Wearing away of a tooth. It may be caused by incorrect tooth brushing (The point where the tooth meets the gum is particularly vulnerable as the root may have become exposed). It can be made worse by the use of abrasive toothpaste (e.g. smokers). Any damage near the gum may be extremely sensitive and need treatment from a dentist. Applying sensitive toothpastes may be an effective remedy.
An accumulation of pus and inflammation which is formed at the root of a tooth. The tooth will be very tender and there can be an intense throbbing pain. An abscess in the area where the tooth meets the gum is known as a periodontal abscess.
Dental treatment will be needed to effect a cure, but some measures can be taken to ease the pain: Taking normal painkiller tablets and rinsing your mouth with hot water into which you have dissolved a teaspoonful of salt. This may help soothe the pain and assist the healing process.
Accidents that involve injury to the teeth affect all ages groups. However, children are more vulnerable (just over one third of all five year olds will have suffered an injury to their first [primary] teeth.) By 12 years of age, 20-30% of children will have suffered injuries to their teeth.
Immediate action in the event of some injuries, such as a knocked out tooth, gives a much better chance of a good recovery.
Injuries to the teeth can include the fracture of a portion of the crown, of the tooth, or the root. The fracture can go through enamel only; through into the sensitive yellow tissue under the enamel [dentine] or into the pulp (nerve and blood vessels) in the middle of the tooth.
Injuries can also affect the tissues that hold the tooth in place (periodontal ligament), or the tooth can be loosened or knocked out of its socket completely.
The dental industry is undergoing dramatic change. Independent practices are facing new competition with the entry into the market place of a number of big corporate providers. In response, some independent dental practices are seeking to highlight their particular skills by adopting recognised quality management systems such as BDA Good Practice, Denplan Excel, Investors In People, and the ISO 9000 Standard.
A plastic, or synthetic resin, material derived from acrylic acid. It is used extensively in the manufacture of dentures and other dental appliances.
A substance produced by the Adrenal Glands, which prepares the body for fight or flight. It increases blood pressure, the heart rate, and nervous activity. Local anaesthetics contain adrenaline (“Epinephrine”) in very small quantities. Some patients are sensitive to adrenaline and it can induce a very rapid heart rate and palpitations. Dentists should be informed of any allergies/sensitivities.
Toothache experienced during high-altitude flying. It is caused by the expansion of gas within the pulp chamber of a tooth due to the reduction in atmospheric pressure. It is usually the sign of a dead or infected tooth that is in need of treatment.
The techniques used to improve the position, colour shape and symmetry of the teeth and jaws. Aesthetic dentistry techniques are used to improve the appearance, as well as the function, of the teeth and mouth. Orthodontic treatment may be included under this classification.
This is a way of removing staining, decaying tooth and old white fillings using fine powder particles in a stream of water. It is also used to prepare the surface of metal (fillings and crowns) and porcelain before it is cemented or repaired.
The alveolus (or alveolar bone) is the bony part of the jaw, which supports the tooth and its supporting attachments.
A mixture of finely powdered silver, tin, a small quantity of copper, and mercury which forms a plastic material used to fill a tooth. Once tightly packed into the prepared tooth, the material is then carved into the required shape. It will set within a matter of hours to form an extremely durable, and long lasting filling. This is often referred to as a “silver amalgam filling”.
A substance that is used either to ‘numb’ specific areas applied by injection (local), applied by cream (topical) or, to cause unconsciousness applied by injection or gas (general).
An absence of pain. An analgesic is a substance, which has the ability to dull or remove the sensation of pain (refer to Toothache also).
The sudden and dramatic collapse of the circulatory system as the result of an acute allergic response (e.g. from a bee or wasp sting). There may be a rapid drop in blood pressure that causes a loss of consciousness in which case emergency treatment is required. This consists of the administration of Epinephrine and antihistamines or cortisones. The condition can prove fatal.
A condition in which the tooth’s supporting attachment disappears and the root becomes bonded to the jawbone making extraction of the tooth difficult or impossible. The condition is more likely to be associated with a previously traumatised or root treated tooth.
A rare genetic condition that causes the teeth to fail to develop. It can be either complete (a total absence of teeth) or partial hypodontia [only one or two teeth may be missing]. The most common site is the upper lateral incisors and wisdom teeth. The condition is hereditary.
Drugs that can help clear up infections caused by bacteria, but not by viruses, worms or fungi. They do not however remove the cause of a dental infection and should therefore only be used as an aid to treatment.
Distinguishing illnesses which result from bacterial infections (as opposed to viral, worm or fungal infections) is the key to using them successfully.
A chemical agent which can be applied to living tissues to destroy germs and prevent the spread of infection.
The tip (apical) area of the root of a tooth. The apex is a very important part of the tooth. The blood and nerve supply, which keep the tooth alive, run through a small opening in it into the root canal. If this part of the tooth has to be removed (in a root treated tooth) the surgical operation is called an apicectomy or root resection.
The normal relationship of the upper and lower teeth when biting together. Sometimes it is necessary to use aids to help our labs reproduce this when making Crowns, Bridges and Dentures.
An instrument used to assist with setting models of teeth in the correct relationship. It is used whenever a complete set of dentures is made to ensure that the jaws are in the correct relationship. It is also used when making Crowns and Bridges.
The wearing away of the biting surfaces of the teeth by the opposing teeth. Attrition occurs as a normal part of the ageing process but may become a problem if it advances too quickly.
A piece of equipment used to sterilise instruments. Superheated steam is held under pressure for a set period of time. The heat kills any bacteria/virus activity and prevents any cross infection.
A fever causing illness when bacteria are present in the blood stream. Of particular concern to patients who may have a heart condition or have suffered from rheumatic fever. Patients with a history of these conditions used to be given antibiotics to prevent or control bacteraemia during dental procedures. Evidence now shows this is not necessary.
Bad Breath (halitosis)
An unpleasant smell expelled by the mouth. It often arises as a result of poor oral hygiene (cleaning).
To eliminate bad breath a good oral healthcare routine is essential – regular toothbrushing and flossing or interdental brushing – and visits to your dentist for regular check-ups.
Bands and Brackets
Used in Orthodontics, bands are retaining devices made of stainless steel are bonded to teeth and then used to attach springs and hooks in order to move the teeth into line.
Brackets are small squares bonded to the side (lip side or tongue side) of the teeth and allow the orthodontic wire to engage with them allowing the tooth movement to be controlled. They can be metal or tooth coloured ceramic.
A condition caused by the inflammation and swelling of the facial nerve that paralyses the facial muscles. It usually only affects one side of the face and it is very noticeable if the patient tries to smile or blink their eyelids. The onset of the paralysis is frequently associated with the patient having been exposed to a cold draught on the side of the face (for example driving with the car window open). Treatment is sometimes assisted with the use of anti-inflammatory agents such as cortisones. Many cases will return to normal after 4 to 6 weeks but it is important to seek medical advice in the beginning.
An American term for a tooth with two cusps – the premolar teeth – of which adults have eight.
Divided into two parts. It is applied to the junction area of nerve trunks, blood vessels, and the molar teeth where the root area divides into two or more roots.
The removal of a small piece of soft or hard tissue for microscopic examination. The operation is usually carried out under a local anaesthetic. The tissue is sent to a laboratory for cellular diagnosis. A specialist (histologist or pathologist) will study the cells under magnification and diagnose any abnormalities.
Small x-ray films (radiographs) that are taken to check for decay between the back teeth and under existing fillings. They are also used to monitor bone levels around the back teeth which is a key indicator of gum disease.
Bleaching is a method for lightening the colour of teeth and can be carried out as external or internal bleaching. It is a very effective way of whitening your smile without damaging your teeth.
Anaesthesia of a nerve trunk that covers a large area of the jaw. A mandibular block injection on one side produces numbness of half of the lower jaw, teeth, half the tongue and the lower lip.
Bonding is a term used to describe a number of procedures that involve “sticking” composite resins to the tooth. Composite resins are plastic materials made of micro particles of glass and resin. Bonding can be used to treat fractured, cracked or chipped teeth; badly stained teeth; or teeth that are loose. It is also used extensively in orthodontic treatment to attach the bands and springs that are used to change the positions of the teeth.
Appliances that are fitted to the teeth to improve their position and alignment. Braces are either fixed to the teeth by brackets that are bonded to the enamel surfaces or they are removable. Removable braces are wires and springs attached to a plastic resin base. Braces are also known as orthodontic appliances.
A porcelain false tooth that cements in place to replace a lost tooth [or teeth]. There are two types of bridge – conventional bridge and adhesive bridge.
A false tooth is attached to a crown on one or both sides of a gap between teeth.
A false tooth is attached to a wing of metal and then glued to the adjacent tooth.
Tooth grinding. This is often caused by stress and usually happens unconsciously at night. It is damaging to teeth so a flexible mouthguard should be worn at night to reduce its effects.
The tooth surface which lies in contact with the cheeks (the buccinator muscle). It usually only refers to the back teeth touching the cheeks.
Hardened plaque. Calcium salts produced by saliva harden any plaque which is left on the surface of teeth. These deposits are particularly liable to build on the tooth surfaces nearest to the salivary ducts beneath the tongue and in the cheeks close to the upper first molars. Smoking tends to encourage calculus formation. The build up of calculus must be controlled by scaling of the teeth otherwise gingivitis and the breakdown of the tooth attachment can occur.
Usually applied to the narrow space within the root of a tooth that contains the blood vessels, nerves and tissues i.e. the root canal.
Cancer of The Mouth
Cancer of the mouth and pharynx is the fifth most common form of cancer in men and the seventh most common in women. Most people are not aware of its existence Cancer of the mouth is responsible for nearly 3% of all cancer deaths. There is a 50% survival rate in those cases diagnosed at an early stage. Factors which are commonly associated with cancer of the mouth are smoking and alcohol.
Regular examination of the mouth will reduce the likelihood of an early lesion being unnoticed. Any ulcer of the mouth which is present for more than a few days should immediately be seen by a dental surgeon.
A fungal infection. Candida is often present in the mouth without causing symptoms, even in healthy people. Candida is the cause of oral thrush, denture stomatitis and angular cheilitis.
The pointed teeth beside the front incisors, this is tooth sometimes called the eye-tooth in the upper jaw. So named as the tooth begins to develop just beneath the floor of the eye socket. Also referred to as cuspids.
The destruction of tooth substance leading to cavities. See also Decay.
Used as temporary fillings in cases of emergency, when many fillings have to be done in a short period of time, or when further treatment to a tooth may be required. They are made of zinc oxide and eugenol or similar materials and may last for a few weeks to many months.
There are also a different stronger types used to fix crowns and bridges permanently.
The surface covering the root of a tooth which is part of the tooth attachment to the jaw bone. This area can become exposed when the gums recede and, due to the presence of nerve fibres, can lead to discomfort and sensitivity.
The two upper and two lower teeth in the centre of your mouth also known as the central incisors.
Teeth can chip due to trauma, but they can also fracture through underlying tooth decay (cavities). Teeth that are brittle due to root canal treatment, congenital abnormality or bruxism (tooth grinding) may chip more easily.
A tooth may have damage to the hard tissue – a chip or fracture of the crown or crown and root– or it may have damage to the supporting soft tissues and blood vessels. The fracture can go through enamel only, through into dentine (sensitive yellower tissue under the enamel) or into the pulp (nerve and blood vessels). It is important to have the teeth checked to ensure that injures are treated appropriately and promptly.
A chronic condition is a long-term disease, illness or injury (as opposed to an ‘acute’ condition which is short-term.).
Chronic conditions may be extremely difficult to cure permanently and tend to recur. Long term monitoring of these conditions is essential. The most common chronic dental conditions are associated with gum disease. To avoid this regular dental visits are essential.
Cold sores are small eruptions usually affecting the lips at the point where the lip joins the skin of the face. They tend to recur in the same place. They begin as a tingling sensation, and then a small blister (vesicle) forms, which then crusts over to leave a small scab that eventually heals.
They are caused by a virus called herpes simplex virus (HSV).
Composites are tooth coloured resin filling materials. Often called white fillings, they are used as an alternative when an amalgam filling is not cosmetically acceptable. The quality of the finished result will vary depending on the experience and craftsmanship of the practitioner. As amalgam becomes more of an environmental concern they are becoming more frequently used.
Techniques that can be used to improve the appearance of teeth. Crowns, veneers, orthodontics, tooth-coloured fillings and tooth whitening are included.
The upper teeth meet inside the lower teeth either on one or both sides of the mouth. It may be possible to correct a crossed bite with orthodontic treatment.
The part of a natural tooth which is exposed in the mouth is called the crown and is covered in enamel. The term is also used to refer to an artificial covering that is made from metal [e.g. gold], or porcelain, to restore or conserve a damaged tooth.
A tissue sac which becomes filled with fluid. If left untreated it will gradually enlarge and cause the surrounding bone to resorb. Cysts are most frequently found at the pointed bottom [apex] of a dead or infected tooth. They are rarely associated with any symptoms in their early stages but can become infected and painful.
Deciduous Teeth [primary, temporary, milk or baby teeth] So-called because like the leaves on some trees they are eventually shed or exfoliated. The deciduous teeth start shedding from the age of 6 years or so [slightly earlier in girls] with the loss of the lower central incisors. The replacement process usually finishes when the last deciduous molar is lost by about 12-13 years of age.
A compound which has been formulated to clean the teeth e.g. Toothpastes and tooth powders.
The calcified part of a tooth beneath the enamel which surrounds the pulp chamber and root canals. It contains microscopic channels [tubules] that contain nerve fibres that connect to the dental pulp. Dentine is the “living” part of the tooth. Dentine can regenerate when it has been damaged but this is a very slow process. When decay reaches the dentine it usually needs to be restored or sealed.
The industry involved in the care and treatment of the tooth and it’s associated areas. It is currently undergoing considerable change. In the past, the NHS dominated the service. It suffered from underfunding and centralised controls. Now, the private [non-NHS] sector is growing rapidly, bringing with it new investment, better services and new technology.
A removable device or appliance [prosthesis] (complete or partial) made to replace missing natural teeth and their supporting tissues.
A disease involving a disturbance of the sugar metabolism caused by lack of insulin from the pancreas. It is controlled by either monitoring the diet or by regular insulin injections or medication. Poorly controlled diabetes is a well known risk factor for gum disease and tooth decay.
A gap or space between two teeth. Most commonly used to describe a gap between the upper two central incisors when the lip attachment (fraenum) causes a separation of these teeth. The diastema can sometimes be as much as 2-3mm and surgery, together with orthodontic treatment, may be needed to correct it. Sometimes these spaces can be reduced or closed simply by bonding tooth coloured fillings to the side of the teeth.
A tablet or liquid which stains plaque in order to identify deposits and make tooth cleaning more efficient.
The surface of a tooth situated furthest from the mid-line. The dentist will use the expression to notify on the charting the exact site of a filling or a cavity.
A home visit made because of a patient’s incapacity.
The top surface of the tongue which carries the complex array of taste buds or papillae.
A temporary filling material used to help relieve toothache. The material often contains eugenol and zinc oxide which is inserted into the tooth as a paste and then gradually hardens over 24 hours or so. Eugenol(found in oil of cloves)has been used for generations to treat dental pain.
The dental hand-piece which the dentist uses to prepare teeth for treatment.
“Dry Mouth” [Xerostomia] is associated with a reduced output or absence of saliva, producing dryness of the mouth. It is a common side effect of many medications. Saliva is important in the defence against tooth decay and gum disease. The risks associated with Xerostomia can be reduced by using the following techniques:
• Brush your teeth after every meal and before you go to bed
• Drink plenty of water
• Chew a sugar-free gum
• Avoid sugary food and drink
• Avoid using a mouthwash with an alcohol base
A dry socket is the most common complication following a dental extraction. The socket becomes infected and will begin to become very painful. A bad taste and foul smell will be present. It is important to return to your dentist for treatment without delay.
Out of hours emergency cover is not easy to find and some practices will only cater for their own registered patients. Please see the practice website for details of our emergency cover arrangements.
Enamel is the hard glossy natural protective coating that covers the crown of a tooth. There are no living cells present and it is therefore insensitive. It is translucent so the colour of the tooth is dependent on the colour of the underlying dentine. With the exception of diamond, it is the hardest naturally occurring substance known to man.
A specialist field of dentistry concentrating on the preservation of diseased or damaged teeth. Endodontic treatment or root canal therapy (RCT) carried out well can save teeth which, until recently, would have been extracted.
The study of the incidence of disease in a population. Dental decay is the most common disease in the U.K.
The irreversible loss of tooth substance as a result of chemical action. It is caused by excessive exposure to acid substances e.g. fruit juices and fizzy drinks or regurgitated food.
The controlled application of an acid to the tooth surface to clean and roughen it to enhance the adhesion of tooth attachments.
[see deciduous teeth]
The removal of a tooth – usually under local anaesthesia.
An instrument used to transfer facial recordings and measurements to an articulator to give correct angulation of the cast of the upper teeth. It is important to have these recordings made in complex restorative work to ensure that the natural articulation is preserved.
The folds or pillars of tissue and muscle in the sides of the pharynx that demarcate the region of the tonsils. The areas can be seen at the back of the throat.
An insoluble protein formed during the clotting process that traps and enmeshes the red blood cells and platelets to stop the flow of blood.
Materials placed in the teeth to replace lost tooth substance. Various materials are used as fillings.
Amalgam: [see amalgam] Composite: [see composite] Glass ionomer: [see glass ionomer] Cements: [see dental cements]
A fold, groove or trough in the enamel of the tooth. This area is vulnerable to decay as it is difficult to clean. Sealants are used to prevent the area becoming decayed.
A permanent hole or opening in tissue through which fluid can drain. One type of fistula can occur during the extraction of an upper molar where the roots are very close to the sinuses. If the lining of the sinus is breached an opening (fistula) connecting the mouth to the nasal airways can occur. If this is not treated, the tissues can heal and leave an opening through which food can leak into the nasal area.
Floss and Flossing
A thread used to clean between teeth as a part of good oral hygiene practice. Without some form of cleaning in between the teeth, even the best brushing misses about 40% of the tooth surface.
A naturally occurring chemical that improves the tooth’s resistance to acid attack and therefore decay.
The result of excessive fluoride exposure. The enamel becomes discoloured (often white, orange or brown patches) and mottled. In extreme cases it can also be pitted.
A piece of fleshy tissue that is associated with the lip attachment. An exaggerated fraenum in the centre of the inside upper lip may cause a gap between the upper incisors – see diastema.
The tissue that joins the tongue to the floor of the mouth. Occasionally this piece of tissue may have to be removed if it restricts the movement of the tongue (tongue-tie) and impedes speech development.
An electrical charge that is created when two dissimilar metals come into contact. The sensation is most frequently experienced when a new amalgam filling has been placed in a tooth which comes into contact with a gold restoration. Silver paper or a fork coming into contact with an amalgam filling may cause an electric “shock” or a metallic taste. In severe cases, the filling may have to be replaced with a “white” non-metallic restoration.
Spacing between the teeth either naturally occurring or through tooth removal. Cosmetic dentistry can close or fill these gaps.
By use of injection or gas to render a patient unconscious in order to carry out a surgical procedure
The NHS and the General Dental Council actively discourage GA in general dental practice in favour of hospital facilities.
A harmless condition affecting the top surface of the tongue. It appears to have white and red patches with wavy outlines on the affected areas, supposedly resembling the coastline on a map.
The study of dentistry which relates to the care of the elderly. This area of dentistry has become increasingly relevant as our population demographics ages and as more of our patients keep their teeth for longer.
Gingivitis – Inflammation of the gums
Healthy gums are pale pink and firm. Gums that are red and swollen, probably have gum disease or gingivitis. One of the commonest signs is the gums bleeding after brushing and/or flossing. The cause is often plaque (bacteria) left behind after brushing.
Tooth coloured filling material made from glass. It can be used in small shallow cavities but it generally has poor strength. It is very useful in children’s teeth and can leach fluoride, which helps prevent further decay. It is sometimes used with dental composite to help the sealing of the tooth. Like composite it is very sensitive to moisture before it has set.
An area of tissue associated with an infection. A granuloma can increase to a large size and become invasive.
True gum disease is where the supporting ligaments and bone become destroyed by the inflammation around the gums. It is caused by certain species of bacteria but is dramatically worse and more difficult to treat in smokers and poorly controlled diabetics.
The gingivae or the areas of mucosa immediately surrounding the teeth.
These purple lumps are a collection of blood vessels on the surface of the skin which form into a tumour. A “port wine stain” is a less severe condition brought about by surface blood vessels becoming obtrusive.
[see Bad Breath]
[see Cold Sores]
Having an affinity with water.
Having water-repelling properties.
A dental professional who specialises in the maintenance of good oral hygiene, dental fitness, and preventive dentistry.
A horseshoe shaped bone that lies between the thyroid cartilage and the base of the tongue.
Excessive or exaggerated reaction to a stimulus such as temperature (hot or cold).
Breathing at an abnormally high rate which can induce unconsciousness.
A condition in which the enamel fails to develop properly. This can occur if the patient suffers a serious illness whilst the tooth germ is developing leaving a defective line on the surface of the tooth.
A condition in which some of the tooth germs are absent and the normal number of teeth fail to develop.
A temporary denture fitted immediately after teeth have been extracted.
The introduction of vaccines to encourage the production of antibodies which give resistance to a disease or illness.
A tooth that is malpositioned so that it is growing sideways into another tooth or bone. Often associated with wisdom teeth which may be partially erupted or submerged beneath the gum.
The insertion of titanium posts into the jaw bone onto which crowns are fixed. The discovery that Titanium could be implanted into bone was made in Sweden by Professor Branemark in the 1970s. Given the right clinical conditions he found that cylinders of titanium could be implanted into human bone and after a few months they become inseparable.
Once integrated these Implants act as false roots and can support Crowns, Bridges or Dentures.
A mould of a tooth or teeth that is taken in order to make an accurate replica or die in a durable material on which to make a prosthesis (denture, crown, bridge etc.). The impression materials most commonly used are made from alginate or silicones.
The teeth at the front of the mouth are known as the central and lateral incisors. They cut food. There are eight in each of the deciduous and permanent sets of teeth.
A hardened surface of tissue. The condition is associated with cancerous growths and lesions where the tissues may become tightly bound and rigid.
Inlays and Onlays
A procedure to restore teeth. When cavities become too large and an ordinary filling is not strong enough to cope with the required biting forces the dentist will need to have stronger fillings made in the laboratory.
Inlay – fits inside the tooth
Onlay – fits over the tooth
They are made of various substances e.g. gold, porcelain, etc and last for about 10 to 15 years. They are cemented or bonded to the tooth.
The covering of dental costs by regular payments. There are various schemes available: capitation, insurance and cash plans.
Capitation Schemes – Premiums are calculated based on the patients dental condition so, those with poor teeth can expect to pay a higher premium. Many plans will require dental fitness before acceptance and contain provisions for additional charges such as laboratory fees where crowns, bridges, dentures etc. are concerned. Expensive items such as implants are excluded.
Insurance and Dental Cash Plans – These tend to have lower premiums but require the patient to pay the dentist’s bill and then submit a claim – some have exclusions, some have excess requirements and some have maximum settlement figures. Each policy is different and it is important to consider your own circumstances before making any decisions.
Lack of blood supply to the tissues which become whitened or blanched.
A yellow discolouration of the skin and the eyes brought about by the presence of in the system of bile pigment products. It is an indication that the liver is not functioning properly.
The bony part of the facial skeleton, either the upper jaw (maxilla) or lower jaw (mandible) that provides support for the tooth attachments.
The area or junction of bones at which movement can take place. The ends of the bones are covered in cartilage and bathed in a fluid that lubricates the surfaces. The temporomandibular joint or “jaw joint” is where the mandible joins the base of the skull just in front of the ear.
Relating to the neck or throat.
Small red spots that appear inside the lower lip at the onset of measles on about the second day, before a generalised rash appears.
The surface nearest or adjoining the lips (the labialis muscles). Hence the labial surface of a tooth refers to the front of the upper and lower incisor teeth. A dentist will use the term when describing [charting] a mouth to identify the position of a cavity or a filling.
A product resulting from the metabolism of carbohydrate which weakens the surface enamel and causes decay.
Bacteria actively involved in the decay process breaking down carbohydrates to form acid which attacks the tooth enamel.
The organ which houses the vocal cords. It is at the top of the windpipe [trachea] and is responsible for producing the sounds that enable us to speak.
White blood cells responsible for fighting infection.
A malignant blood condition where the white cells fail to develop properly. The gums can become swollen, very inflamed and discoloured with frequent episodes of spontaneous bleeding.
A surface thickening of the mucous membranes which has a white appearance and occurs in patches. It is often associated with smoking and can be a pre-cancerous condition.
A condition that may affect the lining of the mouth and tongue. It is an inflammatory condition that sometimes causes soreness, sensitivity and discomfort. The condition has a variety of appearances. It is commonly seen as a network of fine white lines on the inside of the cheeks, often on a reddish background. Less commonly it can appear as white patches of different sizes and shapes on the tongue or roof of the mouth. Occasionally the gums can be affected, both with white patches and, sometimes, shiny red sore-looking gums.
A local anaesthetic commonly used in dentistry and often combined with 2% adrenaline to prolong the effect by reducing the blood flow. A dental anaesthetic can last for as long as 3 hours and patients should take great care not to drink very hot fluids or chew on the affected side until the normal sensation has returned. It is very easy to bite the anaesthetised area and cause serious soft tissue damage and ulceration.
Thread usually made of silk or cotton used to tie off blood vessels or stitch tissues together. It is removed when healing is well advanced. In some instances, a dissolvable material [e.g. catgut] is used to bring the deeper tissues together before the surface tissues are repaired. These deep stitches [sutures] are then left undisturbed.
The surfaces of the teeth or tissues nearest to the tongue. The term is derived from the Latin word for the tongue.
Spasm of the jaw muscles caused by tetanus toxins.
A specialised white blood cell that plays an active role in destroying bacteria that infect the blood stream.
The lower jaw which is attached to the base of the skull through the temporo-mandibular joint.
The muscles on either side of the mandible. They provide exceptionally strong biting and chewing forces. The muscles can be seen clearly on the side of the face when the teeth are clenched together.
The chewing and grinding of food prior to swallowing. It is the start of the digestive process.
The upper jaw and bone structure that supports all the upper teeth.
A base metal used in amalgam fillings. There is much debate about its use as it is – in its pure form – toxic. It has never been proven to be harmful when combined with other metals in amalgam.
The surface of a tooth nearest to the mid-line and another term used frequently by dentists to describe [chart] the position of a cavity or filling in a tooth.
[see Deciduous Teeth]
Tooth at the back of the mouth that is used for crushing and grinding. There are eight deciduous molars and twelve permanent molars although the third molars (wisdom teeth) often fail to erupt because of lack of space in the jaw (impacted).
A term used to describe the appearance of teeth that have been affected by excessive exposure to fluoride during their development (see fluorosis).
A device worn over the front teeth to protect them from damage. Usually worn during sporting activities. They are made from a flexible material designed to cover the upper teeth and protect against the effects of a blow to the face. A properly designed mouth guard will also minimise the damage to the soft tissues.
The coloured liquid which is used to rinse away debris from the mouth following dental treatment. It contains thymol, sodium bicarbonate and a colouring agent.
A painful area affecting the soft parts of the inside of the mouth: the cheeks, lips and tongue.
Seven million people in the UK get mouth ulcers each year – 16% of the whole population. Despite being small, ulcers can be very painful and make eating, drinking, talking and even kissing very painful.
A fluid that seeks to reduce or eliminate damaging bacterial activity and help to interfere with plaque formation.
There are different types including fluoride rinse to protect against tooth decay, general purpose daily rinse to supplement the toothbrushing routine and reduce bacterial activity, and specialist rinses for short term use to help control a chronic gum condition.
The process that destroys living tissues. e.g. gangrene. If the blood supply is cut off from an area of the body or an organ, tissues will become necrotic. This can happen to a tooth and leads to the formation of a dental abscess.
An abnormal growth or swelling of the tissues. May be slow or fast growing and either benign or malignant. Diagnosis depends upon a biopsy being taken and the cell histology being studied.
Pain arising from a nerve trunk or pathway. Very severe facial pain can be caused by trigeminal neuralgia which affects the face. It can be severely debilitating, sometimes requiring surgery to cut or relieve pressure from the nerve supply.
A unit of nerve tissue which is part of the nervous system connected to various parts of the body and transmitting impulses enabling sensation and movement.
National Health Service
The sweet smelling gas used during the early days of general anaesthesia in dentistry – known as laughing gas. It is rapidly absorbed into the blood stream and has analgesic effects. Nitrous oxide is still used in obstetrics mixed with oxygen to reduce the discomfort of child birth.
The patients intake of food and drink. The quality and type has a significant effect on general and dental health.
Sugar is a major contributor to dental decay. A key finding is that tooth decay depends on how often – rather than how much – sugar is eaten. The dental profession recommends restricting sugar intake to no more than five times a day for every two lots of toothbrushing.
Acidic food and drinks, such as citrus fruits and drinks and any fizzy drink, are a major cause of erosion. This softening of the enamel leads to its accelerated wear and surface loss.
A specialised cell that is responsible for laying down the calcified substance called dentine that surrounds and protects the pulp tissues. Odontoblasts remain active throughout life and are continually laying down new dentine during the ageing process. It gradually seals up the minute channels previously occupied by nerve fibres and reduces tooth sensitivity.
An abnormal growth of calcified dental tissues made up of dentine and enamel. The growth will frequently remain embedded in the jaw and not give rise to any symptoms.
The leaking of fluid [plasma] into the tissues which creates a swelling either caused by an obstruction of a blood vessel, trauma or increased cellular permeability.
Of the mouth [derived from Latin].
[see cancer of the mouth]
The process of keeping teeth and gums clean and free from decay and gum disease.
The scientific discipline concentrating on diseases of the mouth.
Any operation which involves the soft or hard tissues of the mouth.
The dental process that straightens teeth or brings teeth into a regular arrangement [the correction of malocclusion].
In recent years orthodontic technology has improved dramatically and with the use of fixed appliances (train tracks) teeth can be moved significant distances into perfect positions.
Specialised cell that forms bone.
Specialised cell that breaks down bone or calcified tissues. These cells are very active during the exfoliation stages of a deciduous tooth when the roots are being absorbed prior to it being lost.
The surfaces of the teeth adjoining the roof of the mouth. Used by dentists to chart the position of a cavity or filling.
A form of dental shorthand used to describe individual teeth.
The mouth is divided into four parts called quadrants, upper left quadrant, upper right quadrant, lower left quadrant, and the lower right quadrant. Each tooth in the quadrant is then given a name and a number (e.g. the two upper and two lower teeth at the centre of your mouth are called centrals or 1’s). The numbers of these teeth, added to the quadrant in which they are placed, give a precise location e.g. the central on the upper right side of your mouth is called an upper right central or upper right 1.
A term often used to describe a panoramic radiograph of the teeth and jaws. Literally ‘around the mouth’.
The disease of the tissues around the tooth.
Plaque left at the neck of the tooth may cause an inflammation below the top of the gum. This affects the supporting structures of the tooth – the elastic (ligament) fibres that attach the tooth to the bone, and the bone itself. The inflammation will eventually destroy this attachment resulting in ‘pockets’ along the root of the tooth and finally a loose [mobile] tooth.
The tooth supporting structure that attaches the root of the tooth to the jawbone. This is a very complex structure which allows for microscopic movements of the teeth to ensure that mechanical stresses are evenly distributed.
The study of conditions which adversely affect the supporting structures of the teeth. In simple terms “gum conditions” but in reality another most complex dental speciality.
The fashion of piercing the tongue with decorative jewellery. The fashion should not be encouraged as it is risky and unhygienic.
A film of bacteria and food residue that collects on the surfaces of the teeth.
The area around the neck of the tooth that forms as a result of the gum tissue becoming detached. Very deep pockets can develop which harbour bacteria and threaten the whole tooth attachment (periodontium) resulting in loosening and tooth loss.
Your premolars and molars. These are the teeth in the back of your mouth.
Teeth have to withstand very heavy demands during pregnancy. In the absence of excellent oral hygiene measures this can have a devastating effect on the teeth. A good balanced diet taken at regular mealtimes with plenty of calcium, vitamins and minerals are essential during pregnancy for both mother and developing child.
It is not uncommon for the gums to become inflamed and start to bleed during the last six months of pregnancy. This is quite natural and is a direct result of the hormonal changes that take place within the body. A mouth rinse such as CORSODYL is a useful product to help reduce this inflammation.
It is important to see a dentist at the beginning of the pregnancy, about two months prior to delivery and again when the baby is about three months old.
The bicuspids (two cusped) teeth set behind the canines and in front of the molars.
[see deciduous teeth]
The removal of plaque and surface stains with a paste carried on a rotating cup shaped polishing brush.
Prosthesis – an artificial replacement of missing teeth [e.g. a denture or a bridge] in the mouth. A dental prosthesis can be removable (denture) or fixed (crown or bridge).
Prosthetics or Prosthodontics
The provision of artificial or false appliances which have been carefully designed to fit the hard or soft tissues of the mouth.
Fixed prostheses can be used to replace the missing teeth and take the form of crowns or bridges. Removable prostheses are worn by those who have lost all of their teeth (complete dentures), some of their teeth (partial dentures) or by children to straighten their teeth (orthodontic appliances).
The soft inner structure of a tooth, consisting of nerve and blood vessels. It is contained in the pulp chamber which is the very inner part of your tooth containing nerve cells and blood vessels [also known as the pulp canal].
A rise in body temperature above the normal 98.4F (37C) usually as a result of an infection causing an increase in pulse and respiration rate.
The General Dental Council maintains a Register of all those who can legally practice dentistry in the UK. To be licensed to practice dentistry requires a qualification from a recognised body. Examples include the Royal College of Surgeons (a licence in dental surgery – LDS) or a University Degree (bachelor of dental surgery – BDS).
Higher or post graduate qualifications can be taken in order to be recognised as a specialist.
An abscess of the tonsils making it very difficult to swallow. It is extremely painful and is accompanied by a high temperature. Responds quickly to antibiotics.
Sensitive films that give a permanent record of relative tissue densities when they are exposed to x-ray radiation. Highly calcified dense areas of bone or tooth substance will prevent the transmission of radiation and so will show as opaque or white areas on the film. The dark areas of film indicate areas of lower tissue density.
They are used to identify any abnormalities in the teeth and gums that may need treatment.
An area on an X-ray which is darker and indicates an area of lower tissue density allowing the passage of radiation. Decay is radiolucent compared to healthy tooth tissue.
The shrinkage of the gum tissues that exposes more of the root surface of the tooth. A natural ageing process that can give rise to sensitivity, it can also occur pathologically due to localised irritations.
A sensation of pain that occurs in an area which is different from the area causing the problem. The very complex nature of the facial nerves sometimes makes it difficult for a patient to accurately signify where the source of the pain originate e.g. at the start of a dental abscess it is possible to perceive that the pain may even be coming from the opposite jaw.
A mixture of nitrous oxide [“laughing gas”] and air is still used frequently as a very safe method of reducing pain. It is used in dentistry and midwifery in conjunction with local anaesthesia. The patient remains in a cooperative state of consciousness and the effects wear off very quickly.
The re-basing of a denture to improve the fit. The dentist may use temporary soft liners to gain better stability or suction.
The bone structure remaining following the loss or extraction of teeth. The lower (mandibular) ridge tends to suffer more from residual bone loss than the upper and this makes it more difficult to stabilise a lower denture.
The process of returning the tooth and its surroundings to its previous condition after damage or loss has occurred.
Dental technology and materials have advanced rapidly in recent years. The more advanced technical procedures require special skills and knowledge.
The tissue behind the last molar teeth. It is more easily recognised in those patients who have lost all their teeth.
The root is the part of a tooth which is attached by a membrane to and embedded in the jawbone(alveolus).
The chamber in the middle of a tooth that contains the nerve [pulp].
Root canal treatment is carried out when the pulp (or nerve) inside the tooth is damaged or becomes infected. If infected pulp is not treated, it may become an abscess.
Lack of saliva [dry mouth or xerostomia] is an extremely distressing condition which is experienced by an increasingly large proportion of the population.
Saliva is responsible for lubricating the teeth and mouth tissues which makes chewing, eating, swallowing and speaking possible. It helps to cleanse the mouth, neutralise acid production, begin the digestion of carbohydrates, repair the early damage caused by tooth decay, and it has the ability to protect against infection.
A healthy adult produces about 500mls per day and the flow normally increases at meal times in response to chewing. Some sour fruits such as lemons will promote an exaggerated flow of saliva.
A plastic coating which, when applied to the grooves and pits on the biting surfaces of children’s teeth, can protect them from decay.
If a small amount of decay has already occurred in part of a groove the decay must be removed. Provided the resulting cavity is small, a sealant restoration can still be used to fill the hole and seal the remaining grooves.
The permanent teeth that replace the deciduous(primary) dentition.
The use of safe and effective drugs to help nervous and apprehensive patients to relax. It ensures that the patient is fully conscious, but at the same time relaxed and co-operative. The dentistry is carried out under local anaesthesia to eliminate any painful experiences and patients often forget about their dental treatment and find the events difficult to recall.
Hypnotherapy and even acupuncture have also been used to reduce dental anxiety.
Sensitivity [dentine sensitivity]
The painful sensation that occurs when dentine is exposed by caries, fracture of the enamel, or recession of the gums.
An opening into a tract of tissue which is linked to the oral cavity. Usually associated with an infected tooth root. Also a term used in association with the major air cavities in the maxilla which can become infected and give rise to sinusitis.
An infection of the cavities in the maxilla situated behind the cheek-bone. The symptoms can frequently give rise to toothache in the upper premolar and molar regions. Fluid can build up and the pain can be made worse by sudden movement of the head.
Antibiotics may be required. Inhalation with eucalyptus and menthol can help to alleviate the discomfort and clear the sinuses.
Making a variety of noises when exhaling during sleep.
About 40% of the population snore. At best it is a nuisance but at worst it can give rise to serious medical problems. Invariably snoring occurs whilst sleeping on one’s back and it is caused by a temporary blockage of the airways by the soft tissues at the back of the throat. More modern methods involve the fitting of appliances in the mouth to prevent the soft tissues obstructing the airway.
In exceptional circumstances surgery may be required. There are a number of dental surgeons who specialise in treating snorers.
Manufactured fluids drunk to relieve thirst or by habit. Commonly containing sugar and/or carbon dioxide.
Fizzy drinks (whether diet or regular), artificial fruit squashes, cocoa, and milk shakes all cause harm to teeth. The sugar in them causes decay whilst the acid in both normal and diet drinks dissolves the enamel on the teeth. Comfort feeders and bottles containing sugary drinks, which are given to young children for prolonged periods of time, cause severe dental problems, because they bathe the teeth in sugar that quickly converts to acids.
Dentists who offer services in addition to those connected with general dental practice.
Many practices offer a range of specialised services that may not be covered by General Dental Council specialists (see A-Z specialist
The General Dental Council maintains a Register of dental surgeons who are qualified to practice dentistry in the UK. In addition it has lists of specialists who have obtained certification in particular areas of dentistry which recognises their higher level of knowledge, experience and qualification.
These specialist areas are:-
Dental Public Health
Dental and Maxillofacial Radiology
Inflammation of the tissues of the mouth. It is particularly common in denture wearers where food debris and bacteria can quickly set up an inflammatory condition.
Denture-induced stomatitis is a condition caused by candida, a fungus infection. It is manifested as redness in the gum covered by a denture, often without soreness.
Persistent cracking or soreness at the corners of the mouth (angular chelitis) may also be a sign of oral candida infection.
Extra or additional to the normal. A supernumerary tooth does not resemble the morphology of another in the dental arch and will have developed from an aberrant tooth germ. An additional tooth which resembles the morphology of another is called a supplemental tooth.
The presence of pus as a result of a spreading infection.
Radical treatment of dental problems e.g. infected root tip.
A Stitch used to bring the edges of a wound together to promote healing. They can be resorbable (dissolve on their own) or non-resorbable (need removing).
Every human is born with a genetic programme which will develop for us two sets of teeth – a deciduous set and a permanent set. Nature has given us a second chance to learn from our mistakes if we fail to keep the first temporary set in perfect condition. By the age of six years we have to have a carefully regulated diet and an effective cleaning programme which will be part of our daily routine.
All teeth erupt free of tooth decay and a life-time preservation programme must be put into practice. It is important that life-time habits are developed in the young. Cleaning must be fun and it is the very last thing that has to be done before bed time. Nothing must be eaten or drunk afterwards. If a child has to have a drink by the bed at night then this should only be water.
The development and eruption of the first set of teeth in the young.
The eruption of the milk teeth is usually accompanied by excessive salivation and a redness of the cheeks. This is particularly noticeable when the molar teeth appear. Babies will tend to push things into their mouths to gnaw upon in an attempt to relieve the soreness. It is rare that the front teeth give much of a problem but the first molar teeth which appear at about twelve months can give a problem. Eating hard rusks can help the eruption process.
The second deciduous molars will finally complete the temporary set of teeth at about the second birthday. These larger teeth frequently give rise to listlessness, sometimes loss of sleep and can be accompanied by a fever. These symptoms can last for a week or so with the lower teeth erupting first. These symptoms may reoccur some weeks later as the upper teeth follow. Disprol or Calpol, and the local application of Anbesol will often help relieve the symptoms of teething.
The complex hinge joint which connects the mandible with the base of the skull just in front of the ear.
Temporomandibular joint disorders (known as TMJ disorders or TMD) are the most common condition affecting the jaw joint. TMD is also known as facial arthromyalgia, and literally means face, joint and muscle pain.
An infectious disease spread by the tetanus bacillus which causes severe muscular spasm and lockjaw. Can be contracted through a cut or wound exposed to dirt or soil. Can be effectively protected against by vaccination.
A broad spectrum antibiotic. Care must be taken with the administration of Tetracycline in children as it can lead to unsightly mottling or yellow staining of the tooth.
Babies can be born sucking a thumb or a finger! X-rays sometimes show the developing child sucking a thumb whilst still in the womb. It is quite normal for infants to suck a thumb or a finger and only becomes a problem if the habit is allowed to become persistent from about 2 years of age. The thumb can become very sore, which usually acts as a deterrent.
A light metal with unique bone bonding properties that were discovered in the 1960’s by Professor Branemark. Carefully designed implants are now used extensively in dentistry to replace natural teeth and to anchor bridges and dentures in place.
The discomfort [pain] caused by changes in the health of teeth. The best advice is to go and visit a dentist as soon as possible.
The teeth and the tooth attachments may give rise to painful symptoms as a result of decay, abscess, periodontal (gum) disease or eruption problems. The pain may vary from an intermittent or fleeting sensitivity to hot and cold that may indicate the early onset of decay to the most dreadful acute throbbing pain caused by advanced decay and a dental abscess. In this latter case it may be impossible even to touch the teeth together and eating may be difficult.
An aid to keeping teeth and gums clean and in good condition. They may be manual or electric powered.
The method adopted for the use of a toothbrush.
A thick creamy material used, in combination with a toothbrush to assist in tooth cleaning.
There are three main categories of toothpaste – family, children’s and specialist. Both fluoride and non-fluoride tooth pastes are available in adult and children’s formulae.
An agent applied on the surface e.g. a topical anaesthetic applied to the mucous membranes; or fluoride applied to the enamel surfaces.
A bony protuberance or swelling sometimes found in the centre of the palate (torus palatinus) or on the inside of the lower jaw beneath the tongue in the region of the pre-molars (torus mandibularis).
The removal of a tooth or tooth germ and insertion into another part of the jaw.
A rare facial pain that causes a sudden, brief but severe electric shock-like or stabbing pain on one side of the face. It tends to be more common in women than in men and usually affects people aged 50 and over.
Spasm of the jaw muscles which closes the teeth tightly together (lockjaw). It occurs in tetanus and in people who suffer from epilepsy. It may also arise as a result of a severe infection affecting the jaw muscles e.g. an impacted wisdom tooth.
A swelling or abnormal growth of tissues.
On one side of the mouth only.
An organic compound that used to be used in toothpastes to reduce caries activity.
A rash or inflammation of the skin which tends to be persistent or recurrent.
The soft pendulous piece of tissue that hangs from the centre of the soft palate at the back of the throat.
A volatile material used in dentistry to provide a protective film or sealant. The solution evaporates to leave a barrier against moisture or irritant substances and can be used under filling material to protect the sensitive dentine underneath.
A substance such as adrenaline used in dentistry to restrict the blood supply by making the blood vessels contract. This can reduce bleeding of the tissues after surgery and prolong the effect of the local anaesthesic.
A substance that enlarges a blood vessel to allow greater blood flow.
A layer of tooth-coloured material, which is attached to and covers the surface of a tooth. They are usually made of porcelain or composite resin.
Composite resin veneers can be built up directly on the tooth, while porcelain veneers are made in the laboratory and are later glued (bonded) on to the tooth.
A very small amount of enamel is removed from the tooth surface. This is usually completely pain free, subsequently the veneer will be glued to the tooth.
The hollow areas between the cheeks and the outer surfaces of the teeth.
An extremely painful ulcerative gingivitis which can be very destructive. It is indicative that a patient is very run down and debilitated. The condition used to be referred to as “trench mouth” as it occurred in soldiers in the First World War who were exhausted from lack of nourishing food and sleep.
A tiny micro-organism that attacks and lives within the host cells and is not susceptible to antibiotic treatment.
The flow properties of a substance relating to stickiness. Low viscosity or low flow fluids being stickier than high flowing or thinner ones.
Used to describe a live or healthy tooth which reacts normally to hot or cold temperature changes.
Blood anticoagulant used for patients who have suffered a thrombosis. Patients on Warfarin must tell the dentist before any treatment is carried out. Special precautions are needed for tooth extractions. Surgical treatment may need to be carried out in hospital.
A material used very extensively in dentistry, especially in prosthodontics. There are so many dental applications that a variety of waxes are made each with specialised properties. Different melting points and strengths are required for various tasks e.g. making replica dentures, or crown forms. The “lost wax” process is the foundation of dental casting techniques.
Whitening (see also Bleaching)
A process that will result in a change in the appearance of a tooth. The treatment required will depend on the underlying cause.
Tooth discoloration can be a result of either external factors (surface stain) or internal factors (internal stain). As a general rule our teeth become darker as we become older – it is a normal ageing process.
Large teeth at the back of the mouth (third molars or 8’s). They are usually the last to appear, normally in the late teens and early twenties.
Wisdom teeth can cause problems because they erupt at the back of the mouth after all the other permanent teeth have erupted and there is very little space left. Wisdom teeth have a habit of slowly breaking through the gum tissues at the back of the jaws. These tissues can then become infected and swollen. It is often the lower wisdom teeth that become the most troublesome. There can be serious facial swelling and a raised body temperature and fever. In these circumstances professional advice should be sought immediately.
Other wisdom teeth may never come through but remain buried and impacted at an angle in the jaw.
Xerostomia (see dry mouth)
The reduced output of saliva, producing dryness of the mouth.
If you suffer from xerostomia you can treat it by using the following techniques:
Brush your teeth after every meal and before you go to bed
Drink plenty of water
Chew a sugar-free gum
Avoid sugary food and drink
Avoid using a mouthwash with an alcoholic base
A reflex action in which air is drawn into the lungs through distended airways and an open mouth. Usually a sign of tiredness and shallow breathing when the carbon dioxide levels build up and oxygen levels are depleted.
A single celled organism related to a fungus.
Zinc Oxide A white amorphous powder used extensively in dentistry as a component of filling and impression materials. When mixed with eugenol and used as a temporary filling it can bring relief for toothache and sooth inflamed tissues.
Part of the facial skeleton, which forms the floor and side of the eye socket.