ALGINATE: Alginate is a natural seaweed based powder material. It is mixed with water and is used by dentist to make impressions of a patient’s teeth. It can also be used to create molds of any object for art purposes. At ClearCorrect, we do not accept impressions made with alginate because alginate is only best if used within a few days after being made, after which it is not as sturdy and will begin to deteriorate. Instead of using alginate, we request doctors use PVS material to make impressions.
ANKYLOSED TOOTH: (pronounced: ăng′ki-lōs′) An ankylosed tooth means the root of a tooth is permanently connected to the jaw and cannot move because the tooth no longer has the protective periodontal ligament around it. The root of the tooth is now touching the jaw bone directly. The jaw bone will then attach to the tooth’s root. This attachment is permanent and the tooth will not move in orthodontics. An ankylosed tooth looks exactly like a regular tooth, except that sometimes it may be higher or lower in the gum line.
ANTERIOR: Any of the front six teeth (the incisors and canines) in the upper or lower jaw.
APEX: The end of the root of a tooth.
BICUSPID: (also called PREMOLAR): The two teeth between the canine and molar, typically having two cusps (hence bi and cuspid).
BITE REGISTRATION (BITE): This shows a bite registration being done: Sometimes referred to as a “bite”. A BITE is the way the upper and lower arches come together. A registration is a record of something. A bite registration refers to what the dentist makes when he applies PVS material to the patient’s lower arch and has the patient bite down. When it dries it will show the way the upper and lower teeth close together (the bite.)
BRIDGE: A dental bridge is a false tooth or group of false teeth that are attached to a patient’s natural teeth. There are different types of dental bridges but it usually consists of a false tooth with connecting caps or hooks that go over or around the nearest tooth (or teeth) for support. The false tooth (or teeth) is "bridged" to the surrounding teeth. If a missing tooth is not replaced with a false tooth or something to support it, it can cause the nearby teeth to shift, loosen and eventually fall out. The purpose of a bridge is to close gaps where natural teeth are missing and to support the nearby teeth.
BUCCAL: Pertaining to or toward the cheek (as in the buccal surface of a posterior tooth)
CANINE (also called CUSPID): The pointed tooth on both sides of the incisors.
CLASS I: The Class 1 is determined by the 1st molar relationship and the canine relationship. There is a Class I and there is also a Class I malocclusion. Class I is the ideal way to have your teeth.
CLASS I MALOCCLUSION: is class I occlusion exists with the 1st molars and the canines BUT there are also gaps, crowding, misalignment of the teeth or, crossbites, etc.
CLASS II: A class II malocclusion is when the 1st molar and canine relationships are mesial to
where they should be for a Class 1.
CLASS III: A class III malocclusion is when the 1st molar and canine relationships are distal to
where they should be for a class 1.
CONTRAINDICATE: It means “pointed out as being against.” It means that some procedure or medicine should not be used with another procedure, medicine or physical condition because it will most likely be harmful. For example, if a person is taking blood thinning medicine, doing surgery is contraindicated because they could bleed to death. It could be something such as women should not take certain painkillers while pregnant because it can hurt the unborn baby. Or if a person has gum disease they should not do clear aligner therapy. Mixing prescription drugs with alcohol is contraindicated because it puts too much stress on the body and can stop the heart. Usually used in reference to mixing medicines or therapy.
CROSSBITE: Crossbite is a word used to describe when the upper or lower teeth are in the wrong position in comparison to the location of the opposing arch. It is a misalignment of one of the dental arches. There are two types of crossbites:
CROWN: The part of a tooth opposite the root and typically outside the gums (or an artificial substitute for this). The term “clinical crown” refers to the visible portion of the tooth that a doctor can observe directly.
CROWN TIPPING: is the tilting of the crown of a tooth without moving the apex of the root. See also Root Tipping.
CUSP: A pointed part on the biting surface of specific teeth (from the word cuspis meaning “a point”).
CUSPID: (also called CANINE) The pointed tooth on both sides of the incisors.
DENTAL IMPLANT: (Also simply called “implants”.) A dental implant is a permanent fake tooth surgically inserted into the jaw. The base is screwed into the jaw bone and then a fake tooth (crown) is inserted on top of it. The purpose is to permanently replace a damaged or missing tooth so a person can still chew food, support the nearby teeth, keep their smile looking nice, etc. Word history
DENTITION: Dentition refers to how and when teeth develop and grow (i.e. what age certain teeth grow in, etc.) and the way teeth are arranged in the mouth (cutting teeth in front, grinding teeth in back)
DIASTEMA: (Pronounced dī′a-stē′ma.) A gap between two teeth in a dental arch. Plural is spelled: diastemata and pronounced dī′a-stē′ma-ta.
DISTAL: (opposite of mesial.) The surface of a tooth that faces toward the back of the arch is the distal surface, as in the picture on the left below. It can also indicate direction or movement away from the mid-line. The diagram on the right shows teeth moving distally.
DISTALIZE: In straightening teeth with metal or clear braces, “distalize” refers to moving the teeth away from the mid-line and toward the back of the arch (distal), which would make space for the teeth in the arch. Distalization is another way to create space in the mouth. Teeth being distalized with metal braces:
ENGAGER: Small attachments to the tooth to help engage a device and assist its performance (also called a “button”). An engager is a small, shaped object made of tooth-colored material that a dentist glues to a patient’s tooth. It is used to give an aligner extra hold and help the tray move the teeth easier. Engagers “engage” the aligner to assist with difficult movements.
EXPAND: In straightening teeth with metal or clear braces, “expand” refers to moving the posterior teeth facially. By doing this, it creates more space by widening the U-shape size of the arch. Expanding the arch is sometimes required to properly put the teeth straight or to give the patient a correct bite relationship.
EXTRACT: The removing of a tooth or teeth from a patient’s arch.
EXTRUDE: In clear aligner therapy, extrusion means to move a tooth in the direction out of the bone and gums. The tooth is not pulled out all the way, just enough to make it consistent with the height of the other teeth. When clear braces are going to extrude a tooth, an engager is used.
FACIAL: Indicates the surface of the teeth facing the cheeks and lips. Facial is also the movement of a tooth toward the face (opposite of lingual).
IMPRESSION: A dental impression is a record of a patient’s dental arch. When an impression of a dental arch is taken properly, it shows the details of each tooth and the gum line. The doctor or qualified assistant has the patient bite onto a soft material set in an impression tray. The material remains in the patient’s mouth for a few minutes until it dries, and is then removed. Impressions are taken and used to make custom dental appliances.
INCISAL: The biting edge of incisors and canines.
INCISOR: One of the flat, usually sharp-edged teeth located toward the front of the mouth used for cutting and tearing food. Incisor comes from the word incidere meaning “to cut into”. Incisors are the two front teeth and the two teeth right next to the two front teeth on the upper and lower jaw. There are eight incisors in the human mouth. The two middle incisors are called central incisors; the incisors next to them are lateral incisors (lateral comes from the word latus for side).
IPR (INTERPROXIMAL REDUCTION): A procedure that files the surfaces down (reduction) between two adjacent teeth. Interproximal refers to the contact between two adjacent teeth. This procedure can be recommended when contact between two teeth prevents desired orthodontic movement. Also called IPR, the procedure uses an abrasive disc on a dental drill (hand-piece). [Example sentence: The dentist did IPR between these two teeth to allow them to move into place.]
INTRUDE: In clear aligner therapy, you use intrusion to mean to push a tooth further into the jaw bone and gums. When clear braces need to intrude a tooth, an engager is used.
LINGUAL: The surface of the teeth facing toward the tongue. The red areas below indicate the lingual surface of each tooth. Lingual is also the movement of a tooth toward the tongue
MACRODONTIA: is a condition in which the teeth are abnormally large. Macrodontia are overdeveloped teeth. This can affect the whole mouth, a few teeth or just one.
MALOCCLUSION: “Mal-“ means bad and “occlusion” is the way the upper and lower teeth come together. Malocclusion means “the teeth do not meet up correctly”.
MANDIBLE: These pictures show the mandible. It is the lower jaw bone.
MAXILLA: These pictures show the maxilla. It is the upper jaw bone.
MESIAL: Indicates the surface of a tooth facing toward the mid-line (at the middle of the arch). Mesial surfaces are shown in the picture on the left. Mesial can also refer to the movement of a tooth toward the mid-line. The diagram on the right below shows teeth moving in a mesial direction (mesially).
MICRODONTIA: Means abnormally small teeth. It is a condition that happens when adult teeth are underdeveloped. It can affect the whole mouth, a few teeth or just one.
MIDLINE: A reference point down the middle of the human body. The mouth is divided along the mid-line as a reference to where the central incisors from both side of the mouth should meet.
MOLAR: Any of the larger back teeth, used for chewing and grinding food. Molars have different names and appear at different ages. The last molars are sometimes called “wisdom teeth.”
OCCLUDE: Occlude means to bring the upper and lower teeth together, closing the jaw. An open mouth is not occluded.
OCCLUSAL: Indicates the chewing surface of premolars and molars.
OCCLUSAL PLANE: The occlusal plane is the imaginary line where the upper and lower teeth touch when the mouth is closed. It goes from where the upper and lower incisal edges of the incisors meet through to the back of the mouth where the upper and lower occlusal surfaces meet. It is not a plane (flat surface) in the true
sense of the word but represents the curvature of the surface where the teeth touch.
OCCLUSION: Occlusion is the relationship of how the teeth in the upper arch meet with the same teeth in the lower arch when the mouth is closed. There are good and poor occlusions. Ideal occlusion:
OSTEOBLAST: Osteoblasts are bone-forming cells. They are part of the bone building process and are responsible for bone formation. If you break a bone, osteoblast cells would be the cell that would re-grow the bone back together. Osteoblast cells are the cells that grow bones. When a tooth has been pushed through the jaw because of pressure from the aligners, the osteoblast cells are re-growing the bone where the tooth has moved from.
OSTEOCLAST: Osteoclasts are a specialized bone cell that absorbs bone cells. Old bone cells will be absorbed so that new bone can grow in that spot. This cycle occurs naturally in the human body and continually keeps the skeleton strong and healthy. Osteoclastic activity can also happen if pressure is put on a bone. For example, when a person wears braces, it puts a continuing pressure on different parts of the teeth, which then puts pressure on the periodontal ligament that is sitting in the jaw bone. The teeth then begin to shift through the jaw bone into the desired positions. This pressure forces the osteoclast cells to begin forming to break down the jaw bone so the tooth can move through it. There are different bone cells (osteoblast) that then rebuild the bone on the other side of the tooth where it moved from. The rate of bone breaking down and bone re-growing equal each other so the mass of the bone remains the same (except in a child when the bones are growing for development.) A mass of osteoclast cells absorb bone from the outer surfaces inward for about three weeks. Then the bone forming cells (osteoblast) come in and form the new bone. With this natural process, the human body replaces the entire human skeleton about twice a year with osteoclast and osteoblast. Stabilizing the results takes about 10 to 12 months. Pressure removed from teeth for four hours will stop osteoclastic activity.
OVERBITE: An overbite is when the upper anterior teeth overlap the lower anterior teeth and cover more than 1/3 the length of the lower anterior teeth. “Over” means something is too much, so the upper anterior teeth are extended down and are covering the lower anterior teeth more than they should be. NOTE: Do not get this confused with the fact that the upper anterior teeth are larger and sit slightly in front of the lower anterior teeth. For proper cutting of food, the incisal surfaces should not be hitting each other. The upper anterior teeth sitting slightly in front of the lower anterior teeth is not what is called an overbite.
Overbite Normal Occlusion
OVERJET: Overjet is a word used to describe the abnormal distance the upper arch sticks out past the lower arch when the mouth is closed. Specifically, it is the abnormal distance between the incisal edges of the upper and lower anterior teeth. This is what is known as “buck teeth”.
PALMER NOTATION NUMBERING SYSTEM: The Palmer notation numbering system is another numbering system, sometimes it is referred to as the “orthodontic numbering system”. The Palmer divides the teeth into 4 quadrants. Adult teeth are numbered 1 to 8. .
Palmer notation consists of a symbol (┘└ ┐┌) designating in which quadrant the tooth is found and the number or letter indicating which tooth. The “left” and “right” always refer to the patient’s left and right.
The quadrants may also be abbreviated by letters, such as “UR” for “upper right”. Specifically, all 3rd molars are the same number (#8), but the 3rd molar in the upper right side would have the symbol, "┘", with the number like: 8┘. While the one on the upper left side would have this symbol the other way, like this: └8. Lower right 3rd molar: 8┐ Lower left 3rd molar: ┌8 Remember that the designations "left" and "right" on the chart correspond to the patient's left and right.
PEG LATERALS: Peg laterals are microdontia (underdeveloped teeth) that affect the adult lateral incisors. Sometimes, the permanent adult lateral incisor teeth do not develop at all, leaving only the baby teeth in their place. Although some people refer to these teeth as peg laterals, they are really over-retained baby teeth. A true peg lateral incisor is a term reserved for the underdeveloped adult permanent tooth that grows out after the baby tooth has been lost. The tooth resembles a small peg (a round, pointed and small piece of something) which is where the name came from.
PERIODONTAL LIGAMENT: The periodontal ligament is a group of specialized connective tissue and nerve fibers in the mouth that attach the root of a tooth to the upper and lower jaw bone within which it sits. The periodontal ligament helps the tooth withstand the pressures of chewing, keeps the tooth in place in the jaw bone, supports the tooth, provides nourishment, sensation and helps the tooth break through the gums when growing in. Every healthy tooth has a periodontal ligament that is a protective “sock” around it. It’s called “periodontal” because “peri” means around and “odont” is a Greek word meaning “tooth”. So the periodontal ligament means having to do with the tissue surrounding a tooth. Ligaments are special tissue that connects bones, supports organs in place, etc. The white around the root of the tooth in this picture shows the periodontal ligament:
PONTIC: A pontic is the fake tooth attached to a larger item such as dentures, a dental bridge, a dental implant or in an aligner. The pontic is just the fake tooth, not the appliance it is attached to. While in clear aligner treatment, a patient wouldn’t wear their partial dentures (removable bridge) at the same time. If a patient has a missing anterior tooth ClearCorrect may add a false tooth to the manufactured
model so when an aligner is made there will be a tooth void for the doctor to fill in the aligner with a pontic (as can be seen in the picture below on the right.) This ensures a missing anterior tooth is less obvious.
POSTERIOR: Indicates the teeth toward the back of the mouth (opposite of anterior). It comes from a word meaning “toward the back.” Premolars and molars are the posterior teeth:
PREMOLAR (also called BICUSPID): The two teeth between the canine and molar, typically having two cusps (hence bi and cuspid).
PROCLINE: In straightening teeth with metal or clear braces, “procline” refers to moving the anterior teeth facially. The whole tooth can move or it can be tipped facially at the crown. The anterior part of the arch opens up wider and creates more space for the teeth. If you have crowded teeth, this would make room to straighten them or make the teeth sit correctly on each other.
QUADRANT: These sections of the teeth are called quadrants. They are usually identified by Upper Right (UR), Upper Left (UL), Lower Left (LL) and Lower Right (LR). A quadrant is one quarter of a circle. In dentistry, a quadrant is used to describe one fourth of the mouth. The two arches of teeth are the “whole” and one half of one arch, is one quadrant.
RESTORATION: Restoration is a word that refers to dental methods of fixing the structure of teeth and putting the structure of a tooth back into the condition before it deteriorated (such as from decay or a crack). When a person has their teeth corrected with man-made dental materials (crowns, fillings, etc.), the surface structure is no longer the natural tooth and a dentist cannot easily attach engagers onto the facial surface of those teeth. And if the doctor does put an engager on the tooth, it can ruin the restoration that was done to the tooth, and so may need to be re-done. The doctor notes on the Case Submission Form which teeth have had restoration done to the facial surface so it can be determined which teeth could have engagers applied to them if necessary.
ROTATE: In clear aligner therapy, you use rotation to mean the tooth surface is being repositioned but the center of the tooth stays in the same location.
ROOT: The part of a tooth located deepest within the gums.
ROOT TIPPING: In clear aligner therapy is tilting the root of the tooth without moving the apex of the crown.
TORQUE: The definition of torque has evolved from fixed appliances and although there is no wire and bracket, the concept remains the same with clear aligners. In clear aligner therapy, to torque a tooth is to move the tooth buccolingually around the centerpoint, so the crown and root move in opposite directions. It is the twisting force which is traditionally required to adjust the inclination of a crown.
TRANSLATE: In clear aligner therapy, translation means to move the whole tooth to new location.
UNIVERSAL NUMBERING SYSTEM: The universal numbering system is most commonly used in the US and is one way of identifying each specific tooth in the mouth with a number or letter assigned to it. Adult teeth have a number and baby teeth have an upper case letter. A full set of teeth for an adult is 32.
For the adult teeth, tooth #1 starts at the upper right 3rd molar and goes clock-wise across the top arch, counting each tooth as the numbers move to #16, the upper left 3rd molar. Then, it drops down to the lower left 3rd molar #17 and goes across the bottom arch to the 3rd molar on the lower right, #32. #1 through #16 are in the upper arch and #17 through #32 are in the lower arch. If you are missing your upper right third molar, your first number will be 2 instead of 1, acknowledging the missing tooth.