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GLOSSARY

A

Abfraction:  (ab = away.  fraction = break apart) the process by which the energy put into the tooth through chewing, clenching or grinding results in the loss of enamel and/or dentin from the tooth surface, normally around the neck of the tooth, but also at the tips of the cusps. It is also affected by the acidity of the saliva, any gastric influences in the mouth, e.g. GERD, and other oral habits that enhance erosion (medicines, recreational drugs, highly acidic foods (lemons). The result is indentations in those places: hollowed out areas at the necks of teeth; depressions on the tips of cusps.  The size and shape depends on the intensity and duration of the forces.

 

Action Potential:  the amount of stimulus a nerve needs to cause it to send its electrical signal to the brain.  When tissues become inflamed and infected the action potential drops and a tooth becomes ‘more sensitive’ .

All-porcelain restorations: syn. Ceramic.  Restorations (crowns, inlays, onlays, venners) that are made entirely of porcelain and complementary materials (zirconia, Lithium Disilicate).

Amalgams: syn. silver, mercury filling.  A very common filling material composed of several materials, including tin, silver, zinc, copper and mercury.  They are vigorously mixed together and form a hardened, chemically stable material that is inexpensive and durable.

Acid reflux disease:  characterized by return of acidic contents of stomach to the mouth if only by gastric vapors.  These vapors can cause severe erosive destruction of the tooth surfaces.  

Analgesic: a medicinal pain reliever.  It does not work like an anesthetic which blocks pain message.

Anesthetic: syn. local injection, topical paste.  A chemical, normally a liquid or paste, which blocks the transmission of pain and sensory signals to the brain.  It creates a numb, wooden or ‘fat lip’ kind of sensation.  There are many types of anesthetics which last varying amounts of time so the doctor can select the one which is most appropriate for a procedure.

Anesthetic block: an injection of anesthetic which blocks the signal of the nerve at a point before it enters into the body of the bone through an opening called a foramina*.

Anesthetic Infiltration: an injection of anesthetic which blocks the signal of the nerve after it enters into the body of the bone by infiltrating through the bone to the nerve as it enters the root tip.

Anorexia nervosa: a psychological condition characterized by an excessively reduced intake of food associated with other weight loss habits to maintain a self image of thinness. 

Antibodies: a defensive protein mechanism of the body which fights off invading materials or organisms (antigens) to keep it healthy.  Part of the immune system.

Antigens: a substance produced by a foreign material, such as bacteria or enzymes, which attacks the body tissues and, in most cases, activates the immune system and is responded to by antibodies produced by the body.

ANUG: syn. Acute Necrotizing Ulcerative Gingivitis, Trench Mouth.  A severe bacterial reaction in a weakened body (depleted of its immune reserves by continued loss of sleep, high stress and poor hygiene and diet) which is characterized by profuse ulceration with decaying surface skin, large amounts of plaque and debris on the teeth and a very distinct, foul odor.

Anterior teeth: see incisors, cuspids.  Teeth in the front of the mouth.  Each anterior tooth has one cusp (edge).

Apex: the tip of the root of a tooth

Apical foramen: the small hole at the tip of the root through which the nerves and blood vessels enter and leave the tooth into the root canal complex thus supplying vitality to the tooth. Inflammation of any source causes a backup of blood causing pain.

Apicoectomy: a minor surgical procedure used to remove and seal the infected tip of the tooth root.  It is usually performed by a surgically trained endodontist or an oral surgeon and is ideally done with a high powered microscope to minimize the surgical field.

Arch (maxillary):  the upper boney ridge in the mouth which holds the upper teeth.  It is part of the fixed skull and does not move in function.

Arch (mandibular): the lower boney ridge on the top of the lower jaw (mandible) which holds the lower teeth.  The somewhat            ‘L shaped’ mandible hinges from the area just forward of the ears when it opens and closes and shifts side to side in function.

B

Benedryl: one of the components of a palliative rinse (Swish and Spit) for herpetic lesions.

Bicuspid:  the fourth and fifth teeth (first and second bicuspids), upper and lower, from the center of the face on either side.  They are immediately behind the cuspids.  Bicuspids have two (i.e.-bi) cusps each.  They create the transition from the front teeth, with one cusp each, to the molars which can have four or more cusps.

Bilateral: occurring on both sides of the mouth or jaw.

Bisphosphonates: a class of drugs used to combat osteoporosis (see In The News: Articles: Bisphosphonates)

Board certified: a specialist who has passed a specialty review board exam for the specific area of dentistry in which he/she is specializing in.  (see Specialist)

Board eligible: a dentist who has graduated from post graduate school (after 4 years of dental school) but has not passed the specialty review board exam (see Specialist)

Body (of the mandible):  the main part of the lower jaw that holds the teeth.

Bonding: a technique which gently etches the surface of the tooth, allowing the resin component of the filling material to soak into and seal the surface of the tooth, both enamel and dentin.  Many different materials can be bonded, including metals.

Bridge: any restorative device, fixed or removable, which fills in a space of a missing tooth between two existing teeth.

Buccal:  this means or implies toward the outside of the mouth or face but on the side, not the front of the face (see facial*, labial*).  The term is used to describe the location of surfaces and parts of teeth or mouth parts more toward the cheek and away from the palate* or tongue. The buccal word is applied here because the ‘buccinator’ and masseter muscles form the side of the face to which these surfaces face.  These are the main muscles that open and close the jaw.  Conversely, see lingual*, palatal*. In the front of the mouth the term facial or labial is used.

Bulimia: an emotional illness characterized by regurgitating food with the expressed purpose of maintaining a very thin physical appearance or low weight (also seen in certain athletics).  The process washes the teeth in gastric fluids which are severely damaging to teeth.  This illness can totally devastate the teeth in the mouth.  It demands strong intervention to protect the teeth.

C

CAD-CAM: computer-aided-design; computer-aided-manufacture.  It means the design and manufacture of a product is primarily run by computers.  Implant placement is one such application.

Calculus: syn., tartar*; the porous mineral deposits that form on the surfaces of teeth when they are not effectively cleaned on a regular basis.  Minerals from saliva form on the bacterial plaque* that grows on teeth that are not well maintained.  Calculus acts as a template for more plaque accumulation and more mineral deposits.  The degree of sugar intake through one’s diet will directly affect the quantity of calculus formed.

Calculus, subgingival: calculus found under the visible gum line along the root surface.  This is extremely difficult to clean from teeth because it is hidden from view and often can be very smooth to touch.  Patients cannot clean this.

Calculus, supragingival: calculus found above the visible gum line on the crown and root surface.  This is easier to clean because you can see it.

Canal: the chamber in the root of a tooth that holds the nerves and blood vessels for the tooth

Canine: see cuspid

Caries: syn., cavity, decay; the technical word for tooth decay

Cariogenic: decay producing, as in cariogenic bacteria

Cementum: the skin-like outermost surface of the root.  It allows the tooth to be retained by the bone by having the periodontal ligament* embed into the cementum layer and connect it to the bone.  

Ceramic: porcelains used in the creation of restorations with high esthetic values.

Charting: syn.: perio charting; the measurement of the depth of the gingival sulcus from the tip of the free gingiva to the base at the epithelial attachment.  It signifies a  numerically relevant condition of periodontal health.

Clenching: a stress-releasing habit in which the person squeezes the teeth together with above-normal force (see grinding*).  This eventually breaks down the enamel crystalline structure which protects the biting surface of the tooth leaving the underlying dentin vulnerable to more rapid breakdown.  Teeth wear very rapidly and form abfractions*.

Cold sore: syn. fever blister*, herpes(-tic) lesion*; a lesion of viral origin that is very painful (burning).  It can appear anywhere in the mouth or lips, lasts about two weeks. Palliative treatment: "Swish and Spit" solution

Collagenase: a natural defensive enzyme found in oral soft tissues which the body uses to help get rid of a foreign irritant, such as bacteria.  While fighting the bacteria it breaks down collagen, the fibrous material that gives shape to the gums, causing the gums to swell and become loose.

Composite: a filling materials, any resin based, tooth colored restorative materials (there are countless versions). Silica, quartz or similar glass-like powders add the body and durability to the resin substrate.

Condyle (mandibular): the movable part of the jaw joint (TMJ*) that slides in the condylar fossa*.  It is connected to the lower jaw which moves up and down in all functions: chewing, talking, opening and closing.  When it moves it slides over a firm fibrous ‘cushion’ or disk that acts like cartilage in a knee.

Condylar fossa: basically the fixed part of the jaw joint (TMJ*) which is, in fact, part of the base of the skull.  It is the smooth depression on the underneath surface of the skull which guides the condyle through its functional movements (similar to the working surfaces of the knee).

Condylar disk: the semi-flexible cartilaginous disk which acts as a cushion between the functioning boney parts of the jaw joint.  It is held loosely in place by fibrous ligaments which allow it to move in function.

Cross bite: a tooth arrangement in which the outside edges of the lower teeth are outside of the upper teeth.  Normally the upper teeth are outside of the lower teeth.

Crown: the visible part of the tooth which is covered by enamel.

Crown: syn., cap, jacket; a restoration (see indirect restorations) which covers the entire visible surfaces, or nearly so, of the tooth.  It can be made of many different materials or combinations of them, i.e. porcelain-fused to-metal crown (pfm crown), all-ceramic, resin based, porcelain over zirconium core and compomer to name a few.

Crown: Porcelain butt shoulder:   the all-porcelain margin of a ‘pfm’ crown which has had the metal cut back from the edge for better esthetics.  It lets more light into the tooth and helps prevent the ‘black line” common around the edge of pfm crowns.

Crown: Porcelain fused to metal crown: syn., p-f-m crown.  A crown which has layers of porcelain baked on top of a metal base.  A long-time standard in dentistry.  Various metals and porcelains can be used.

Curing: the process by which a composite material is hardened from its putty-like or liquid state.  It can be applied to a large variety of materials. This is either self or light activated.

Cusp (…tip(s)): the point(s) on the tooth

Cuspid: syn., canine, fang or eye (named so because of its location below the eye) tooth; the third tooth from the center of the face.  It has the largest root of the anterior teeth and creates the angle that marks the front of the face from the side.  It is a very important tooth in facial esthetics.  

Cuspid guidance: the process by which the upper and lower cuspids will move the jaws apart when the lower jaw chews to the left or right.  The lower cuspid slides down the inner surface of the upper cuspid in side to side (lateral) movement.

D

Deciduous teeth: syn., primary teeth, baby teeth; the first teeth to form in the mouth after birth and which are lost sequentially as the permanent teeth erupt into place.

Decussation: the twirling pattern of enamel crystals as they are laid down in the formation of a tooth.  Numerous crack lines appear in enamel in almost all teeth over time. This twirling prevents the cracks from splitting the tooth apart.

Debridement: syn. root planning and scaling*, cleaning, removal of debris.  The technical term used for scraping the debris off a root surface during periodontal therapy.

Dentin: syn, primary dentin; the body of the tooth, underneath the enamel and surrounding the pulp in the center.  It is softer and more flexible than enamel and gives color to the tooth as well as its fluid and sensory supply.

Dentin, secondary: the dentin which forms from the inner most wall next to the pulp chamber after the tooth has erupted into place and become fully formed. It forms due to external stimuli such as temperature, filling placement and chewing forces.

Diagnostic waxup: a recreation in wax of how the final restoration of the teeth should look.  This serves as a template for the final restoration and can be a most important communication tool.

Diplomat:  a doctor who has taken certified postgraduate courses and successfully completed his/her specialty exam in their field of study.

Direct restorations: syn. fillings.  These are placed directly by the dentist without the use of a laboratory fabrication step.  Most often they are done in one appointment.  Can be tooth colored or silver. (See indirect restorations)

Distal: syn., disto-; this means or implies more distant from the middle or midline of the mouth or face.  Conversely, see mesial*.  The term is used to describe the location of surfaces and parts of teeth or mouth parts.  A distal root on a molar, as opposed to the mesial root, will be more toward the back of the mouth and more toward the throat and away from the front of the mouth or face.

Dry mouth: see xerostomia.  Can be a natural condition or one brought on by drugs, medicines or other illnesses.

E

Enamel: the outer shell of the crown area of the tooth.  It is the hardest substance in the body and is crystalline in nature being made of layers of calcium hydroxyapatite crystals.

Emergence Profile: the angle at which a crown (natural or man-made) emerges from under the gums.  This angle is important to enable the gums to adapt tightly around the tooth.

Endodontics: the treatment of the root canal system of the tooth

Endodontics: that branch of dentistry, which is concerned with the morphology, physiology and pathology of the human dental pulp and tissues surrounding the root. Its study and practice encompass the basic clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated peri-radicular (around the root) conditions. (Adopted by ADA December 1983)

Endodontist: syn., root canal specialist.  A board certified dentist who performs endodontics.  This may also include surgical procedures to repair the root end (apex*) in a procedure called apicoectomy*.

Epithelial attachment: the point at which the free gingiva first attaches to the root surface.  This point starts the attachment apparatus of the tooth to the bone. (see also periodontal ligament, gingival sulcus, periodontal pockets)

Enzymes: natural chemical liquids (with names that end in ‘-ase’) that promote or enhance body metabolic functions, such as collagenase, which breaks down the fibers in soft tissues while combating bacteria (e.g. gums) and creates swelling and redness.

Eye tooth: see cuspid

F

Facial: syn., labial*, buccal*; this means or implies toward the outside of the mouth or face.  Conversely, see lingual*, palatal*.  The term is used to describe the location of surfaces and parts of teeth or mouth parts more toward the face and away from the palate*  or tongue.  In the back of the mouth the term buccal is used.

Fever blister: see cold sore.

Fissure: the natural grooves that exist in teeth.  They are mostly present on the biting surfaces of  molars and bicuspids and help in the process of grinding up food by creating irregular surfaces.

Fixture: the name used by dentists to describe the actual implant placed in the bone (normally by a surgeon) to replace missing natural roots.  The fixture can be restored in many different ways depending on the specific needs of the patient.

Fluoridosis: a condition caused by taking too much fluoride into the body.  With fluoridosis the enamel is damaged, weakened and discolored.

Foramen(-a, pl.): a small opening(s) in bones which allow nerves to pass into the bone

Fossa: the indentation(s) or pit(s) in the biting surface of a tooth seen most easily on bicuspids and molars which have several fossas.  Cusp tips on a tooth come together at a fossa.

Full Mouth Rehabilitaion (reconstruction): the complete reconstruction of the teeth and tissues in the oral cavity to a fully healthy, balanced functioning unit.  It requires precise application of many comprehensive techniques in dentistry.

Furcation: the point where the roots of a tooth separate.  This is similar in shape to the point on the hand where the fingers separate.  The norm is that upper molars split into three roots (trifurcations*) and lower molars split into two roots (bifurcations*).  Some bicuspid* teeth have two roots.  See fig. xx pg.xx

G

General Dentist: syn., general practitioner, family dentist, restorative dentist, dentist; any dentist who has received a DDS (doctor of dental surgery) or DMD (doctor of dental medicine) degree from an accredited dental school.  Normally has studied four years in dental school.  To practice any dentist must also pass a board exam (state or regional) and have a state license.  Foreign dentists must satisfy all similar testing procedures and requirements to obtain licensure.

Gingiva:  syn. gums; the soft pink tissue that forms the gums around the teeth.  Gingiva protects the bone and the neck of the tooth.  There are two parts to the gingival tissue, free gingiva and attached gingiva.

Gingiva—attached:  the pink gum tissue that adheres tightly to the underlying bone and tooth. It stabilizes the entire gingival tissue complex.  Without it all soft tissues would move around in the mouth and not protect the teeth and bone.  It is adjacent to the free gingiva and varies in height.

Gingiva—free: the loose edge of the gingival tissue which is not attached to the underlying bone or tooth.  It may be 1-3 mm high in an ideal healthy mouth; more in a diseased mouth due to inflammation or loss of attachment from gum disease.

Gingival papilla: the ‘peak’ of soft tissue which extends down between each of the upper teeth and up between the lower teeth.

Gingival sulcus: the inside surface of the free gingiva starting from the top edge, down to the point where it attaches to the tooth at the epithelial attachment*.  It should be 1-3 mm deep in a healthy mouth. It is similar to the relationship between the finger and fingernail.

Gingivitis: a low level of periodontal disease characterized by inflamed gingival tissues.  Gingivitis without bone loss is easily corrected with good oral hygiene.

Glenoid Fossa: the small depression in the bone of the base of the skull that makes up the maxilla.  The depression serves as a socket in which the mandibular condyle moves.

Grafting: the name of the process by which added bone, or bone-like grafting material (from a variety of sources) which allows the creation of new bone, is brought to an area.  The bone will ‘fix’ itself to the existing bone, solidifying it.

Grinding: a normally subconscious (you are unaware of it) dental habit in which the teeth are tightly placed together and are either minimally or aggressively rubbed together.  The forces not only wear down the biting surfaces of teeth but also contribute to the formation of abfractions*.

Guidance: the means by which upper and lower teeth function against each other

Guidance, incisal: the process by which upper and lower front (anterior) teeth rub against each other. Improper incisal guidance leads to chipping and premature wear.

Guidance, canine: the process by which the upper and lower canine (eye teeth, cuspids) teeth open up the jaw when it moves side to side. This is a major means by which the front teeth are protected from premature wear. Dentists try to create it in all their work.

Guidance, group function: in lieu of canine guidance, this occurs when all or most of the back (posterior) teeth contact in side to side movement. If properly set up (harder to do than canine guidance) it can function and perform much the same way as canine guidance.

Gums: see gingiva

Gutta percha:  the rubbery filling material used to fill a root canal after it has been thoroughly cleaned and which prevents bacteria from re-entering the canal.

H

Halitosis: bad breath. I can be derived from a variety of sources.

Herpes lesion: syn. fever blister, cold sore. A viral lesion that can occur just about anywhere in the mouth.  They are characterized by very strong, localized, burning pain lasting about two weeks.

Hydrodynamic theory of tooth pain (HTTP): the pulp of the tooth, which houses the blood vessels and nerves in the center of the tooth, is the source of all sensory responses inside the tooth.  The HTTP is based on the fact that the tissue fluid in the pulp slowly moves outward toward the enamel of the tooth.  Any change in this rate of flow causes a response, often painful, from the pulp.  It can be caused by temperature change, chemicals, including sugars, bacteria or trauma. Patients feel as if the nerve has been touched.

I

Iatrogenic: caused by a person, not of natural origin

Implants: man-made titanium replacements for missing natural roots of teeth.  They are placed into the bone and become fixed in it.  They can be very effective means of rebuilding lost teeth.

Implants, immediate load: the immediate placement of teeth (temporary) on implants, giving them function after 1 or 2 days.
Incisal edge: the very biting edge of the front (four upper, four lower) teeth.  It is mainly used in biting or tearing (softer) food, but not grinding.  

Implants, immediate placement: an implant that is placed immediately after a tooth is extracted. The shape of the root space left behind after extraction and bone quality determine if immediately placement can be done.

Incisal guidance: the back surface (the one you don’t see) of the upper front teeth which ‘guide’ the lower teeth downward and forward as they rub together in forward motion of the lower jaw.

Incisor teeth: the four upper and lower teeth located in the front of the mouth.  The two center teeth are the central incisors (left and right), and the next teeth to the side are the

Incisors, central: the two center teeth in the mouth, upper or lower.

Incisors, lateral: the second tooth from the midline. They are used to bite things, preferably food and not bottle caps, bobby pins, tough plastic bags, necks etc. Discretion is advised.

Incline planes: important angled surfaces on the biting (grinding) surface of a tooth.  The uneven surface assists in grinding food.
Indirect restoration: a restoration that is made by a lab technician from an impression taken by the doctor, which is cemented or bonded to the tooth. It routinely takes two appointments and is stronger than a direct restoration.  It can be made of resin, porcelain, metals or combinations of them (see ‘pfm crowns).

Inflammation: a natural response of the body to a foreign object (e.g. bacteria) by which chemicals, called enzymes, are produced by the body to destroy the foreign object.  The process also breaks down the body’s own fibrous tissues, causing swelling, redness and pain.  (Think of a dirty, open cut and how it looks.)

Inman Aligner: an orthodontic device used to align only the front six teeth in either arch. Normally the process takes 4-16 weeks which is shorter than conventional orthodontics.

Integrate: see osseointegration

Interproximal: means the area or surface between teeth.  An interproximal surface will be the side facing the adjacent tooth, just as a side of one finger faces its neighbor.  An interproximal area is the one between two teeth.

Invisalign: the brand name of an orthodontic appliance which uses sequentially preformed, clear plastic trays to move teeth through a predetermined series of stages to the ultimately desired position.  Many variations of the technique are available. It tends to be more expensive than traditional brackets and takes longer to achieve the desired result.

J

Jaw: a layman’s term for the arches* of the mouth that hold the upper and lower teeth.  They are more precisely referred to the upper maxillary arch and the lower mandibular arch.

Jaw Joint: syn., temporal mandibular joint, TMJ*; the point around which the lower jaw hinges and moves in all functional directions.

K

Kaopectate:  one of the three ingredients in the palliative rinse called swish and spit*.  The others are an anesthetic and benedryl. Used for cold sore relief.

L

Labial: syn., facial, labial; this means or implies toward the outside of the mouth or face.  Conversely, see lingual*, palatal*.  The term is used to describe the location of surfaces and parts of teeth or mouth parts more toward the lips and away from the palate*  or tongue (no definition is deemed necessary here).  In the back of the mouth the term buccal is used.

Lateral cephalometric x-ray: an x-ray taken of the side of the face to show the doctor the overall position of the bones of the face and how the teeth are positioned in them.  It is a critical x-ray in the specialty of orthodontics*.

Laser:  a general term for columnated light of high energy that is used to perform many functions in dentistry depending on the wavelength of the light emitting source. It can be used to cut, heal, kill bacteria, seal wounds and other functions.

Ligaments: fibrous attachments that connect one bone to another stabilizing the moving parts, such as in the jaw joint* or TMJ*.  We often hear or read of injuries to ligaments around the knee or shoulder which serve a similar function around those joints.  TMJ ligaments can also become injured or weakened.

Lingual: means or implies toward the inside of the mouth or tooth on the lower jaw.  It relates to the tongue side of a tooth.

Loading:  applying chewing forces to a tooth, implant or other dental structure (e.g. denture)

Lysozyme: chemical compounds found in our cells which act to break down (lyse) materials in the body.  Sometimes the items attacked are body components and other times it attacks invading materials.  

M

Malfiesense: a concept in the code of ethics for dentistry which states that a dentist cannot ‘do harm’ to a patient.  

Mandible: the lower jaw of the mouth, which is composed of the body of the jaw that holds the lower teeth and the ramus which connects the body to the condyle on which the mandible swings open and close

Mandibular condyle: the uppermost part of the lower jaw on which the jaw swings.  It is the ball of a ball and socket arrangement with the base of the skull being the socket.

Mandibular nerve: see Nerves, mandibular.

Materia-alba: a thin bio-film that forms on the surface of the tooth.  It is removed by effective brushing.

Maxilla: the upper ‘jaw’ of the mouth which is really the base of the skull.

Maxillary (and premaxillary) Excess:  the excessive growth of the bones of the face that support the upper front teeth.  People with this excess will have very prominent upper tooth and gum smiles.  Teeth seem to hang down from the face.  

Maxillo-facial surgeon: a specialist trained in the advanced surgical treatment of the oral environment, from extractions to complex facial reconstructive (orthognathic*) surgery.

Mesial: syn., mesio-; this means or implies toward the middle or midline of the mouth or face.  Conversely, see distal*.  The term is used to describe the location of surfaces and parts of teeth or mouth parts.  A mesial root on a molar, as opposed to the distal root, will be more toward the front of the mouth which means it is also more toward the midline or center line of the mouth or face.

Micro-abrasion: the process of sand blasting teeth with a special abrasion device to remove small areas of discoloration.  The area can be polished without a filling if the defect is small enough.

Missing or misplaced teeth: due to an error in genetics a tooth or teeth may never develop at all or it may come in a severely improper position.

Molars: syn., 6 year…, 12 year…, wisdom teeth, grinding teeth.  The big broad surfaced teeth in the back of the mouth used for grinding and chewing food.  They normally have four or more cusp tips

Molars, first: the first teeth behind the bicuspids.  The sixth tooth back from the center of the face.  It normally erupts at about 6 years of age.

Molars, second: the molar just behind the first molar; the seventh tooth back from the center of the face.  It normally erupts at about 12-14 years of age or later.

Molar, third: syn. wisdom tooth.  The last and eight tooth in the mouth from the center of the face.  It has a much more unpredictable time of eruption, sometimes never doing so.

Mucosa:  the loose and movable tissues that fill in the gap between the gingival tissues and other tissues such as the lips, cheeks, tongue.  They are essential for the flexibility of facial skin, expressions and mouth movement.  If they were rigid so would our faces be.

N

Nerves: mandibular: the main nerve with its branches, one on each side of the lower jaw, which brings sensation to the teeth and soft tissues. It comes from the fifth cranial nerve.

Nerve Block: an injection of anesthetic which blocks the signal of the nerve at a point before it enters into the body of the bone through an opening called a foramina*.

Nerve Infiltration: an injection of anesthetic which blocks the signal of the nerve after it enters into the body of the bone by infiltrating through the bone to the nerve.

Neutral Zone: a term that describes the state in which all the forces that exist in the mouth—chewing and grinding, the tongue, lips, cheeks, facial muscles and bones—are in functional and static balance.

Nicotine: one of the chemicals found in cigarettes which damages the body by restricting blood flow and impeding the transport by the body of its defense mechanisms to any necessary site.

Nightguard: syn. mouthguard, athletic mouthguard, a plastic appliance that is routinely worn to reduce the wear and tear effects of stressful dental habits on the teeth and jaw.  It acts like a buffer between the upper and lower teeth and helps to relax the musculature to allow for development of better function and comfort.  Type ‘A’ or tense patients benefit greatly from using such a device. A nightguard created by a dentist is much more precise in fit and can be much more durable. There are many types.

NTI Nightguard: a nightguard that sits only on the front teeth, opening up the bite in all the posterior (back) teeth. This allows muscles to relax and helps the dentist develop a proper relationship between upper and lower teeth when in contact. Cannot be worn 24 hrs/day.

O

Occlusal adjustment: the precise adjustment of the biting surfaces of the upper and/or lower teeth to create a balance in the overall chewing mechanism of the mouth.  Delicate grinding removes areas of contact between teeth that are causing the jaw to have to shift to allow the remaining teeth to come into contact.  When successfully completed, all the back teeth will contact simultaneously and, when chewing, contact in a precise and organized manner.

Occlusal prematurity: a condition of imbalance in the manner in which the upper and lower teeth come together in chewing or closing.  One or more teeth will make contact before the others causing a shifting, wear or breakage of tooth structure and a likely dysfunction of the jaw joint and supporting musculature.  This often results in chronic pain.

Odontoblasts: the cells that line the inner surface of the dentin of the tooth, next to the pulp.  Over time they deposit more dentin (see dentin, secondary) on that inner surface effectively pushing the pulp away from the outside of the tooth, reducing sensitivity.

Open bite: a bite arrangement characterized by the front teeth being apart when the back teeth are in contact.  It may originate from improper bone development or be a consequence from thumb sucking or other adverse habit.

Oral and Maxillofacial Surgery: is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial regions. (Adopted by ADA October 1990)
Organ:  a group of tissues (muscles, nerves, bones, blood vessels) that function as a group.  The mouth is an organ with each of the above tissue groups working as part of the digestive, vocal, and even emotive systems of the body.

Orthodontics and Dentofacial Orthopedics: the dental specialty that includes the diagnosis, prevention, interception and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures.

Orthodontics: a specialty area of dentistry which focuses on the movement of teeth and bones in order to place them in proper functional and esthetic alignment to each other. This can be accomplished with braces, wires and springs or clear plastic trays (see Inman Aligner, Invisalign).

Orthopedics, dental: syn. interceptive orthodontics.  A process used when the bones of the growing child’s face (up to 5-7 years old) are not in proper alignment; the dentist can utilize the growth patterns of the developing face to add additional growth or retard growth in order enhance the balance of the jaws.  It can save significant treatment later in a child’s dental development.

Orthognathics:  the area of dentistry the focuses on the repair of abnormal, structural, bony relationships of the oral environment.  Repair of bony facial deformities is handled here.

Osseous: of or like bone.  Osseous tissue is bone.

Osseo-integration:  the name of the process by which implants are fixated into the bone.

Osteoblasts: cells that create, form or lay down bone. They work in balance with osteoclasts to remodel bone.  They are more active in younger people and in bone repair.

Osteoclasts: cells that remove or remodel bone.  They work in balance with osteoblasts and tend to predominate as we age.

Osteoporosis: a generalized condition in which the bone density decreases and the bones become weak, brittle and prone to fracture. In this process the osteoclastic activity overwhelms the osteoblastic activity. Bisphosphonates are the drug category that tries to prevent osteoporosis. They must be used with extreme caution (see In The News: Articles: Bisphosphonates)

Overbite: the vertical overlap of the upper front teeth over the top edge of the lower front teeth.

Overhanging margins: excessive filling or restorative materials that sit away from the surface of the tooth creating a ledge, or that are placed beyond the areas of the tooth that have been prepared by the drill.

Overjet: the horizontal dimension that the upper front teeth extend forward of the lower front teeth

P

Palate: syn., roof of the mouth; it is composed of two parts: hard palate (the boney roof of the mouth shaped by the bottom of the skull; soft palate (the soft flexible back part of the palate that ends in the loose extension called the uvula).   The soft palate has many critical functions.

Palatal: the part or surface of a tooth that is on the inside, toward the palate.

Pain threshold level: the level of sensory pain input at which a person first perceives it.  It varies between individuals and within an individual as conditions change.

Papilla, gingival: the ‘peak’ of soft tissue which extends down between each of the upper teeth and up between the lower teeth

Paresthesia:  a long term numbness that sometimes occurs as a consequence of dental treatment which affects a nerve.  It is most often associated with the main nerve in the lower jaw (mandible) but can occur in several locations.  It normally is temporary but in rare situations it can be permanent.

Parotid duct: the duct through which the parotid gland expresses its salivary fluid

Parotid gland: the main salivary gland found in the cheek just outside the upper second molars

Pediatric Dentistry: is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence including those with special health care needs. (Adopted by ADA 1995)

Pedodontist: a dentist who specializes in the treatment of children

Peg lateral (incisors): a genetically produced defect of the lateral incisors* in which they are very narrow and almost round in shape, like a peg.  This can be corrected  by veneers or crowns.

Perio-Aid device:  a device used to hold the ends of a round toothpick to facilitate cleaning the gingival sulcus* of each tooth.  It is especially valuable in cleaning deeper pockets. As used at CDE it is the main tool at healing periodontal disease along with regular and interproximal brushing and flossing.

Periodontal disease:  syn., gum disease, Periodontitis; a predominantly bacterial caused deterioration of the health of the tissues which can lead the boney support of teeth to weaken, allowing them to get loose and possibly fall out.  The bacteria involved in advanced periodontal disease have been implicated in many other ailments of the body, especially the heart, lungs, artificial joints and splints and also pregnancy related issues.

Periodontal ligament: tiny fibers that connect the tooth to the bone and thus support it by attaching into the surfaces of the tooth and the bone and act like a shock absorber for the tooth.

Periodontal pocket: a diseased gingival sulcus that has than 4 mm or greater in depth from the tip of the free gingiva to its base at the epithelial attachment.

Periodontal probe:  a device used to measure the depth of the gingival sulcus* or, in a diseased state, a periodontal pocket*.

Periodontics: that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted by ADA December 1992).

Periodontist:  a dental specialist who focuses his work on the health of the soft tissues and boney tissues of the mouth.

Periosteum: a thin protective ‘skin’ that adheres tightly to the outside surface of bones.  It is highly sensitive and can be the source of pain in a bone bruise.

Plaque: a bacterial film which continuously forms on teeth due to the warm, moist environment of the mouth and the regular supply of nutriments from our diet.  Plaque will harden into calculus* within a week through the minerals deposited on it from saliva.

Pontic:  (from Latin: pons, which means bridge) the part of a cemented or removable bridge which replaces a missing tooth.

Pontic—ovate: a special type of pontic which ‘fits’ into a depression intentionally made into the soft tissue causing the tissue to form into a normal shape including papilla* as if a tooth were present.

Porcelain butt shoulder:   the all-porcelain margin of a ‘pfm’ crown which has had the metal cut back from the edge for better esthetics.  It lets more light into the tooth and helps prevent the ‘black line” common around the edge of pfm crowns.

Porcelain fused to metal crown: syn., p-f-m crown.  A crown which has layers of porcelain baked on top of a metal base.  A long-time standard in dentistry.  Various metals and porcelains can be used.

Post and core: a reinforcing procedure which adds physical structure and strength to a tooth after a root canal treatment has been completed. It involves cementing or bonding a strengthening rod (various types available) into a canal and rebuilding lost structure around it with a composite or similar filling material.  If there is insufficient remaining tooth structure to resist breakage from functional use, this is a very important step in creating a final restoration.

Practice limited to: a phrase which indicates the dentist is a board certified specialist in that field

Practice restricted to: a phrase which can be used by any dentist to indicate a personal wish to restrict the areas in which he/she does dentistry, e.g. cosmetics, family dentistry, implants, etc.  There is no official degree.

Premedication: recommended for patients with cardiac conditions associated with the highest risk of adverse outcomes from endocarditis:  prosthetic cardiac valve, previous endocarditis, congenital heart disease (with specifications). Can also be applied to analgesics (pain medicine) to prevent post-operative pain.

Prognathia: a condition characterized by the excessive forward growth of the lower jaw causing the lower front teeth to extend forward of the upper teeth.  

Proprioceptive: using the sense of touch to determine the nature of things (as in the use
of brail to assist a blind person)

Prosthodontics: (syn. prosthetics) is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted by ADA April 2003)

Prosthodontist: a specialist who is primarily involved in the maintenance and rehabilitation of the oral function, appearance and health of the teeth

Pulp:  all the tissue that makes up the sensory response mechanism of the tooth.

Pulp chamber: the small chamber in the center of the tooth that contains all the vital tissues that give sensory responses to tooth stimulation: hot, cold, chemicals, pressure, fractures, etc.  It has a main chamber in the crown of the tooth connected to a canal in the root of the tooth called the root canal.  There may be more than one canal in a tooth (e.g. molar).

Q

R

Ramus: the part of the mandible that connects the body, which holds the teeth, to the condyle, which is part of the hinge mechanism of the jaw joint (see TMJ*)

Resin: a generic term used to describe any material used as a filling material which uses special plastics as a primary ingredient.  All bonded composite filling materials are resin based.

Receding gums: syn. recession, the ‘pulling back’ of the gums which can occur for a wide variety of reasons: tooth shape, position, chewing forces, mechanical irritation from incorrectly fitting restorations, medical issues, etc.  This may or may not be associated with gum (periodontal) disease.

Retrognathia: a condition characterized by the insufficient forward growth of the lower jaw (mandible) during childhood.  The chin looks receded and the lower front teeth are far behind the uppers leading to overjet*.

Root canal treatment:  treatment of the soft tissues in the pulp chamber of the tooth often, but not always, involving removal of these infected or damaged tissues, cleansing of the canal in the root and filling the canal with a heat sensitive material called gutta percha* which fills in all the voids to the tip of the root (the apex) and seals out bacteria..  

Root planning and scaling*: syn. debridement*; a cleaning process by which calculus deposits are carefully and meticulously scraped from all the root surfaces, including those under the gumline.  It is a difficult procedure done by a skilled doctor or a hygienist.

S

Sleep apnea: the potentially dangerous interruption of the sleep process by means of loss of air flow to lungs due to malfunction of the epiglottis in the back of the throat.  Sleep apnea can cause irregularities to the heart leading to a heart attack

Saddle: the part of a removable partial denture that sits on the bony ridge (like a saddle on a horse) and on which artificial teeth may be placed.

Saliva: the liquids in the mouth that serve several very important functions: assist in digestion by lubricating foods; keep fragile gingival, mucosal and even tongue soft tissues moist; washing lubricant to help in cleansing teeth; French kissing assist (just checking to see if you are reading this). There are over 100 identified components in saliva, each with a function.

Silver filling: see amalgam

Sounding: a term used at CDE to describe the technique in brushing in which the bristles are gently tapped into the gingival sulcus to give the fingers the feeling of exactly where they are.  It is important to do this frequently to make sure the bristles are properly placed.  This same approach is used with the Perio-Aid* and any other device in areas to clean where the vision is blocked.

Specialist: a dentist who has graduated from post graduate school for an additional >>>> years after receiving a DDS or DMD degree and has satisfied the stated specialty board requirements.  The process can take 5 years to be board certified, prior to that the doctor is board eligible.  Only a certified specialist can use the nomenclature of “specialist, or specialist in”

Specializing vs Specialist: any dentist can indicate that they are “specializing in” an area, but only certified specialists can refer to themselves as a specialist.

Splinting: joining of teeth together, either by external or internal tooth retention, for the purpose of creating stability and reducing excessive tooth movement.  Excess movement of teeth is bad.

Sublingual gland: a major salivary gland that sits below the tongue toward the front of the lower jaw. The 'squirter'.

Submandibular gland: another major salivary gland located farther back under the tongue.

Stent, surgical implant: a guide, which can be made manually or by CAD-CAM technology, which helps direct the bone preparation and precise placement of implants.

Supernumerary tooth: syn, extra tooth.  A flaw in the genetic code allows an extra tooth (or more) to develop beyond the normal count of 32.

Swish and spit rinse: a rinse that can be obtained through your pharmacist that is used as a soothing palliative against surface oral pain such as fever blisters, cold sores, and ANUG.  It contains equal amounts of local anesthetic, benedryl, and Kaopectate.

Synovial Fluid: the fluid in the temporal-mandibular joint, that keeps the components moist and supple, acts as a hydraulic cushion, and supplies nutriments to the joint because the blood supply there is minimal.

T

Tachycardia: an increase in the hear rate.  It occurs with dental injections that have epinephrine or similar compounds in them to lengthen the anesthetic effect.  It can also be brought on naturally by highly stressful events.

Tartar: syn., calculus*.  Hard deposits that form on teeth by mineralization of existing plaque.

Temporo-Mandibular-Joint: syn. TMJ, the jaw joint; the top ends (left and right) of the lower jaw (condyle*, condylar head) fit into depressions in the base of the skull (condylar fossa*) and rotate and slide forward and back when in function. It is held together by ligaments, tendons and muscles.

Tendon: the fibrous end of a muscle which tightly attaches the muscle to bone (also see ligaments*).

Tongue thrusting: a habit of uncertain origin (possibly from early feeding patterns) which causes the patient to push their tongue more forward instead of upward when swallowing and talking.  The upper and lower front teeth are pushed outward and apart as a result. It can be controlled with practice.

Tooth mobility:  a key factor in the progression of periodontal disease characterized by the loss of the periodontal ligament attachment which connects the tooth to the bone.  Mobility speeds up any deterioration process.  This process is similar in any other joint in the body.

U

Unilateral: occurring on one side of the face or jaw

V

Vasoconstrictor: any chemical, such as nicotine, or epinephrine (similar to adrenalin) included in the local anesthetics given by injection or topical paste which helps keep the anesthetic in the area longer.  It does so by ‘constricting’ the area blood vessels thus reducing the speed with which they are removed from the anesthetic from the area. The duration of the anesthetic is altered by varying the percent of vasoconstrictor, 1-2% is normal, in the solution.  Nicotine is also a vasoconstrictor which reduces the ability of the gingival tissues to fight gum disease and reduces salivary flow which enhances decay.

W

Wisdom teeth: syn., third molars; the last of three molars on each side of each arch.  They tend to be more of a problem than an assistance and often should be removed for preventive reasons.

X

Xerostomia: syn., dry mouth.  A condition characterized by a reduction or loss of salivary flow which can cause significant damage and pain in the mouth.  Patients exhibit increase susceptibility to decay and gum disease because of the inability to naturally c
leanse and moisten the mouth.  Can be brought on by natural circumstances or through medicines or drugs.

X-ray: bitewing: ‘cavity check’; taken periodically to primarily assist in detection of decay in the crowns of teeth.  It does not necessarily show all the root of the tooth.

X-ray: CT Scan: a computer driven, 3-D scan of a selected area of the boney structure of the mouth.  This x-ray will supply views of the bone structures from three different vision points, thus 3-D(imensional).  Complex implant cases require a CT Scan before work is started.  Many oral surgery problems can be assessed more clearly with these scans also.

X-ray: Facial: an x-ray taken of the front of the face to show the width of the bones of the face.  An important diagnostic x-ray in the field of orthodontics*.

X-ray: Full mouth series: a series of from 16-22 x-rays taken as a group to show the crowns and roots of all the teeth in the mouth.  It is a critical diagnostic tool in many areas of dentistry.

X-ray: Lateral cephalometric x-ray: an x-ray of the side profile of the skull to show the relationship of the major bones of the face and the position of the teeth in them.  It is used primarily in orthodontics* but also is valuable in full mouth reconstructions.

X-ray: Periapical: an x-ray which shows the full length of the tooth including the entire root to its tip (apex)

Y

Z

Zygomatic arch: syn. cheekbone, an important bone at the top of the face that gives shape to your face; to which some of the major muscles of chewing connect.