Glossy

Abfraction
A wedge shaped wear pattern, or notching, at the base of your tooth where it meets the gum line. Can cause sensitivity and weakening of the tooth. Thought to be caused by excessive clenching or grinding.

Abutment, Implant
The part of an implant restoration that brings the height of an implant from below to above the gumline. Allows the restoration to be attached to the implant

Amalgam Filling
The traditional silver filling. An amalgam actually means a mixture or blend. In this case, a mixture of silver, mercury, copper, and tin.

Bitewings
Dental radiographs which check for cavities in-between the teeth as well as showing the quantity and quality of bone in-between the teeth.

Bonding
A composite resin, aka a tooth colored filling.

Inlay/Onlay
When decay is extensive, the remaining portion of the tooth becomes compromised. Placing a filling alone can eventually lead to fracturing of the tooth. An inlay or onlay made from porcelain is cemented in, increasing structural integrity.

Bone Graft
Used to preserve or form new bone. This procedure is done to preserve a site where a tooth extraction was just done, or to create new bone around an existing tooth or in the jaw to facilitate the placement of an implant in the future.

Bridge, Fixed
Using adjacent teeth between a missing tooth by replacing a missing tooth by placing at least two crowns on adjacent teeth and suspending a false tooth, or pontic, in between or cantilevered from one end. This restoration is cemented to your teeth and is not removable. It is carefully crafted for esthetics, fit, comfort, and cleansibility. Depending on the size and situation, the bridge may take from two to six visits to complete. A quality provisional (temporary) bridge will be in place in-between appointments.

Bridge, Removable - see Removable Partial Denture.

Bruxism
The habit of clenching and grinding the teeth using extremes of muscle power. Often some part of the mastication system is harmed, either the muscles, the jaw joint, or the teeth. Over thirty percent of the population does this to some degree, mostly at night in deep sleep stages. People are often unaware of the habit until either signs or symptoms appear. The habit often correlates with physical or emotions.

Calculus
The scientific term for tartar, which is the accumulation of calcified substance that adheres to the teeth. Calculus is microscopically porous, and provides a multitude of hiding places for the bacteria that cause gum disease. It should be removed on a schedule chosen specifically for the individual needs of each patient. It is the major target of your "cleanings".

Canker Sore
A painful ulcer that lasts seven to ten days, usually on the looser gum tissue in the softer areas of the mouth. Scientifically known as aphthae, these ulcers can sometimes occur on the tongue, palate, and throat. They can be treated with steroid cream if they are debilitating. The over the counter styptic "alum" also works well.

Cold Sore
The common name for blisters cause by the Herpes Simplex virus, to which 98% of the world's population has been exposed by the age of two. This is a different but similar virus to that which causes genital herpes. Cold sores often occur on the external lip (herpes labialis), and on the gum tissue near the teeth. They last from seven to ten days, and can be treated with antiviral medications when severe.

Crown
A covering placed on a tooth to replace missing structure and reinforce or strengthen it. The most common crowns made today are from a cast metal (preferably a gold alloy) with esthetic porcelain baked to the outside. In non esthetic areas, or for patients with exremely strong masticatory musculature, gold crowns are still used and are still the most durable restorations known. Today, we also have all-porcelain crowns, with incredible esthetics (see Procera). Crowns are indicated for broken or cracked teeth, and any tooth in which the previous filling encompassed more than one-half of the width of the tooth. Crowns are also still used to solve some cosmetic problems when bonding or veneers would not be adequate. Crowns generally require two visits, and fine crafted provisional crowns are placed for the interim.

Deprogrammer
A type of bite appliance for patients with muscle pain, or myositis. It allows only the front teeth to touch, eliminates clenching and grinding for most patients, and relaxes muscles. It IS NOT for all day use; it is usually prescribed for nighttime therapy. Many studies have shown that the majority of dangerous clenching, grinding, and bruxism occurs at night in the deepest sleep stages, even in people who snore with their teeth apart in lighter sleep stages. Studies have also shown that when asleep, with inhibitory muscle reflexes decreased, people can and clench with four to five times the muscle force that they could consciously develop. Hence myositis can develop in overworked muscles, with the net effect of a "charley horse" in your jaw muscles. The deprogrammer helps to relieve these muscular symptoms.

Enamel
The hard crystalline material that covers the outside of the tooth. The hardest substance in the human body.

Fistula
A drainage spot in the gums. Referred to as a "gum boil" in the past, is a sign that infectious pus is draining into the mouth. Very often people have fistulae with no symptoms at all; however, the cause of this drainage must be addressed. We have recently reviewed a case in which pus from a dental abcess entered the lungs and caused a pulmonary abcess which killed the patient.

Fluoride
A halide element (small molecule) found commonly in water and foods. Low concentrations have been found to greatly lower the amount of cavities in our society. Fluoride's most beneficial effect is to remineralize (reharden) areas that have just been softened by decay. A new toothpaste, Enamelon, has some extra ingredients that make this remineralization process even greater. Dr. Groh did some research with this formulation at NIH over 15 years ago and found it to be very usefull. Fluoride is also a poison to many oral bacteria and thus prevents cavities and periodontal disease. Like any medicine, it must be used carefully. Heavier concentrations have been found to create mottling or staining of tooth enamel. Most communities today add fluoride to the drinking water supply and carefully monitor its concentration for safe health improvements. Very few bottled waters contain fluoride. Additionally, fluoride is removed by many water softeners and reverse osmosis units. Most municipalities offer inexpensive analysis to check the levels of fluoride in your drinking water to test for safe but effective cavity protection. Insufficient levels can be supplemented by dentists or pediatricians with prescription fluoride drops. Fluoride is also found in most toothpastes and in the mouthrinses Fluorigard and Act. Fluoride does occur naturally in some foods, most notably in tea leaves. In hot tea, most of the fluoride boils off; "sun tea" iced tea is a good natural source of dietary fluoride.

Implants
Artificial tooth roots that are placed into and fuse with the bone of the jaw. They can be used to replace teeth or to support and retain dentures. The placement is generally so simple as to be

Membrane Graft
A special technique for bone grafting which greatly increases the success rate. There are two types of membranes used, one which needs to be removed and another which slowly disolves by itself. The membranes allow bone grafts to consolidate without interference from certain types of cells.

Night Guard
A device similar to a retainer which separates the teeth and oftens relaxes the muscles which position the jaw. A variety of configurations are used. A nightguard is indicated for people who overwork their jaws at night and possibly risk damage to their teeth, jaw joints, and/or muscles. People who wake up withsore muscles, facial weakness, or a jaw that is "locked" are good candidates for this device. Some types may also be used to diagnose jaw posture problems.

Nitrous Oxide
Also known as "laughing gas" or "sweet air", was the first general anesthetic discovered; significantly it was discovered by a dentist, Horace Wells. It is a poor general anesthetic by any standards, but carefully administered doses are excellent at lowering patient's anxieties. It also does increase pain tolerance to a measurable degree. It is especially useful in the management of fearful children, for whom it provides a pleasant, fantasy-like state. It is a very safe drug, with no reported allergies, and very few side effects when administered properly. Patients should note that careless dentists often administer nitrous oxide in a "cookbook" fashion, and provide safe but uncomfortably high doses of the drug. Many adults require low doses to relieve anxieties and don't care for the higher amounts. It is not a "truth serum" and people do not misbehave under its effect.

Gingivitis
The first stage of periodontal disease, characterized by inflammation of the gum tissue without any bone loss. The clinical signs are swelling and bleeding upon stimulation. Rarely are these signs noticed as a problem by patients. Many people think it is normal for gums to bleed when brushing, which is not true. Gingivitis is the result of chronic infection caused by plaque bacteria. Gingivitis is the first stage of your body's literally trying to reject your teeth, and requires immediate treatment if it is not to progress into more destructive forms of gum disease. A person can have gingivitis and periodontitis in different parts of the mouth at the same time.

Sinusitis
Infection in the sinus cavities, of which we have four in our skulls. The largest of the sinuses is the maxillary sinus, located just above the roots of the upper molars. A pressure cousing infection in this area can be mistaken for tooth pain. Maxillary sinusitis is sometimes characterised by pain in the jaw or face that changes when you lean over, lay down, or stand up. It can literally cause pain with every footstep.