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Dentistry: A to Z


Dentist at work

Please find below some dental terms explained so that you can better understand what dental treatment has been done or might need doing as part of the Natural Recovery Plan to recover from your chronic fatigue syndrome, M.E., fibromyalgia or autoimmune disease.

Abrasion Usually refers to wear from tooth brushing.

Abscess A dental infection, most often at the tip of the root of the tooth due to the nerve (pulp) inside the tooth dying and decomposing.

Amalgam Dental amalgam is a 50:50 mix of liquid mercury and powdered silver, copper, tin, zinc and other metals. It does not bond to the tooth, so cavities are undercut so as to retain the filling once it has set. It can be quite destructive when going from a dental amalgam filling to an inlay, for instance, where the cavity needs to be flared towards the surface to allow for removal and insertion. It is not an aesthetic filling material and there are serious health concerns about the use of metals in dental restorations – especially mercury in dental amalgam.

Apicectomy or apicoectomy This is a mini-operation where the tip of an infected root is removed and the root canal sealed. Historically, dental amalgam was most frequently used. Often done where access through the top of the tooth is blocked due to posts or crowns or when a root-filling has failed.

Bicuspid The preferred US term for a premolar tooth. These teeth have two cusps and lie between the molar (back) teeth and the canine teeth. There are eight bicuspids in total – two right and left in both upper and lower jaws in most people. One from each quadrant is often extracted to permit orthodontic alignment of teeth in an ‘overcrowded’ mouth.

Bleaching This can be done in the surgery using a light and carefully applied gel or done at home using custom made trays and gel. Although no long-term harm has been demonstrated the bleach works by penetrating through the tooth. Some people also complain of sensitivity afterwards. Bleaching is certainly effective and less destructive than other methods of treating discoloured teeth, although the long-term effects are not fully known. 

Block injection Used most often to refer to an inferior dental (ID) block which is an injection which anaesthetises one half of the lower jaw.  Unlike the upper jaw, the lower jaw is too thick to allow anaesthetic to penetrate through the bone and so the nerve has to be anaesthetised where it enters the jaw bone at the back of the mouth. 

Bonding Usually used in conjunction with etching. An acid gel is applied to the tooth which causes a microscopic roughening of the enamel to which a liquid resin can then be applied and set – most often with a light. This enables other plastic filling materials to be bonded to the tooth. This technique can also be used to bond to dentine.

Canines The UK term for what are called cuspids in the US. The large pointed teeth adjacent to the incisors that are used for tearing flesh and that are prominent in most carnivores.

Calculus  This is plaque that has mineralised to become hard and this requires professional removal by a dentist or hygienist.

Cap Another word for a crown. It can be made of ceramic, gold or may have an internal metal structure (for strength) covered in porcelain (for aesthetics). Usually used to cover a fragile, heavily filled or root-filled tooth to preserve it and/or to improve the appearance of a tooth.

Caries Dental caries is the proper technical term for tooth decay. Acids produced by bacteria acting on sugar soften the enamel enabling bacteria to invade the inner dentine where the cavity can often progress unchecked until it may affect the inner pulp (nerve) causing pain and/or infection.

Cavitation Short for neuralgia-inducing cavitational osteonecrotic lesions (NICO). Refers to ‘chambers’ that can form within the jawbone after the extraction of teeth – most often of a lower molar or wisdom tooth. A toxic cocktail can form involving remnants of the extracted tooth membrane and bacteria which can become anaerobic and act as a source of toxins and bacteria that can affect the entire body.

Ceramic These are glass-like restorative materials that can be cast or milled in a laboratory or created by a technician using powdered ceramics and then baked.

Composite A tooth-coloured filling material that comprises glass particles in a plastic resin. Usually set by an ultraviolet light, but can also be activated by mixing two pastes.

'Core' Acts as the foundations for a crown or bridge in a heavily filled tooth. Cores can be made of composite, amalgam, glass ionomer or cast metal. Dental amalgam cores under gold or porcelain-fused-to-metal crowns or bridges are thought to induce galvanic currents which drive mercury into the surrounding tissues.

Crown See Cap

Cuspid See Canine

Cyst This is a fluid-filled cavity that forms within the jaw bone often contained within a membranous ‘sac’. The body is attempting to wall-off and contain some infective matter. Can be symptomatic or asymptomatic.

Deciduous teeth The 20 baby teeth replaced from the age of 5 – 13 years of age by the 32 permanent teeth.

Dental amalgam See Amalgam.

Dentine The ‘ivory’ within the tooth. This is a living hard substance made of lots of tiny tubules radiating from the nerve and blood supply in the centre of the tooth out towards the enamel and root surface. Decay (dental caries) often penetrates the enamel and then ‘mushrooms’ out within the dentine.

Empress This is an aesthetic crown material which is a leucite-reinforced ceramic that is pressed into a mould and treated under pressure.

Enamel The visible part of the tooth. This heavily mineralised ‘dead’ layer covers the living dentine within and is the hardest substance in the body.

Endodontic treatment Otherwise known as root fillings or root canal fillings. ‘endo’ means ‘within’ and ‘dont’ means ‘tooth’. This involves attempting to clean out all living matter from within the root system of the tooth, disinfect and obdurate all the space with an inert filling material. Teeth tend to become weak and discolour after treatment and may require a crown or overlay to protect them from subsequent fracture.  

There is also concern that root-filled teeth can act as a reservoir in which bacteria can grow unchecked within the dentine and lateral and accessory canals of the tooth also morphing into their anaerobic forms and acting as a source of toxins and bacteria within the body. 

Endodontist A dental specialist who does root fillings or surgical retrograde root-fillings for a living – often the difficult ones or re-treating ones that have already failed.

Erosion Refers to the combined effect of softening the teeth with acidic foods, drinks and/or drugs often combined with vigorous tooth brushing.

Etching The use of an acidic gel to produce a microscopically ‘rough’ surface on the enamel or dentine to which resins can then be bonded.

Glass ionomer This filling material contains glass particles that are dissolved by acidic gels to form a solid, tooth coloured filling material. Does not have much structural strength but does bond to dentine. Typically used in deciduous teeth. Leaches fluoride. 

'Gold' Used to make cast restorations such as inlays and crowns. Actually consists of up to 6 or more metals added for strength and colour.

Gum disease  Although this involves inflammation of the gums, the issue is that gum disease progressively destroys the bone that holds the teeth in the jawbone. Plaque gets trapped in the crevice where the gum meets the tooth and causes inflammation – which unless removed in a timely manner can initiate a progressively destructive process.

This undermines the support for the tooth over decades, ultimately resulting in more extractions than for tooth decay. This can often progress to its terminal stages without pain or major symptoms. Gum disease is a major source of bad breath. It has also been shown to be associated with diseases such as heart disease and pre-eclampsia by causing systemic toxicity.

Granuloma Often a chronic infection around the root of a tooth. A ‘bag’ of infected fibrous tissue forms as the body attempts to control the spread of noxious substances from within the tooth.

Implants Metal – often titanium – ‘screws’ or ‘pegs’ that are used to replace the roots of teeth (not to be confused with posts where the root of the tooth remains). Can be used to support a crown, bridge or denture. 

Impression A 3D ‘negative’ of the mouth taken using a putty. The dental technician then pours in a powdered stone mix to obtain an accurate facsimile of the mouth that they can then work on. 

In Ceram This was one of the earliest non-metal restorative materials and is a fused glass/ceramic that has largely been superseded by other products.

Incisor The four upper and lower front ‘blade-like’ teeth used for biting.

Interference A concept that teeth can ‘clash’ in the preferred chewing movement of the jaws possibly causing TMJ problems and/or causing damage to the teeth concerned.

Inlay A restoration (often gold or ceramic) that is most often made in a laboratory and cemented into place in the tooth. Requires impressions, two visits and temporary fillings in the interim unless machined in-house from a scanned image of the tooth.

Intravenous sedation A ‘twilight’ anaesthetic used to sedate, but not render the patient unconscious. Can be used for lengthy, unpleasant procedures or where the patient is fearful. Involves an injection in the hand. The sedated person usually has amnesia, forgetting the events before, during or after the procedure also.

Lining A thin layer of material placed over the floor of the cavity to protect the pulp. There is some concern about the toxicity and/or allergenicity of some of the materials used as lining materials.

Local anaesthetic  Frequently contains noradrenaline (norephinephrine) to hold the anaesthetic in place long enough to be effective – and to prevent excessive bleeding with surgery and extractions. Some people may react badly to this especially if it is injected directly into the blood vessels (there is no real way of knowing). Works by temporarily blocking the transmission of nerve signals.

Molars The big back teeth meant for crushing and chewing foods. The first molar does the lion’s share of the work. Molars usually have three or four roots although these may be fused in some teeth.

‘Nerve’ The inner living part of the tooth (also known as the pulp) contains nerves, blood and lymph vessels and the remnants of the tissues that originally formed the tooth. Can die and require a root-filling or extraction in certain circumstances.

NICO See Cavitation.

Occlusion  The way the teeth intermesh both at rest and during chewing and swallowing.

Oral sedation  This is a valium-like sedative given as a tablet prior to treatment. The patient is still fully aware, but less anxious than otherwise would be the case.

Orthodontic ‘Ortho’ means correct and ‘dont’ tooth. These dentists are often specialists that straighten the teeth using braces. They do this either by expanding the dental arches (which have collapsed over evolution since prehistoric times) or by extracting teeth to make space. Braces may be fixed or removable.

Overlays  This is like a crown only shallower and the advantage is that it involves removing less tooth. Often done where the tooth is still substantially present but may have required a root-filling or had one or more cusps shear off.

Onlay See Overlay.

Periodontal disease See Gum disease

Periodontist ‘Peri’ means around and ‘dont’ tooth. These are specialists who treat all aspects of gum disease. This may involve deep cleaning under the gum (known as root planing) and/or gum surgery.

Pins Used where a corner or a cusp of the tooth is missing to support the filling material. Known to cause internal crazing within the tooth and possible nerve death.

Plaque A soft deposit of dead bacteria and food. Can be removed by brushing effectively.

Porcelain fused to metal (PFM) This is a type of crown and bridge material where the underlying support is gained from a metal substructure and then porcelain is baked on for aesthetics.

Posts Usually either prefabricated or cast metal. These are inserted into the root-filled canals of dead teeth to provide some support for a crown or bridge. Some non-metal posts are now available.

Premolars See Bicuspids

Procera This is an aesthetic crown material which involves fabricating an underyling ‘core’ from an aluminium or zirconia material for strength and then layering regular porcelain for aesthetics over the top.

Pulp  See ‘Nerve’

Relative analgesia This is a nitrous oxide gas and oxygen mix such as used by women in labour. It reduces anxiety and relieves pain, but a local anaesthetic is usually still required.

Retrograde root-filling This is often performed where normal access to the root canal system is blocked by posts. It involves a mini-operation and attempting to remove the tip of the root of the tooth, clean it and seal it. Historically usually involved the use of dental amalgam.

Root-fillings See Endodontic treatment.

Sinus Two meanings. One refers to the air-filled cavities in the skull eg: maxillary or frontal sinus. The other refers to an infection that is draining from a tooth out through a channel in the bone and that will appear like an oozing pimple. These can be intraoral or drain out through the skin.

Tartar Common word for calculus. This is mineralised plaque and needs to be removed professionally.

Temporary crown Made of plastic and cemented into place with temporary cement whilst the permanent restoration is made (or to assess healing, etc).

Tempero-Mandibular Joint Dysfunction (TMJ) This is the name give to the jaw joint – where the mandible (lower jaw) meets the temple bone of the skull. Dysfunction refers to the fact that in some people this clicks and pops, they may have restricted opening and their lower jaw may deviate on opening or closing and may also get stuck occasionally. Sometimes this is accompanied by constant or occasional pain and headaches.

Wisdom teeth Wisdom teeth are the last teeth to erupt (third molars) and there frequently isn’t room for them which means that they can become impacted and need to be removed, although this practice is currently being discouraged.

X-ray A form of electromagnetic radiation that can penetrate soft tissue and bone and be captured by film or sensitive screens. Denser objects show up as being white (because they blocked the passage of x-rays) and less dense objects as black. So root fillings and metal fillings will show as white and cavities within the bone or around the tip of roots as dark areas. 

Zirconia This is the latest aesthetic dental crown material. The inner part of the crown is made with zirconia which is white, fits well and which can withstand the pressures likely to be generated in the mouth and then covered with porcelain for optimal aesthetics.