Dr. Foushee's Specialty is Composite Inlays of all the different types of restorations

What Is an Inlay? It is a space placeholder. You can think of a dental inlay or onlay as being midway between a filling and a crown. Inlays or onlays are used when not enough tooth structure remains to support a filling, but the tooth is not so severely damaged that it needs a crown. An inlay is similar to a filling, but it lies within the cusps (bumps) on the chewing surface of your tooth. An onlay is more extensive than an inlay and covers one or more cusps. Inlays or onlays can be made of gold, composite resin (plastic) or ceramics. They can last for decades. However, how long they last depends on the material used, the teeth involved, the forces of chewing and how well the patient maintains them with good oral hygiene and regular visits to a dentist.

"I do, I enjoy doing composite inlays the most because it engages me artistically and patients are uniformly happy with the service. Indeed in all the years I’ve been doing them, I’ve not had a single case of post-operative sensitivity. I use them primarily in back teeth that need large fillings but do not need a crown. Large composites have a draw-back when used as a direct filling because they shrink as they harden and they are not very resistant to biting forces. By using the composite as an inlay, I can solve these problems of shrinkage and softness."

INLAYS ONLAYS

How It's Done? There are two types of inlays and onlays: direct and indirect. Direct inlays and onlays are made in the dental office and can be completed in one visit. Indirect inlays and onlays are made in a laboratory and require two visits. Which type of inlay or onlay is used depends on how much sound tooth structure is remaining and whether there are any cosmetic concerns.

"An inlay is a two-step process where an impression is taken of the prepared tooth, a laboratory prepares the piece that will fit into the preparation, and then the composite piece is bonded to the tooth. This two-step process allows us to heat cure the inlay to make it harder and more polishable before placement into the tooth. Also, this two-step process allows us to compensate for the natural shrinkage of composites by adding a minute amount of composite to the tooth on placement of the inlay. Although the restoration is a two-step process, I have techniques that allow me to start and finish the work in one visit, which for many patients is a plus. I love being able to hold the little inlays in my hand and create these works of art. I’m also gratified that when I am done, you hardly know a dentist had been there. It’s also good to know that the heat curing process has volatilized out the components that would have otherwise made for a weaker restoration. I can show you the results with my intra-oral camera."

BEFORE AFTER

BEFORE AFTER

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What does treatment involve?
Treatment often involves from one to three visits. The pulp chamber and root canal(s) of the tooth are then cleaned and sealed. Here's how your tooth is saved through treatment:



1. First, an opening is made through the crown of the tooth.

2. An opening is made through the crown of the tooth into the pulp chamber.

3. The pulp is then removed. The root canal(s) is cleaned and shaped to a form that can be filled.

4. The pulp is removed, and the root canals are cleaned, enlarged and shaped.

5. Medications may be put in the pulp chamber and root canal(s) to help get rid of germs and prevent infection.

6. A temporary filling will be placed in the crown opening to protect the tooth between dental visits. Your dentist may leave the tooth open for a few days to drain. You might also be given medicine to help control infection that may have spread beyond the tooth.

7. The pulp chamber and root canals are filled and sealed.

8. The temporary filling is removed and the pulp chamber and root canal(s) are cleaned and filled.

9. In the final step, a gold or porcelain crown is usually placed over the tooth. If an endodontist performs the treatment, he or she will recommend that you return to your family dentist for this final step.

10. The crown of the tooth is then restored.

Your smile is important. It's one of the first things you notice when you meet someone. A whiter, brighter smile is beautiful - it can help you feel better about yourself and make a memorable impression

Your lifestyle and the aging process can stain and darken your teeth. Many things we do on a regular basis can contribute to stained teeth, such as drinking coffee, tea, cola and red wine or smoking.

Whitening can get your smile looking its best. Non-professional procedures and clinically unproven teeth whitening tips can often lead to unsatisfactory results, you should look for a whitening procedure that is:

Fast and convenient
Long lasting
Low sensitivity
Proven to be safe and effective
Supervised method by a Dental Professional

Teeth Whitening Procedures Can Help:

Lighten coffee-stained teeth.
Remove cigarette and tobacco discolorations.
Correct yellowing in teeth due to aging.

Dental Health: Cavities

Cavities occur as a result of tooth decay. Tooth decay is the destruction of tooth structure. Tooth decay can affect both the enamel (the outer coating of the tooth) and the dentin layer of the tooth.

Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or caries.

Who Gets Cavities?

Many people think cavities only affect children, but changes that occur with aging make cavities an adult problem too. Recession of the gums (a pulling away of gum tissue from the teeth), often associated with an increased incidence of gingivitis (gum disease), can expose tooth roots to plaque. Also, sugary food cravings in pregnant women can make them more vulnerable to developing cavities.

Decay around the edges of fillings is also common in older adults. Because many older adults lacked the benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and can fracture, allowing bacteria to accumulate in the tiny crevices causing tooth decay.

How Do I Know if I Have a Cavity?

Your dentist can discover cavities during your regular dental checkup The tooth surface feels soft when probed by your dentist with a dental instrument. X-rays can also show cavities before they become visible to the eye.

In advanced stages of tooth decay, you might experience a toothache, especially after consuming sweet, hot, or cold foods or drinks. Other signs of tooth decay are visible pits or holes in the teeth.

How Are Cavities Treated?

Cavities are treated in a number of different ways depending on the extent of tooth decay. If decay is not extensive, the decayed portion of the tooth is removed by drilling and replaced with a filling made of silver alloy, gold, porcelain, or a composite resin. Restorative materials used in fillings are considered safe. Concerns have been raised over the safety of mercury-based, silver amalgams in particular, but the ADA, FDA, and other public health agencies continue to support the safety of this restorative material. Allergies to silver amalgam are rare as are allergies to other restorative materials.

If the decay is extensive and there is limited tooth structure remaining, crowns will be used. If a crown is needed, the decayed or weakened area of the tooth is removed and repaired and a crown is fitted over the remainder of the tooth. Crowns are made from gold, porcelain, or porcelain fused to metal.

If the decay causes the nerve or pulp of the tooth to die, a root canal will be performed. During the procedure, the center of the tooth (including the nerve, blood vessel, and tissue) is removed along with the decayed portions of the tooth. The roots are then filled with a sealing material. If necessary, a crown can be placed over the filled tooth.

Several new treatments are under development. One experimental technique uses fluorescent light to detect the development of cavities long before they can be detected by traditional means, such as x-rays or dental examination. In many cases, if cavities can be detected early, the decay process can be stopped or reversed.

Researchers are also working on a "smart filling" to prevent further tooth decay by slowly releasing fluoride over time around fillings and in adjacent teeth.

Reviewed by the doctors at The Cleveland Clinic Department of Dentistry - Souce WEBMD.
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Q. I have some old silver fillings which are beginning to look bad. What can be done to improve them.

A. Silver amalgam fillings, which are composed of 50% mercury and 50% silver alloy ,eventually need to be replaced. It may surprise you to know that the average life span of a silver filling is five to eight years. Your dentist can tell you when they appear to NEED to be replaced due to leakage, breakdown or recurrent decay.

If your concern is strictly COSMETIC, there are many new methods available to replace the fillings with beautiful, functional long lasting restorations.

Such things as white filling materials, porcelain inlays , crowns and veneers may be used to give you the smile you are seeking.

There is currently a great deal of interest in new reinforced hybrid materials. These beautiful resin materials may be reinforced with fibers, similar to fiberglass, and used in very conservative inlays and bridges without having to grind away a whole healthy tooth.

A. You are correct. There are many products and techniques available. Some work great and some don't work at all. The various over the counter products give the least predictable results.

To get a really great result you should probably use one of the products sold through dental offices which utilize custom made trays for home app- lication of a bleaching gel.

At our practice we offer some the best whitening formulas and products on the market.

We also get questions about "laser whitening". With this method a laser is used as a light source to activate the bleaching gel which is applied to your teeth in the dental office. It may be necessary to use the at home trays in addition to this initial lengthy treatment. Side effects can include senstivity to treated teeth.

A. Dental implants are a wonderful way to replace missing teeth when certain conditions exist. Such things as your overall general health and the length of time you have been missing your teeth must be considered. The replacement of missing teeth using dental implants frequently requires a team approach.

After your dentist does a thorough examination and treatment plan the surgical phase of treatment takes place. In most cases a periodontist or an oral surgeon will put the implant(s), the artificial root(s) into the jaw. When healing is complete, usually after 4-6 months, The tooth or bridge segment can be placed on top of the healed implants by a general dentist or a prosthodontist . Some dentists are trained to place the surgical part of the implant as well as the prosthetic or tooth part.

You should ask your dentist if you are a good candidate for implants and ask for a referral if he or she doesn't do them.

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A. This is a good question, which we hear daily. The brand of the toothbrush is not nearly as critical as the type of bristle, the size and shape of the head and how frequently you replace your brush.

We recommend a soft bristled brush with a small head. The soft bristles are most important for the health of your gums. A small head allows you to get around each tooth more completely and is less likely to injure your gums.Daily frequency of brushing and replacement with a new brush are much more important issues than the brand you choose.

We recommend replacing your brush at least once a month.

My employees and I all brush, on average, 5 times a day. We brush first thing in the morning, after each meal and at the end of the day .

If you are not able to do this because of your busy schedule, we recommend brushing twice a day at a bare minimum.

Q. When I visited my dentist for my last checkup, she told me that I have impacted wisdom teeth and she wants to remove them. They are not bothering me. Should I see a specialist if I decide to have them removed? What should I do?

A. Having regular dental checkups with x-rays allows you to learn about potential problems and have them corrected BEFORE they begin to bother you. There are a number of reasons for recommending removal of unerupted or impacted teeth. Your dentist may have seen that these teeth could cause problems for the adjacent teeth if left in place. There is also the possibility that you could develop such things as a cyst or abscess if left in place.

General dentists who provide any specialty service such as root canal treatment, braces, oral surgery or periodontal surgery are required by law to adhere to the same standard of care provided by a specialist

Your dentist should be happy to talk more with you about this. If you still have questions, you might want to see another dentist for a second opinion.

Q. I just recently went to a new dentist for a checkup and cleaning and asked him to check a cap that that was put on one of my front teeth by my former dentist. He informed me that I did not have a cap on any of my teeth. I know my last dentist fixed a broken front tooth and said he capped it. Who should I believe?

A. You have just experienced one of a number of common misunderstandings we see in dentistry today. Terminology used in dentistry is not 100% uniform throughout our profession. Both dentists were probably "correct".

The word "cap" as used in dentistry by different dentists can refer to a number of different things. A pulp cap refers to a calcium containing dressing placed under a deep filling to stimulate healing. A full crown, made by a dental laboratory which completely covers the outside of your tooth is frequently called a cap. A partly broken tooth may be built up by your dentist in the office with a bonded filling material. This is called a cap or "capping" by some dentists. This sounds like what you probably had done.

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Q. My son is six years old and starting to get his permanent teeth. I am concerned because the teeth are discolored. Some even have a brownish or greenish hue. What caused this and what can be done about it?

A. From your description, it sounds like a very normal situation and nothing to be concerned about. When the teeth are forming in the jaws, they are surrounded by a soft tissue membrane called Nasmyth's Membrane (named after Alexander Nasmyth, a Scottish dental surgeon in London who died in 1847).

As the teeth erupt, remnants of this membrane remain on the surface of the enamel. The fibrous nature of the membrane readily picks up coloration from food.

In most cases normal chewing and brushing will remove the remnants with time. If they don't come off, they can be removed by having a professional cleaning.

Other causes for staining of teeth include high fevers during infancy, too much fluoride in drinking water and certain medications if taken while the teeth are still forming.

Q. It has been quite a while since I have been to a dentist because I cannot stand the sound of the drill. I think I have a new cavity but am reluctant to call a dentist . What can I do? I don't want a toothache and certainly don't want to lose my tooth.

A. Dental technology has come a long way in recent years. If you have a new cavity that requires a filling, there is "new" air abrasive equipment which replaces the drill for removing decay. It is quick, silent and in most cases you do not need a shot of anesthetic because there is no heat or vibration to cause pain.

Air abrasion theory has been around in dentistry since the fifties but has only recently become practical to use because of downsizing of equipment and the development of filling materials which can be used with the new way of preparing teeth for fillings.

Our patients love it. For youngsters who are experiencing their first cavity, it is a great way to go - no noise, no needle, no pain! It won't work for all cavities, but with your dislike of the drill, you should certainly see a dentist who uses this technology.

Q. My boyfriend thinks it would be neat if I got my tongue pierced. What can you tell me about this? I am a little concerned about whether it would be safe. I do have pierced ears and have not had any trouble with that.

A. In a word (or four) PLEASE DON"T DO IT! Fortunately, I have only seen a couple of these in "real life". I have read of numerous cases in our dental journals which have resulted in all sorts of problems.

To begin with, the tongue is an extremely vascular organ, which means that it has loads of blood vessels. A tremendous amount of swelling is expected when the tongue is pierced and a large oversized "barbell" is initially placed to accommodate for the expected swelling.

This can cause difficulty in breathing and swallowing. Eating, drinking and speech are all impaired. The large barbell flops around and has caused unrestorable fractures of teeth when accidentally bitten.

The barbell can come unscrewed and be swallowed or possibly be aspirated, sucked into the lung. Either of these could require surgery.

I repeat, PLEASE DON'T DO IT!

Fillings

We are a mercury-free practice. However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and Tooth Colored Restorations (onlays) create fillings that are not only beautiful (or unnoticeable) but also add strength to weakened teeth. These restorations are esthetically pleasing and very strong thanks to new bonding technologies.

Disadvantages of Silver fillings

Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break.  This results in the tooth not being protected and lets cavities get started once again.  With age, the metal of a silver filling expands, contracts, and can split.

Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums.

Fortunately, silver fillings can safely be replaced with Tooth Colored Restorations.

Advantages of Tooth-Colored Restorations

There are many advantages to tooth colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth.  Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Since the resin used in tooth colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!

The result is a beautiful smile!

Replacing Silver fillings with a Tooth Colored Restoration

You can have your silver fillings replaced with Tooth colored restorations (onlays). This process requires two appointments.

Your First Appointment

1. The old filling is removed and any additional decay.
   
2. An impression is made of your teeth. A model of your teeth is made and sent to the lab.
   
3. A temporary onlay is placed on the tooth.

At the Lab

A resin is carefully placed into the model of your teeth. It is then designed to look natural.

Your Second Appointment

1. The temporary onlay is removed.
   
2. A conditioning gel is placed on your tooth to prepare it for the new onlay.
   
3. Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
   
4. The tooth is then polished.

Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!

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Sealants

Highly effective in preventing decay on the biting surfaces of your chewing teeth, sealants are a simple procedure in which a tooth-colored acrylic "coating" is painted onto the surface of the tooth. This effectively "seals" the deep grooves acting as a barrier, protecting enamel from plaque and acids.

Sealants protect the depressions and grooves of your teeth from food particles and plaque that brushing and flossing can't reach.

Easy to apply, sealants take only a few minutes to seal each tooth. Sealants hold up well under the force of normal chewing and can last several years before a reapplication is needed. 

Children and adults can benefit from sealants in the fight against tooth decay.

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Veneers

What are porcelain veneers?

Porcelain veneers are thin shells of ceramic that bond directly to the front and top surfaces of the teeth. They are an ideal choice for improving your smile and have become increasingly popular due to their simplicity and versatility. With veneers as an alternative, there is no reason to put up with gaps between your teeth, teeth that are stained, badly shaped or crooked. A veneer placed on top of your teeth can correct these maladies, simply and quickly, to help you achieve a beautiful smile!

Will they look like normal teeth?

When bonded to the teeth, the ultra-thin porcelain veneers are virtually undetectable and highly resistant to coffee, tea, or even cigarette stains. For strength and appearance, their resemblance to healthy, white tooth enamel is unsurpassed by other restorative options. Because they are thin, light can shine through them and they take on the natural color of the underlying tooth.

How durable are porcelain veneers?

With proper care, porcelain veneers will brighten your smile for well over a decade.
Dr. Fushee will ensure that your veneers are crafted from the highest quality porcelains and are bonded with the most advanced and proven materials available.

The Procedure

This procedure will require three appointments:

• Diagnosis and treatment planning
• Preparation
• Bonding

Diagnosis and treatment planning

You will want to take an active role in planning your smile design. Your doctor will review the corrective limitations of this procedure and help you plan your new smile.

Preparation

The second appointment will take one to two hours. Although the porcelain veneer is very thin, the teeth are lightly buffed to allow for the added thickness. Approximately one half of a millimeter of tooth is removed. This may require little or no local anesthesia.

Then a mold is taken of the teeth and sent to the lab for fabrication. If the teeth are too unsightly a temporary veneer can be placed at this time. The veneer should be ready in approximately one to two weeks.

Bonding

At the time of your third appointment, your doctor will first place the veneer on your teeth with water or glycerin to check their fit and color. At this point the color of the veneer can still be adjusted by the shade of the cement used to adhere it. Once the color is determined, and the veneer is ready to be applied, the tooth is cleansed with specific chemicals to achieve a bond. A special cement is placed between the teeth and the veneer and a visible light beam is used to harden the cement. This appointment takes approximately one to two hours.

Care and follow up

Brush and floss daily. Return for a follow-up visit after one to two weeks.

Maintenance of your new Veneers

Brush and floss as you normally would. Don't be afraid that you will damage your veneers by brushing and flossing. Non-abrasive toothpaste is recommended. A good home care regimen will insure the best esthetic success of your veneer.
You may experience some sensitivity to hot and cold after placement of your veneer. This is due to the amount of enamel left on the tooth after preparation. Sensitivity is totally normal and should dissipate after one to two weeks. If sensitivity persists please call the office.

If you are a known clencher (bruxer), please be sure to let us know. Your doctor may recommend a soft night guard for you to wear to minimize stress placed upon your teeth while you sleep.

We hope that your new veneers fulfill your esthetic goal. With proper home care and scheduled visits, they are sure to provide you with a beautiful smile for years to come.

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Bonding

Bonding can be used as a restorative procedure for teeth that are chipped, cracked, discolored or misarranged, and is an alternative to veneers.

How does it work?

The tooth is prepared for the procedure by lightly etching the surface and applying a bonding liquid. Once the liquid sets, a plastic resin is applied and sculpted into the desired shape by the dentist. Once set, the resin is trimmed, smoothed and polished to a natural appearance.

Considerations

The bonding procedure can often be completed in a single office visit, and can improve the appearance of a tooth significantly. However, since the plastic resin used is not as strong as your natural tooth enamel, it is more likely to stain, chip or break than natural teeth. Bonding typically lasts three to five years before repair is needed.

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Extractions

You and Dr. Foushee may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, your dentist will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Extraction Process

At the time of extraction Dr. Foushee will need to numb your tooth, jawbone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure.  This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

Sectioning a Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can't expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

After Care

Bleeding

Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 45 minutes can control this.

Blood clots that form in the empty socket.
This is an important part of the healing process and you must be careful not to dislodge the clot.

• Avoid rinsing or spitting for 24 hours after the extraction.
• Avoid use of a straw, smoking carbonated or hot liquids.

Swelling

If swelling occurs you can place ice on your face for 20 minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.

Pain and Medications

If you experience pain you might use non-prescription pain relief medications such as acetaminophen or ibuprofen.

Eating

For most extractions just make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours.
A liquid diet may be recommended for 24 hours.

Brushing and Cleaning

After the extraction avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the site. Beginning 24 hours after the extraction you can rinse with salt water (1/2 teaspoon in a cup of water) after meals and before bed. 

Dry Socket

Dry socket is when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and the healing is significantly delayed.

Following the post extraction instructions will reduce the chances of developing dry socket. Dry sockets manifest themselves as a dull throbbing pain, which doesn't appear until three to four days after the extraction.  The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.

Dr. Foushee will apply a medicated dressing to the dry socket to sooth the pain.

Healing

After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was.  In time, this will smooth and fill in with bone. This process can take many weeks or months. However after 1- 2 weeks you should no longer notice any inconvenience.  Socket preservation is indicated to preserve the bone in the extraction site.  

Replacing teeth with:
Dental Implants (link to dental implant page)
Bridges (Link to bridges page).

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Bleaching

Having a beautiful smile may be even easier than you think. Many people achieve the look they've been dreaming of with our simple "bleaching" procedure.

It's safe, quick, and inexpensive. Just let us know at any appointment if you would like to begin bleaching. You can lighten only your upper teeth or both the upper and lower, depending on how much of each shows when you talk and smile.

In only a day or two your custom bleach splints will be ready for you to pick up. We provide you with a special bleaching agent that you put into the clear, almost invisible splints. With only a few hours of wear per day, our special bleaching agent bubbles stains right out of your enamel in a very short time without altering tooth structure or existing dental work in any way. When your teeth reach the brightness you want, only occasional treatment is needed to maintain your new smile. We'll want to take "after" photos at your next appointment.

Dental bleaching can be used to correct many tooth discolorations. These discolorations may have been caused by staining, aging, or chemical damage to teeth. Using the latest in bleaching technology, we can offer a safe method for creating a beautiful, "brilliant" smile. In cases of extreme tooth discoloration, crowns or veneers may be the only choice. But because of the low cost of bleaching treatments, bleaching is nearly always worth a solid try.

Before	After

Key Benefits

• Corrects brown, yellow and mottled tooth staining 
• Works on people of all ages. 
• Is a near permanent solution for a "dull" smile, restoring brightness and bringing a smile alive. 

How is it done?

An impression is taken to make a specialized "mouthguard" or "stent" to hold the bleach against the teeth. The material is used each night for about 3-4 hours for a week or two, after which significant whitening will occur. In some cases, the change is nothing short of brilliant. For confidence in appearance, bleaching technology offers improvements in yellowing, aging or stained teeth. For very severely stained teeth, crowns or veneers may be more appropriate.

Considerations

Over-the-counter bleaching agents are available at drug stores and pharmacies. However, since these products can harm the gums and teeth, it's better to use products that our practice recommends.

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When a tooth is missing, the neighboring teeth can drift out of position, and that can cause:

• A change in your bite
• Loss of additional teeth
• Decay of the remaining teeth
• Gum disease

If you've lost one or more teeth, Dr. Foushee may recommend a bridge .

A bridge is a group of interconnected crowns, which replace the missing teeth and support the surrounding teeth. When it's held in place by two crowns, a bridge can:

• Lower the risk of gum disease
• Help correct any bite misalignment
• Improve clarity of speech

When done by a fully qualified cosmetic dentist, bridges are effective and durable, and can last over 10 years.

How is a bridge constructed?

• Dr. Foushee will first reshape the targeted teeth so they can accommodate the crowns
  
  
• Then he'll take impressions of those teeth, and from the impressions, the crowns will be made
  
  
• When the crowns are ready, the porcelain tooth or teeth will be bonded to them
  
  
• A temporary bridge will be inserted, giving you a feel of how the final bridgework will modify your mouth
  
  
• A couple of weeks later, the temporary bridge will be removed and the permanent one inserted, adjusted and cemented into place.

After the bridge is cemented, you can again enjoy your favorite foods with confidence.

Bridges enable us to avoid that sunken look that's caused by missing teeth, and by stabilizing that area they give us a more youthful appearance. We can smile with confidence again.

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PROPHYLAXIS - FLOURIDE - SEALANTS

HOW TO BRUSH AND FLOSS
Brushing and flossing "good oral hygiene" are the two mainstays of oral hygiene. Most people brush, but few have been shown to remove the plaque from under the edge of the gum. The bristles of the brush must slide into the cuff of the gum, like a broom may slide under the edge of the refrigerator. The brush should be positioned at a 45 degree angle to the tooth, and move in a small circular motion, or shimmy. Scrubbing is not recommended, in that it may lead to gum recession. (See How to Brush below) We recommend the use of an electric toothbrush and would be happy to discuss which one would be best for you.	Brush angles under the gum Brushing lower molars Brushing upper molars
Electric brushes have been shown to be more efficient than manual brushes. For most people they are easier to use. However, they also must be properly placed around the teeth to remove plaque. They do NOT replace the need for floss.
How To Brush The object of brushing is to remove plaque from the tooth surface and from under the edge of the gum, on the inside and outside of the tooth. It is important to remember that periodontal disease starts under the gum edge, and placing the bristles in the sulcus is important when brushing. Also, remember that brushing cannot access plaque that forms under the gum's edge between the teeth, and flossing is needed to complete that important step of oral hygiene. Toothbrush at 45 degree angle to tooth, allowing bristles to slide between the tooth and gum, to clean plaque hidden in the sulcus. To brush, angle the bristles of the brush at 45 degrees to the side of the tooth. This allows the bristles to slide under the edge of the gum, reaching the hidden plaque. Think of sliding broom bristles under the edge of a refrigerator to remove dirt. The brush should not be scrubbed back and forth, but rather shimmied or rotated in small circular motions. This allows the bristles to remain under the gum's edge, and also prevents wearing the gum. Brushing the inside of the upper back teeth. Angle the bristles at 45 degrees and make a jiggling motion. Brushing the outside of the upper back teeth. Do not scrub. Brushing the inside of the lower back teeth. Brushing the outside of the lower back teeth. Brushing the outside of the upper front teeth. Brushing the outside of the lower front teeth. When all the teeth have been brushed under the edge of the gum, the top surfaces can be brushed. Brush the cheeks and tongue as well, for plaque forms throughout the mouth. Remember that brushing does not clean between the teeth, and flossing is needed to complete your daily oral hygiene We generally recommend the usage of an electric toothbrush such as the Sonicare, Braun or Oral-B. These toothbrushes have been scientically proven to be superior at plaque removal than manual or regular toothbrushes. The angle that these brushes should be directed is similar to a manual toothbrush, however the toothbrush will perform the brushing action required. We recommend you spend 2 minutes brushing the top teeth, 2 minutes brushing the bottom teeth and spend 1 minute for flossing every morning and evening. Flossing is the only way to remove plaque from under the gum, between the teeth. Because most periodontal disease starts between the teeth, flossing is even more important than brushing. MOUTHWASHES DO NOT REPLACE THE NEED FOR FLOSSING. Good flossing is a skill that takes practice, but nothing can replace it in preventing periodontal disease. When learned, it should only take 2-3 minutes a day. When flossing it is important to slide the floss slightly under the gum, wrapping around the tooth as far as possible. A clean surface will elicit a "squeaky clean" sound. How To Floss Brushing removes the bacterial plaque from the sides of the teeth, but no brush is able to go between the teeth AND under the gums. Unfortunately, this is where most periodontal disease starts, so it is critical to remove plaque from these critical areas. Flossing is the most important contribution you can make to your own oral health. Learning how to floss properly takes time and patience, and most patients feel awkward flossing at first. However, once learned, it is an easy task that you will enjoy because your mouth will feel cleaner than ever before. It is not important when you floss, only that you do it at least once a day. Because it is not necessary to rinse when flossing, many patients find that after learning the technique, they can floss while watching television. First, break off an 18-inch length of floss (any kind you like). Wrap the floss around your middle fingers, allowing enough room to control the floss with your index fingers and thumbs. Floss wrapped around middle fingers leaving 4 - 5 inches between hands Floss crosses over top of index fingers, which act to guide floss between teeth Using index fingers allows easy placement of floss in back regions of the mouth Floss may also be used by crossing over an index finger and opposite thumb Using thumb and index finger for flossing front teeth Gently slide the floss between two teeth, allowing it to pass through the contact of the two teeth. Many people think this is the stopping point , but it is only the preliminary step. Flossing going past the contact point of the front two teeth. The gum has not yet been cleaned. Once the floss "breaks the contact", slide it between the gum and one of the teeth as far as it will go, without causing discomfort. The floss is moved up and down several times, until the plaque is dislodged. When you hear the floss "squeak", the tooth surface is clean. Don't remove the floss, but rather slide the floss against the other tooth, and repeat the procedure. Each time the floss goes between two teeth there are two places that must be flossed: the side of one tooth and the side of the other tooth. These are two separate steps. Slide the floss under the edge of the gum of one tooth, wrapping around the tooth. Gently move the floss up and down. Next guide the floss under the gum of the adjacent tooth, wrapping the floss and guiding it up and down. Once the floss has cleaned between the two teeth, move to the next contact and repeat the procedure until all the teeth have been flossed, front and back. Flossing the back of the canine, pulling the floss forward to wrap around the tooth. Flossing the front of the adjacent tooth by pushing the floss backward to wrap around the tooth At first it may take 10-15 minutes to complete the mouth, but when you become proficient, flossing should take a total of less than 5 minutes. This is the best investment of time you can make toward your oral health. There are many other aids that are available to help with oral hygiene. These include small brushes that can clean spaces between the teeth (proxibrush), and threaders to guide floss under bridges (floss threaders). Toothpicks may be recommended to help clean furcations. Each patient is individually assessed to see what may help optimize their cleaning efforts. Proxibrush entering space between teeth Proxibrush cleaning between teeth

A crown is a prosthetic placed over an existing tooth to create a smoother, cleaner look and to increase the strength and durability of that tooth. It's the same size and shape as the natural tooth. They're a good option if you have damage or decay that's so extensive that filling materials can't keep the tooth strong enough. The crown not only restores the appearance of your teeth, but can also affect the muscles in your face. So it will help to keep your jaw and bite properly aligned and will prevent other teeth from shifting or taking on a too-large share of the work of biting and chewing. A crown may be recommended when a tooth: Is fractured Has an outdated filling Is severely damaged by decay

Types of crowns

Crowns can be made from different materials:

• Full porcelain
• Porcelain-fused-to-metal
• All-metal crown

Crown Technology

Crown technology has much improved over the years, and if you have any older crowns, Dr. Foushee can replace them with new, more real-looking ones. Today's well-constructed crowns look and function like natural teeth.

When crowns are made of porcelain, they're carefully matched in color to your other teeth, so they can't be recognized as being crowns.

The biggest benefit is the all porcelain crowns are much less likely to create periodontal infections and cause gum recession. They are a better technology than conventional metal crowns.

• Many people prefer porcelain crowns because of their cosmetically pleasing appearance.
  
  
• New materials are now available that in some cases allow the use of "all-ceramic" crowns.

As an alternative to porcelain, crowns are sometimes made of gold and sometimes of stainless steel.

• Some people would rather not have gold crowns, because they stand out from the other teeth in appearance.
  
  
• But if the crown is on a back molar, others feel the cosmetic issue isn't a big one.

If a crown is recommended for you, Dr. Foushee will discuss the types of materials available and together you can arrive at the best course of action.

Protecting your crown

Once your crown is in place, it needs to be cared for, just as natural teeth do. In particular, the base of the crown needs careful cleaning to prevent bacterial growth and gum disease from starting underneath the crown.

Regular brushing and flossing will keep your crown in place for years to come.

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Laughing Gas (see Nitrous Oxide)

Source: Dentalfind

Nitrous Oxide, N2O, also called laughing gas, is a colorless gas with pleasant, sweetish odor and taste, which when inhaled produces insensibility to pain preceded by mild hysteria or laughter.

Nitrous oxide was discovered by the English chemist Joseph Priestley in 1772, but was named nitrous oxide by Humphry Davy. The principal use of nitrous oxide is as an anesthetic in surgical operations of short duration as prolonged inhalation of nitrous oxide can cause death.

Nitrous oxide is prepared by the action of zinc on dilute nitric acid, by the action of hydroxylamine hydrochloride on sodium nitrite, and, most commonly, by the decomposition of ammonium nitrate.

Nitrous oxide has very distinct characteristics and when inhaled, nitrous produces a variety of physical effects including:

• Disorientation
• Fixated vision
• Throbbing or pulsating auditory hallucinations
• Similarly pulsating visual hallucinations
• Increased pain threshold
• Deeper mental connections

The physiological effects of using nitrous oxide last approximately a minute for a lungful of nitrous and then mainly dissipate. Some residual effects may last up to several minutes later. Nitrous gas works by infusing into the membranes of the body and produces an anesthetic effect.

Nitrous oxide is used in roughly one third of dental practices in the United States, especially to allay anxiety that many patients may have toward dental treatment, and it offers some degree of painkilling ability. The benefits of nitrous oxide are many, and the risks are few. The gas is administered with a comfortable mask placed over the nose, and the patient is instructed to breathe in through the nose and out through their mouth. As a precaution, patients should not eat anything for about two hours prior to use of the gas. The patient begins to feel a pleasant level of sedation in anywhere from 30 seconds to three or four minutes. The cheeks and gums will also begin to feel numb in about a third of the patients.

After the gas is adjusted to the appropriate dose, and the patient is relaxed and sedated, the dentist can comfortably give the anesthetic injection (if needed) to the patient, and then proceed with dental treatment. After the treatment is completed, the patient is given pure oxygen to breathe for about five minutes, and all the effects of sedation are usually reversed. Unlike IV sedation or general anesthesia, the patient can almost always leave the office by themselves, without an escort.

Nitrous oxide has few side effects although high doses can cause nausea in some patients, and about 10% of patients do not benefit from it. Patients that are claustrophobic or have blocked nasal passages cannot use nitrous oxide effectively. Nitrous oxide is one of the safest anesthetics available.

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Laser Dentistry

For patients who do not look forward to needles, drilling, or numbness, Laser Dentistry, may be the right choice.

Laser dentistry is one of dentistry's latest advances. The Laser delivers energy in the form of light.  Depending on the intended result, this energy travels at different wavelengths and is absorbed by a "target."  In dentistry, these targets can be enamel, decay, gum tissue, or whitening enhancers.  Each one absorbs a different wavelength of light while reflecting others. Laser dentistry can be used for both tooth and soft tissue related procedures.  Often times no local anesthesia is required.  Unlike the dental drill with laser dentistry there is no heat or vibration, making the procedure quite comfortable for most patients.  For soft tissue (surgical) procedures it eliminates the need for suturing and healing is much faster.

Lasers can be used to diagnose cavities. They can find hidden decay in teeth in early stages, and in some cases the decay can be reversed through hygiene and fluoride treatment and may never need filling.

Areas of dental care that benefit from laser technology:

• Cavity diagnosis and removal 
• Curing, or hardening bonding materials
• Whitening teeth
• Periodontal, or gum related care
• Pediatric procedures.
• Apthous Ulcer treatment (canker sore)
• Frenectomy (tongue-tie release) without anesthesia or sutures
• Root Canal and apiecopectomies
• Crown lengthening, gingovectomy and other gum corrections

Click here for a complete list of FDA cleared procedures

Dental lasers have been shown to be safe and effective for treating both children and adults. 

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Gum Disease Laser Therapy

Periodontal or gum disease happens when bacteria gets below the gum line and the attachment between the gum and tooth is lost.  Three out of four Americans have some form of periodontal disease and only 3 out of 100 will ever get treated before its too late.

Gum disease is a silent, chronic, painless and communicable bacterial infection that often goes undetected or ignored until severe gum and bone destruction is unbearable and no longer able to be ignored.  Left untreated gum disease can cause tooth loss and traditional treatment can hurt.

The latest conservative gum therapy uses a laser. The laser gently disinfects and evaporates diseased tissues from around the tooth and inside the gum pocket. This treatment interrupts the bacterial destruction of the tissues and bone giving the gum pocket a chance to heal. Systematic repeated visits, generally 2-8, allow the gum pocket to be disease-free and sometimes allow tissues to reattach to the pocket back to a normal or near-normal depth. This new laser therapy is gentle, less painful, has a quick recovery. While surgery may still be indicated for severely advanced periodontal cases, laser therapy is a much more conservative, effective and comfortable option for beginning to moderate periodontal cases.

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Intraoral Camera

Many patients, especially younger patients, are very familiar with the latest technology and are more comfortable with the high tech practice. Computers and TV screens are their primary method of information processing.

Dr. Foushee utilizes intraoral camera technology that helps enhance your understanding of your diagnosis.  An intraoral camera is a very small camera. In some cases, an intraoral camera is just a few millimeters long.  An intraoral camera allows our practice to view clear, precise images of your mouth, teeth and gums, in order for us to accurately make a diagnosis.  With clear, defined, enlarged images, you see details that may be missed by standard mirror examinations. This can mean faster diagnosis with less chair-time for you!

Intra oral cameras also enable our practice to save your images in our office computer to provide a permanent record of treatments. These treatments can be printed as for you, other specialists, and your lab or insurance companies.

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Precision Dentistry

When you seek care at our office, you are assured that Dr. Fushee utilizes the latest in technology to enhance the quality and fit for your dental care.  

Our practice high power microscopes to enhance the precision of patient care.

Dentistry is micro-surgery.  Using a similar microscope that an ophthalmologist uses enables us to create dental restorations with incredibility precise fit and finish.  You just can't fulfill that level of care with the naked eye.

In addition to allowing precise, close up work, the microscope directs a beam of light directly on the teeth, minimizing glare to you.

Many dentists use air-driven "hand-pieces" (the dental term for "drills").  While acceptable for many procedures, these "whiney sounding" air powered hand pieces all have a degree of non-concentricity; they do not rotate perfectly smoothly.

For the most precise aspects of restorative procedures, we use electric hand-pieces.  This results in extraordinarily precise interfaces between your tooth and your new restoration (crown, veneer, or filling). This will bring more comfort to you as well. With a more precise tool, there is less vibration and less noise!

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Digital Imaging

Dr. Foushee chooses carefully which and when radiographs are taken. There are many guidelines that we follow. Radiographs allow us to see everything we cannot see with our own eyes. Radiographs enable us to detect cavities in between your teeth, determine bone level, and health of bone. We can also examine the roots and nerves of teeth, diagnose lesions such as cysts or tumors, as well as assess damage when trauma occurs.

Dental radiographs are invaluable aids in diagnosing, treating, and maintaining dental health. Exposure time for dental radiographs is extremely minimal.  Dr. Foushee utilizes Digital Imaging Technologies within the office. With digital imaging, exposure time is about 50 percent less when compared to traditional radiographs.  Digital imaging can also help us retrieve valuable diagnostic information.  We may be able to see cavities better.

The advantages of digital imaging enables us to not only store patient images, but also enables us to quickly transfer them to appropriate specialists or insurance companies.

Digital X-Rays

Digital X-rays offer more precision since we view the image on a computer monitor, instead of holding up a 35mm film up to the light. Digital X-rays results in 1/6th the radiation exposure to you.

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Glossary of Dental Terms

ABSCESS -  a local infection. A  Severe decay, periodontal disease, or trauma are causative  factors. It is characterized by swelling and pain. If an abscess ruptures, it  will be accompanied by sudden relief from pain due to a reduction in pressure. A  foul taste may also be noticed.

ABUTMENT - a term used to denote  the teeth on either side of a missing tooth.

ACRYLIC RESIN - the  plastic widely used in dentistry to make dentures.

ACTIVE ERUPTION - the emergence of the tooth from its position in the jaw.

ADHESION - the sticking together of unlike substances

ADJUSTMENT - a modification made upon a dental prosthesis after it has been completed and inserted into the mouth.

AEROBIC BACTERIA - bacteria which grow in oxygen rich environments; in the oral cavity the  bacteria are found outside the sulcus.

AFFERENT - nerves that  carry sensory messages toward the brain.

AGAR - a gelatin like substance obtained from seaweed; used in impression materials.

ALGINATE - an impression material used by dentists for making stone models.

ALVEOLECTOMY - an operation where portions of the alveolar bone are removed.

ALVEOLAR BONE - the bone surrounding the root of the tooth; loss of this bone is typically associated with severe periodontal disease.

ALVEOLAR CREST - the highest portion of alveolar bone.

ALVEOLAR EMINENCE - outline of the root on the facet portion of the bone.

ALVEOLAR PROCESS - the portion of the mandible or maxilla that surrounds the root of a tooth.

ALVEOLUS - the bony socket in which the root of the tooth sits.

AMALGAM - or silver filling; an alloy in which one of the metals is mercury. Below are the approximate percentages of the component elements:

Mercury Hg 50%
Silver Ag 35%
Tin Sn 13%
Copper Cu 0-3%
Zinc Zn 0-1%

ANAEROBIC BACTERIA - bacteria that do not need oxygen to grow;  they are generally associated with periodontal disease.

ANODONTIA - the developmental absence of teeth.

ANTIBIOTIC - substance  produced by or derived from bacteria which is able to inhibit or kill other  bacteria.

ANTIMICROBIAL - destroying or inhibiting the growth of bacteria.

ANATOMICAL CROWN - the portion of the tooth that is covered with enamel.

ANTISCEPTIC - A chemical agent which can be applied to living tissues to destroy germs.

ANESTHESIA - medication which relieves the  sensation of pain.

ANNIVERSARY YEAR - begins on the day of the month that the patients' insurance became effective.

ANOMALY - a  deviation from the normal or expected outcome.

ANTAGONIST - a  structure that opposes or counteracts another structure.

ANTERIOR - situated in front of.

ANTERIOR TEETH - the front teeth  (incisors and cupids).

ANUG - Acute Necrotizing Ulcerative Gingivitis. An acute, painful condition characterized by severe gingival  redness, spontaneous bleeding, foul breath and pain.

APEX - the  pointed extremity of a structure.

APICAL FORAMEN - the opening at the end of the root of a tooth through which the tooth receives its nerve and blood supply.

APPOSITION - the laying down of, or addition of.

ARCH - a curvature; both the maxillary and mandibular ridge form  a horseshoe shaped arch.

ARTICULATING PAPER - carbon paper;  placed between the upper and lower teeth to mark contact.

ARTICULATOR - a mechanical device used to replicate functional movements of the jaw to casts.

ASSIGNMENT OF BENEFITS - a clause in an insurance policy  that allows the insured person to direct the carrier's payment to the dentist.

ASPIRATOR - The tube-like straw which the dentist place in your mouth for suction.

ASYMMETRY/ SYMMETRY - To be esthetic, tooth Size, shape and gum contour should be as close to identical from one side of the mouth to the other. Ideally, the incisal edges of your teeth should follow the contour of the upper lip. 

ATTACHMENT LEVEL - a numerical measure of the amount of attachment of the periodontal ligament to a tooth; the number is generally determined by combining a pocket depth measurement with a measurement of  gingival recession. Attachment level is considered one of the most important measures of periodontal disease progress or treatment success

ATTRITION - the wearing away of tooth structure through normal use (ie. chewing, biting, etc.).

AXON - the process that carries impulses away from the cell body of a nerve.

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B

BACK TEETH - see POSTERIOR TEETH

BENEFIT YEAR - generally begins on the  month of the year that the employer purchased the plan.

BICUSPIDS - or having two cusps. The first and second bicuspids; they are the fourth and fifth teeth from the center of the mouth, respectively. These are the back teeth that are used for chewing.

BIFURCATION - having two branches, or dividing into two parts.

BILATERAL - both sides.

BIRTHDAY RULE - applies when a child is covered under both parent's plans; the plan of the parent who's birthday (month and day, not year)  falls earlier in the calendar year is billed first (in cases of divorce or  separation, other factors pertain).

BITEWING - a single X-ray that shows the upper and lower teeth's biting surfaces on the same film.

BLEACHING - cosmetic whitening of teeth using peroxide.

BOLUS - chewed up mass of food and saliva.

BONDING - the covering of a tooth surface to correct stained or damaged teeth.

BRIDGE - a fixed appliance (prosthesis) that replaces missing teeth. A bridge is a series of attached crowns (abutments and pontics).

BRUXISM - or the grinding of teeth, usually occurs during sleep.

BUCCAL - or pertaining to the cheek.

BUCCINATOR MUSCLE - the cheek muscle.

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C

CALENDAR YEAR - January 1st to December 31st.

CALCIFICATION - the process  of hardening through the deposition of lime salts.

CALCULUS -  hard calcium like deposits which form on teeth and dentures.

CANAL - the narrow chamber inside the root of a tooth that contains nerve tissue and blood vessels.

CANINES - See CUSPIDS; so named because the  correspond to the long teeth of a dog.

CAPITATION PLAN - a plan whereby the dentist is contracted with the administrator to provide dental services to persons covered under the program in return for payment on a per-capita basis.

CARIOGENIC - or cancer-causing

CARIES - medical term for decay; caused by decalcification of the enamel and disintegration of the dentin by acid producing bacteria.

CARIOGENIC - or decay-causing

CARRIER - the party  (usually an insurance company) that pays claims and collects premiums.

CARRYOVER - If the deductible was paid last year, the next year  (or quarter, Jan., Feb. and March) they do not have to pay the deductible again.

CAST - reproduction of the mouth in stone or plaster.

CAVITY - see CARIES.

CEMENT - a dental material  used to seal inlays, onlays, and crowns; also used for pupal protection.

CEMENTUM - makes up the dull yellow outer surface of the roots.

CENTRIC OCCLUSION - the relationship of the occlusal surfaces of one arch to those in the opposing arch at physical rest position.

CENTRIC RELATION - the relationship of the maxillary arch to the  mandibular arch when the condyle is in its most retracted position.

CERVICAL - pertaining to the neck of a tooth.

CERVIX - the neck of the tooth; the area where the crown joins the root or the  enamel joins the cementum.

CHEEK POUCH - the area of the mouth  inside the cheek.

CHEMOTHERAPEUTIC - an agent of a chemical nature which exerts an antimicrobial effect.

CINGULUM - a raised area on the lingual surface of anterior teeth.

CLASP - the metal  part of a partial denture and which helps to retain, support, and stabilize the appliance.

CLEANING - See PROPHYLAXIS.

CLEFT PALATE - an opening in the palate.

CLINICAL CROWN - that portion of  the tooth visible in the mouth, extending from the occlusal or incisal edge to the crest of the free gingiva.

CLOSED PANEL - a plan where the covered patient only receives benefits if the services are provided by a dentist  contracted with the plan's administrator.

COL - a "V-shaped  depression in the facial-lingual interdental papilla located cervically to the  contact area of the tooth.

COMMUNITION - crushing or grinding to  a powder.

COMPLETE SERIES - See FULL-MOUTH X-RAYS.

COMPOSITE FILLING - tooth-colored restorative material. The word "composite" refers to the mixture of filler particles in a liquid resin. Commonly, the resin used is BIS-GMA (bis-gammamethylmetacrylate). Filler particles are added to alter the color and wear characteristics. Common filler particles are silica, aluminum, zinc, tin, copper and iron.

CONCAVE - curving inward away from the viewer.

CONTACT  AREA - that portion of the proximal surface of a tooth that touches the adjacent tooth.

CONVEX - curving outward toward the viewer.

COSMETIC DENTISTRY - aesthetic improvement of the color and shape of teeth performed by a general dentist.

CREST - a prominence or  ridge.

CROSS CONTAMINATION - Passing disease indirectly from one patient to another through the use of improper sterilization procedures.

CROWN - full coverage for a tooth (used when the tooth cannot be restored by a filling).

CURETTAGE - the surgical scraping of bacteria from soft tissue. This is a periodontal procedure and is usually performed one quadrant at a time.

CUSPID - the third  tooth from the center of the mouth towards the back, also known as canines.

CUSPS - elevated points on the chewing surfaces of back teeth  (posterior teeth).

CUSTOM TRAY - an individual tray; custom made  to fit a patient's mouth.

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D

DEBRIDEMENT - treatment of a bacterial infection by removing irritants (bacteria,  calculus) from the periodontal pocket so as to allow healing of adjacent  tissues.

DECALCIFICATION - The loss of calcium from your teeth, weakening the teeth and making them more susceptible to decay

DECIDUOUS TEETH - baby teeth; teeth that exfoliate or  shed. see PRIMARY TEETH.

DEDUCTIBLE - the amount paid by the patient before the carrier begins benefit payments.

DEGLUTITION -  swallowing.

DEMINERALIZATION - loss of mineral from tooth enamel  just below the surface in a carious lesion; usually appearing as a white area on the tooth surface.

DENDRITE - the process that conducts impulses toward the cell body of a nerve.

DENTAL MAINTENANCE ORGANIZATION  (D.M.O.) - a legal entity that accepts the responsibility of providing  services at a fixed price.

DENTAL RESIN - a dental material  applied to the tooth which is used in cases of severe dentinal hypersensitivity; usually not used unless all other treatment attempts have failed.

DENTAL VARNISH - a hypersensitivity treatment which sometimes contains sodium fluoride; applied to the tooth surface, covering the outer surface of dentin and thus blocking transmission of stimuli to the pulp.

DENTIN - the hard, yellowish tissue underlying the enamel and cementum; it makes up the major bulk of the tooth.

DENTINAL TUBULES - microscopic canals that run from the outside of the dentin to the nerve  inside the tooth.

DENTITION - the natural teeth as a unit.

DENTURE - a removable appliance (prosthesis) that replaces missing teeth in either the upper or lower jaw.

DESENSITIZATION -  the blocking of painful stimuli which cause dentinal hypersensitivity.

DESICCATE - to make dry; to remove all moisture.

DESQUAMATION - a peeling of gingival tissue; in cases of  desquamative gingivitis, the tissues may appear smooth and shiny, with patches  of bright red and gray. Surface tissue may peel away, exposing a raw, bleeding,  painful surface.

DEVELOPMENTAL DEPRESSION - a concavity in a surface that formed while the tooth was developing.

DIAGNOSIS - the process of identifying the nature of a disorder.

DIAGNOSTIC -  procedures performed by the dentist to identify what's going on in the mouth.

DIASTEMA - a space between the teeth.

DILACERATION - an abnormal tooth that where both the crown and the root are twisted.

DIPHYODONT - having two successive sets of teeth.

DIRECT CONTAMINATION - Direct contact with impurities or germs.

DISINFECTION - A cleaning process which destroys the majority of microorganism, but not highly resistant forms such as bacterial and mycotic spores.

DISINFECTANT - A chemical agent which is applied onto inanimate surfaces to destroy germs.

DISPOSABLE MATERIALS - materials intended for one-use and discarded. (e.g.: Gloves, paper gowns, cotton rolls, etc.)

DISTAL - the surface of the tooth farthest from the midline of  the dental arch.

DIVERGENT - spread.

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E

EDEMA -  swelling resulting from fluid accumulation in gingival tissues.

EDENTULOUS - having no teeth.

EFFERENT - the  nerves that carry motor messages away from the brain.

EMBRASURE -  the space between two teeth created by the sloping away of the mesial and distal surfaces.

EMINENCE - a prominence.

EMPRESS - Type of porcelain crown and porcelain veneer/laminate. The advantage Empress is that it blends very nicely with the surrounding teeth; it is very esthetic.

ENAMEL - the  hard, white shiny surface of the crown; composed of 95% calcium hydroxyapatite.

ENDODONTICS (ENDO) - the treatment of diseases or injuries that affect the root tip or nerve of the tooth.

EROSION - The dissolution of tooth structure due to the presence of gastric juices or citrus. Erosion seldom occurs alone; it is often accompanied by attrition or abrasion (or both) to varying degrees. Acidic foods, such  as citrus fruits and juices should be avoid in patients with signs of erosion.

ERUPTION - the moving of the tooth occlusally.

EXCLUSION - services not covered by a  dental plan.

EXFOLIATE - to shed.

EXPLORER - a  probe used to detect cavity growth.

EXTERNAL - on the outer surface.

EXTRACTION - the removal of teeth.

EXTRAORAL - Outside the mouth.

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F

FACIAL -  the surface next to the face; the outer surface of a tooth resting against the  cheeks or lips.

FEE SCHEDULE - a set amount paid by the insurance company regardless of the doctor's fee.

FILTRUM - the dimple or indentation under the nose directly above the upper lip.

FISSURE - cleft-like grooves in the chewing surface of the back teeth.

FISTULA - an abnormal passage formed in the gum tissue through which an abscessed tooth drains.

FLUORIDE - topical application of a gel or liquid that  prevents decay.

FLUOROSIS - discoloration of the enamel due to excessive fluoride absorption (greater than one 1 part per million) into the bloodstream, also called enamel mottling.

FORAMEN - an opening in  bone.

FORNEX - vault or arch shaped.

FOSSA - a  shallow depression on the lingual (tongue) surfaces of some front teeth.

FREE GINGIVA - the marginal part of the gingival (gums) that can  be deflected from the tooth surface; it forms a collar around the tooth.

FRENUM - a fold of mucous membrane that connects two parts.

FRONT TEETH - See ANTERIOR TEETH.

FULL MOUTH X-RAYS - X-rays showing all the teeth. Includes 14 periapicals and 4 bitewings, also known as a complete series.

FURCATION - an area where the  root divides.

FURROW - a groove.

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G

GALVANIC CURRENT - a current of electricity produced by chemical action between two metals suspended in liquid.

GENDER RULE - when a child is covered  under both parent's plans, the father's plan is billed first (in cases of divorce or separation other factors must be considered).

GENERAL  ANESTHESIA - relieves the sensation of pain.

GENERAL DENTIST - primary care provider for patients in all age groups.

GERIATRIC  DENTIST - general dentist who primarily treats senior citizens.

GINGIVA - the soft tissue surrounding teeth, also known as the gums.

GINGIVAL CREST - the prominent edge of occlusal or incisal  gingiva.

GINGIVAL HYPERTROPHY - The abnormal enlargement of the gingiva surrounding the teeth caused by poor oral hygiene or the use of certain medications.

GINGIVECTOMY - the removal of soft tissue surrounding the tooth; typically used in the treatment of periodontal disease.

GINGIVITIS - inflamed and swollen gum tissue most commonly caused by plaque.  If left untreated, may lead to periodontitis.

GOLDON PROPORTION - The guidelines which dentists use in determining the most esthetic appearance of a particular tooth (teeth need to maintain a certain height to width ratio to look their best.)

GROOVE - a long, narrow depression.

GUTTA PERCHA - material used in the filling of root canals.

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H

HANDPIECE - the instrument used to hold and revolve burs in dental operations.

HEAT-STERILIZING - Use of an autoclave or dry-heat sterilizer to kill all potential disease-causing  agents that remain following patient treatment. Any instruments that is not heat stable and cannot tolerate high temperatures should be thoroughly cleaned and soaked in disinfectant chemicals.

HETERODONT - different types of teeth within the same dentition (ie. incisors, canines, molars).

HISTO-DIFFERENTIATION -  development into a specialized tissue.

HISTOLOGY - the study of tissues.

HOMODONT - the presence of only one type of tooth in the  dentition.

HYPERPLASIA - over-growth of a part; an increase in  the number of cells.

HYPERSENSITIVITY - a sharp, sudden painful  reaction in teeth when exposed to hot, cold, chemical, mechanical or osmotic  (sweet or salt) stimuli.

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I

IDEAL  OCCLUSION - a complete harmonious relationship of the teeth and masticatory  system.

IMMEDIATE DENTURE - a complete or partial denture made before the natural teeth are extracted.

IMPACTION - an unerupted or partially erupted tooth that will not fully erupt into the mouth because of an obstruction.

IMPLANT - a post that is implanted into bone. A  crown, bridge, or denture is then placed over the implant to restore function  and esthetics.

IMPRESSION TRAY - formed in the general shape of the mouth, used for taking impressions.

INCENTIVE PROGRAM - a  dental plan where the percentage of benefits increase each year as the patient  receives regular, annual dental care (preventive treatment). If the patient fails to go to the dentist each year, the percentage drops back to where it started.

INCISORS - the central and lateral incisors; the first  and second teeth from the midline of the mouth.

INLAY - a gold,  porcelain, or composite custom-made filling cemented into the tooth. If it  covers the tips of the teeth, it is called an onlay.

INCISAL EDGE - the cutting edge, ridge, or surface of anterior teeth.

INSERTION - the movable end of a muscle.

INTERCUSPATION - interlocking; a cusp-to-fossa relationship of  the maxillary to mandibular teeth.

INTERPROXIMAL - the space  between two adjacent surfaces.

IINTRAORAL - Inside your mouth.

INVAGINATION - to enclose within.

INVISALIGN - The system is a way to move teeth without the use of conventional brackets and archwires. Basically, a series of clear plastic trays are computer fabricated with each tray gradually shifting the teeth into proper alignment. The system works best for minor tooth movements.

IONTOPHOR - the process of introducing a drug through the dental enamel by use of an electrical current; often used in the treatment of dentin  hypersensitivity.

IRRIGATION - the technique of using a solution to wash out your mouth.
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J

JAW - a  common name for the maxilla or mandible.
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K

No terms Available

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L

LABIAL -  relating to the lip; another name for the facial surface of anterior teeth (next  to the lip).

LAMINATE VENEER - a porcelain, or composite covering which is bonded to restore discolored, or damaged teeth.

LATERA L  - to the side.

LEAST COST ALTERNATIVE - an insurance policy  clause that allows the insuring company to pay for the least expensive  treatment.

LESION - any wound or local degeneration.

LINGUAL - the surface of a tooth nearest the tongue; relating to the tongue.

LOBE - center of tooth formation.

LOCAL  ANESTHESIA - relieves the sensation of pain in a localized area.

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M

MALOCCLUSION - any deviation from the ideal positioning of the teeth or jaws.

MAMELON - small elevations of enamel present on the incisors as  they erupt.

MANAGED CARE PLANS - plans that restrict the type,  level, and frequency of treatment; these plans limit access to care and control the level of service reimbursement (ie. DMO's, Capitation plans, and Closed  Panel plans).

MANDIBLE - the lower jaw.

MARYLAND BRIDGE - A type of Bonded Bridge. Its main difference from conventional bridges is in the reduced amount of abutment preparation necessary. Only the lingual surfaces of the abutments are reduced.

MASTICATION - chewing.

MASTICATORY SYSTEM - the teeth and surrounding  structures: jaws, temporomandibular joint, muscles, lips, and tongue.

MAXILLAE - the upper jaw.

MEDIAL - relating to the  middle or medial plane.

MENTAL - relating to the chin.

MERCURY - a metal, component of amalgam fillings.

MESIAL - is the surface of the tooth nearest the midline of the dental arch.

MICRO ABRASION - a drill-free technique using an  instrument resembling a tiny sand blaster that delivers tiny aluminum oxide  particles to the surface of teeth.

MIDLINE - imaginary line through the middle of an object which divides it into two equal parts.

MIXED DENTITION- The developmental stage when both deciduous and permanent teeth are present.

MOLAR - the first, second and third molars; these are the sixth, seventh and eighth teeth from the center of the mouth, respectively.

MOUTHGUARD - a soft-fitted device which protects teeth against  impact or injury.

MUCOSA - the thin, outer pink or red membrane lining the inside of the oral cavity.

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N

NASAL -  relating to the nose.

NEURON - a nerve cell.

NEOPLASM - a proliferation of cells interfering with surrounding tissues; refers to cancer.

NICOTINE PATCHES - typically worn for 24 hours over several weeks, supplying a steady flow of nicotine. The main brands include: Habitrol, Nicoderm, Nicotrol and Prostep. Over the course of  treatment the amount of nicotine in the patch gradually decreases. Studies have shown that this method has approximately a 25 % success rate.

NIGHTGUARD - a removable acrylic appliance to minimize  the effects of grinding (bruxism) and TMJ associated problems.

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O

OBLIQUE RIDGE - a linear elevation that transverses a surface.

OCCLUDE - to bring together.

OCCLUSAL - relating to the biting surface of  teeth.

OCCLUSAL EQUILIBRATION - process of refining and  perfecting the occlusion.

OCCLUSAL GUARD - see NIGHTGUARD.

OCCLUSAL PLANE - The imaginary surface on which upper and lower teeth meet.

OCCLUSAL TRAUMA - results from excessive force placed on a normal  dentition, i.e. grinding and clenching of teeth. If left uncontrolled, occlusal trauma may result in rapid attachment loss and bone destruction.

OCCLUSION - the relationship of the teeth in a closed position in  both the maxillary and mandibular arch.

ONLAY - A laboratory processed restoration made of metal, porcelain or acrylic that replaces one or more of cusps of a tooth.

OPAQUING - covering the metal work of a prosthesis with a material so that it doesn't show through.

OPEN BITE - increased distance between the two arches; space between the front upper and lower teeth when the back teeth are touching.

ORAL CAVITY -  the mouth.

ORAL SURGERY (O.S.) - surgery of the mouth.

ORAL AND MAXILLOFACIAL SURGEON - treats and surgically corrects diseases, injuries and defects of the mouth and jaws.

ORAL PATHOLOGIST - examines oral tissues for evidence of suspected abnormalities  such as cancer.

ORIGIN - the fixed end of a muscle.

ORTHODONTICS - a branch of dentistry dealing with irregularities  of the teeth and their correction.

ORTHODONTIST - designs and  applies corrective and supportive appliances, braces, to realign crooked teeth.

OSTEOBLASTS - Cells which aid in the growth and development of teeth and bones.

OSTEOCLASTS - Cells which help remodel bone. 

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P

P.A. - see  PERIAPICAL.

PALATE - roof of the mouth.

PALATAL  SURFACE - the surface of the maxillary teeth nearest the palate.

PALMER?S NOTATION- An identification system for teeth; widely used to designate individual teeth amongst orthodontists.

PANOREX - a single, large x-ray taken outside of the mouth that  shows all the teeth on one film.

PARTIAL DENTURE - a removable  appliance that replaces some of the teeth in either the upper or lower jaw.

PASSIVE ERUPTION - describes the process by which teeth continue  to erupt into the mouth as tooth structure is lost to attrition and wear.

PATHOGENS - Disease producing organism

PATHOLOGY - The study of abnormal (diseased) tissue conditions.

PEDODONTICS (PEDO) - the treatment of children's teeth.

PELLICLE - the first step in plaque formation; a clear, thin  covering containing proteins and lipids (fats) found in saliva. It is formed  within seconds after a tooth surface is cleaned.

PERIAPICAL - an x-ray that shows the whole tooth, also known as a single film or P.A.

PERIAPICAL ABSCESS - infection of the pulp of the tooth and tissues surrounding the base of the tooth.

PERICORONITIS -  infection of the tissue overlying a partially erupted tooth. Treatment involves keeping this tissue clean and free of bacteria.

PERIODONTAL CHARTING - measures the pocket depth resulting from attachment loss between the gums and teeth.

PERIODONTAL LIGAMENT - the fibers which suspend the tooth in the bony socket; it is attached at one end to the cementum, and at the  other end to the alveolar bone of the socket.

PERIODONTAL MAINTENANCE - cleaning of the teeth following periodontal treatment, includes perio  charting.

PERIODONTAL POCKET - the pocket that forms when the gums lose attachment from the teeth.

PERIODONTAL PROBE - a dental instrument used to measure pocket depth.

PERIODONTAL PROPHY - see  Periodontal Maintenance.

PERIODONTAL RECALL - see  Periodontal Maintenance.

PERIODONTICS (PERIO) - the treatment of diseases of the gum.

PERIODONTIST - diagnoses and treats diseases of the tissues supporting and surrounding the teeth, especially periodontal, gum,  disease

PERIODONTITIS - a form of periodontal disease affecting  adults resulting in destruction of alveolar bone.

PERIODONTIUM -  the structures that surround and support the teeth.

PERMANENT  DENTITION - see PERMANENT TEETH.

PERMANENT TEETH - the teeth  that replace the deciduous or primary teeth.

PHONETICS -  production of sounds.

PIT - a pinpoint depression in the occlusal  surface od a tooth.

PLAQUE - a sticky film that accumulated on  teeth.

PLASTER OF PARIS - gypsum, used to make models of teeth.

POLISHING - a dental procedure that removes stain, plaque and  acquired pellicle by using an abrasive polishing paste in a rubber cup attached  to a slow-speed handpiece.

POLYPHYODONT - possessing several sets  of teeth during a lifespan.

PONTIC - the component of a bridge  that replaces the missing teeth.

PORCELAIN - a tooth-colored  sand like material; much like enamel in appearance.

PORCELAIN VENEER - ultra-thin shells of ceramic material bonded to the front of the tooth.

POSTERIOR TEETH - the back teeth (Bicuspids and molars).

POSTPALATAL SEAL - an elevation of material on the back (tissue side) of a denture; for the purpose of sealing the denture.

PPO -  see PREFERRED PROVIDER ORGANIZATION.

PREDETERMINATION - the  doctor notifies the insurance company beforehand of the intended treatment and  the insurance company estimates the benefits that will be paid. 

PREFERRED PROVIDER ORGANIZATION (PPO) - A plan where the patient can go to any dentist they choose, or they can choose a preferred dentist and  receive discounted fees. These plans are listed on our system as Preferred and  Non Preferred.

PREMOLARS - two-cusped teeth immediately in front  of molars.

PREVENTIVE - a procedure performed to aid in  preventing decay and/ or gum disease.

PRIMARY PLAN - when a patient is covered by two insurance plans, the plan that is billed first is the primary plan.

PRIMARY TEETH - the baby teeth, also known as the  primary dentition.

PRIMATE SPACING - the normal spacing between primary anterior teeth.

PROCERA - Procera is a type of Porcelain Crown.  They are one of the strongest all-porcelain crowns available. Procera?s framework is computer generated; porcelain is then added to the structure.

PROPHY - see PROPHYLAXIS.

PROPHYLAXIS - a general meaning to clean the teeth, also known as  a prophy.

PROSTHETICS - a fixed or removable appliance used to replace missing teeth (ie. bridges, partials, and dentures).

PROSTHODONTIST - constructs artificial appliances designed to restore and maintain oral function by replacing missing teeth and other oral structures such as dentures

PROXIMAL - nearest the point of attachment; the mesial or distal surface of the tooth.

PROXIMAL SURFACE - the surface of the tooth adjacent to the next tooth; refers to the mesial and distal surfaces.

PUBLIC HEALTH DENTIST - concerned  with the dental health needs of entire communities, and can design and administer large-scale prevention and dental care programs by compiling and  analyzing statistics

PULP CANAL - the portion of the pulp in the root.

PULP CHAMBER - the portion of the pulp in the crown of the  tooth.

PULP HORN - the portion of the pulp chamber that extends towards the cusp.

PULP TISSUE - the soft (not calcified) tissue  in the pulp chamber; composed of blood vessels and nerves.

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Q

QUADRANT -  denotes one of four equal sections in the mouth. The upper right, upper left, lower right or the lower left.
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R

RADIOGRAPHIC - referring to x-rays.

RADIOSURGERY - surgical technique that  uses radio waves to produce a pressureless, bloodless incision.

RAPHE - a union of soft tissue.

RCT - see ROOT CANAL THERAPY.

REBASE - process where only the tissue surface of a denture is  replaced by new material.

RELATIVE VALUE SCHEDULE (RVS) -  procedures are given a point value based upon their degree of difficulty. Each procedure is also assigned a given a dollar amount. The dollar amount is then  multiplied by the point value to determine what the insurance company will pay.

RESIN FILLING - see COMPOSITE FILLING.

RESORB - to dissolve into the tissue.

RESTORATIONS - any replacement for lost tooth structure or teeth (ie. bridges, fillings, crowns and implants).

RESTORATIVE DENTISTRY - process of restoring missing, damaged or diseased teeth to normal form and function.

RETAINER - a  removable appliance used to maintain teeth in a given position (usually worn at night).

RIDGE - a linear elevation.

ROOT CANAL THERAPY (RCT) - procedure used to save an abscessed tooth in which the pulp chamber  is cleaned out, disinfected, and filled with a permanent filling.

ROOT PLANING - the removal of hard deposits from the root surface below the gumline.

ROOT TRUNK - that portion of the root that is not bifurcated or trifurcated.

RUGAE - elevated folds or wrinkles of soft tissue in the front part of the palate.

RVS - see  RELATIVE VALUE SCHEDULE.

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S

SAGITTAL PLANE - An imaginary longitudinal vertical plane that divides the mouth into two halves (left and right.)

SCALING -  scraping of the tooth above the gums.

SEALANTS - the application  of a clear resin over the biting surfaces of teeth to prevent decay.

SECONDARY PLAN - when a patient is insured by two plans, the plan that is billed second is the secondary plan.

SIGNATURE ON FILE -  the insured person signs a form stating that the payments made by the carrier go to the dentist. This form expires 1 year from the date it is signed.

SINGLE FILM - see PERIAPICAL.

SLOUGHING - a  condition in which the gingival tissue deadens and peels away from the living tissue.

SOCKET - a cavity in the bone, see ALVEOLUS.

SOFT PALATE - the back 1/3 of the roof of the mouth composed of  soft tissue.

SOMATIC - nerves that supply muscles.

SONICARE - electric toothbrush. Vibrates at over 31,000 brush strokes per minute.  Most models offer a 3 - minute timer to let you know when you?re done.

SPACE MAINTAINERr - A dental appliance used to maintain space in the mouth.

SPILLWAY - see EMBRASURE.

STAIN, EXTRINSIC - stain  located on the outside of the tooth surface originating from external substances such as tobacco, coffee, tea or food; usually removed by polishing the teeth with an abrasive prophylaxis paste.

STAIN, INTRINSIC - stain  originating from the ingestion of certain materials or chemical substances during tooth development, or from the presence of caries. This stain is  permanent and cannot be removed.

SUBMUCOSA - the layer of tissue  under the mucous membrane.

SUCCEDANEOUS - a tooth that replaces  or succeeds another.

SULCUS - a broad depression on the chewing  surfaces of your back teeth.

SUPERGINGIVAL - the area above the gingival margin.

SUPERNUMERARY TEETH - Extra teeth, in addition to the development of the normal 32.

SURGICAL TEMPLATE - a clear tray used in immediate denture fabrication.

SUTURE - a joining of two bones, also stitxhes.

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T

TARTAR -  see CALCULUS.

TEETHING - baby teeth pushing through gums.

TEMPOROMANDIBULAR JOINT (TMJ) - temporo (temporal bone), mandibular (lower jaw). This is the connecting hinge between the lower jaw and  base of the skull. Also known as T.M.J.. T.M.J. treatment is sometimes paid under medical.

TERMINAL MESIAL STEP - the position of a vertical plane along the distal surfaces when the deciduous second molars are in Class I position.

TERMINAL PLANE - the distal surfaces of the maxillary and mandibular deciduous second molars that are on the same line or plane.

THIRD MOLAR - see WISDOM TOOTH.

TMD -  temporomandibular disorder; a problem with the joint that connects the lower jaw  with the skull. Typically associated with a pop and pain in the joint.

TOPICAL - applied directly to an infected area for treatment.

TRANSVERSE RIDGE - a linear elevation that crosses a surface  (usually the occlusal surface).

TRIANGULAR RIDGE - a linear elevation that forms a triangle.

TRIFURCATION - forked or divided  into three parts.

TUBERCLE - a small, rounded projection.

TUBEROSITY - a large, rounded projection.

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U

ULTRASONIC - the conversion of high frequency electrical current into mechanical  vibrations.

UNIVERSAL PRECAUTIONS - These precautions require all dental staff involved in patient care to use appropriate protective wear, such as gloves, masks and eyewear. After each patient visit, the gloves must be discarded, hands washed and a new pair of gloves donned for the next patient. These precautions are considered universal because they are used for each and every patient to prevent the transmission of infectious diseases.

USUAL, CUSTOMARY AND REASONABLE (UCR) - the doctor's fee is considered usual, customary, and reasonable if it meets the following  requirements: 1. Usual: the doctor's usual fee is charged; 2. Customary: if the doctor's fee falls in the same range as other dentists in the area; 3. Reasonable: the doctor's modified fee is justified because of special  circumstances.

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V

VENTRAL -  the underside, used when speaking of the tongue; thus the ventral surface of the  tongue is the underside of the tongue.

VERMILION - red.

VIRGIN TEETH - teeth that are free from decay or restorations.

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W

WAIVER OF  DEDUCTIBLE - under some policies certain procedures are excluded from the deductible.

WISDOM TOOTH - the third molar; the eighth tooth from the center of mouth.

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X

XEROSTOMIA - dryness of the mouth.

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Y

No Terms Available

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Z

No Terms Available

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