1. Introduction to Dentistry and Dental Terminology

3. Dentistry Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body; provided by a dentist, within the scope of his/her education, training and experience, in accordance with the ethics of the profession and applicable law.

4. Dental Specialties 1.Dental Public Health 2.Endodontics 3.Oral and Maxillofacial Pathology 4.Oral and Maxillofacial Surgery 5.Oral and Maxillofacial Radiology 6.Orthodontics and Dentofacial Orthopedics 7.Pediatric Dentistry 8.Periodontics 9.Prosthodontics

5. Dental Public Health Concerned with preventing and controlling dental diseases and promoting dental health through organized community efforts.

6. Endodontics Concerned with the diagnosis, prevention, and treatment of diseases and injuries of the pulp and associated periradicular tissues. Known most for the performance of: “Root Canals”

7. Oral Pathology Concerned with the nature of disease affecting the oral structures and adjacent regions Involved with diagnosis of: “biopsies”

8. Oral and Maxillofacial Radiology Concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region.

9. Oral and Maxillofacial Surgery Concerned with the diagnosis and surgical treatment of diseases, injuries, and defects of the oral and maxillofacial regions Known for: “Extraction of Wisdom Teeth” “Reconstruction of Facial Regions”

10. Orthodontics and Dentofacial Orthopedics Concerned with the supervision, guidance, and correction of all forms of malocclusion of the growing or mature dentofacial structures Known most for: “Braces”

11. Pediatric Dentistry Concerned with the preventive and therapeutic oral healthcare of children from birth through adolescence. Known as: “Children’s Dentist”

12. Periodontics Concerned with the diagnosis and treatment of disease of the supporting and surrounding tissues of the teeth. Involved mainly with the treatment of: “Gums”

13. Prosthodontics Concerned with the restoration and maintenance of oral functions by the restoration of natural teeth or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes known as prostheses. Known for treatment of denture patients or those patients requiring extensive crown and bridge work.

14. Introduction to Dental Terms

15. Basic Dental Terminology Teeth Person with teeth Person without teeth Baby teeth Gums Gums of person without teeth Dentition Dentate Edentulous Deciduous (primary) Gingiva ridges

16. Basic Dental Terminology Gum disease Tartar Roof of mouth Upper jaw Lower jaw Jaw joint Gingivitis / periodontitis Calculus Palate Maxilla (maxillary arch) Mandible (mandibular arch) Temporal mandibular joint (TMJ)

17. Basic Dental Terminology Cavity Filling Shot Bite Teeth cleaning Caries Restoration Local Anesthesia Occlusion Oral prophylaxis (prophy)

18. Tooth Anatomy root crown

19. Tooth Anatomy Cementum Cemental enamel junction (CEJ) Enamel

20. Tooth Anatomy Enamel Dentin Pulp Cementum

21. Anatomy of Teeth and Surrounding Tissues

22. Enamel Makes up the anatomic crown of the tooth. Hardest material of the body. Is translucent (allows light to pass through it) and ranges in color from yellow-white to gray-white. Shade differences are dependent on the color of the dentin that lies beneath the enamel.

23. Structure of Enamel 96-99% Inorganic Matter Hydroxyapatite, which consists primarily of calcium, is the largest mineral component. Enamel is composed of millions of calcified prisms, known as enamel rods. These rods extend from the surface of the tooth into the DEJ.

24. Dentin Makes up the main portion of the tooth structure extending almost the entire length of the tooth. It is covered by enamel on the crown surface and cementum on the root surface. Dentin is light yellow and some what translucent. The color may darken with age

25. Structure of Dentin Dentin is harder than bone and cementum, but not as hard as enamel. It is composed of 70% inorganic material and 30% organic material and water. This decrease in mineralization allows for the more rapid spread of caries through tooth structure. Instead of enamel rods, dentin is composed of many, many microscopic dentin tubules.

26. Cementum The primary function of cementum is to anchor the tooth to the bony socket with attachment. Cementum is light yellow and is easily distinguished from enamel due to its lack of luster and darker hue.

27. Structure of the Pulp The pulp is made up of nerves and blood vessels that enter the pulp chamber via the apical foramen. The tissue fluid interchange between the dentin and the pulp allow for moisture and nutrients of the dentin. The nerve supply of the pulp receives and transmits pain stimuli.

28. How does the tooth “attach” to the bone? The tooth is not in contact with the bone but is suspended in place by the periodontal ligament which is sandwiched between the cementum and the alveolar bone

29. Oral Cavity Terminology and Anatomy

30. Oral Cavity Many areas in the oral cavity are identified according to their relationship with the tongue, palate, cheek, facial surface or lips. Lingual- closest to the tongue. Palatal-closest to the palate. Buccal-closest to the cheek (also Facial) Labial-closest to the lips (also Facial)

31. Vestibules The spaces between the lips, cheeks, and gingiva are called the maxillary and the mandibular vestibules. A frenum is a band of tissue that connects two structures. Labial Frenum Buccal Frenum

32. Gingiva Most commonly referred to as the gums. The gingiva is the masticatory mucosa previously discussed.

33. Palate The roof of the mouth has two parts: Anterior Posterior The anterior firm portion is called the hard palate. The posterior loose portion is called the soft palate. The uvula hangs down in this region.

34. Tongue The dorsal (top) surface is covered by thick and highly specialized epithelium, The ventral (underside) surface is highly vascular and covered with a very delicate lining mucosa. The tip of the tongue is termed the apex of the tongue. Dorsal surface Lateral surface Ventral surface Apex

35. Lips Also known as Labia. Formed externally by the skin and internally by mucous membranes. Commisure: the angle at the corner of the mouth where the upper and lower lips meet. Vermillion Border-the red free margins, representing a transition from skin to the red mucous membrane portion. Philtrum Vermilion Zone

36. Tooth Numbering

37. 32 adult teeth total Each arch (maxilla & mandible) has 16 teeth Each arch has two quadrants of 8 teeth

38. 32 adult teeth Each arch has 16 teeth Each arch has two quadrants of 8 teeth

39. Universal Numbering System (ADA) The permanent teeth are numbered 1-32. Numbering begins with the upper right third molar continues around to the upper left third molar. The mandibular numbering starts at 17, with the mandibular left third molar continuing to the mandibular right third molar.

40. Primary Dentition There are 20 teeth in the primary dentition, all teeth are eventually exfoliated during the eruption of the permanent dentition. There are no premolars in the primary dentition. However when erupted the premolars replace the existence of the primary first and second molars. Each quadrant contains five teeth Two incisors (central & lateral) One cuspid Two molars (1 st & 2 nd )

41. Types of Teeth

42. Posterior teeth 1 st premolar 2 nd premolar 1 st molar 2 nd molar 3 rd molar Anterior teeth Central incisor Lateral incisor Canine (cuspid) Types of Teeth

43. Incisors Incisors are single rooted with a sharp thin edge. They are located at the front of the mouth. They are designed to cut food without the application of heavy forces. 8 in total dentition (4 in maxillary arch, 4 in mandibular arch.

44. Canines Designed for the cutting and tearing of foods that require the application of force. The single canine root is the longest in the dentition. The bony ridge over the facial part of the root is called the “bony eminence.” The canine crown is thick with one well developed pointed cusp. 4 in total, 2 maxillary, 2 mandibular arch. Referred to as the cornerstone of the dental arch due to location. Usually one of the last teeth in the mouth to be lost.

45. Premolars Similar to canines in that they have points and cusps for grasping and tearing. They have a somewhat broader working surface for chewing. 8 in total, 4 in maxillary arch, 4 in mandibular arch. The premolar is the only type of tooth that is not found in the primary dentition.

46. Molars Molars have the most cusps of all the teeth in the dentition. The shorter, blunter design of these cusps produces a broad working surface that is used for chewing and grinding solid masses of food that require the application of heavy forces. An adult dentition has up to 12 molars present. The number depends on development, eruption, and prior needs for extraction.

47. Tooth Surfaces

48. Five surfaces: 1.Facial (labial / buccal) Facing out 2.Lingual (palatal) Facing in 3.Masticatory (incisal/occlusal) Chewing surface 4.Mesial Towards the midline 5.Distal Away from the midline

49. Tooth Surfaces 4. Mesial 1.Facial (labial) 2. Palatal 3. Incisal 5. Distal

50. Tooth Surfaces Distal Mesial Both Mesial and Distal Surfaces are also referred to as PROXIMAL

51. Anatomic Features of the Teeth A pronounced elevation on the occlusal surface terminating in a conical or rounded surface. Cusp:

52. Anatomic Features of the Teeth Mamelon: A rounded or conical prominence on the incisal ridge of a newly erupted incisor. They are usually three in number, and soon disappear as a result of wear.

53. Contours When tooth is restored, it is important to return it to normal contour With inadequate contour, the gingiva may be damaged (B) With overcontouring the gingiva will lack adequate stimulation (C)

54. Contacts The contact area is the region of the mesial and distal surfaces (proximal surface) of a tooth that touch the adjacent tooth.

55. Contacts The proper contact relationship between adjacent teeth accomplished 3 things It serves to keep food from being trapped between teeth It helps to stabilize the dental arches by combined anchorage of all teeth in either arch in positive contact with each other. It protects the interproximal gingival tissue from trauma during mastication.

56. Occlusion Occlusion is the contact between the maxillary and mandibular teeth in all mandibular positions and movements.

57. Occlusion Centric Occlusion Occurs when the jaws are closed in a position that produces maximal stable contact between the occluding surfaces of the maxillary and mandibular teeth. Malocclusion Refers to abnormal or malpositioned relationships of the maxillary teeth to mandibular teeth

58. Dental Restorations

59. Dental Decay Periodontal Disease Genetic Disorder Missing Teeth Missing Tooth Structure (Esthetic Imperfections) Restoring Form & Function (Esthetic Improvements) Restoration of Tooth StructureReplacing Missing Teeth Direct Restorations Composite Fillings Amalgam Fillings Gold Foil Fillings Indirect Restorations Crowns Inlays/Onlays Veneers Fixed Restorations Bridges (w/Pontic) Implants Removable Rest. Partial Denture Complete Denture

60. Restoration of Tooth Structure Direct Restorations (Fillings placed directly in the mouth) Composite (Resin) “White fillings” Most popular Bonded Restorations  Adhesives  Composites  Polishers Gold Foil “Gold fillings” Declining Amalgam “Silver fillings” Economic

61. Fixed vs Removable Restorations Some restorations are meant to be fixed to the patient’s tooth / teeth –Veneers –Inlay –Onlay –Crown –Bridge Some restorations are meant to be removable by the patient –Partial denture –Complete denture

62. Restorations Direct restoration (Clinical) Indirect restoration (Technical)

63. Clinical restorations A typical clinical restoration can be a silver filling (amalgam) or a tooth colored filling (direct resin).

64. Indirect Restorations The decision to do an indirect (technical restoration) is usually determined by the amount of tooth structure that needs restoration. The following is a list of technical restorations from the least amount of tooth structure / teeth that needs to be replaced to the most. –Veneer –Inlay –Onlay –Crown –Bridge –Partial denture –Complete denture

65. Veneers A veneer is a conservative restoration that is selected when the facial surface of a tooth requires replacement primarily due to esthetic considerations. Minimal tooth structure is removed (0.3-0.8mm)

66. Inlay An inlay is a conservative restoration that is designed to fit into a preparation that is within the tooth. It does not involve replacement of the cusps. Like a Class II restoration, covers a portion of the occlusal and proximal surface areas. The materials of choice are; Indirect resin Cast metal Porcelain

67. Onlay An inlay is a conservative restoration that is designed to fit into a preparation that is within the tooth. It does involve replacement of one or more cusps. The material options are; Indirect resin Cast metal porcelain

68. When more than 50% of the crown of a tooth must be replaced it is necessary to prepare the tooth for a full crown in order to restore the tooth back to its original contour and function. Material options: All metal All ceramic Porcelain fused to metal (PFM) Crown

69. If a tooth is missing it can be replaced by preparing a tooth on either side of the missing tooth and fabricate a “bridge” Material options; Bridge (Fixed Partial Dental Prosthesis/ FPDP ) Material options: All metal All ceramic Porcelain fused to metal (PFM)

70. Bridge (Fixed Partial Dental Prosthesis/ FPDP ) A pontic is an artificial tooth, or part of the dental appliance that replaces a missing natural tooth. An abutment, also known as a retainer, is a natural tooth that serves as the support for the replacement tooth or teeth in a fixed bridge. The abutment tooth is usually prepared with an onlay or a cast crown.

71. Bridge (Fixed Dental Prosthesis/ FDP) Framework Material Options: Metal (PFM) Ceramic (All ceramic) Pressed CAD/CAM

72. Partial Denture Removable Prosthodontics is the area of dentistry dealing with replacement of missing teeth with a prosthesis that the patient is able to remove and replace. Removable Partial Dentures- commonly referred to as a partial, replaces one or more teeth in one arch

73. Partial Denture Denture teeth Base metal framework Denture Base Resin

74. Complete Denture Removable Complete Denture, (Denture): A removable dental prosthesis that replaces all the teeth and associated structures of one arch. Complete removable dental prosthesis.