DentFirst Dental Definitions

Third molars

Are commonly called "wisdom teeth". There is usually one in the posterior of each quadrant They can be seen as erupted soft tissue impaction or bony impaction

Clinical

Having to do with a hands-on physical examination, diagnosis or treatment. Easily visible.

Restoration

Any procedure which brings a tooth or teeth back into function such as fillings or crowns

Caries

Is dental tooth decay. It is literally an infection of the tooth structure.

Infiltration

The injection of the anesthetic next to a tooth (usually in the maxilla ).

Block

Or nerve block. The injection of the anesthetic in the back of the mouth (usually in the mandible ).

Posterior

Towards the back.

Erupted

Fully visible and in position so that the clinical crown of the tooth is evident.

Soft tissue impaction

Either totally or partially covered with gum tissue. In order to extract a tooth which is covered in gum tissue it is necessary that the overlying gum tissue be surgically removed first.

Bony impaction

Either totally or partially covered with bone. In order to extract a tooth which is covered by bone it is necessary for the overlying gum and bone to be surgically removed first.

Crowns

Also known as "caps". These restorations cover the biting surface as well as the front, back and both sides. They are hollow in the center (like a thimble) and are used when the tooth is so broken down that amalgams or light bonds would not work. When several crowns are joined together to replace a missing tooth or teeth we have a bridge spanning that space.

Post

Is a stabilizing device anchoring a crown bridge to the underlying tooth. It is used when the underlying tooth is missing most of its clinical crown

Clinical crown

That portion of the tooth which is covered in enamel . It is the part which is usually visible to the eye. It does not include the root or roots.

Amalgam

Silver colored restorations made up predominantly of silver and mercury and chemically bonded together. These are often used posterior teeth where esthetics are not as important. The US government has determined that the mercury in the amalgam is not harmful to patients and the American Dental Association considers it unethical for a dentist to remove amalgams, replacing them with composites or lightbonds , without clear medical evidence that of its harm.

Light-Bonds

A tooth colored restoration which is inserted into a tooth and then hardened by shining a special blue light on it from a handheld light gun.

Composites

A tooth-colored restoration which can be either chemically cured or light-cured as in a light-bond restoration.

Enamel

The extremely hard covering of a tooth. It is the hardest substance in the human body.

Esthetics

Good-looking. The area of dentistry concerned with making teeth look good and smiles bright. For example: while a silver restoration might function well on an incisor , it would not be esthetic.

Cure

No, not "made well". It is used here to mean the final hardening process of a dental material so that it is fully functional.

Incisor

A front tooth which is used for tearing. There are six upper and six lower incisors.

Anterior

Towards the front. There are six anterior teeth on the top and six on the bottom.

Impaction

A tooth which is not visible to the eyes because it is encased in bone or gum.

Mount

1. Noun: A cardboard or plastic holder designed to store and display radiographs in a useable sequence.
2. Verb: To place radiographs into the holder.

Panographic

A radiograph taken extra-orally which shows the maxilla, mandible , sinuses and all the teeth. It is especially useful in those cases where because of difficult tooth position or the young age of patient it would be impossible to obtain intra-oral radiographs.

Panorex

A x-ray machine which takes panographic radiographs. (Actually this is a brand name but we use it to describe our machines even though they may came from another manufacturer.)

Autoclave

Is also called the sterilizer. It utilizes steam under pressure and heat to completely kill bacteria and viruses. We periodically inspect the machine by running a spore test on it and then incubating the test tube. At 270° only 3 minutes are needed to kill all living organisms. At 260° 10 minutes is required.

Darkroom

This is the room in which radiographs are developed. It is light tight and has a safelight for seeing what you are doing without harming the film.

Lidocaine

This is the most commonly used local anesthetic used in dentistry. (No one has actually used "Novocain" for 30 years.) It come in 1.8 cc vials with four possible concentrations of epinephrine included: 1 part in 20,000 1:50,000 1:100,000 (or none).

Epinephrine

Pronounced EPI-NEF'-RINN Also called "adrenaline" it is added to some anesthetic solutions to decrease the flow of anesthetic away from the area being worked upon. This, in turn, allows the numbness to last longer.

Mepivicaine

Pronounced MEPP-IF'-E-CANE Another anesthetic solution. It comes two ways: with and without a vasoconstrictor called Neo-cobefrine. The 3% mepivicaine solution without neo-cobefrine is used for short acting more diffuse anesthetic or for a patient with a poor reaction to epinephrine.

Model trimmer

A large abrasive wheel cooled and cleansed by water, which shapes and trims stone models. It is very dangerous.

Nitrous head

No, it is not someone who abuses nitrous oxide! It is the flowmeter which regulates the mixture of oxygen and nitrous oxide. It is capable of administering up to 70% nitrous oxide and 30% oxygen. Room air contains 20% oxygen so there is a margin for error. The head also turns off the flow of nitrous oxide if no oxygen is running through it (as when an oxygen tank runs empty).

X-ray Processor

The automatic processor takes the undeveloped film and sequentially places it in developer solution, fixer solution and finally a water wash. It is then dried and exits from the processor ready to be read or mounted.

Safelight

A low-wattage (15 watts) light with a special red filter allows you to see what you're doing in the darkroom without harming the film by allowing it contact with regular light which would immediately ruin it once the film packet is opened.

Suction pump

In the machine room is a dual engine pump, driven by water, which is attached to the suction tip and saliva ejectors in all the treatment rooms.

Nitrogen

Is used to power a special handpiece used in Oral Surgery. In some offices the tank sits on a roll-around dolly. The gas is harmless (in fact the air we breath is 79% nitrogen).

Television (ceiling)

Each treatment room has a ceiling-mounted remote control 17-19 inch television for our patients' use during dental procedures. Allow them to control the remote control while they are in the chair having their teeth fixed.

Vasoconstrictor

A slight concentration of this is added to a local anesthetic to keep the anesthetic at the injection site for a longer time. This causes the numbness to last longer. We use Neo-cobefrine and epinephrine.

Suction tip

This item is a rigid tube about 6 inches long and a half an inch in diameter, held by the dental assistant in the patient's mouth to remove the water sprays used by her and the dentist. There is one in every treatment room . They are sterilized after each use.

Film packet

X-ray film is enclosed in thin cardboard (for rigidity), a thin lead sheet (to prevent scatter radiation from fogging the film) and a plastic pocket (for sterility and to keep it dry). In the darkroom , with only the safelight on, this packet is opened and the film inserted into the processor.

Saliva ejector

A flexible, pencil sized tube which is usually shaped by the assistant into a question mark and hung gently in the corner of a patient's mouth so that excess water will not pool in his mouth. The device is discarded after each patient.

Benefits-less-benefits

A legal insurance gimmick which costs double-covered patients money. The secondary insurance coverage will only pay if its coverage would be more generous than that of the primary coverage. Example: Mr. N's primary insurance covers $700 on a crown while Mr. N's secondary insurance covers $750 on a crown. He is paying full premiums on both policies. But because his secondary coverage is BLB while his primary pays $700, his secondary will pay only $50. If our fee is $850 he still has to come up with $100 out of pocket. Without BLB our total fee would be paid by the two insurance companies; one paying $700 and the other $150.

Group number

Generally each employer has one group number. But this is not always the case. Sometimes there are several option plans available for the employee. Usually hourly workers will have a different level of coverage than will management or contract employees.

Guarantor

The individual who is responsible for paying is for the work when it is completed. This person is also often called the "responsible party".

MedHx sticker

Medical History sticker. This is a small red label which indicates that there is something in this particular patient's medical status which significantly alters the way in which he should be treated. Examples include allergies to medicines and previous or present illnesses.

Option Plans

An employer may offer several plans to its employees; usually at varying costs to that employee. For example: High option usually covers crowns at 50% while Low Option may not pay anything on them at all. The employee may or may not have the choice of making up the difference in the premiums required to move from Low to High Option coverage.

Premium

The payment (usually monthly) made to an insurance company for dental insurance coverage.

Provider

The professional providing treatment to the patient. This can be the doctor or the dental hygienist.

Assignment of Benefits

The patient's permission, in writing, for the insurance company to make payments for dental procedures directly to the dental practice providing them. In this way the patient does not receive the insurance check directly from the company. Patients give permission for assignment of benefits unless they wish to pay us directly at the time services are rendered.

Carve-out

The money the covered patient should receive but won't because his secondary policy has a Benefits less benefits provision.

ADA form

The American Dental Association (ADA) has standardized on a dental insurance claim form. This is what we usually refer to as the `insurance form'.

Medical Insurance form

If the patient has medical insurance and has had a surgical procedure done then a medical (CPT) form is printed along with his dental insurance form. Sometimes a patient's medical insurance will pay for certain dental procedures. This coverage is in addition to, and will not reduce, the patient's dental benefits. Although we print out the patient's medical insurance form we do not mail it. It is placed inside the patient's chart and it should be given to the patient at the appointment.

Patient exam codes from the ADA

There are 4 basic kinds of patient exams:

• Sercode 110; Initial examination which is done for all NP at the time of their initial FMX and any subsequent FMX's. This is usually once every 3 to 5 years. "Initial" is a poor choice of words since it will recur time and time again.
• Sercode 120; Periodic Oral Evaluation is done at every scheduled prophy appointment not to exceed twice a year.
• Sercode 130; Emergency exam is done when the doctor treats a problem at a time other than scheduled hygiene maintenance therapy appointment.
• The 93xx series of sercodes are reserved for specialists' exams.

ADA Code

Is the American Dental Association's identification number for each and every dental procedure we might perform. 

Pre-medicate

Patients who have had rheumatic fever, pacemakers, artificial joints and several other conditions will need to have an Rx of antibiotic before their scheduled appointment. They can not be seen without having taken their medication or getting a release letter from their physician.

Double coverage

The patient has two insurance policies in force simultaneously. This usually occurs when both the primary and secondary employers provide insurance coverage. Remember, however that just becauser the patient has two dental insurance policies does not mean that they pay the entire fee. This is especially true if one of the policies has a benefits-less-benefits provision.

Primary

If the patient has 2 active policies this refers to the insurance billed first for dental coverage. If both parents have coverage, for example, the wife's primary is her employer while the husband's primary is his employer. For their children many insurance companies consider the primary parent to be that parent born earliest in the year. If Dad was born on May 19th and Mom was born on Nov 29th then the Dad's insurance is primary for all the kids. The insurance company will tell you of any exceptions.

Comprehensive

As opposed to preventive type procedures, it generally means insurance coverage for major items such as crowns , root canals , bridges and dentures. For example the insurance company may pay 100% of preventive , 80% of amalgams and 50% of comprehensive or major.

HMO

Health Maintenance Organization. The dentists in such a plan are paid a certain amount each month to provide all treatment to certain patients. They are paid this amount whether the patient comes in or not. If the patient needs a lot of work then the dentist will lose a lot of money. If the patient needs no work then the dentist makes money. Do you think that the dentist will find anything wrong when he does his exam? DENTFIRST has never participated in any HMO because we feel it encourages dishonesty and patchwork dentistry.

PPO

Preferred Provider Organization. This is a group of dentists who have agreed to treat a group of patients for less then the usual fee. Not to be confused with an HMO.

PTR

Pretreatment. This is notification to a patient's insurance company of what we have found to be necessary for his treatment. It is DENTFIRST policy to PTR all work if it exceeds $200. This gives the patient reassurance that the insurance company agrees that the work is necessary.

Walk-in

A patient who is not on your schedule who just shows up at your door for treatment (usually of a toothache). We try to be nice to these patients and work them into the schedule.

EOB

Explanation of Benefits. This is the insurance company's response to our PTR . In it they state exactly what dollar benefits will be paid if we do the specified procedures.

(Schedule( of Benefits

Or "schedule" as opposed to percentage . The insurance company will pay up to a certain amount for each sercode . It is as if they had their own fee schedule . If we charge $500 for a procedure and their schedule lists it at $400 then they will pay only $400. If We charge $400 and their schedule lists it at $500 then they will pay us our fee of $400. Either way they win and the patient loses.

Percentage (of benefits)

Or "percentage" as opposed to schedule . The insurance company will pay up to a certain percentage for each sercode . It is as if they had their own fee schedule . If we charge $500 for a procedure and their percentage is 80% then they will pay $400. If we charge $400 and their schedule lists it at $500 then they will pay us 80% of our fee or $320. Often insurance companies only pay a percentage of a schedule additionally reducing their benefits. We still call this "percentage", although the insurance companies' intent is to mislead.