Adults over 35 lose more teeth to gum diseases, (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily.
Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film, which sticks to your teeth at the gum line. Plaque constantly forms on your teeth. By thorough daily brushing and flossing you can remove these germs and help prevent periodontal disease.
How to Brush
While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.
When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.
To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.
Next you will clean the biting surfaces of your teeth by using short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing. If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.
How to Floss
Periodontal disease usually appears between the teeth where your toothbrush cannot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.
Start with a piece of floss (waxed is easier) about 30 cm long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.
To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gum line then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.
To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the backside of the last tooth on both sides, upper and lower.
When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.
Caring for Sensitive Teeth
Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive consult with your doctor. They may recommend a medicated toothpaste made especially for sensitive teeth.
Choosing Oral Hygiene Products
There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.
Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes and especially the sonic brushes. Some toothbrushes have a rubber tip on the handle; this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.
Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gum line so these products have not been proven to reduce the early stage of gum disease.
Anti-plaque rinses contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.
Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Your visit to our office is an important part of your program to prevent gum disease. Keep your teeth for your lifetime.
Good nutrition plays a large role in your dental health. Brushing and flossing help to keep your teeth and gums healthy and strong however a balanced diet will help to boost your bodies immune system, leaving you less vulnerable to oral disease.
How often and what you eat have been found to affect your dental health. Eating starchy foods such as crackers, bread, cookies and candy causes the bacteria in your mouth feed on it, they then produce acids, which attack your teeth for up to 20 minutes or more. Also foods that stick to your teeth or are slow to dissolve give the acids more time to work on destroying your tooth enamel.
Sticky/slow to dissolve foods:
chewy fruit snacks
Sticky and starchy foods create less acid when eaten as part of a meal. Saliva production increases at mealtime, rinsing away food particles and neutralizing harmful acids.
Foods such as nuts, cheese, onions, and some teas have been shown to slow growth of decay- causing bacteria in the mouth.
We will make your new dentures look as natural and pleasing as possible. You must remember, however, that these are not your own teeth. They are artificial replacements and will not function like your own teeth did. Your expectations should be reasonable and you should work at learning to live with these limitations of artificial teeth.
Care of your mouth
We recommend that you leave your dentures out of your mouth for six to eight hours every day. Your gums need to rest and allow proper blood circulation without the pressure from your dentures. Your mouth should be rinsed often with any of the commercial mouth washes. We urge you to brush your gums, tongue and palate with a soft brush at least once a day, to remove any debris and prevent inflammation (any teeth remaining in your mouth, if you have partial dentures, should be brushed and flossed daily).
Care of your dentures
Your dentures are made very precisely just to you, and they have to be protected from harm. Always clean them over a thick towel or a sink full of water to prevent them from breaking if you should drop them You should clean them daily using a toothbrush and non abrasive soap or toothpaste. You may soak your dentures twice a week in a solution of one teaspoon bleach in a full cup of water for twenty minutes, or you may use any of the commercial denture cleaning tablets. Whenever you are not wearing your dentures, you should keep them soaking in plain water so they will not dry out and warp. Never attempt to do anything more than clean and brush your dentures. Please call the office with any problem and before using any denture adhesive.
Getting accustomed to your dentures
You should expect to have some discomfort after receiving your new dentures. We expect it and will schedule you for a twenty-four hour and a one week observation. if there is any later need for adjustment please do not attempt to adjust them yourself. Most people have an increased flow of saliva and some speech difficulties for the first week or two. However, you will soon learn to adapt to these changes and we expect that you will be comfortable in a short period of time.
Proper use of your dentures
Learn to eat with your new dentures by eating semisolid foods for a few days. Take small bites of food and chew them slowly. Use a knife and fork to cut or break up food instead of using your front teeth. These front teeth are for looks only: the back teeth are for chewing. Any time you experience any forced muscular movements such as a sneeze, a cough or a bellowing laugh your dentures may be dislodged. Cover your mouth to protect your dentures from falling out. Don't expect to eat solid foods without discomfort for some time.
If your dentures should ever need any kind of repair, never attempt to do it yourself. You could damage very sensitive mouth tissues. Let us correct them properly - call the office immediately.
Length of service
Your mouth tissues are constantly changing, but your denture are not. This is why we urge you to come back for checkups once every six months. If necessary, your dentures may need to be relined, rebased or, on occasion, remade. Only your dentist can determine this. A properly fitting denture will protect your gums, which are essential for denture wearing.
Use of adhesives, etc.
In a very few cases, for a short period of time, adhesives may help keep new dentures in place. Denture retention is a matter of muscular control which is gained by practice and time. Adhesives serve as a crutch, and should be avoid if possible.
Oral and maxillofacial surgeons are dentists specializing in surgery of the mouth, face and jaws. After four years of dental school, surgeons receive four to seven years of hospital-based surgical and medical training, preparing them to do a wide range of procedures including all types of surgery of both the bones and soft tissues of the face, mouth and neck.
What is a Periodontist?
Periodontists are dentists who specialize in the diagnosis and treatment of periodontal disease. They have had extensive training with four additional years of study after dental school. As specialists they devote their time, energy and skill to helping patients care for their gums. They also perform crownleghtening procedures and place dental implants.
Why is your dentist referring you to a Periodontist?
Your dentist has determined that your gums require special attention. The periodontist and dentist work together as a team to provide you with the highest level of care. They will combine their experience to recommend the best treatment available to you while keeping each other informed on your progress. By referring you to the specialist, your dentist is showing a strong commitment to your dental health.
What is an Endodontist?
The Endodontist examines, diagnoses and treats diseases and destructive processes, including injuries and abnormalities of dental pulps and periapical tissues of the teeth.
Endodontists examine patients and interpret radiographs and pulp tests to determine pulp vitality and periapical tissue condition. They evaluate their findings and prescribe a method of treatment to prevent loss of teeth.
In South Africa endodontics is part of the four year post graduate program to become a Prosthodontist. Therefor in South Africa a Prosthodontist become automatically a Endodontist as well.
What is a Prosthodontist?
The prosthodontist examines and diagnoses disabilities caused by loss of teeth and supporting structures. They formulate and execute treatment plans for the construction of corrective prostheses to restore proper function and esthetics of the mouth, face, and jaw.
What is an Orthodontist?
An orthodontist prevents and treats mouth, teeth, and jaw problems. Using braces, retainers, and other devices, an orthodontist helps straighten a person's teeth and correct the way the jaws line up.
Orthodontists treat kids for many problems, including having crowded or overlapping teeth or having problems with jaw growth and tooth development. These tooth and jaw problems may be caused by tooth decay, losing baby teeth too soon, accidents, or habits like thumb sucking. These problems also can be genetic or inherited.
So why would you go to the orthodontist?
Your dentist or one of your parents might recommend it because they see a problem with your teeth or jaws. Or a kid who doesn't like the way his or her teeth look might ask to see an orthodontist.
Periodontal diseases are infections of the gums, which gradually destroy the support of your natural teeth. There are numerous disease entities requiring different treatment approaches. Dental plaque is the primary cause of gum disease in genetically susceptible individuals. Daily brushing and flossing will prevent most periodontal conditions.
Why is oral hygiene so important? Adults over 35 lose more teeth to gum diseases, (periodontal disease) than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and periodontal disease is by good tooth brushing and flossing techniques, performed daily.
Periodontal disease and decay are both caused by bacterial plaque. Plaque is a colorless film, which sticks to your teeth at the gum line. Plaque constantly forms on your teeth. By thorough daily brushing and flossing you can remove these germs and help prevent periodontal disease.
Periodontal diseases can be accelerated by a number of different factors. However, it is mainly caused by the bacteria found in dental plaque, a sticky colorless film that constantly forms on your teeth. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar).
Bacteria found in plaque produces toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss.
Preventing Gum Disease
The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.
Other important factors affecting the health of your gums include:
Abcess A collection of pus. Usually forms because of infection.
Abutment A tooth or tooth structure which is responsible for the anchorage of a bridge or a denture.
Air Abrasion Air abrasion uses a process where pressurized air prepares a cavity with the use of fine, non-toxic abrasive powder (aluminum oxide) instead of using a conventional drill. Air abrasion is quiet and faster than a drill. Anesthetic is not necessary so multiple teeth can be worked on during one visit. Air abrasion can only be used on small cavities. It cannot be used for crowns or cavities between teeth. A tooth colored filling is used to fill the preparation.
Alveolar Bone The bone which surrounds the root of the tooth, holding it in place. Loss of this bone is typically associated with severe periodontal disease.
Amalgam Fillings Amalgam fillings are also known as "silver" fillings. Amalgam fillings have been in use for many years and still are a good and stable type of filling. They require a deeper more extensive preparation than other types of fillings and lays into a tooth with no retention. Amalgam fillings cannot be used on front teeth due to the low esthetic value and, for the same reason, are being used less frequently on other teeth as well. Some patients are concerned about the mercury that is incorporated in the amalgam filling, although research has not yet conclusively shown that amalgam filings are a danger to the body. In response to concerns about the mercury, researchers are developing new types of amalgam that do not incorporate mercury. Amalgam fillings, like composite fillings, may have to be replaced in time depending on a patient's oral habits (i.e., teeth clenching, grinding, ice chewing, etc.). See also "Composite Fillings."
Anesthesia Depending on the type of treatment a patient is to receive, a dentist may recommend some type of dental anesthesia. Local anesthesia involves the numbing of the teeth and gums. Topical anesthetic may be used to help make the injection more tolerable. Most dental work falls under this type of anesthesia (i.e., fillings, crowns, root canals and gum surgery) and may cause the patient to feel a temporary numbness. Nitrous Oxide or "laughing gas" may be used in combination with local anesthetics or alone if the patient cannot tolerate a local injection. Nitrous Oxide is an anti-anxiety agent that helps relax both children and adults. Patients wear a mask to breathe in the nitrous air. The effects soon dissipate once the nitrous is turned off and the patient begins to breathe oxygen through the mask. There are very few known side effects with Nitrous Oxide. General anesthesia is used during more complex procedures or for those that experience a high level of anxiety and wish to be asleep during the treatment. An anesthesiologist or a dentist who has received special training administers general anesthesia. Sometimes oral medications are used to relieve dental pain or anxiety. These analgesics may be used in combination with the above types of anesthesia or alone to help relieve post treatment discomfort.
Anterior Teeth These are the six teeth located in the front of the mouth, and are used as cutting (biting) surfaces rather than chewing surfaces.
Apex The end of the root.
Appliance Any removable dental restoration or orthodontic device.
Asepsis No micro-organism.
Attachment Level This is numerical measure of the attachment of periodontal ligament, which is determined generally by combining a pocket depth measurement with a measurement of gingival recession. Attachment level is considered one of the most important measures of periodontal disease progress or treatment success.
Attrition Wear of teeth due to activities such as chewing.
Baby Bottle Tooth Decay Decay in infants and children, most often affecting the upper front teeth, caused by sweetened liquids given and left clinging to the teeth for long periods (e.g. in feeding bottles or pacifiers).
Bitewing A kind of dental x-ray which is taken with the teeth bite together. The main funciton of this kind of x-ray is to detect cavity in between teeth and height of bone support.
Bleaching Whitening of teeth.
Bonding Bonding is a process in which tooth-colored material is applied to the tooth's surface and contoured into the proper shape. A variety of color resins are blended so the bonded teeth will look natural and will match your other teeth. Bonding will close gaps between teeth, cover discolored teeth, or repair cracked, chipped or poorly shaped teeth. The bonding procedure typically involves minimal discomfort and can be accomplished in a single visit.
Bridge A prosthesis which is fixed inside the mouth to replace missing teeth.
Bruxism Teeth grinding.
Buccal This is the technical term for the cheek, and is also used to refer to the cheek side of tooth surfaces. Technically, this term is used to describe the cheek surfaces of the posterior teeth, but is also used to describe the cheek surfaces of anterior teeth as well.
Calculus Also called tartar. A tenacious, hardened material formed by mineralization (calcification) of dental plaque, which once formed can only be removed by a dentist/hygienist.
Canine The third tooth from the middle of the jaw. There are totally four of them. They are the longest teeth in human.
Canker Sore An ulceration with yellow base and red border in mouth. It can be caused by trauma or herpes simplex virus.
Caries Tooth decay.
Cavity A hole on the tooth.
Cast A model of teeth.
Cementation The process of "glue" the appliance/prosthesis on the associated area.
Cementoenamel Junction Abbreviated as "CEJ", this is the point at which the tooth and root come together.
Cementum Located at the root of the tooth, cementum serves as the anchor point for the ligaments that join the tooth to the boney tooth socket. It is the softest part of the tooth structures.
Chlorhexidine An anti-microbial agent. It is available in many forms such as gels and rinses. It is an effective agent in controlling gum diseases.
Clasp A metal arm extends from a removable partial denture. It helps to hold on to natural tooth structure and thus provide anchorage for the denture.
Cold Sore An ulcer or blister on lip. A form of herpes simplex.
Composite Fillings Composite fillings are sometimes referred to as "white fillings". Almost every dentist uses composite fillings at this time on the front or back teeth. The material used in a composite filling is colored to match the patient's natural teeth. Composite fillings are bonded in place with a high intensity light, thereby causing the filling to "stick" to the tooth for improved strength. Most composite fillings also have fluoride incorporated into the material, which is released into the mouth. This gives the tooth added protection against decay. Composite fillings look and feel better on the tooth, require less tooth preparation by the dentist, and generally last longer than amalgam fillings. Composite fillings, like amalgam fillings, may have to be replaced in time depending on a patient's oral habits (i.e., teeth clenching, grinding, ice chewing, etc.). See also "Amalgam Fillings."
Cross Bite An abnormal bite relationship of upper and lower jaw. The lower teeth/tooth align toward the check/lip side more than the upper teeth/tooth.
Crowns A crown is a permanent restoration that covers a tooth to strengthen and protect a decayed tooth from further fracture. A crown also may be used to support a large filling when there is little tooth remaining. A crown can be made of different types of materials (gold, composite resin, porcelain or a combination of these materials) depending on the location and condition of the problem tooth. If properly cared for, a crown can last over 25 years.
Curettage The removal of damaged or diseased tissue from the inside of a periodontal pocket.
Debridement Treatment of bacterial infection by removing irritants (bacteria, calculus) from the periodontal pocket so as to allow healing of the adjacent tissues.
Decay The rotten part of the tooth.
Deciduous teeth Baby teeth.
Demineralization A loss of mineral from tooth enamel just below the surface in a carious lesion. May appear as a small white area on the tooth surface.
Dental Resin A dental material applied to the tooth which is used in cases of severe dentinal hypersensitivity. Typically not used unless all other treatment attempts have failed.
Dental Varnish A hypersensitivity treatment which sometimes contains sodium fluoride. Varnishes are applied to the tooth surface, covering the outer surface of dentin and thus blocking transmission of painful stimuli to the pulp.
Dentinal Hypersensitivity A sharp, sudden painful reaction when the teeth are exposed to hot, cold, chemical, mechanical or osmotic (sweet or salt) stimuli.
Dentinal Tubules Microscopic canals that run from the outside of the dentin to the nerve inside the tooth.
Dentin This is the main tissue that forms the shape of the tooth. Dentin is the material which exists between the pulp and the enamel, and is comprised of a series of dentinal tubules stacked on top of each other.
Dentistry A branch of medicine that involves diagnosis, prevention, and treatment of any disease concern about teeth, oral cavity, and associated structures.
Dentition The position, type, and number of teeth in upper and lower jaw.
Dentures A denture or a complete denture as it is often called, is an appliance that is inserted in the mouth, replaces natural teeth and provides support for the cheeks and lips. Most dentures are made of acrylic and can be fabricated two different ways. A conventional denture is made after all teeth have been extracted and the tissues (gums) have healed. An immediate denture is fabricated and inserted immediately after the teeth are extracted and the tissues are allowed to heal under the denture. An upper denture has acrylic, usually flesh colored, that covers the palate (roof of the mouth). A lower denture is shaped like a horseshoe to leave room for the tongue. The teeth are made of plastic, porcelain or a combination thereof. Dentures can be fabricated to fit over endodonticly treated teeth (See "Root Canals") and a complete denture can be attached to implants (See "Implants") to allow for a more secure fit of the appliance. Dentures over a normal course of time will wear and need to be replaced or relined in order to keep the jaw alignment normal. The alignment will slowly change as the bone and gum ridges recede or shrink due to the extraction of the teeth. Regular dentist examinations are still important for the denture wearer so that the oral tissues can be checked for disease or change. See also "Partial Dentures."
Denturist The person who specializes in fabricating dentures. Denturist is not responsible for making any type of diagnosis or carrying out any other treatment (e.g. Removing teeth).
Desensitization A procedure to reduce the sensitivity of teeth.
Desquamation A peeling of the tissue of the gingiva. In cases of desquamative gingivitis, the tissues may appear smooth and shiny, with patches of bright red and gray. Surface tissue may peel away, exposing a raw, bleeding and extremely painful surface.
Diagnosis The process of identifying dental disease.
Diastema The space in between two adjacent teeth.
Dietary Sugar Sugar occurring in your diet, including sugar found in sweets, fruits and processed foods.
Distal A direction indication in the mouth. It indicates the direction away from the middle of the jaw.
Dorsal Surface The top surface, typically used when speaking of the tongue, i.e. the dorsal surface of the tongue.
Edema Swelling that occurs when fluid accumulates in the gingival tissues.
Edentulous No teeth.
Enamel Shaping If your teeth have small chips or wear spots, are crowded, uneven or too long, enamel shaping can change the tooth's appearance to create more balance in the mouth. Enamel shaping can be performed without anesthetic. This procedure may be used in combination with bonding or orthodontics if the crowding is too severe.
Endodontics A department of dentistry involves diagnosis, prevention and treatment of dental pulp (where the nerves and blood vessels inside the tooth).
Endotoxins Endotoxins are a poisonous substance released from bacteria when it dies, and can cause tissue destruction directly or trigger an immune response which causes tissue breakdown.
Eruption The process of the tooth appearing in the mouth.
Excision The action of cutting someting off.
Explorer A probe used to detect tooth decay.
Facial Describes the surfaces of the anterior teeth facing the lips.
Filling A restoration places on a tooth to restore its function and appearance.
Fissures Cleft-like grooves in the chewing surface of the back teeth.
Fixed Bridge A fixed bridge replaces or spans the space where one or more teeth have been lost. A fixed bridge is attached to natural teeth (abutments). It is cemented into place and can only be removed by a dentist. The abutment teeth are crowned to provide strength. The ponic, or artificial tooth, is the part of the fixed bridge that replaces the missing tooth or space between the abutments. The ponic is fused to the abutments to form one piece that is cemented or bonded into place in the mouth. These restorations prevent collapse of the mouth and movement of teeth. Fixed bridges have special instructions for proper home care, which will be explained by the dentist or dental assistant upon completion of treatment. See also "Maryland Bridge."
Flipper A temporary denture to replace missing teeth during the waiting period for long term treatment.
Floss A thread/tape goes in between teeth for cleaning.
Fluoride A compound of fluorine (an element) which be put in different forms such as water, gels, rinses to strengthen up teeth.
Fluoride Treatment Teeth treat with fluoride agents like gel or rinse. It helps to prevent tooth decay.
Fluorosis Discoloration of the enamel due to too much fluoride ingestion (greater than one (1) part per million) systemically into the bloodstream, also called enamel mottling.
Framework A metal skeleton of a removable partial denture to support the false teeth and the plastic attachments.
Free Gingiva The marginal part of the gingival (gums) that can be deflected from the tooth surface. The free gingiva forms a collar around the tooth.
Gingival Crevicular Fluid Abbreviated as "GCF", this is the clear fluid which continually flushes out the sulcus. In a state of health, there is little gingival crevicular fluid; however as inflammation increases, the amount of GCF increases also.
Gingival Margin Area of gingiva closest to the tooth surface, commonly referred to as the "gumline"
Gingival Recession The condition which exists when the gingival margin has receded towards the root from the cementoenamel junction (the area where the tooth and root meet).
Gingiva The dense tissue surrounding the teeth and covering the alveolar bone, commonly referred to as "gums".
Gingivitis Gingivitis generally refers to an inflammation of the gingiva (gums), and ranges in classification from mild to severe. Gingivitis is associated with redness, edema (swelling), bleeding, and tenderness of the gingiva.
Gum Line Space between tooth (including root) and gum tissue.
Hard Palate The bony front portion of the roof of the mouth.
Homeostasis Stop bleeding.
Hypersensitivity A sharp, sudden painful reaction when the teeth are exposed to hot, cold, chemical, mechanical or osmotic (sweet or salt) stimuli.
Immune Response The body's natural defense against bacterial assault, the immune response can also destroy alveolar bone in its attempt to destroy bacteria.
Impaction A condition that a tooth is not able to come in normally or stuck underneath another tooth or bone.
Implants Dental Implants are titanium inserts that are surgically placed into the jawbone by an oral surgeon or a periodontist, and then allowed to integrate into the bone. This process may take up to six months. The implants then can be restored with a post and an artificial tooth that is either screwed into the implant or cemented onto the implant. Implants are more costly than crowns, dentures or bridges and are appropriate only for patients who demonstrate good oral hygiene. Implants enable the dentist to provide the patient with artificial teeth that look and function much more like natural teeth and are as secure as natural teeth. Implants also may be attached to a denture to allow denture wearers a more secure and functional option. Patients must follow the proper home care instructions and visit the dentist at the recommended intervals or the implants can fail or fracture. There are no strict age limitations as to who can receive implants; in fact, implants have been placed on children, adults and the elderly.
Impression A mold taken by some jelly-like material loaded on a tray.
Incisal The cutting edge of front teeth.
Incisor The four upper and lower front teeth.
Inlays/Onlays Inlays and onlays are more permanent types of restorations similar in longevity to crowns. A more conservative tooth preparation is done which allows a tooth to maintain more of its original characteristics. A mold is made with a special plaster and from that model the inlay or onlay is custom made. Inlays and onlays can be fabricated from gold, porcelain or a composite resin. The inlay or onlay is then cemented or bonded into place to give the tooth superior support. An inlay differs from an onlay in that the onlay material covers one or more cusps of a tooth and generally is a better choice if the tooth has a fracture.
Interproximal The space in between two adjacent teeth.
Irrigation Mechanical method of flushing supra- and subgingival areas with fluid to disrupt debris and plaque.
Labial Referring to the surfaces of the anterior teeth that oppose the inner surface of the lip.
Lasers Recently high intensity light (lasers) has been developed for use in the dental field. Dental lasers allow for an easier and cleaner way to cut soft tissue and recently have been improved to enable the dentist to cut hard tissue (enamel) as well. The lasers used in dentistry come in three different variations. The greatest difference is in the laser beam and the depth of cut and temperature at the surface of the cut being made by the laser. The two most common types of soft tissue lasers are the CO2 laser and the YAG laser. The CO2 cuts more on the surface and does not raise the temperature very high on the surface to be treated which allows the tissue a better response to healing. The YAG laser will cut deeper and at a higher temperature so it can overheat some of the underlying structures below the tissue surface. The third type of laser is the newly developed laser for cutting hard tissue (enamel) called the erbium laser. An attribute of the erbium laser is that it does not overheat the tooth so that the tooth pulp (nerve) will not die. The erbium laser is currently being utilized in a small number of dental practices in the United States but may be more generally available in the near future.
Lingual The side of the tooth towards the tongue.
Maintenance Regularly scheduled dental visits designed to maintain the health of the patient. Maintenance visits and therapy are based on the status of the patients oral health.
Malocclusion Refers to abnormal or malposition relationships of the maxillary teeth to the mandibular teeth. Correction of malocclusion involves orthodontic treatment.
Mandible The mandible is the bone that forms the lower jaw. This the largest and only freely movable bone of the face.
Maryland Bridge Sometimes a situation arises where a missing tooth is abutted by healthy teeth on each side. If an implant (See "Implants") is not being used to restore the missing tooth, then a more conservative, less expensive alternative treatment like the Maryland Bridge can be used. Unlike conventional fixed bridges, the Maryland Bridge does not require the use of crowns or extensive tooth preparation. The bridge is bonded (or attached) directly to the abutment teeth. A Maryland Bridge is not as strong as a conventional bridge or implants and may not last as long before needing replacement. See also "Fixed Bridge."
Maxilla The upper jaw, which forms the upper portion of the mouth. The maxilla consists of two bones joined together at the midline of the face.
Mesial The side of the tooth towards the middle of the jaw.
Molar The last 3 upper and lower teeth on both side of the mouth.
Mouthguard A device to be worn in the mouth. Depends on the design of it, it prevents injury on teeth and/or jaw during teeth grinding or sport events.
Mucosa The thin, outer pink or red membrane lining the inside of the oral cavity.
Nightguard A mouthguard which is worn at night time.
Occlusal The biting surface of the back teeth.
Occlusal Trauma Occurs when excessive forces are placed on a normal dentition, i.e. grinding and clenching of teeth. If left uncontrolled, occlusal trauma may result in rapid attachment loss and bone loss.
Occlusion The way how the upper and lower teeth close together.
Onlay A restoration covers the entire biting surface of a tooth.
Open Bite The situation that the upper teeth not able to contact the opposing lower teeth.
Orthodontics Orthodontic procedures are most commonly done on children but in recent years have become very popular for adults. Orthodontics treats patients with bite and teeth positioning problems that cannot self-correct with growth or other interceptive procedures. The orthodontist may use either a removable or a fixed appliance. Removable orthodontic appliances are easier to wear and care for and are advantageous in that it is easier to check the patient's progress and oral health. Fixed orthodontic appliances are attached to the teeth and can only be removed by the dentist. In determining whether to use a removable or fixed orthodontic appliance the dentist will factor in the nature of the problem and the tooth movement required to obtain a good result. In children, the child's ability to cooperate with the dentist and maintain good oral hygiene also will be considered. Orthodontics cannot only improve one's smile, but also improve the function of the teeth so they can last a lifetime.
Over Bite The overlap of upper teeth and lower teeth when they close together.
Overhang The portion of filling material that hangs beyond the border of the cavity.
Palate The roof of the mouth.
Panoramic Radiograph An x-ray film to obtain the wide view of upper and lower jaw and their associated structures.
Papilla Refers to the "v" shaped gum tissue between individual teeth.
Partial Dentures A partial denture replaces missing teeth so that the remaining teeth, oral tissues and cheeks have support. A partial denture also will allow the patient to chew and speak properly and smile with confidence. A partial denture, like a complete denture, is made out of acrylic but unlike a denture it also uses a metal framework that attaches to the remaining teeth by use of clasps or precision attachments, which attach to crowns and give a partial denture a tighter fit and a more natural look. A partial denture is fabricated by taking impressions after the necessary work has been done on the remaining natural teeth. A partial denture will be checked for any discomfort or pressure. If a partial denture does not fit properly, a clasp or tooth can break as an end result. A partial denture must be removed before proper brushing can be accomplished. The teeth, gums and partial denture must all be cared for by the patient. Like a complete denture, regular examinations by a hygienist and dentist are important to check the supporting teeth for decay and periodontal disease and to check the continuing fit and comfort of the partial denture. See also "Dentures."
Pellicle The first step in plaque formation, the pellicle is a clear, thin covering containing proteins and lipids (fats) found in saliva. Pellicle is formed within seconds after a tooth surface is cleaned.
Perforation An opening on a tooth or other oral structure.
Periapical The surrounding of the bottom of the root of a tooth.
Periodontal Of or pertaining to the tissue and bone that support teeth.
Periodontal Abscess Acute infection of the gingival tissues surrounding an individual tooth, typically involving bone loss, pain, bleeding, severe redness and swelling of the affected area.
Disease of the supporting structure of the tooth.
Periodontal Ligament The fibers which suspend the tooth in the boney socket. The periodontal ligament is attached at one end to the cementum, and at the other end to the alveolar bone.
Periodontal Probe An instrument used to measure pocket depth.
Periodontal Surgery Periodontal surgery is usually reserved for patients who have gum problems that cannot be addressed by more conservative treatment (See "Scaling and Root Planing"). One sign of periodontal problems is having excessively large pockets between the gum and the teeth (normal pocket depth is typically 3mm or less). Patients who have excessively deep pockets usually cannot keep these pockets free of the bacteria that causes gum disease and periodontal deterioration. There are various surgical techniques that a dentist or periodontist can use to reach the affected area and treat the disease. Surgery may consist of lifting the gum away so the plaque and bacteria can be more easily removed, the roots are scaled smooth and then the gum is laid back down in a position that should make it easier to clean. Sometimes surgery involves bone grafting and the use of membranes to help stabilize and make mobile teeth firm in the bone again. If there is extensive gum loss a gingival (gum) graft may be used from tissue elsewhere in the mouth. After surgery, a periodontal pack is placed over the surgical area and the tissues are allowed to heal. Antibiotics and a mild pain reliever may also be used to help combat infection and reduce swelling. After surgery, a program of good oral hygiene and proper home care will be established for the patient to help maintain the new healthy smile. Patient recall appointments with the hygienist will also be made in shorter intervals. In recent years some periodontal surgery has been performed with the use of soft tissue lasers (See "Lasers").
Periodontics A specialty of dentistry involves diagnosis, prevention, and treatment of supporting unit of teeth.
Periodontitis A form of periodontal disease resulting in destruction of alveolar bone.
Permanent Teeth Adult's teeth. The first permanent tooth usually comes in around 6 years old.
Pin A piece of "nail-like" metal. It usually is used for better retention of a filling.
Plaque A colorless, sticky film of bacteria in a protein matrix that constantly forms on the teeth. The main factor in causing dental caries and periodontal disease when allowed to remain over a period of time.
Plaque Attached Bacterial plaque which is attached to hard tooth surfaces and can be removed only by mechanical means (i.e. instrumentation, oral hygiene aids such as toothbrushes, floss, etc,).
Plaque Loosely Adherent Free floating bacterial plaque found on the surface of supragingival and subgingival plaque; contains most of the disease causing bacteria, and can easily be flushed from subgingival area with irrigation.
Polish A process to make the tooth or filling or other denture smooth and glossy.
Pontic The false tooth in a bridge or denture to replace the missing tooth.
Post A big pin which can be made with different materials such as metal or carbon. Its function usually is to support a big buildup on a tooth.
Posterior Locate at the back.
Pre-authorization An approval from the particular authority (usually insurance company in dentistry) before any action (treatment) is carried out.
Pre-medication Medication needs to be taken before treatment.
Premolar The two teeth located in front of the molar.
Prescription A written statement (from a doctor to a pharmacist) regarding the type, the amount and direction of the use of a medication for a patient. In dentistry, prescription can also be a written statement on preparation of an appliance from a dentist to a lab technician.
Primary Teeth Baby teeth.
Prohylaxis/Prophy The procedure of teeth polishing. It also means the prevention of diseases.
Prosthesis An artificial part to replace missing teeth and their associated structures.
Prosthodontics A specialty of dentistry involves diagnosis, treatment planning, and fabrication of artificial parts to replace missing teeth and their associated structures.
Pulp The inner most part of a tooth. It contains nerves and blood vessels inside a tooth.
Pulpectomy The removal of the whole pulp inside a tooth.
Pulpotomy The removal of the top part of the pulp inside a tooth.
Radiography An x-ray picture.
Recall The regular checkup and teeth cleaning appointment.
Recementation The process of "glue" the appliance/prosthesis back on the associated area.
Remineralization Redeposition or replacement of the tooth's minerals into a demineralized (previously decayed) lesion. This reverses the decay process, and is enhanced by the presence of topical fluoride.
Restoration An item a dentist uses to restore the normal function of a tooth or an area in the mouth. It can be a filling, a crown, a bridge, etc.
Retainer A device used for maintaining the position of teeth in the jaw in orthodontic treatment.
Retreatment The process of repeating the root canal treatment.
Root The bottom part of tooth. It anchors the tooth to its supporting units.
Root Canal The canal that runs inside the root of the tooth. It contains the nerves and blood vessels inside the tooth.
Root Canal Therapy When a tooth abscesses or has a pulp (nerve) exposure due to decay or trauma, root canal therapy or endodontic treatment is performed so that the damaged tooth may remain in the mouth and be saved. Years ago, if a tooth abscessed, it had to be extracted. Today dentists can save teeth by removing the pulp, the soft tissue in the root, cleaning and shaping the canal or canals and filling the root to seal out recontamination of the root system. This procedure is usually done in one to three visits with relatively little pain. If the abscess is severe, antibiotics may be used to help heal the infection. In almost all cases a crown and post (See "Crown") will be needed to restore the tooth to proper function and appearance. Root canal teeth can last a lifetime with proper care of the teeth and gums.
Root Planing The action of cleaning on the rooth area of teeth.
Rubber Dam A rubber sheet that fits around teeth. It isolates the treatment area from the rest of the oral cavity.
Scaling and Root Planing Scaling and root planing is usually performed after the dentist has diagnosed some periodontal disease. Scaling and root planing involves removal of the sticky plaque and tartar that builds up on teeth. The procedure may be performed under local anesthetic with an ultrasonic scaler, which can reach below the gum line and into the effective pocket to remove bacteria and the toxins they release. After this procedure, the dentist or hygienist will plane the root surface thereby allowing the gum to reattach to the tooth. Depending on the severity of the case, scaling and root planing may not cure the affected pockets and further periodontal treatment may be needed.
Sealants Sealants protect the chewing surfaces of teeth from decay. Brushing will remove plaque and food from the smooth surfaces of your teeth, but the bristles cannot effectively reach into all the grooves of the back teeth. Sealants are plastic materials that are applied to the back teeth, usually the premolars and molars. A dentist or hygienist will place these resin materials in the grooves of the teeth acting like a barrier protecting the enamel from plaque and food. This procedure is most commonly done for children as their permanent teeth erupt. However, some decay-prone adults are beginning to see the benefits of this treatment as well. Sealants can last for 4 to 5 years or even longer. They will be monitored at the patient's regular check-ups and may be reapplied if they become worn.
Sedation The use of medication to calm down a patient.
Sloughing A condition in which the gingival tissue deadens and peels away from the living tissue.
Soft Palate The back tissue portion of the roof of the mouth.
Space Maintainer An appliance to maintain the space in between teeth.
Splint An appliance or a material to prevent movement of a mobile part.
Stain Extrinsic stain refers to tooth stain located on the outside of the tooth surface originating from external substances such as tobacco, coffee, tea or food. This stain can often be removed by polishing the teeth with an abrasive prophylaxis paste. Intrinsic stain refers to tooth stain located within the tooth. It may originate from the ingestion of certain materials or chemical substances during tooth development. This stain is permanent and cannot be removed by polishing. Tooth bleaching may alter the stain.
Subgingival The moat-like area below the gingival margin which surrounds the tooth.
Sulcus A space or trough lined by mucous membrane (e.g. gingival sulcus).
Supragingival The area above the gingival margin.
Teething The effects of baby teeth pushing through gums.
Temporomandibular Disorder / TM Sometimes called "TMJ disease" or TM dysfunction, this is a painful condition of the jaw joint which can cause a variety of symptoms such as headaches, facial pain, tenderness or ringing in the ears, clicking or popping of the jaw, or pain when opening and closing the mouth. These problems are referred to as TM disorders. The causes of TM are not well understood and there are varying opinions on how to most effectively diagnose and treat these conditions. The causes of TM disorder may include trauma, arthritis and stress, or a combination thereof. Oral habits such as clenching or bruxing the teeth especially at night when a patient is asleep can slowly cause the muscles to fatigue and spasm without the awareness of the patient. Treatment is usually done in a step-by-step plan, as only minor corrective treatment may be necessary. If pain persists some patients may need more advanced treatment such as medication, psychological intervention, physical therapy or splint therapy. In some severe cases surgery may be needed to correct the joint.
Torus An outgrowth on bone. It usually develops on the roof of the mouth or around the premolar area on the lower jaw.
Veneers Veneers are thin, custom-made laminates consisting of porcelain or composite material that covers the surface of a tooth. The dentist will prepare the tooth's surface to a depth of about 1mm to 2mm (the thickness of a fingernail), make an impression of the tooth, and send the impression to a dental laboratory technician for fabrication. Veneers have a longer life than bonding. Veneers are used to close gaps between teeth, cover discolored teeth, or repair cracked, chipped or poorly shaped teeth. Porcelain veneers are very natural looking and even the most severely stained or discolored teeth can be covered to match other teeth.
Ventral Surface The underside, used when speaking of the tongue; thus the ventral surface of the tongue is the underside of the tongue.
Whitening Tooth whitening is a safe, simple and comfortable procedure that lightens the tooth enamel. The patient's dentist will fabricate custom appliances for the patient to wear on the upper and lower arches of the mouth. A mild bleaching gel is placed into the mouth pieces and the mouth pieces are worn a minimum of one to four hours a day/night for one to four weeks depending on the severity of the discoloration. Teeth can begin to lighten after the first day. Proper home care is needed and sometimes sensitivity of the gum tissue can result from the bleaching gel. Periodic renewal bleaching may be necessary in six to twelve months, although the teeth will almost always be lighter than before the whitening process.
Wisdom Tooth The eighth (also the last tooth) tooth from the middle of the jaw.