This page provides a glossary of terms that
you may encounter while exploring this site. Simply click on the highlighted
letters below to jump to the alphabetical listing you require.
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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 abscesses.
An ACUTE abscess is one which is very active and often painful, and which
you will want to seek help quickly. It may also be associated with SWELLING
A CHRONIC abscess may or may not be painful, and is generally a slower process
for the abscess to form and to heal. It may also be associated with swelling
and inflammation, but is often not so painful as pus finds a route to drain
away in the form of a SINUS.
All abscesses should be treated, as they are a sign of PATHOLOGY. Your dentist
may recommend all or one of the following: OPEN surgically and DRAIN the abscess,
ANTIBIOTIC treatment, ENDODONTIC treatment, PERIODONTAL treatment or ROOT
PLANING, other SURGICAL treatment.
You should not try to treat an abscess at home, as you might exacerbate
the problem and spread the infection. Seek treatment from a dentist as soon
as possible, and do not use hot or warm compresses in the area unless told
to, as this may also alter the way which infection spreads.
A tooth or root or other device e.g. an IMPLANT, used for support, stabilization
or anchorage against lateral or horizontal thrust for either a fixed or removable
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, thereby
improving the bonding to filling materials. The acid used is generally 30%
to 50% Phosphoric acid.
Aesthetic / Esthetic dentistry
The treatments, skills, and techniques used to improve appearance of the
patients as a whole by adjusting the position form, function, and symmetry
of the teeth, jaws and face. Importance is placed especially on colour and
Also called SILVER FILLING RESTORATION or ALLOY RESTORATION. Dental amalgam
is a mixture or ALLOY of metals, including mercury,silver, copper and zine,
which is combined to form a soft and silvery looking paste which hardens on
setting. It is the filling materials that used for the restoration of the
form and function of teeth.
Dental amalgam has been used extensively for many years in dentistry as
the material of choice for fillings. In recent years there has, however, been
much debate both within the profession and amongst the general public, about
the safety of the material, and more specifically, the safety of the MERCURY
used in the mixture. Mercury and mercury vapor are toxic, and may produce
acute or chronic poisoning, causing damage mainly to the nervous system. Once
combined with other metals, however, mercury alloy becomes SAFE, so the mixing
and handling procedures are the most important as far as safety is concerned.
There are very strict guidelines in Hong Kong and other countries relating
to the handling of mercury in dental practice.
Over the years, amalgam has provided a stable and extremely useful restorative
material. There are literally billions of amalgam restorations that have been
carried out, and the reports of side effects, symptoms, and reactions to the
material are negligible in comparison to the number of teeth treated. There
is however, an ever more vocal and well documented lobby against the use of
amalgam, and many recorded cases now of patients who appear to have had symptoms
which have been attributed to amalgam, and which have been reduced or have
disappeared after the removal of amalgam from their teeth. Some countries,
most notably in Scandinavia, have either banned the use of amalgam, or are
no longer recommending it's use as a filling material of choice, especially
in the treatment of children and pregnant women.
Your dentist will advise you on whether or not he still recommends the
use of amalgam as a filling material. The improvement in the structure and
techniques of other materials in recent years has meant that patient and dentist
have more choices in the alternative materials available.
Angle's Classification of Occlusion
To help dentists quickly describe a patient's teeth and the way they come
together, certain normal and abnormal situations have been described and classified,
and these are used for communication and defining the case. The man who invented
this system was an American ORTHODONTIST called Edward Angle.( 1855- 1930
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 and to facilitate healing.
The procedure is usually associated with ROOT CANAL TREATMENT, either during
the procedure, or more often afterwards, if an earlier root canal treatment
has not healed satisfactorily. The dentist or surgeon may also carry out a
RETROGRADE ROOT FILLING, i.e. a filling placed in the end of the remaining
portion of the root to seal the ROOT CANAL at the same time.
You will normally need to have a number of X-RAYS or RADIOGRAPHS associated
with this treatment. These are necessary to control and check the success
of the procedure. After the surgery, you may notice some swelling around the
area, as the wound heals. Your dentist may also wish to give you some ANTIBIOTICS
to help the healing and prevent further infection prescribes.
This is a machine which sterilizes instruments using steam at high temperature
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℃
(250 ℉) 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, used according
to the manufacturers' instructions.
A bitewing x-ray is a radiograph taken inside the mouth to show the interproximal
surfaces of both upper and lower teeth. This x-ray helps to detect decay occurring
on the proximal (in between) surfaces of the teeth. The x-ray is held in place
in the mouth by biting on a tab on the film.
Bleaching 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.
HOME BLEACHING KITS are a relatively recent addition to products available
to the general public. There are also several types for use in the dental
office, and they all work on a similar principal in which the solution or
gel of the bleaching agent is held on the teeth for a period of time, which
varies from one product to another, in a TRAY or special form which fits over
the teeth. There is a risk of damage to the health of the teeth and gums with
overuse, and the possibility of the teeth becoming more sensitive is also
high. The results of home bleaching are usually of limited duration, so the
process may need to be repeated, but many people are satisfied with the results
they get. Caution should also be exercised with existing RESTORATIONS in the
mouth, which may be damaged or bleached at a different rate to the tooth substance.
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.
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.
In dental terminology, a bridge is a FIXED PROSTHESIS to replace one or
more missing teeth, to restore the function, form or aesthetics of the mouth.
It is also known as a FIXED / NON-REMOVABLE PARTIAL DENTURE. Bridges are supported
and held in position by attachments to adjacent or remaining teeth.
There are many different types of bridge including FIXED- FIXED, FIXED-MOVEABLE,
CANTILEVERED, MARYLAND, ROCHETTE, SPRING CANTILEVERED, ACID-ETCHED, PORCELAIN
BONDED, and many others.
Common materials used in their construction include gold and precious metals
and their alloys, and porcelain and ceramics.
Teeth generally need to be PREPARED before a bridge can be provided and
this will include altering the shape of the teeth, taking IMPRESSIONS and
MODELS of the mouth and jaws, and other procedures, so that the bridge can
be constructed in the laboratory. RADIOGRAPHS will also be required to check
the stability of the remaining teeth and associated structures.
Homecare of bridges should be discussed with your dentist or hygienist,
as they may recommend special techniques to keep the bridge clean.
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 cannot be 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 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 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
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
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.
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
A complete denture ( used to be known as FULL denture) is a dental PROSTHESIS
replacing all the natural teeth and the associated structures of the maxilla
or mandible, except usually the THIRD MOLARS. Complete dentures are usually
made of acrylic or metal (cobalt-chrome) and acrylic.
Composite Filling Material.
When used in relation to filling materials the term COMPOSITE usually refers
to a substance made up of an acrylic resin filled with inorganic substances
such as glass, lithium aluminum silicate, quartz, or tricalcium phosphate.
The composite is usually, but not always, applied to the tooth in a plastic
i.e. pliable form, and sets, either by itself, or with the use of a blue light.
A technique called ACID ETCHING i.e. etched preparation of the tooth surface,
is usually used to improve the stability of the filling in the CAVITY. Other
techniques, such as COMPUTER GENERATED restoration forms, and INDIRECT COMPOSITE
RESTORATIONS i.e. where a filling is first made in a model of the tooth and
then fitted in the mouth, are also now being used.
Composite filling materials are used most commonly in the restoration of
anterior (front) teeth because they have very good aesthetic properties. They
are easy to colour match, and come in many shades and brands.
They are also used now extensively in posterior teeth, i.e. PRE MOLARS and
MOLARS, because they are aesthetically more pleasing than amalgam or gold
restorations, and also have adequate hardness and strength characteristics.
There are still, however limitations on the use of composite filling materials,
especially in posterior teeth, but your dentist will be able to advise you
about what sort of material is the best for your particular tooth.
This term is used to define an abnormal situation when the teeth are held
together. In a normal mouth, the upper teeth lie just outside the lower teeth
when the patient closes her mouth. In a crossbite situation, the lower tooth
or teeth lie outside or in the same vertical line as the upper ones. Also
called a REVERSE HORIZONTAL OVERLAP.
Crossbites may occur in one or just a few teeth, or in a row of teeth at
the side of the mouth. They may indicate an underlying problem such as a discrepancy
between the jaw size, or a habit like thumb-sucking which needs treatment.
Crown / Cap
In PROSTHODONTIC or RESTORATIVE terms, a crown or cap is an artificial replacement
of part or whole of the ANATOMICAL CROWN of a tooth. It restores ANATOMY,
FUNCTION and usually AESTHETICS of the tooth, and is cemented or bonded to
the remaining tooth substance.
There are various different types of crown, including BASKET, GOLD, COMPLETE
VENEER, FULL, JACKET, PARTIAL, STAINLESS STEEL, THREE- QUARTER, TELESCOPIC,
PINNED, WINDOW, TEMPORARY.
Common materials used in crown construction are gold and other precious
metals and their alloys, porcelain and ceramics.
Each different type of crown has a different indication and use, and your
dentist will advise you on the best type for your case.
A tooth must be PREPARED to have the crown fitted to it, and usually this
involves altering the shape of the tooth and making IMPRESSIONS and MODELS
of the teeth and mouth so that the crown can be constructed in the laboratory
to fit the tooth.
Currettage 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.
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
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
This is the hand-held device which the dentist uses to remove tooth tissue,
for cleaning the teeth, polishing restorations, and so on. The usual choice
for the dentist is between one HIGH SPEED drill, which the patients recognize
by it's high pitched whining noise, and a drill with a slower speed, which
can be used for tasks such as polishing, CARIES removal and so on.
There are many, many different makes, and designs of handpiece. Some of
the more common categories of drill include STRAIGHT HANDPIECE, CONTRA-ANGLED,
MINIATURE, RECIPROCATING, GIROMATIC, TURBINE and so on.
Drills are driven either by a rotating shaft or compressed air.
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, 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.
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 is the forceful wedging of food into the PERIODONTIUM or
embrassive 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 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.
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.
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 is a type of material which is made from the sap of trees found
in Malaya. It is a very safe substance, and is used in ROOT CANAL treatment
to fill up the canals once the PULP has been removed and also as a TEMPORARY
FILLING MATERIAL. It is often a pink or grey colour, comes in various shapes
and forms, and usually needs heat or pressure to form it into the correct
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
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 affect the long term success and the time it takes to finish treatment.
A hygienist is a person trained to perform preventative procedures such
as cleaning teeth, applying fluoride, placing sealants, taking x-rays and
educating patients on oral health care. Dental hygienists must practice under
the supervision of a dentist.
Impaction/ Impacted tooth
Impaction is the condition of a tooth being blocked from ERUPTING, or growing
into the mouth, by a physical barrier. This barrier is usually another tooth.
If there is OVERCROWDING present i.e. not enough space for the teeth to grow
into the correct position, this may lead to the impaction or wedging of teeth
in the bone.
WISDOM TEETH, that is the teeth at the very back of the mouth, are frequently
impacted and may cause quite severe problems for the patient. This includes
pain, discomfort, and possibly limited opening of the mouth, as well as RESORPTION
and CARIES in the teeth in front of them. It is often necessary for IMPACTED
WISDOM TEETH to be SURGICALLY REMOVED as a result.
If this does become necessary, your dentist may advise you to have special
ANAESTHETICS, and even possibly a stay in hospital for a few days. This is
not necessary in most cases, however.
Although implants are not a new type of treatment, their development into
the general sphere of dental practice has been remarkably pronounced in recent
years. An implant is a metal pin, blade or casting which is insert into, or
placed on top of, the bone of the upper or lower jaw to provide ANCHORAGE
or stabilization either to teeth or PROSTHESIS. An ENDOSTEAL ( Endosseous)
implant is one which is introduced into the maxilla or mandible so that 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.
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.
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.
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
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.
(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 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.
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.
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.
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.
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,
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.
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.
A partial denture is a removable artificial or PROSTHETIC substitute for
missing natural teeth and adjacent tissues which does not include the replacement
of all the teeth in the ARCH.
There are many different sorts and classifications ( most commonly by the
KENNEDY SYSTEM ) and methods of construction. Common materials used in their
construction include DENTAL ACRYLIC, ALLOYS OF METAL including COBALT CHROME,
GOLD, and many more. Partial dentures may be tooth supported ( i.e. relying
on the tooth substance for support via a system of rests and clasps ) or mucosal
supported, ( i.e. relying on the gums and soft tissues for support ) or a
combination of the two. Partial dentures must be carefully designed and constructed
within certain guidelines so that they do not cause destruction of the remaining
and supporting structures of the mouth.
People who have been provided with partial dentures will often be specially
advised how to clean them and their remaining teeth correctly. Wearing any
form of tooth replacement, like dentures or bridges, means extra care must
be taken with oral hygiene as PLAQUE will collect differently around them.
Ask your dentist or hygienist for advice.
Periodontal disease\periodontitis\gum disease
Periodontitis involves inflammation of the gingiva which progresses to infection
of the bone and supporting tissue. Left untreated, it may lead to loss of
periodontal ligament attachment, and loss of bone resulting in mobility(loosening
of the teeth), and eventual tooth loss.
Periodontal disease as usually a slowly progressing disease of middle and
old age. It is a chronic disease which can be kept under control but not "cured".
Periodontitis may also occur in children where it mostly affects the first
permanent molars and incisors.
The symptoms of periodontal disease include swelling and bleeding gums,
receding gums, exudate(pus) from the gums, halitosis(bad breath), splaying
or pushing outwards of the upper front incisors, and mobile loose teeth.
The treatment for periodontitis most often includes scaling and root 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
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 pockets with a periodontal probe and assessing the presence
of blood or pus in the pockets are different ways your dentist can evaluate
your periodontal health.
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.
An interlocking mechanical device in which one part (the female) is fixed
to an ABUTMENT, either inside or outside the CROWN of a tooth, and the other
part (the male) is integrated into a BRIDGE or DENTURE. Precision attachments
provide extra support in the form of retention or stabilization to the appliance.
There are very many different sorts of precision attachments, like Huster,
Mccollum, Dalbo, ball and socket, bar, to name but a few.
Preventive dentistry 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.
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.
A prophylaxis is a preventive treatment, also known as a cleaning, involving
removal of plaque, calculus, debris and stain from teeth above the gumline.
A comprehensive prophylaxis also includes any necessary X-rays to help detect
decay formation, checking restorations present for defects and overhangs,
examination of the gums to check for periodontal health, checking for areas
of food impaction, plaque detection using colored disclosing tablets or solution,
and application of topical fluoride to prevent decay formation.
It is recommended to have a dental prophylaxis every 6 months to help prevent
the onset of periodontal disease and detect any decay formation in its early
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.
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
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 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
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 / 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.
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.
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.
This is an ORTHODONTIC procedure in which PRIMARY or DECIDUOUS teeth are
removed over a period of years in a particular sequence to prevent or relieve
OVERCROWDING of the PERMANENT teeth when they ERUPT or come through into the
mouth. At the end of a serial extraction procedure, it may still be necessary
to remove some permanent teeth, but the crowding will have been localized,
and the orthodontic treatment then needed will be less than otherwise would
have been necessary.
Also called SELECTED or PROGRESSIVE extraction
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.
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℃ ) 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.
An alternative regime for complete sterilization is 12 minutes at 134℃,
in an autoclave.
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.)
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!)
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.
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.
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.
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.