY but these terms are more unusual. It is a surgical
procedure to remove the tip or end of the root of a tooth lying in the bone
of the jaws, through an opening made in the buccal ( cheek side) or palatal
side of the tooth. At the same time, tissue from around the APEX or end of
the root may be removed to control a disease process or to facilitate
healing. The procedure is usually associated with ROOT CANAL TREATMENT,
either during the procedure, or more often afterwards, if an earlier root
canal treatment has not healed satisfactorily. The dentist or surgeon may
also carry out a RETROGRADE ROOT FILLING, i.e. a filling placed in the end
of the remaining portion of the root to seal the ROOT CANAL at the same
time.
You will normally need to have a number of X-RAYS or RADIOGRAPHS associated
with this treatment. These are necessary to control and check the success of
the procedure. After the surgery, you may notice some swelling around the
area, as the wound heals. Your dentist may also wish to give you some
ANTIBIOTICS to help the healing and prevent further infection.
Autoclave
This is a type of machine which sterilizes instruments using steam and
pressure. It consists of an hermetically closed container in which the
temperature of electrically heated water is allowed to rise to at least 121/
C (250 / F) at which all living organisms are killed, with a parallel
increase in steam pressure to 15 psi. Instruments have to be cleaned
thoroughly before sterilization, and also occasionally packed or wrapped in
special sterilizing sacks which permit easy penetration of the heat and
pressure. (which must be present for no less than 20 minutes.)
B
Bitewing X-ray
A bitewing x-ray is a radiograph taken inside the mouth to show the
interproximal surfaces of both upper and lower teeth. This x-ray helps to
detect decay occurring on the proximal (in between) surfaces of the teeth.
The x-ray is held in place in the mouth by biting on a tab on the film.
Bleaching
Bleaching is the act or process of removing stains or color by chemical
means using usually OXIDIZING AGENTS. CORONAL bleaching is the same thing,
but carried out within the crowns of PULPLESS teeth, and often in
combination with heat or UV light. The material used generally is 30%
HYDROGEN PEROXIDE.
HOME BLEACHING KITS are a relatively recent addition to products available
to the general public. There are also several types for use in the dental
office, and they all work on a similar principal in which the solution or
gel of the bleaching agent is held on the teeth for a period of time, which
varies from one product to another, in a TRAY or special form which fits
over the teeth. There is a risk of damage to the health of the teeth and
gums with overuse, and the possibility of the teeth becoming more sensitive
is also high. The results of home bleaching are usually of limited duration,
so the process may need to be repeated, but many people are satisfied with
the results they get. Caution should also be exercised with existing
RESTORATIONS in the mouth, which may be damaged or bleached at a different
rate to the tooth substance.
Bonding
This means the binding together of various substances like, for instance,
gold and porcelain or certain filling materials and the surface of the
tooth. In the case where the bonding is between tooth enamel and a filling
material, an UNFILLED RESIN is used to assist the mechanical adhesion of the
resin material. Bonding may also be carried out with an adhesive substance
e.g. glue or cement
Bracket
A small metal, plastic, or ceramic attachment which serves to fasten an
ORTHODONTIC wire to the teeth or to a band around the teeth. There are many
different sorts of brackets, and your ORTHODONTIST will select the one
suitable for your case.
Bridge
In dental terminology, a bridge is a FIXED PROSTHESIS to replace one or more
missing teeth, to restore the function, form or aesthetics of the mouth. It
is also known as a FIXED / NON-REMOVABLE PARTIAL DENTURE. Bridges are
supported and held in position by attachments to adjacent or remaining
teeth.
There are many different types of bridge including FIXED- FIXED,
FIXED-MOVEABLE, CANTILEVERED, MARYLAND, ROCHETTE, SPRING CANTILEVERED,
ACID-ETCHED, PORCELAIN BONDED, and many others.
Common materials used in their construction include gold and precious metals
and their alloys, and porcelain and ceramics.
Teeth generally need to be PREPARED before a bridge can be provided and this
will include altering the shape of the teeth, taking IMPRESSIONS and MODELS
of the mouth and jaws, and other procedures, so that the bridge can be
constructed in the laboratory. RADIOGRAPHS will also be required to check
the stability of the remaining teeth and associated structures.
Homecare of bridges should be discussed with your dentist or hygienist, as
they may recommend special techniques to keep the bridge clean.
C
Calculus
Calculus is the hard stone like deposit on teeth formed by plaque that has
calcified. Calculus is usually strongly attached to the teeth and must be
removed by an instrument. It can not be just brushed off the teeth.
Subgingival calculus (below the gums) is usually darker and more adherent to
the tooth than the creamy yellow supragingival calculus.
Caries ( dental )/ Tooth Decay
Caries or 'tooth decay' is a disease of the hard structure of the teeth
caused by various bacteria in the mouth. For caries to form, the bacteria
which are present in PLAQUE need to have sugars from food, and need to be
present long enough on the tooth surface to cause DEMINERALIZATION i.e. to
cause a reduction in the amount of, for example, Calcium, in the structure
of the tooth. Once DEMINERALIZATION has taken place, the bacteria can invade
the tooth to deeper levels, and eventually a CAVITY or CARIES LESION may
occur.
Your dentist will be able to detect the presence of caries by noticing
changes in the appearance of your teeth, and by the use of light and X-RAY
FILMS or RADIOGRAPHS. This is one of the reasons why dentists recommend
regular check-ups; so they can advise you if caries is forming.
When this happens, your dentist may need to do a FILLING or RESTORATION. If
caries is left untreated for a longer time, and the bacteria have invaded
into the middle i.e. the PULP, of the tooth, you may even need to have a
ROOT CANAL TREATMENT or EXTRACTION carried out. Your dentist will advise you
on the treatment she thinks is most appropriate for your tooth.
You can do a lot at home to prevent caries forming in your teeth. Brushing
your teeth correctly to remove plaque with a FLUORIDE TOOTHPASTE, and
cleaning between the teeth with DENTAL FLOSS or sticks will help to reduce
the amount of bacteria (PLAQUE) on your teeth. You can also try to reduce
the amount, and the frequency of the sugars and sweet things you eat and
drink, as this will also help prevent caries. It has been shown that regular
brushing, the use of fluorides, and the reduction in quantity and frequency
of sugar intake will all help to significantly reduce caries. If you need
more information about CARIES and TOOTH DECAY you should ask your DENTIST or
HYGIENIST about it.
Cephalometric x-ray
A cephalometric x-ray is a very specific radiograph taken outside the body
to show a side view of the head. This x-ray is used to analyze and measure
jaw and tooth relations for orthodontics and oral surgery.
Class I Occlusion
This is considered the 'normal' or ideal situation in which the teeth come
together. There are various ways of describing and defining the situation,
but the most important is by the way the FIRST MOLAR teeth, that is the
first 'double' or 'chewing' teeth, meet together when the mouth is closed.
In the Class I situation, the lower first molar is slightly in front of the
upper first molar by what is known as 'half a unit' when the teeth are held
together. This Class I relationship is also reflected often in the position
of the front teeth, and the way they overlap one another, slightly forward (
2-4mm ) and slightly deeper ( also 2-4mm ) than the INCISAL, or biting edge,
of the lower ones.
Class II Occlusion
The Class II situation is divided into two sub- divisions, also called
DIVISION 1 and DIVISION 2. The class II situation is that where the FIRST
MOLAR teeth are in line with one another, or the bottom tooth is even behind
the upper first molar tooth when the mouth is closed and the teeth are held
together. This situation often occurs when the bottom jaw lies further back
than it should, in relation to the upper one. The sub-divisions help
describe the common conditions arising in the front teeth when the FIRST
MOLAR teeth are in the position described above.
In DIVISION 1 the top teeth come out further forward than they should so
that there is an increased gap between them and the lower front teeth. This
is a very common situation, and easily recognizable because the front teeth
look as if they 'stick out'.
In DIVISION 2 the back teeth are in the class II position, and the front
teeth then slope backwards from their normal position to compensate for
this. Often the front top teeth overlap the front bottom teeth quite deeply
when they come together.
Class III
In this situation, the lower FIRST MOLAR teeth are more forward than they
should be in relation to the upper first molar teeth when they come
together. They may still bite together when the mouth is closed, but in
extreme cases, they don't meet together at all.
The front teeth usually reflect what is happening in the back teeth in the
class III situation. The bottom front teeth lie forward from their ideal
position, and in some cases, may lie completely in front of the upper front
teeth when the mouth is closed together. People who have this type of Class
III occlusion usually have it in association with a forwardly positioned or
enlarged lower jaw. This type of malocclusion is quite easy to recognize
because the person looks like they have a large or prominent chin.
There are also divisions called CLASS 1, 2, AND 3, relating to the positions
of a persons jaw bones which are used to classify and describe a situation.
These are called the SKELETAL CLASSIFICATIONS, and run usually, but not
always, in a similar way to the Angle's classifications. For example, a
person with a Class 3 skeletal relationship often has a Class III Angle's
relationship too. The definitions of skeletal relationships are more
technically defined than the Angle's classification. X-RAY pictures of the
patient's skull and jaw bones are normally required for measurement of
various normal lengths and angles ( in degrees here! ) and are a little
complicated for description here.
Complete denture
A complete denture (used to be known as FULL denture) is a dental PROSTHESIS
replacing all the natural teeth and the associated structures of the maxilla
or mandible, except usually the THIRD MOLARS. Complete dentures are usually
made of acrylic or metal (cobalt-chrome) and acrylic.
Composite Filling Material.
When used in relation to filling materials the term COMPOSITE usually refers
to a substance made up of an acrylic resin filled with inorganic substances
such as glass, lithium aluminum silicate, quartz, or tricalcium phosphate.
The composite is usually, but not always, applied to the tooth in a plastic
i.e. pliable form, and sets, either by itself, or with the use of a blue
light. A technique called ACID ETCHING i.e. etched preparation of the tooth
surface, is usually used to improve the stability of the filling in the
CAVITY. Other techniques, such as COMPUTER GENERATED restoration forms, and
INDIRECT COMPOSITE RESTORATIONS i.e. where a filling is first made in a
model of the tooth and then fitted in the mouth, are also now being used.
Composite filling materials are used most commonly in the restoration of
anterior (front) teeth because they have very good aesthetic properties.
They are easy to color match, and come in many shades and brands.
They are also used now extensively in posterior teeth, i.e. PRE MOLARS and
MOLARS, because they are aesthetically more pleasing than amalgam or gold
restorations, and also have adequate hardness and strength characteristics.
There are still, however limitations on the use of composite filling
materials, especially in posterior teeth, but your dentist will be able to
advise you about what sort of material is the best for your particular
tooth.
Crossbite
This term is used to define an abnormal situation when the teeth are held
together. In a normal mouth, the upper teeth lie just outside the lower
teeth when the patient closes her mouth. In a crossbite situation, the lower
tooth or teeth lie outside or in the same vertical line as the upper ones.
Also called a REVERSE HORIZONTAL OVERLAP.
Crossbites may occur in one or just a few teeth, or in a row of teeth at the
side of the mouth. They may indicate an underlying problem such as a
discrepancy between the jaw size, or a habit like thumb-sucking which needs
treatment.
Crown / Cap
In PROSTHODONTIC or RESTORATIVE terms, a crown or cap is an artificial
replacement of part or whole of the ANATOMICAL CROWN of a tooth. It restores
ANATOMY, FUNCTION and usually AESTHETICS of the tooth, and is cemented or
bonded to the remaining tooth substance.
There are various different types of crown, including BASKET, GOLD, COMPLETE
VENEER, FULL, JACKET, PARTIAL, STAINLESS STEEL, THREE- QUARTER, TELESCOPIC,
PINNED, WINDOW, TEMPORARY.
Common materials used in crown construction are gold and other precious
metals and their alloys, porcelain and ceramics.
Each different type of crown has a different indication and use, and your
dentist will advise you on the best type for your case.
A tooth must be PREPARED to have the crown fitted to it, and usually this
involves altering the shape of the tooth and making IMPRESSIONS and MODELS
of the teeth and mouth so that the crown can be constructed in the
laboratory to fit the tooth.
Currettage
Currettage is the removal of diseased gum tissue from the lining of the
periodontal pocket. It usually results in less inflammation and subsequent
repair and shrinkage of the periodontal pocket.
Currette
A currette is a curved ended hand instrument used to remove plaque and
calculus from below the gumline and to remove diseased gingival tissue from
a periodontal pocket.
D
Dentrifice
See Toothpaste
Diastema
An abnormal space or cleft between two teeth in a dental arch. An ANTERIOR
or MEDIAN diastema is one which appears between the two central front teeth.
Treatment of diastemata may take various forms, including ORTHODONTIC
treatment, surgical treatment of the central FRENUM, and AESTHETIC treatment
with CROWNS or VENEERS.
Drill/Handpiece
This is the hand-held device which the dentist uses to remove tooth tissue,
for cleaning the teeth, polishing restorations, and so on. The usual choice
for the dentist is between one HIGH SPEED drill, which the patients
recognize by it's high pitched whining noise, and a drill with a slower
speed, which can be used for tasks such as polishing, CARIES removal and so
on.
There are many, many different makes, and designs of handpiece. Some of the
more common categories of drill include STRAIGHT HANDPIECE, CONTRA-ANGLED,
MINIATURE, RECIPROCATING, GIROMATIC, TURBINE and so on.
Drills are driven either by a rotating shaft or compressed air.
E
Extraction
This means the removal of a tooth from the jaw, usually using instruments
called FORCEPS or ELEVATORS. An extraction can also be carried out
SURGICALLY, when the dentist needs to make extra incisions or remove some
bony tissue to get the tooth to come out. Surgical extractions are carried
out when a normal or straight- forward extraction is not possible.
As a patient there are a few guidelines you should follow after having a
tooth extracted. You should not rinse your mouth out vigorously for some
time (usually 24 hours) afterwards. You should keep your mouth clean,
though, and brush your remaining teeth as normal. You may be given advice on
how to stop bleeding from the socket afterwards, (biting on a clean,
just-damp cloth or handkerchief) and any other special instructions will be
given by your dentist.
F
Floss
Floss is composed of soft strands of thread, usually made of silk, nylon or
gortex which is used to clean and remove plaque and debris from in between
the teeth. It is recommended to floss at least one time per day, and
preferably after each meal.
To floss your teeth, you need to pull the floss in between two teeth, then
curve the floss around one tooth and slide it underneath the gum. Rub the
floss against the tooth up and down a few times. Repeat this procedure on
the adjacent tooth.
Food Impaction
Food impaction is the forceful wedging of food into the PERIODONTIUM of the
teeth by OCCLUSAL, or biting, forces. It often happens in the space between
the teeth ( the interproximal area ) and is frequently associated with
incomplete filings or very heavily filled teeth. This condition is very bad
for the gums, and may lead to severe pain and PERIODONTAL DISEASE which
should be treated urgently. In the above mentioned case, it might be
necessary to CROWN or CAP the teeth to provide them with adequate support,
or build the correct form of the tooth again.
Forceps
Forceps are instruments which have two BLADES and handles, which are used
for holding, compressing, or removing something. DENTAL FORCEPS are used for
the EXTRACTION of teeth. HAEMOSTATIC FORCEPS are used during surgery to
constrict and clamp usually blood vessels. There are many other types as
well, and they all have specific uses and applications.
G
Gingivitis
Gingivitis is inflammation of the gums characterized by red, swollen and
bleeding gums. It is a reversible condition associated with the build up and
accumulation of plaque due to improper oral hygiene. Plaque is an irritant
to the gums and causes inflammation. Other factors involved in gingivitis
are poorly fitting appliances, mal-aligned teeth, mouth-breathing and
overhanging margins of dental restorations.
Gingivitis may lead to a more serious condition known as periodontitis.
Please see your dentist to evaluate the health of your gums.
Glass Ionomer
A type of dental cement made up of Calcium Aluminosilicate glass powder and
a liquid polyacrylic acid. Although useful in many different situations and
restorations, glass ionomer should not be used alone in areas of the mouth
where there are high biting forces, for example, the posterior teeth.
Glass ionomers contain FLUORIDE which leaches out of the material and helps
prevent the return of CARIES under the filling. They also have a good
potential for adhesion with the tooth because the polyacrylic acid reacts
with the calcium in the tooth to form a bond. Glass ionomer cements also
come in a variety of tooth coloured shades, so that matching is usually
quite good.
Gutta Percha
GUTTA PERCHA is a type of material which is made from the sap of trees found
in Malaya. It is a very safe substance, and is used in ROOT CANAL treatment
to fill up the canals once the PULP has been removed and also as a TEMPORARY
FILLING MATERIAL. It is often a pink or grey colour, comes in various shapes
and forms, and usually needs heat or pressure to form it into the correct
shape.
H
Halitosis/Bad Breath
Halitosis, commonly known as bad breath may be due to a number of factors
including: poor oral hygiene, decayed teeth and general neglect of the
teeth, periodontal disease, deeply furrowed tongue, sinus infection, and
tonsillitis. Acidosis, a metabolic condition often caused by diabetes or
starvation is another common cause of bad breath.
Diet, especially garlic and onion, can also be a factor in halitosis.
Mouthwash does not work well in this situation as the odor is present in
your blood stream and is transmitted when breathing.
"Morning mouth" occurs due to the drying of oral tissues especially in those
who snore or sleep with their mouth open. The drying allows for increased
amount of bacteria to remain in the mouth.
See your dentist to evaluate which of the above factors accounts for your
halitosis.
Headgear
This is a harness-like device which is fitted about the head and/or neck in
ORTHODONTIC treatment to provide extra support or forces to the APPLIANCE
being worn. Because headgear looks a little strange when fitted, the
ORTHODONTIST may suggest only wearing it at night or at home; but even if
the regime recommended is more than that, the daily wearing time should be
strictly adhered to, as this will effect the long term success and the time
it takes to finish treatment.
Hygienist
A hygienist is a person trained to perform preventive procedures such as
cleaning teeth, applying fluoride, placing sealants, taking x-rays and
educating patients on oral health care. Dental hygienists must practice
under the supervision of a dentist.
I
Impaction/ Impacted tooth Impaction is the condition of a
tooth being blocked from ERUPTING, or growing into the mouth, by a physical
barrier. This barrier is usually another tooth. If there is OVERCROWDING
present i.e. not enough space for the teeth to grow into the correct
position, this may lead to the impaction or wedging of teeth in the bone.
WISDOM TEETH, that is the teeth at the very back of the mouth, are
frequently impacted and may cause quite severe problems for the patient.
This includes pain, discomfort, and possibly limited opening of the mouth,
as well as RESORPTION and CARIES in the teeth in front of them. It is often
necessary for IMPACTED WISDOM TEETH to be SURGICALLY REMOVED as a result. If
this does become necessary, your dentist may advise you to have special
ANAESTHETICS, and even possibly a stay in hospital for a few days. This is
not necessary in most cases, however.
Implant Although implants are not a new type of treatment, their
development into the general sphere of dental practice has been remarkably
pronounced in recent years. An implant is a metal pin, blade or casting
which is insert into, or placed on top of, the bone of the upper or lower
jaw to provide ANCHORAGE or stabilization either to teeth or PROSTHESIS. An
ENDOSTEAL ( Endosseous) implant is one which is introduced into the maxilla
or mandible so that it part of it protrudes into the mouth. Implants usually
consist of 3 sections; 1. the body, which is placed into the bone, 2. the
abutment, which is the section visible in the mouth which supports or
retains the prosthesis and, 3. the superstructure to which other components
of the prosthesis are attached.
Infection Control These are the procedures and protocols designed to
prevent or limit cross contamination in health-care environments, and to
prevent the transmission of infection from one patient to another. These
procedures are, in the dental practice, relevant in not only the surgery
itself, but all other areas of the dental office like recovery rooms,
waiting rooms, rest rooms, and so on. CROSS INFECTION is defined one which
is transmitted between individuals who are infected with different
PATHOGENIC MICROORGANISMS.
Inlay This is a RESTORATION of metal, fired porcelain, or plastic
made outside a tooth to fit into a tapered CAVITY PREPARATION and fastened
or LUTED into it with a cementation medium. Inlays can be divided by how
they are produced into DIRECT and INDIRECT types. In the DIRECT sort, the
pattern for the inlay is made in the mouth from the patient's teeth. In the
INDIRECT form, an accurate IMPRESSION of the mouth is made, models
constructed, and the pattern made up (usually in wax) on this model.
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N
Nursing
bottle caries This form of caries or tooth decay is found in the
DECIDUOUS dentition and is related, as expected, to the incorrect use of
nursing bottles and the liquids in them. Nursing bottle caries affects
typically the anterior teeth in the upper arch while the lower teeth remain
unaffected as they are protected by the tongue while the infant is sucking
the bottle. The cause of tooth decay is the presence of bacteria, and sugars
in the mouth over extended periods of time. (see section on CARIES ) In the
above situation, a nursing bottle is allowed to stay in the child's mouth
over long periods, usually as a soothing mechanism to induce sleep, and
because of this, the rate of caries development is fast and severe. Because
the PRIMARY dentition is also less mineralized and therefore 'weaker' than
the permanent dentition, the caries is particularly aggressive and
pronounced. The amount of sugar in the liquid in a baby's bottle is crucial
to the rate of caries formation. Fruit juices, although a 'natural' product,
are particularly high in sugars, and there are many other products on the
market for babies which will cause damage to the teeth. The precaution of
reading the product contents should always be taken, and anything with
sugar, fructose, or lactose rejected. Pure water is the best filler if using
a nursing bottle cannot otherwise be avoided. Treatment of this type of
caries is notoriously difficult and unpleasant for all concerned. Because of
the young age of the patient the treatment is often the first introduction
to the dental practice environment, and the extensive nature of the work
required means that it is especially traumatic for the child, the family and
the dental team. In extreme cases, the use of GENERAL ANESTHETICS may be
necessary, which increase the risk to the patient's health and general
well-being. Parents must be especially vigilant and determined to avoid this
type of caries, as they thereby prevent enormous amounts of trauma,
especially psychological, to their children. Methods of prevention include
the avoidance of nursing bottles if possible, the correct types of liquids
being drunk, regular and correct tooth-brushing techniques ( see PREVENTIVE
DENTISTRY section ) and, where necessary, the use of FLUORIDE diet
supplements and treatments. Your dentist or hygienist will be able to offer
you advice on prevention and hygiene.
O
Onlay
(Also sometimes called an OVERLAY) An onlay is a cast RESTORATION retained
by friction, mechanical factors, and cementation in a specially prepared
tooth, which replaces one or more CUSPS and adjoining structures of the
tooth. This term may also be used to describe part of a REMOVABLE PARTIAL
DENTURE which is extended over the entire OCCLUSAL surface of a tooth to
provide extra support to the appliance.
Orthodontics Orthodontics is that branch of dentistry which is
concerned with the growth, development, and treatment of malformations of
dentofacial structures. It may include the movement of teeth or facial bones
through the application of forces and/ or the stimulation and redirection of
functional forces within the CRANIOFACIAL COMPLEX. ORTHODONTIC TREATMENT is
frequently carried out on children in their childhood and teenage years as
this is the most effective time to alter the position and growth patterns of
the mouth and jaws. Adult orthodontics is, however, increasingly common, and
improved understanding and techniques means that this form of treatment is
available to ever larger numbers of people. Orthodontic treatment is
generally carried out with the use of a BRACE or ORTHODONTIC APPLIANCE which
is either removable or fixed in the mouth, (generally by being bonded onto
the teeth.) There are very many different styles and forms of appliances,
most of which are worn inside the mouth, but some which include external
parts like HEADGEAR. Orthodontic appliances are generally made of metal or
plastic wires and BRACKETS, sometimes with acrylic sections, and sometimes
even with elastic bands to apply forces. Orthodontic treatment generally
aims not only to improve the functioning of the mouth and jaws, but also the
appearance of the face by improving the alignment of the teeth and related
bone structures.
Orthognathic surgery This is the type of major surgery which deals
with the cause and treatment of mal-positioning of the jaws. The surgery is
usually carried out to alter the position of the dental ARCHES and/ or the
supporting structures, and is frequently done in combination with
ORTHODONTIC treatment. The surgeons who carry out these types of treatment
will have undergone extensive training, as this is a very specialized field
of dentistry.
Overbite The overlap between the upper INCISORS ( front teeth ) and
the lower incisors in a vertical plane. Also sometimes called the VERTICAL
OVERLAP. Normally between 2 and 4 millimeters.
Overdenture Also known as a TELESCOPIC DENTURE, or an OVERLAY
DENTURE. This is a removable partial or complete denture which has secondary
COPINGS or fixtures, which telescope (fit) over primary copings prepared in
natural teeth, or on posts or on studs.
Overjet The horizontal projection of the upper INCISORS ( front teeth
) beyond the lower incisors when the teeth are held together. Usually 2 to 4
millimeters. Also called the HORIZONTAL OVERLAP, the HORIZONTAL OVERBITE,
and less frequently, the overjut.
P
Palatal
expander Some types of ORTHODONTIC APPLIANCE have these devices fitted,
which are designed to increase the width between the teeth in the upper arch
by expanding the palate or by tilting the upper teeth. Often the patient
needs to adjust the EXPANDER herself between visits to the orthodontist, and
this will be explained in detail by the doctor or nurse before she starts
treatment. As each patient is different, so the instructions for use of the
palatal expander will be different. If there is any doubt what needs to be
done, the patient should contact the ORTHODONTIST before making any
adjustment herself.
Panoramic X-ray A panoramic x-ray is a radiograph taken outside the
mouth to show the entire upper and lower jaws (maxilla and mandible) in one
continuous film.
Partial Denture A partial denture is a removable artificial or
PROSTHETIC substitute for missing natural teeth and adjacent tissues which
does not include the replacement of all the teeth in the ARCH. There are
many different sorts and classifications ( most commonly by the KENNEDY
SYSTEM ) and methods of construction. Common materials used in their
construction include DENTAL ACRYLIC, ALLOYS OF METAL including COBALT
CHROME, GOLD, and many more. Partial dentures may be tooth supported ( i.e.
relying on the tooth substance for support via a system of rests and clasps
) or mucosal supported, ( i.e. relying on the gums and soft tissues for
support ) or a combination of the two. Partial dentures must be carefully
designed and constructed within certain guidelines so that they do not cause
destruction of the remaining and supporting structures of the mouth. People
who have been provided with partial dentures will often be specially advised
how to clean them and their remaining teeth correctly. Wearing any form of
tooth replacement, like dentures or bridges, means extra care must be taken
with oral hygiene as PLAQUE will collect differently around them. Ask your
dentist or hygienist for advice.
Periodontal disease\periodontitis\gum disease Periodontitis involves
inflammation of the gingiva which progresses to infection of the bone and
supporting tissue. Left untreated, it may lead to loss of periodontal
ligament attachment, and loss of bone resulting in mobility(loosening of the
teeth), and eventual tooth loss. Periodontal disease as usually a slowly
progressing disease of middle and old age. It is a chronic disease which can
be kept under control but not "cured". Periodontitis may also occur in
children where it mostly affects the first permanent molars and incisors.
The symptoms of periodontal disease include swelling and bleeding gums,
receding gums, exudate(pus) from the gums, halitosis(bad breath), splaying
or pushing outwards of the upper front incisors, and mobile loose teeth. The
treatment for periodontitis most often includes scaling and root planing
(deep cleaning) and possibly gum surgery. Thorough home oral care and
continued regular maintenance care by your dentist is also very important
for periodontal health.
Periodontal pocket The periodontal pocket is the space between the
gum and the tooth as associated with periodontitis. The deepening space is
cause by the destruction of the periodontal ligament attachment and
supporting tissues. The pocket is often lined with ulcerated and inflamed
tissue. As the pocket becomes deeper, it becomes more and more difficult to
clean out accumulated plaque and calculus. Measuring the depth of pockets
with a periodontal prove and assessing the presence of blood or pus in the
pockets are different ways your dentist can evaluate your periodontal
health.
Plaque Plaque is the sticky soft thin film on tooth surfaces composed
of food debris and bacteria. Accumulation of dental plaque is responsible
for the formation of cavities, gingivitis and periodontal disease. Because
plaque is so sticky, it can not just be rinsed off your teeth; it must be
mechanically removed. Tooth-brushing and flossing mechanically remove
plaque. Your dentist can evaluate how well you remove the plaque by using a
Plaque Index. After chewing colored disclosing tablets, the dentist counts
and evaluates the colored areas on your teeth where plaque is remaining to
arrive at a plaque index score. After learning correct brushing and flossing
methods your plaque index score should improve.
Precision attachment An interlocking mechanical device in which one
part (the female) is fixed to an ABUTMENT, either inside or outside the
CROWN of a tooth, and the other part (the male) is integrated into a BRIDGE
or DENTURE. Precision attachments provide extra support in the form of
retention or stabilization to the appliance. There are very many different
sorts of precision attachments, like Huster, Mccollum, Dalbo, ball and
socket, bar, to name but a few.
Preventive Dentistry Preventive dentistry involves the dental care
and health programs given to prevent the onset of disease in the mouth. It
includes teaching good home oral cleaning care, diet advice, regular oral
prophylaxis (cleaning), fluoride treatments, and sealants.
Primary, Deciduous or Baby teeth These are the 20 teeth of the first
dentition which are shed and replaced by the PERMANENT or adult dentition.
They begin to form when the baby is still in the womb, and first appear in
the mouth around 6 months of age. The first teeth to appear are usually, but
not always the lower front INCISORS, and these are followed by the upper
incisors and then the POSTERIOR or deciduous molars. By the time the child
is about two and a half years old, all the deciduous teeth should have
'erupted' or appeared in the mouth, although the timing, sequence and
position of the teeth is not always totally predictable. Many children have
difficulty when the baby teeth are erupting, and this may take the form of
irritability, sleeplessness, tiredness, areas of slight ulceration in the
mouth, and even diarrhea. There are many preparations available from the
dentist, chemist or doctor to help the baby get over this difficult time.
The primary teeth are smaller, and of a different shape and form, relative
to the PERMANENT dentition. They are whiter but also less mineralized than
the adult teeth, and this means that they are also more susceptible to
CARIES.
Probe A periodontal probe is a blunt ended slender instrument used to
measure the depth of periodontal pockets. The measurements are usually in
millimeters. Bleeding of tissue or the presence of pus upon probing are also
used as guides to evaluate periodontal health.
Prophylaxis/cleaning A prophylaxis is a preventive treatment, also
known as a cleaning, involving removal of plaque, calculus, debris and stain
from teeth above the gumline. A comprehensive prophylaxis also includes any
necessary X-rays to help detect decay formation, checking restorations
present for defects and overhangs, examination of the gums to check for
periodontal health, checking for areas of food impaction, plaque detection
using colored disclosing tablets or solution, and application of topical
fluoride to prevent decay formation. It is recommended to have a dental
prophylaxis every 6 months to help prevent the onset of periodontal disease
and detect any decay formation in its early stages.
Prosthodontics Prosthodontics is that branch of dentistry which is
involved in the restoration and maintenance of oral function, comfort,
appearance, and health of the patient by the replacement of missing teeth or
tissues by artificial means. Also called PROSTHETIC DENTISTRY, DENTAL
PROSTHETICS, and DENTURE PROSTHETICS. A dentist who specializes in this
field is called a PROSTHODONTIST. PROSTHETIC SURGERY or PRE- PROSTHETIC
SURGERY is that required before or during the provision of prosthetic
treatment.
Pulpotomy A PULPOTOMY is a type of ENDODONTIC treatment, which
involves the removal of part of a vital PULP. The PULP is the living part of
the tooth which is contained in the inner ROOT CANALS and PULP CHAMBER, and
contains nerves and blood vessels, amongst other things. A PULPOTOMY ( also
called PULP AMPUTATION :old name; PARTIAL PULPECTOMY ) removes diseased
tissue and leaves healthy tissue behind to allow healing or growth of a
root. The treatment is often carried out on PRIMARY or DECIDUOUS (MILK /
BABY teeth), or on young adult teeth, and will be recommended to you if your
dentist thinks it is the treatment of choice.
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R
Radiolucent
Radiolucent objects are of low density, absorb radiation and appear as
dark gray to black on x-ray film. Some examples of radiolucent objects are
pulp, gingiva, and decayed tooth structure.
Radiopaque Radiopaque objects are of high density and do not absorb
radiation. They are viewed as white or light areas on x-ray film. Some
examples of radiopaque objects are metal, dense bone, and enamel.
Root Canal Treatment / Endodontics The root canals of a tooth are the
parts of the PULP CAVITY which lie within the roots, and in a healthy tooth
contain the vital pulp tissues. The PULP is made up of nerves and blood
vessels, lymph systems and other vital structures, and amongst other things,
is responsible for transmitting feelings of pain within the teeth. Root
canals are different shapes in each tooth; they are different between
different people and races, and they also change their shape as you get
older. Root canals may be made up of just one main channel, or more usually,
of several different channels, which may or may not have smaller side
channels branching off them. ENDODONTICS is the study and treatment of root
canal and pulp systems, and their related structures. If a tooth becomes
diseased or painful, and this may happen for a number of reasons, ENDODONTIC
or ROOT CANAL TREATMENT may be considered necessary. Likely causes may be;
extensive CARIES, TRAUMA, severe PERIODONTAL disease, extensive or large
RESTORATION work. This often leads to the death of the pulp tissue, which
may or may not be noticed by the patient in the form of pain. A pulp may die
straight away after trauma or treatment, or may take days, weeks or years to
die. Sometimes your dentist may decide that it is best to remove a vital or
living pulp, or even to use some medication to cause the death of the pulp
if that will help the treatment. Either way, you may or may not have pain
during the treatment. Even after the pulp has been removed or has died, a
tooth may still be painful due to nerves being affected in the surrounding
tissues. Your dentist should be able to offer you treatment to alleviate
pain, which may include ANALGESICS or pain killers, topical or local
medications, and possibly ANTIBIOTICS to reduce severe infections. The
treatment may last over a few minutes or a few days, or even a few weeks,
depending on what caused the problem. The duration of treatment is also
affected by how long the problem has been present and how difficult the
treatment processes are. Your dentist will normally require a number of X-
RAYS or RADIOGRAPHS during the course of the endodontic treatment so that
she may see how the various stages are progressing, and whether or not the
treatment is successful. You cannot provide any home care which will treat
root canals, but you should follow the instructions of your dentist
carefully during treatment if it is to be successful. This may include the
taking of medication, the way you eat and clean your mouth, and the times
and frequency of appointments.
Rubber Dam / Dental Dam A rubber dam is a sheet of latex rubber which
is placed over teeth during treatment to isolate them from the rest of the
mouth. It is an extremely useful way to keep the area of work clean and
safe, and also prevents the patient from inhaling or swallowing instruments
which may be dangerous. During the removal of old amalgam fillings, it may
be used to reduce the amount of metal swallowed, and therefore the
contamination to the patient. The dam is held in place usually by a little
clamp around the tooth or teeth, as well as dental floss, and is removed
after treatment.
S
Scaler A
scaler is an instrument used by hand to remove plaque and calculus from
tooth surfaces above the gumline. Scaling and Root Planing Scaling involves
the removal of plaque and calculus from tooth surfaces. It removes these
irritants to the gum tissues and allows healing to occur. Scaling below the
gum line is often referred to as a deep clean. Scaling is often combined
with root planing. Root planing is the meticulous cleaning and smoothing of
root surfaces. Inflammation of the tissues is reduced which helps the gum
tissues to return to a healthy state.
Sealant A sealant is a protective coating formed by resin bonded into
the deep pit and fissure grooves on the occlusal (biting) surfaces of molar
and premolar teeth. A sealant helps to prevent formation of decay by
blocking the accumulation of food, debris and bacteria in these vulnerable
areas.
Serial Extraction This is an ORTHODONTIC procedure in which PRIMARY
or DECIDUOUS teeth are removed over a period of years in a particular
sequence to prevent or relieve OVERCROWDING of the PERMANENT teeth when they
ERUPT or come through into the mouth. At the end of a serial extraction
procedure, it may still be necessary to remove some permanent teeth, but the
crowding will have been localized, and the orthodontic treatment then needed
will be less than otherwise would have been necessary. Also called SELECTED
or PROGRESSIVE extraction
Space maintainer A removable or fixed appliance designed to maintain
an existing space in a DENTAL ARCH. Space maintainers are usually fitted in
children when they have lost DECIDUOUS or baby teeth early, and the gap left
needs to be held open to allow the PERMANENT or adult tooth to erupt in the
correct position. There are many different designs of space maintainer, and
the materials normally used are metal or acrylic.
Sterilization This is a process in which a surface or instrument is
rendered free from viable (i.e. living) germ life.( microorganisms) There
are several effective ways to achieve this state, for example using
AUTOCLAVE EQUIPMENT ( see notes above ), using a DRY HEAT sterilization
process ( 160°C ) for one hour, using certain types of GAMMA RAYS, or
ETHYLENE OXIDE gas, and so on. All instruments in a dental practice should
be sterilized before use between the patients the dentist sees. This is to
prevent contamination and CROSS INFECTION.
T
Temporary
restoration Also known as an INTERMEDIATE restoration, this type of
tooth filling is used to restore the form, function or appearance of the
teeth for a limited period of time, from several days to several months.
Temporary restorations are designed to seal a tooth and maintain it's
position until a permanent restoration will replace it. There are many
different sorts of materials used, for example, GUTTA PERCHA, ZINC
PHOSPHATE, ZINC OXIDE-EUGENOL. Some of the temporary restorations may be
indicated as PALLIATIVE treatment, for example during ROOT CANAL TREATMENT
to soothe a PULPAL lesion, or in cases of RAMPANT CARIES to stabilize the
teeth and alter the oral flora.( bacteria predominant in the mouth.) An
alternative regime for complete sterilization is 12 minutes at 134°C, in an
autoclave.
Tooth-brushing The Bass method is a preferred method of brushing. It
involves placing the tooth brush head at a 45 degree angle along the gumline,
pointing downwards on the bottom teeth and upwards on the top teeth. The
tips of the toothbrush bristles should go underneath the gumline. The
toothbrush is gently vibrated, not scrubbed, along the gumline spending
about 3 seconds on each tooth. The entire process of brushing should last
3-4 minutes (about the length of one song on the radio!)
Toothpaste Dentifrice is the toothpaste, powder, liquid or gel that
is used with a toothbrush to clean teeth. It contains a mild abrasive,
detergent, flavoring agent, humectant (retains water) and various
medicaments designed to prevent tooth decay. Only a pea sized amount of
dentifrice is recommended to be placed on the toothbrush. The actual
mechanical action of brushing is more important than the tooth paste used.
However a toothpaste containing fluoride helps to significantly reduce tooth
decay.
U
Ultrasonic
cleaner An ultrasonic cleaner is an instrument which transmits high
frequency vibrations to remove large deposits of plaque, calculus and debris
from tooth surfaces. Water is used with the ultrasonic cleaner to cool the
tooth and flush away debris. Hand instrument cleaning is often necessary
following ultrasonic cleaning to thoroughly clean off tooth surfaces.
V
Veneer A
veneer is a thin layer of tooth colored material, usually porcelain or
acrylic resin, which is attached to the surface of a tooth by direct fusion,
cementation, or mechanical retention. When used without qualification, the
term now usually means a thin layer of porcelain which is bonded onto the
slightly prepared front surface of a tooth to improve the appearance. The
colour and shape of teeth may be dramatically improved with veneers, which
have the advantage over CROWNS of requiring less reduction of the natural
tooth tissue. However, not all cases where crowns are a possibility, are
suitable for veneers. Your dentist will advise you on whether veneers are
the treatment of choice for you.
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X
X-ray/Radiograph An x-ray or radiograph is an image produced on film
following exposure of an object to x-radiation. The image produced is based
upon the density and absorption of radiation of the object.
Y
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Z
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