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 impressions begin to dry out and distort shortly after being taken. Instead of using alginate, we request doctors use PVS material to make impressions.
ANKYLOSED TOOTH: (pronounced: ăng′ki-lōs′-d) An ankylosed tooth in one where the root of a tooth is rigidly connected to the jaw and cannot move because the tooth no longer has a vital periodontal ligament between the root and surrounding bone. 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 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). Typically these teeth replace exfoliated deciduous molars.
BITE REGISTRATION (BITE): Sometimes referred to as a “bite”. This is the way the upper and lower arches fit together in occlusion. A bite registration refers to what the dentists make when they use impressions, scans or a device to record the occlusal relationship between the upper and lower teeth.
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: The surface of the posterior teeth facing toward the cheek.
CANINE (also called CUSPID or eye tooth): The single cusped tooth third from the mid-line.
CLASS I classification: "Class 1" is when the mesiobuccal cusp pf the upper first molar aligns with the buccal groove of the lower first molar and the upper cusp aligns with the embrasure between the lower cuspid and first premolar. Class I is the normal tooth relationship.
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 used to describe when one or more of the upper teeth are positionde lingually to the opposing teeth, or, one or more of the lower teeth are positioned facially or buccally to the opposing upper teeth.
CROWN: The part of a tooth attached to 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”).
DENTAL IMPLANT: (Also simply called “implants”.) A dental implant is a device surgically inserted into the jaw. The implant is screwed into the jaw bone and then a prosthetic 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 all of the teeth present in the mouth at any given time.
- A “deciduous” dentition only has primary (“baby”) teeth present;
- A “mixed” dentition has some primary teeth and some permanent (adult) teeth present;
- A “permanent” dentition does not have any deciduous teeth present
DIASTEMA: (Pronounced dī′a-stē′ma.) A gap or space between the two upper central incisor teeth.
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: Whether using metal braces or clear aligners, “distalize” refers to moving the teeth away from the mid-line (distal). Distalization may be another way to create space in the mouth. Teeth being distalized with a distalizer appliance:
ENGAGER: Small dollops of composite material placed on the tooth to help engage an aligner and assist its performance (also called a “button”, or "attachment") with difficult movements.
EXPAND: Refers to moving the posterior teeth buccally, creating more space by widening the U-shape size of the arch. Expanding is considered "skeletal" when the underlying bone is widened and "dental" when only the dental arch is widened.
EXTRACT: The removing of a tooth or teeth from a patient’s arch.
EXTRUDE: Extrusion means to move a tooth in the direction away from the bone and gums. When clear aligners are going to extrude a tooth, a horizontal engager is used.
FACIAL: Indicates the surface of the teeth facing the 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: Intrusion means to move a tooth toward the jaw bone and gums. When clear aligners need to intrude a tooth, a horizontal 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: The dental midline is a reference line represented by approximation if the mesial surfaces of the central incisors. Ideally this reference line should align with the midline of the facial structures.
MOLAR: Any of the larger back teeth, used for chewing and grinding food. Molars have different names and appear at different ages. The third 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.
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. The picture does not show an 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 horizontal projection of he upper teeth labially beyond the lower teeth. Typically, >4-5mm is an abnormal distance when the upper teeth stick out past the lower arch when the mouth is closed. Extreme overjet 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, referred to as congenitally missing laterals. A true peg lateral incisor is a term reserved for the malformed 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 prosthetic dental crown used to replace a tooth in dentures, a dental bridge, a dental implant or in an aligner. While in clear aligner treatment, for a patient that has a missing anterior tooth ClearCorrect may substitute a pontic in 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 not as apparent.
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: Procline refers to moving the incisal edge of the anterior teeth facially. The whole tooth can move or the crown can be tipped facially. 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 alveolar bone and periodontium.
ROOT TIPPING: In clear aligner therapy is tilting the root of the tooth without moving the apex of the crown.
TORQUE: Torque traditionally refers to the twisting force required to adjust the inclination of a crown. Clear aligners can apply force to effect similar movements without wires or brackets. Colloquially, to “torque” a tooth is to move the tooth buccolingually around the centerpoint, so the crown and root move in opposite directions.
TRANSLATE: In clear aligner therapy, translation means to move the whole tooth without changing the orientation of the long axis of the tooth.
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.