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. 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.
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.
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 demineralisation 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 colour
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.
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.
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 occuring 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 colour 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.
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. 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.
There are many different types of bridge including FIXED- FIXED, FIXED-MOVEABLE,
CANTILEVERED, MARYLAND, ROCHETTE, SPRING CANTILEVERED, ACID-ETCHED, PORCELAIN
BONDED, and many others.
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 adherant 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 DEMINERALISATION
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.
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.
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.
There are various different types of crown, including BASKET, GOLD,
COMPLETE VENEER, FULL, JACKET, PARTIAL, STAINLESS STEEL, THREE- QUARTER,
TELESCOPIC, PINNED, WINDOW, TEMPORARY.
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
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.
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. Drills are driven either by a rotating shaft
or compressed air.
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.
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, malaligned teeth,
mouthbreathing 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 - This material 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.
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 preventative
procedures such as cleaning teeth, applying flouride, 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 infront 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 ontop 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. Nusring 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
the use of 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 ANAESTHETICS 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 toothbrushing
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 malpositioning 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 millimetres.
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 millimetres. 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,
receeding 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
plaing (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 peridontal 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 pckets with a periodontal prove and assessing
thepresence 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. Toothbrushing 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 Dentristry - 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 flouride to prevent deecay 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.
Q
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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 radioluscent 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 homecare 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 - 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. This is also
referred to as 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 (ie.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.
Toothbrushing - 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 dentrifice
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 coloured 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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