Dental Insurance Glossary

Abcess

Acute or chronic, localized inflammation, with a collection of pus

Abutment

A tooth or implant used to support a dental prosthesis

Alveolar

Referring to the bone to which a tooth is attached

Alveoloplasty

A surgical procedure for recontouring alveolar structures, usually in preparation for a prosthesis

Amalgam

A mixture of metals used in dental restorations (commonly referred to as a silver filling)

Analgesia

Loss of pain sensation without loss of consciousness

Anesthesia

Partial or total absence of sensation to stimuli

There are three types of anesthesia:

General Anesthesia - A controlled state of unconsciousness, accompanied by a loss of ability to independently maintain airway and respond purposefully to physical stimulation or verbal command.
Intravenous Conscious Sedation - A depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and to respond appropriately to physical stimulation or verbal accompanied by a loss of ability to independently maintain airway and respond purposefully to physical stimulation or command.
Local Anesthesia - Elimination of sensations, especially pain, in one part of the body by the topical application or regional injection of an anesthetic drug.

Anteroir

Refers to the teeth and tissues located in the front of the mouth - upper and lower incisors and canines

Apex

The tip or end of the root of a tooth

Apicoectomy

Removal (amputation) of the apex of a tooth

Arch

The curved structure of the natural dentition or the ridge remaining after the loss of some or all of the natural teeth

Assignment of Benefits

A clause in the policy that allows the insured person to direct the payment by the carrier to the dentist. The insured person does this by signing the assignment box on the claim form, or by signing a “signature on file” form

Benefit Year

Usually begins on the month of the year that the employer purchased the plan

Benign

The mild character of an illness or non-malignant character of a neoplasm

Bicuspid

A tooth with two cusps, usually in front of a molar and referred to as a premolar.

Bilateral

Pertaining to both sides of the mouth.

Biopsy

Process of removing tissue for laboratory evaluation.

Birthday Rule

When a child is covered under both parent’s plans, the plan of the parent who’s birthday (month and day, not year) falls earlier in the calendar year is billed first

Bitewing

An X-ray that shows the upper and lower teeth’s biting surfaces on the same film. This x-ray shows the portion of the teeth above the gumline

Bonding

The process by which two or more components are made into one by mechanical and/or chemical adhesion at their interface

Bridge

There are two types of bridges:

Fixed Bridge - A prosthetic replacement of one or more missing teeth cemented or attached to the abutment teeth or implants adjacent to the space.
Removable Bridge - A prosthetic replacement of one or more missing teeth on a framework that can be removed by the patient.

Bruxism

Grinding of teeth

Buccal

Facing the cheek

Calendar Year

January 1st to December 31st

Calculus

Hard deposits of mineralized plaque which are attached to the crowns and or roots of teeth; also referred to as tartar

Canal

The narrow chamber inside the root of the tooth that contains the nerve and blood vessels

Capitation Plan

A plan where the dentist is contracted with the administrator to provide dental services to persons covered under the program in return for payment on a per-capita basis (per head).

Caries

Commonly used term for tooth decay

Carryover

If the deductible was paid during the last 3 months of the prior year, it can carry forward into the current year and not be paid again

Cementum

Hard connective tissue covering the root portion of a tooth

Cleaning

See Prophylaxis

Cleft Palate

A congenital deformity resulting in lack of fusion of the soft and or hard palate, may be either partial or complete

Clenching

The clamping and pressing of the jaws and teeth together, frequently associated with psychological stress or physical effort

Closed Panel

A plan where the covered patient only receives benefits if the services are provided by a dentist who is under contract with the dental benefit company or plan

Complete Series

See Full Mouth X-rays

Composite

A dental restorative material made up of separate parts (e.g. resin and quartz particles)

Coordination of Benefits (COB)

This process becomes involved when the patient is covered by more than one plan. Coverage is then divided between the two plans using guidelines establisted by the National Association of Insurance Commissioners.

Coronal

Refers to the crown of a tooth

Crown

There are three types of crowns:

Anatomical Crown - That portion of the tooth normally visible and covered by enamel.
Artificial Crown - A restoration covering or replacing the major part of the anatomical crown.
Abutment Crown - An artificial crown serving for the retention or support of a dental prosthesis.

Crown Lengthening

A surgical procedure exposing more of the tooth for restorative purposes by repositioning the gingival margin and/or removing supporting bone

Curettage

Scraping or cleaning the walls of a cavity or gingival pocket

Cusp

A pointed or rounded eminence on or near the chewing surface of a tooth

Cuspids

The third tooth from the center of the mouth to the back of the mouth. These are the front teeth that have one rounded or pointed edge used for biting. Also known as canines

Cyst

A pathological cavity or space, containing fluid or soft matter

Debridement

Removal of subgingival and/or supragingival plaque and calculus which obstructs the ability to perform an evaluation; removal of bruised and devitalized tissue from a wound surface

Decay

The lay term for carious lesions in tooth; decomposition of tooth structure

Deciduous

To fall off or shed; a name used for the primary (baby) teeth

Dental Health Maintenance Organization (DHMO)

A legal entity that accepts the responsibility of providing services at a fixed price. The enrollees in these plans must have dental care provided through designated doctors

Dentin

That part of the tooth that is beneath enamel and cementum

Dentition

The teeth in the dental arch

Denture

An artificial substitute for natural teeth and adjacent tissues

Diagnostic

Procedures performed by the dentist to evaluate the condition of the teeth and mouth

Diastema

A space, such as one between two adjacent teeth

Distal

Toward the back of a tooth or the dental arch (away from the midline)

Dry Socket

Localized inflammation of the tooth socket, following an extraction, due to infection or loss of blood clot

Edentulous

Without teeth

Enamel

Hard calcified tissue covering the dentin on the crown of a tooth.

Endodontic

Relating to the pulp.

Endodontist

A dental specialist whose practice is limited to treating disease and injury to the pulp. Endodontists perform root canal therapy and other services related to the blood vessels and nerve tissue inside teeth

Equilibration

Reshaping of the occlusal surfaces of teeth to create proper contact between the upper and lower teeth; also know as occlusal adjustment

Excision

Surgical removal of bone and/or tissue.

Exclusion

A service not covered by a dental policy

Exostosis

Overgrowth of bone

Facial

The surface of a tooth directed toward the face (including the buccal and labial surfaces).

Filling

The restoration of lost tooth structure with materials such as amalgams or plastic.

Fluoride

A gel or liquid that prevents decay.

Foramen

A natural opening into or through bone.

Front Teeth

See Anterior Teeth.

Full Mouth X-Rays (FMX)

X-rays showing all the teeth. Includes 14 periapicals and 2 or 4 bitewings. Also known as a complete series.

Gender Rule

When a child is covered under both parent’s plans, the father’s plan is billed first.

General Anesthesia

Medication that relieves the sensation of pain on the whole body. General anesthesia renders you unconscious.

Gingiva

The soft tissue surrounding and supporting the teeth; otherwise know as the “gums”.

Gingivectomy

The removal of gingival tissue.

Gingivitis

Inflammation of gingival tissue

Gingivoplasty

Surgical procedure to reshape gingiva to create a normal, functional shape

Graft

A piece of tissue or material placed in contact with tissue to repair a defect

Hemisection

Surgical separation of a multirooted tooth so that one root and/or the overlaying portion of the crown can be surgically removed

Immediate Denture

A denture constructed for placement immediately after removal of all remaining teeth.

Impacted

An unerupted or partially erupted tooth that is positioned against another tooth, bone or soft tissue so that complete eruption is unlikely

Implant

A device specially designed to be placed surgically within or on the jaw bone as a means of replacing teeth.

Incentive Program

Dental plan where benefits start at a given percentage and the percentage increases each year if the patient visits the dentist annually for preventive treatment. However, if the patient fails to go to the dentist each year the percentage drops back to where it started.

Incisors

The central and lateral incisors are the first and second teeth from the center of the mouth to the back of the mouth. These are the front teeth with flat edges for biting.

Inlay

A laboratory processed restoration made of metal, acrylic or porcelain. This filling does not involve the high points of the tooth (cusps).

Interproximal

Between the adjoining surfaces of adjacent teeth.

Malar

Pertaining to the cheek bone

Malignant

Having the abnormal properties of dysplasia, invasion and metastasis.

Malocclusion

Improper alignment of biting or chewing surfaces of the upper and lower teeth.

Mandible

Lower jaw

Maxilla

Upper jaw

Mesial

Toward the front of a tooth or the dental arch (towards the midline).

Molar

Posterior tooth used for grinding; behind the premolars (bicuspids) on either side of the jaw, having a large crown and a broad chewing surface.

Mucous Membrane

The lining of the oral cavity; also called mucosa.

Nightguard

Removable acrylic appliance to minimize the effects of grinding (bruxism) or joint problems (T.M.J.). Usually worn at night to prevent grinding or relieve joint pain. Also known as an occlusal guard.

Obturator

A prosthesis that closes an opening in the palate.

Occlusion

Any contact between biting or chewing surfaces of the upper and lower teeth.

Onlay

A laboratory processed restoration made of metal, porcelain or acrylic that replaces one or more of the highest points of the tooth (cusps).

Operculectomy

Removal of the operculum.

Operculum

The flap of tissue over an uneruped or partially eruped tooth.

Oral Surgeon

A dental specialist whose practice is limited to diagnosing and treating diseases, injuries, deformities and defects of the mouth.

Orthodontist

A dental specialist whose practice is limited to preventing and treating malocclusion of the teeth.

Orthognathic

The functional relationship between the maxilla and the mandible.

Overdenture

A prosthetic device that is supported by retained roots or implants.

Palate

The hard and soft tissues forming the roof of the mouth that separates the oral and nasal cavities.

Pallative

Treatment that temporarily relieves pain but is not curative.

Panorex

An x-ray taken outside of the mouth that shows all the teeth on one film.

Partial Denture

A prosthetic device that replaces the missing teeth with a framework that can be removed by the patient.

Pediatric Dentist

A dental specialist whose practice is limited to treating children; formerly known as a pedodontist.

Pedontics (PEDO):

The treatment of children’s teeth.

Periapical

The area surrounding the end of the tooth root.

Pericoronal

Around the crown of a tooth.

Perio Charting

Measures the depth that the gums have detached from the side of the tooth.

Periodontal Maintenance

Cleaning of the teeth following periodontal treatment, includes perio charting.

Periodontics (PERIO)

The treatment of diseases of the gum or bone (supporting structures).

Periodontist

A dental specialist whose practice is limited to the treatment of diseases of the supporting and surrounding tissues of the teeth.

Periodontitis

Inflammation and loss of the connective tissue of the supporting or surrounding structures of teeth.

Perio Pocket

Measures the depth that the gums have detached from the side of the tooth.

Permanent First & Second Molars

The adult first and second molars, are the sixth and seventh teeth from the center of the mouth to the back of the mouth.

Permanent Molars

The adult first, second and third molars.

Plaque

A soft sticky substance that accumulates on teeth composed largely of bacteria.

Pontic

The term used for the artificial tooth on a fixed bridge.

Post

An elongated metallic projection cemented within the prepared root canal, serving to strengthen and retain restorative material and/or a crown restoration.

Postier

Refers to teeth and tissues toward the back of the mouth, (premolars, bicuspids and molars).

Precision Attachment

An interlocking device integrated into a fixed or removable prosthesis to help keep the prosthesis in place.

Predetermination

A process used to determine the benefits available for dental services that are planned by the dentist: an estimate of the amounts payable by the plan if services are rendered when the patient is eligible.

Preventive

A procedure performed to prevent decay and gum disease. The procedures that are classified as preventive include prophylaxes, flouride treatment and the placement of sealants

Primary Teeth

The baby teeth. Also known as the primary dentition or first set of teeth to erupt.

Prophylaxis

A polishing procedure performed to remove coronal plaque, calculus and stains; often referred to as a cleaning

Prosthesis

An artificial replacement of any part of the body; dental prosthesis is any device or appliance replacing one or more missing teeth.

Prosthetic

A fixed or removable appliance to replace missing teeth, such as a bridge, partial denture or full denture.

Prosthetic Replacement

The replacement of an existing bridge, partial or full denture

Prosthodontics

Dealing with the replacement of missing teeth with prosthetic devices.

Prosthodontist

A dental specialist whose practice is limited to the restoration of the natural teeth and/or the replacement of missing teeth.

Provisional

Temporary or interim solution.

Pulp

The blood vessels and nerve tissue that occupies the pulp cavity of a tooth.

Pulp Cavity

The space within a tooth, which contains the pulp.

Pulpitisis

Inflammation of the dental pulp.

Pulpotomy

Removal of a portion of the pulp.

Quadrant

One of the four equal sections into which the dental arches can be divided; begins at the midline of the arch and extends back to the last tooth (right and left sides of both arches).

Reline

Process of resurfacing the tissue side of a denture with new material.

Resin Filling

See Composite Filling.

Restorative

Procedures performed to restore missing or decayed teeth.

Retainer

Appliance to stabilize the teeth following orthodontic treatment.

Retrograde Filling

A method of sealing the root canal by filling it from the root apex.

Root

The anatomic portion of the tooth that is covered by cementum and is located in the socket of bone.

Root Canal

The chamber within the root of the tooth that contains the pulp.

Root Canal Therapy

Treating disease of and injuries to the pulp usually by removing the pulp from the canal of the tooth and replacing it with a filling material.

Root Planning

A procedure designed to remove calculus from the root surfaces of teeth

Scaling

The removal of plaque, calculus and stain from teeth.

Sealant

A clear application of acrylic placed over the biting surface of the tooth to prevent decay.

Secondary Plan

When a patient is insured by two plans, the plan that is billed second is the secondary plan. The order is detemined by guidelines established by the National Association of Insurance Commissioners.

Sialodochoplasty

A surgical procedure for the repair of a defect and/or restoration of a portion of a salivary gland duct.

Sialolithotomy

A surgical procedure by which a stone within a salivary gland or its duct is removed.

Splint

A device used to support, protect, or immobilize oral structures that have been loosened, replanted, fractured or traumatized.

Stomatitis

Inflammation of the membranes of the mouth

Suture

A stitch used to repair an incision or wound.

Tartar

See Calculus.

Temporomandibular Joint (TMJ)

The hinge between the lower jaw (mandible) and base of the skull (temporal bone).

Temporomandibular Joint Disfunction

Abnormal TMJ functioning also refers to symptoms arising in other areas secondary to the disfunction.

Torus

A bony elevation or outgrowth of bone.

Trismus

Limited ability to open the mouth, usually due to inflammation.

Unerupted

Tooth or teeth that have not penetrated into the mouth.

Veneer

A layer of tooth colored material attached to the surface.

Virgin Teeth

Teeth that have no decay or fillings.

Waiver of Deductible

When the deductible does not apply to certain procedures (usually diagnostic & preventive).

Wisdom Tooth

Third molar, or eighth tooth from the center of mouth to the back of the mouth. Wisdom teeth are often impacted (obstructed from erupting) and have to be extracted.