This dental glossary and patient education guide is offered as a service by Charlestown Family Dentistry practice of Dr. Jeffrey A. Goldman, DDS, LLC.
GUM DISEASE I
PERMANENT TEETH I
ROOT CANAL I
An accumulation of infection enclosed in a sac in the bone tissue at the tip of a tooth’s root. The cause of a tooth abscess is usually a bacterial infection in the pulp, which produces pus that drains out of the opening at the root’s tip. This infection may originate from untreated tooth decay, or in dead pulp tissue inside the tooth. If there is bacteria in gum tissue that has severely receded or if bacteria remains in the gum surrounding a tooth’s root following a root canal treatment, the bacteria may produce an abscess. An abscess causes persistent toothache or throbbing pain at the site. The side of the face may swell. Treatment includes a full dosage of antibiotics, followed by either an extraction or root canal treatment.
Silver colored filling material used to fill a tooth that has been treated for the removal of tooth decay. Dental amalgam is composed of a mixture of mercury, and silver, tin, and copper. It is considered to be one of the safest, most durable, and least expensive materials used to fill a dental cavity. It usually comes in a plastic capsule with the alloy powder and mercury separated by a membrane barrier. The capsule is mixed for a few seconds and the amalgam comes out as a doughy mix. The amalgam is quickly placed in the tooth and carved as it has an initial set of a couple of minutes. It usually takes 24 hours to fully harden.
The application or injection of medicine to prevent discomfort. Topical anesthesia is used by dentists to numb tissues in an area of the mouth in preparation for injecting a local anesthetic. It comes in gel form or in a spray. Local anesthesia, usually Lidocaine, is generally injected in a specific area of the mouth. This form of dental anesthesia lasts for an hour and is used for preparing cavities and crowns, as well as for surgical procedures.
The relationship between the upper and lower teeth that determines the way the teeth meet when the mouth closes. When the teeth are properly aligned, the top front teeth extend slightly over the lower front teeth, and the top and bottom molars meet evenly on both sides of the mouth. A person’s bite is generally determined by his or her heredity. Few people have perfectly aligned teeth. Others may be due to behaviors and habits such as tongue thrust, or sucking the thumb, fingers or lower lip, all of which apply undue pressure to the teeth. Top teeth that are too far forward and bottom teeth that are too far back are typically called an overbite. If lower teeth are too far forward and upper teeth too far back, it may be referred to as an underbite.
A process that attaches a tooth-colored composite resin material to a tooth to repair it, to improve its color, or to reshape it. Dental bonding, also called dental composite bonding, has many specific uses. It can be used to restore cavities, replace old silver fillings, repair exposed roots, and to close spaces between teeth. After preparing the tooth to be treated, the dentist positions the composite material on the tooth in layers. A special light is used to harden, or cure, each layer. The composite is polished to prevent staining and increase durability. The process can usually be completed in one office visit. Dentists can blend shades to create a color very close if not identical to the shade of the tooth to be repaired. The result is a natural and improved appearance.
A dental appliance that replaces missing teeth by attaching to adjacent teeth. These adjacent teeth are smoothed down to allow space for the bridge to be placed. Fixed dental bridges are more commonly used than removable, partial denture bridges, except in cases in which there are several adjacent teeth missing or the empty space is relatively wide. Unlike partial dentures, the person wearing them cannot take out fixed dental bridges. The fixed bridge is usually made up of two crowns permanently cemented to the abutment teeth with a pontic (false tooth) attached to the two crowns to fill in the space where a tooth has been removed. Dental bridges fill the cosmetic function of replacing missing teeth so that the surrounding facial features are supported and the appearance of the mouth is improved.
The technical term for involuntary clenching or grinding of teeth, especially at night. Over time, dental bruxism can abrade and grind down the teeth, resulting in sensitivity of the teeth. It may also cause the jaw to move out of proper balance. Bruxism may be due to any number of factors including nervous tension, emotional stress, malocclusion (improper bite), and possibly sleep disorders. Early symptoms of bruxism can be a tired jaw and headache first thing in the morning. Other symptoms may include a flattening of the biting surfaces of the teeth, indentations in the tongue, and transient tooth pain. It can also produce the facial pain associated with temporomandibular joint syndrome (TMJ). A clicking or popping sound in the jaw, caused by TMJ, may also be experienced. A dentist can identify and evaluate bruxism, and may recommend a course of therapy to teach a person with bruxism how to relax the tongue, teeth, and lips. The dentist may make a plastic mouth appliance, called a night-guard, to be worn during sleep. The night guard absorbs the pressure of biting, and can help prevent future damage to the teeth as well as helping to change the behavior.
A hole in a tooth caused by decay, which is caused by the formation of dental plaque on the teeth. The plaque is made up of bacteria, food particles, and components in the saliva. The bacteria interacts with sugars in food particles that remain in the mouth to form acid, which dissolves the calcium and phosphate in the tooth’s enamel. This damage to the tooth’s structure is the first step in the development of a cavity. If the cavity is not treated, it can reach the inner structures of the teeth, inflame the pulp of the tooth, and cause persistent pain, especially after eating or drinking food or beverages that are sweet, hot, or cold. Dental cavities are treated by removing the decayed tissue using a dental drill. The dentist fills the prepared tooth with an amalgam or composite filling. Regular daily care including brushing the teeth with fluoride toothpaste and the use of dental floss will help prevent the formation of dental cavities. Foods containing sugar should be eaten in moderation and the teeth should be cleaned as soon as possible after eating.
The visible part of the tooth that normally protrudes above the gum line; also, a restoration that replaces that part of the tooth which may have been lost due to fracture, or removed in the process of treating tooth decay. A crown may be placed over a dental implant as well as over the remaining structure of a natural tooth. Dental crowns are sometimes called caps, and serve the function of restoring the structure, size, shape, function, and appearance of a tooth. They are required when there is not enough tooth structure remaining to hold onto a filling, or when a weak tooth needs additional support. If there is insufficient tooth structure to hold a crown, typically after root canal treatment, a post may be cemented into the root to provide sufficient structure to hold the crown. Placing a dental crown is usually accomplished in two visits to a dental office. On the first visit, the dentist prepares a tooth for a crown by using a dental drill to reduce the structure of the tooth so the crown can fit over it. A dental impression of the reduced and re-shaped tooth, as well as the surrounding teeth, is then made. The impression is sent to a dental laboratory where the crown will be created, with specifications regarding the color as well as the bite, shape, and length of the tooth or teeth being made. Crowns are generally made of porcelain, gold, or a combination of the two materials. The crown is designed to look like a person’s natural teeth. The dentist uses a temporary crown, usually plastic, to cover the prepared tooth while the permanent crown is being made. This usually takes one to two weeks. During the second visit, the temporary crown is removed, the permanent crown is cemented onto the tooth, and the bite is adjusted as needed.
The decalcification and disintegration of a tooth’s structure as a result of bacteria producing acid from food deposits that are on the teeth. The acids dissolve the hard mineral enamel covering the surface of the teeth, creating a small hole, or cavity, in the enamel. Tooth decay originates with this break in the tooth’s protective outer layer. If the small cavity is not treated, the acid continues to destroy the enamel until it has penetrated this layer and begins to damage the dentin below the enamel. Decay through the dentin allows bacteria to enter the inner area of the tooth, called the pulp chamber, which contains the nerve of the tooth. Ultimately, tooth decay can destroy the vital tissues at the core of a tooth and cause the tooth to die. Tooth decay is prevented by taking good care of the teeth and following good oral hygiene practices, including brushing the teeth at least twice a day with a fluoride containing toothpaste and using dental floss at least once a day. Brushing removes food deposits and flossing helps to remove plaque from between adjacent teeth and in the area between the base of the tooth and the gum. Limiting starches and sugars from the diet is another component of preventing tooth decay.
Because pain may not be experienced until tooth decay has made significant progress, regular' dental check-ups, at least every six months, are important for prevention.
An artificial replacement for missing natural teeth and adjacent tissues in the upper jaw, the lower jaw, or both. Dentures are made of a strong acrylic resin, sometimes in combination with various metals. Partial dentures, either fixed or removable, are used to replace one or several missing permanent teeth. A full denture, or false teeth, becomes necessary when a dentist determines that all the teeth, top, bottom, or both, must be removed. This decision may be based on conditions that prevent saving the permanent teeth due to serious periodontal disease or severe tooth decay. Dentures may also be a solution if all or many teeth are lost by physical trauma, and cannot be replaced by other methods. Full dentures must be carefully fitted by a dentist so that they will rest comfortably on the respective ridges. After the teeth are extracted, the gums and jaw are generally allowed to heal before the dentures are fitted. In preparation for the initial fitting of dentures, impressions are taken of the gums, and the natural bite is measured and recorded. Decisions are made regarding the size and color of the teeth. Usually the dentist will set the teeth in wax and try them in. They can be adjusted for fit and comfort before being finished in acrylic.
The branch of dentistry that deals with the treatment of diseases or injuries affecting the dental pulp, or nerve, and the blood supply inside. Endodontics mostly deals with the removal of the dental pulp commonly referred to as a root canal. A root canal is necessary when the dental pulp is injured from deep decay or trauma. The pulp is removed, the canal sterilized, and then filled with a special medicinal dressing. The tooth may then be restored like any other tooth.
The removal of a tooth. This is generally performed by a dentist or oral surgeon for reasons including tooth decay, severe fracture, dental impaction, overcrowding, or malocclusion. Since the appearance and function of a natural permanent tooth cannot be precisely replicated, dentists prefer to try to save teeth rather than extract them.
A nylon string that is inserted between the teeth, then manipulated up and down against the tooth surface for the purpose of removing food particles and plaque. Dental floss may be waxed or unwaxed. The wax helps the floss slide more easily through the spaces but adds bulk to the string. Unwaxed floss may be preferable when the teeth are very close together. The daily use of floss is an essential component of at-home oral hygiene because it removes plaque from places on the teeth that a toothbrush cannot reach.
The addition of fluoride to the public water supply to decrease the occurrence of tooth decay in the general population. Fluoridation has been endorsed by the American Dental Association since the first community fluoridation program began in 1945. Adding fluoride to public water at an optimum level of concentration effectively reduces the occurrence of tooth decay in children, adolescents, and adults. The range in concentration level of fluoridation in public water may be determined in individual areas of the U.S. by such factors as climate and the amount of fluoride naturally present in the water supply. The fluoride works its way in the enamel matrix and makes a tooth more resistant to decay.
A break or crack in the crown or root of a tooth, usually caused by physical trauma to the tooth. A dental fracture may involve only the enamel on the surface of the tooth, or it may involve the inner structures. Premolars and molars with restorations are vulnerable to vertical fractures, which extend through the crown to the root. Teeth that have received root canal treatment without a crown may also be especially vulnerable to vertical fractures. These fractures can be caused by trauma due to excessive pressure of the bite. Fractures in the teeth may be clearly visible, or they may not be detectable even with the use of X rays. Often, locating the problem tooth can be extremely challenging. The only symptom in this case may be pain experienced when chewing. These fractures can be treated with composite bonding or veneers. When part or all of a tooth are lost due to fracture, the teeth may be restored by dental procedures such as fillings, crowns, or implants.
Inflammation of the gums caused by plaque build-up. The plaque attracts bacteria which in turn irritates the gum. This will present itself as bleeding when one brushes their teeth. Root planing is a procedure performed in a dental office that may be implemented to stop the progression of periodontal disease (gum disease) in its earliest stages. Under local anesthetic, a dentist or hygienist cleans below the gumline and smooths the roots so that the gum can reattach to the tooth. Planing the roots of teeth affected by periodontal disease can stop the bacteria from spreading and may reverse some of the damage already done. In some cases, antibiotics may be prescribed for short-term use, in combination with procedures to remove plaque and calculus. Because of the link between periodontal disease and cardiovascular disease, controlling the bacteria that causes gum disease may contribute to a reduction in the risks of heart disease and stroke.
Teeth embedded in the gums or jaw bone that have not erupted because of a physical obstruction. An impacted tooth fails to erupt or erupts only partially because it is blocked by bone or gum tissue, or because it is jammed against another tooth.
An artificial tooth root made of synthetic material that is surgically anchored into the jaw, or placed over it, to retain a permanent replacement tooth, a dental bridge, or a full denture. Implant material is composed of metallic and bone-like materials that are compatible with human body tissue and unlikely to be rejected by the gum and bone. These materials bond with bone and can withstand the pressure created by biting and chewing. Dental implants are permanent and stable, and they don’t require adjoining teeth to support them. They are a good solution to lost teeth because they look and feel like natural teeth. People who are in good health and have the proper bone structure and healthy gums may be good candidates for dental implants. They are also an attractive option for people who cannot wear dentures.
The branch of dentistry that involves the diagnosis, treatment, and prevention of diseases and disorders of the gums and underlying tissues. The dentist that specializes in this type of dentistry is called a periodontist. They receive specialized training in the treatment of inflammation and infection associated with gum diseases such as gingivitis and periodontitis. Usually a general dentist will refer a patient to a periodontist when they are unable to resolve the disease process themselves.
The natural teeth that develop and emerge from the gums after the primary teeth (baby teeth) have been shed. Each permanent tooth emerges individually in the space left when a primary tooth falls out, with the exception of the permanent molars, which erupt in the expanding area at the back of the growing jaw.
The parts of each permanent tooth include the following:
- Crown - Part of the tooth visible above the gum line.
- Enamel - Hard ceramic material covering the crown.
- Dentin - Inner part of the tooth below the enamel.
- Pulp chamber - Innermost part, consists of nerve cells and blood vessels.
- Root - Part of the tooth anchored into the bone.
- Cementum - Thin, calcified layer covering the tooth’s root.
An abnormally deep opening between a tooth and the gum tissue surrounding it. Gingival pockets are caused by the toxin-producing bacteria in plaque. If plaque remains on the surface of a tooth too long, the toxins released by the bacteria in the plaque destroy the fibers anchoring the tooth to the gum. When the attached fibers are destroyed, an opening, or a pocket, is created in the area where the tooth is normally attached to the gum. As the pockets extend deeper, they can erode the underlying bone that surrounds and supports the tooth. The tooth may be loosened and eventually fall out. Gingival pockets are an indication of periodontal disease (gum disease). Gingival pocket depth is measured by a demarcated instrument called a periodontal probe. When pocket depth is over 3mm, a tooth brush cannot properly get in there and clean it. Root planning or periodontal surgery may be necessary to reduce the pocket so that it can be maintained by the patient.
A therapeutic procedure aimed at treating an infection of the tooth’s soft inner core, called the dental pulp, and commonly referred to as the tooth’s nerve. A tooth’s pulp is the soft tissue inside the natural crown and root portions of the tooth. The pulp contains the nerves, blood vessels, and lymph vessels and is contained within a structure of the tooth called the pulp chamber. Root canal treatment involves removing the pulp tissue, sterilizing the canal, and then sealing it with putty like material called gutta percha.
A plastic coating that is applied to the biting surface of posterior teeth (back teeth) as a protective coating to prevent tooth decay. They are applied to patients up to the age of 18 on permanent teeth only. Usually the dental hygienist performs this procedure.
Thin shells of porcelain that are bonded to the front of teeth to correct surface irregularities or discoloration. Veneers may be used to repair chipped teeth or to close spaces between teeth. Porcelain veneers cover the front and upper third of the back of the tooth. They require a lot less tooth reduction than a full crown.
A process used to whiten teeth by cleansing surface discolorations through an oxidation process in the enamel. Dental whitening or bleaching is considered safe for the teeth and gums when supervised by a dentist, who can determine whether or not a person’s teeth can be lightened and what type of whitening system is most appropriate. The most immediate results can be obtained by an in-office whitening system involving the application of a concentrated bleaching solution to individual teeth followed by exposure to a high intensity heat lamp for several minutes; fluoride gel can be applied after the treatment to reduce sensitivity. A bleaching system that can be used at home is the least expensive and most commonly chosen form of dental whitening. It is effective for people who have healthy, unrestored teeth that have become darkened due to age, and/or from drinking tea or coffee. Yellowish shades of teeth tend to respond best to dental whitening. A dentist takes an impression of the teeth, which is used to custom-make a thin, lightweight, mouth-guard tray. The tray is designed to be comfortably worn during waking hours (it does not interfere with speaking), or while a person sleeps. Dental whitening is accomplished by placing a whitening gel in the tray before it is positioned over the teeth. Some whitening systems have the trays worn all night for up to two weeks. Other whitening systems have the trays worn 1-2 hours every day for two weeks. Results will vary from patient to patient depending on the particular color of stains.