(DPT) a special form of tomogram (see tomography) that provides a picture of all the teeth of both jaws on one film. Newer equipment can produce three-dimensional images of part of the jaw.
Over the past four decades the ?nancial outlay on NHS dental services has been around 5 per cent of total NHS funding. This contrasts with 10 per cent during the service’s early years, when the NHS was coping with decades of ‘dental neglect’. The population’s dental health has, however, been steadily improving: in 1968 more than one-third of people had no natural teeth; by the late 1990s the proportion had fallen to 13 per cent.
Dentistry is divided into several groupings.
General dental practitioners Concerned with primary dental care, the prevention, diagnosis and treatment of diseases of the gums and teeth – for example, caries (see TEETH, DISORDERS OF). They also deal with diffculties in biting and the effects of trauma, and are aware that oral disorders may re?ect disease elsewhere in the body. They will refer to the hospital dental services, patients who require treatment that cannot be satisfactorily carried out in a primary-care setting.
Most routine dental prevention and treatment is carried out in general dental practitioners’ surgeries, where the dentists also supervise the work of hygienists and dental auxiliaries. Appliances, such as dentures, crowns, bridges and orthodontic appliances are constructed by dental technicians working in dental laboratories.
There are around 18,800 dentists providing general dental services in the UK. These practitioners are free to accept or reject any potential patient and to practise where they wish. Those dentists treating patients under an NHS contract (a mixture of capitation fees and items of service payments) can also treat patients privately (for an appropriate fee). Some dentists opt for full-time private practice, and their numbers are increasing in the wake of changes in 1990 in the contracts of NHS general dental practitioners.
Community dental practitioner Part of the public-health team and largely concerned with monitoring dental health and treating the young and the handicapped.
In the hospitals and dental schools are those who are involved in only one of the specialities.
Around 2,800 dentists work in NHS hospitals and 1,900 in the NHS’s community services. In some parts of the UK, people wanting NHS treatment are having diffculties ?nding dentists willing to provide such care.
Restorative dentist Concerned with the repair of teeth damaged by trauma and caries, and the replacement of missing teeth.
Orthodontist Correction of jaws and teeth which are misaligned or irregular. This is done with appliances which may be removable or ?xed to the teeth which are then moved with springs or elastics.... dental surgeon
For minor procedures, a local anaesthetic (see anaesthesia, local) is injected either into the gum at the site being treated or into the nerve a short distance away (called a peripheral nerve block).
In addition, topical anaesthetics are often used on the gums.
For more complicated procedures, such as periodontal (gum) surgery and multiple tooth extractions, general anaesthesia is carried out (see anaesthesia, general).... anaesthesia, dental
The affected tooth aches or throbs, and biting or chewing is usually extremely painful. The gum around the tooth is tender and may be red and swollen. An untreated abscess eventually erodes a sinus (channel) through the jawbone to the gum surface, where it forms a swelling known as a gumboil. As the abscess spreads, the glands in the neck and the side of the face may become swollen, and fever may develop. Treatment may consist of draining the abscess, followed by root-canal treatment of the affected tooth, but in some cases extraction of the tooth is necessary. Antibiotics are prescribed if the infection has spread beyond the tooth.
An abscess in a periodontal pocket can usually be treated by the dentist scraping away infected material.... abscess, dental
The surface of the affected tooth is painted with oxidizing agents and then exposed to ultraviolet light.... bleaching, dental
It is sometimes used as an alternative to crowning (see crown, dental) and may also be used as a preventive technique to protect the teeth.... bonding, dental
at the tooth’s core. Advanced decay causes toothache and bad breath.
Treatment consists of drilling away the area of decay and filling the cavity (see filling, dental). In advanced decay, it may be necessary to remove the infected pulp (see extraction, dental).
Water fluoridation and the use of fluoride toothpaste helps prevent caries.
The risk of caries is also reduced by cutting sugar consumption, practising good oral hygiene, and visiting the dentist regularly.... caries, dental
A crown may be fitted by filing the natural tooth to form a peg and cementing the crown over the top. If the tooth is... crown, dental
Dental curettage is one method used to remove the lining of periodontal pockets and diseased tissue from root surfaces in periodontitis.... curettage, dental
(See also caries, dental.)... decalcification, dental
During a routine dental examination, the dentist uses a metal instrument to
probe for dental cavities, chipped teeth, or fillings. Dental X-rays are sometimes carried out to check for problems that may not be visible. Dentists also check how well the upper and lower teeth come together. Regular examinations in children enable the monitoring of the replacement of primary teeth by permanent, or secondary, teeth. Referral for orthodontic treatment may be made. dental extraction See tooth extraction. dental X-ray An image of the teeth and jaws that provides information for detecting, diagnosing, and treating conditions that can threaten oral and general health. There are 3 types of dental X-ray: periapical X-ray, bite-wing X-ray, and panoramic X-ray.
Periapical X-rays are taken using X-ray film held behind the teeth. They give detailed images of whole teeth and the surrounding tissues. They show unerupted or impacted teeth, root fractures, abscesses, cysts, and tumours, and can help diagnose some skeletal diseases. Bite-wing X-rays show the crowns of the teeth and can detect areas of decay and changes in bone due to periodontal disease. Panoramic X-rays show all the teeth and surrounding structures on one large film. They can show unerupted or impacted teeth, cysts, jaw fractures, or tumours. The amount of radiation received from dental X-rays is extremely small. However, dental X-rays should be avoided during pregnancy.... dental examination
outer surfaces of the front teeth is most frequently caused by excessive intake of fruit juices and carbonated drinks. Erosion of the inner surfaces of the molars may be a result of the regurgitation of stomach acid, as occurs in people suffering from acid reflux or bulimia. (See also caries, dental.)... erosion, dental
For most extractions, local anaesthesia is used (see anaesthesia, dental). Teeth are usually extracted with dental forceps, which grasp the root of the tooth. In difficult extractions, some gum and bone may also need to be removed from around the tooth.... extraction, dental
using soft nylon or silk thread or tape.
Dental floss may be waxed or unwaxed.
Flossing should be carried out as an adjunct to toothbrushing.... flossing, dental
Fractures may involve the crown or the root of a tooth, or both.
Fractures of the enamel can usually be repaired by bonding (see bonding, dental); in some cases, a replacement crown may be fitted (see crown, dental).
Pulpotomy may be performed if the pulp of a tooth is damaged.
Fractures of the root may be treated by splinting (see splinting, dental), root-canal treatment, or removing the tooth (see extraction, dental).... fracture, dental
Impacted wisdom teeth are common, and, if symptomless, may not need to be removed.
In some cases, however, symptoms necessitate their removal.... impaction, dental
A quick-setting material, such as alginate, is placed in a mould over the teeth.
The mould is removed, and plaster of Paris is poured into it to obtain a model of the area.
This model is then used as a base on which to build a denture, bridge, or dental inlay.
Dental impressions are also used in orthodontics to study the position of the teeth and to make orthodontic appliances to correct irregularities.... impression, dental
An inlay may be needed for the back teeth or to protect a weakened tooth.... inlay, dental
It is the chief cause of tooth decay (see caries, dental) and gingivitis, and forms the basis of a hard deposit (see calculus, dental).
Some of the microorganisms in plaque, particularly STREPTOCOCCUS MUTANS, break down sugar in the remains of carbohydrate food that sticks to the mucus, creating an acid that can erode tooth enamel.... plaque, dental
Overcrowded teeth may lead to malocclusion or may prevent certain teeth from erupting through the gum (see impaction, dental). They can be difficult to clean, increasing the risk of dental decay (see caries, dental) and periodontal disease.
Teeth may need to be extracted to allow room for others. Usually an orthodontic appliance is fitted to the remaining teeth to position them correctly.... overcrowding, dental
protease inhibitors A type of antiviral drug used to delay the progression of HIV infection (see AIDS).... prosthetics, dental
Internal resorption is rare, occurring in about 1 percent of adults.... resorption, dental
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