Communication LWBK367 C04 P79-98.Qxd 01/07/2009 01:00 AM Page 81 Aptara
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LWBK367_c04_p79-98.qxd 01/07/2009 01:00 AM Page 79 Aptara part TWO Communication LWBK367_c04_p79-98.qxd 01/07/2009 01:00 AM Page 81 Aptara chapter FOUR OUTLINE Purposes of Teeth Speech Mastication Esthetics Dental Parts of a Tooth Dentition Primary Dentition Terminology Mixed Dentition Permanent Dentition OBJECTIVES Arches After completing this chapter, you should be able to do the following: Quadrants • Spell and define key terms Anterior and Posterior Teeth Discuss the purposes of teeth • Types of Teeth • Identify and describe the parts and tissues of a tooth • Explain the differences between primary dentition and permanent dentition IncisorsIncisors Describe the dental arches and the dental quadrants Canines • Premolars List the four types of teeth and their surfaces • Molars • Name and describe the three tooth numbering systems • Discuss the dental chart and how it relates to the dental office administrator Tooth Numbering Systems Universal Numbering System Palmer Notation System KEY TERMS InternationalInternational NumberingNumbering • edentulous • exfoliated System • crown • wisdom teeth Tooth Surfaces clinical crown mixed dentition • • Dental Charting • root • permanent teeth • enamel • secondary teeth Chapter Summary • dentin • succedaneous • dentinoenamel junction • maxillary arch • dentinal tubules • mandibular arch • dentinal fibril • midsagittal plane • cementum • midline • cementoenamel junction • posterior • periodontal disease • anterior • pulp • diastema • apical foramen • Universal Numbering System • primary dentition • Palmer Notation System • deciduous dentition • International Numbering • resorbed System 81 LWBK367_c04_p79-98.qxd 01/07/2009 01:00 AM Page 82 Aptara 82 PART II Communication familiarity with dental terminology related to the function, form, and purposes of Ateeth is a necessity for dental administrative personnel to answer general questions posed by patients regarding teeth and they require. Dental administrative assistants are of- ten responsible for addressing patient concerns over the telephone and need to be able to answer general clinical questions confidently and correctly. Additionally, they must be able to read the patient’s clinical chart and understand the treatment completed for billing pur- poses. Errors made in billing as a result of an inaccurate reading of the treatment per- formed can lead to problems with insurance companies and patients and a loss in revenue for the dental practice. Thus, the study of teeth and their make-up, as well as the terminology used by dental professionals in relation to teeth, is discussed in this chapter. This chapter focuses on fun- damental terms common to all general and specialty dental practices. Specifically, terms related to the purposes of teeth, the parts and tissues of teeth, dentition, arches and quad- rants, types of teeth, tooth numbering systems, tooth surfaces, and dental charting are pre- sented here. Studying the terms presented in this chapter is much like learning a new lan- guage. For some of you, the dental profession is a new world and understanding the language of the profession may seem daunting. However, correctly using dental terminol- ogy is crucial in effectively carrying out your duties. PURPOSES OF TEETH Educating patients on the value of healthy, functioning teeth is partly the respon- sibility of the administrative assistant. Although the clinical staff are well trained in this regard, administrative assistants too should understand how a healthy smile contributes to one’s quality of life. Teeth serve many purposes throughout a per- son’s life, three of which we will discuss here: speech, mastication, and esthetics. Speech The role teeth play in the formation and development of speech can be easily identified in the person who is without front teeth and, as a result, has a lisp. Other oral struc- tures, such as the tongue and lips, also contribute to speech progress, but the teeth con- tribute directly to the formation of words in conjunction with these structures. Speech is produced by the force of air from the lungs, through the voice box (larynx), and together the palate, tounge, lips, and teeth shape the air into sounds or speech. When making the “b” sound, for example, the lips come together to make this sound. Some letters in the English language require that contact between the tongue and teeth are made to pronounce the sound correctly. A lack of teeth in the mouth creates difficulties in this area. The pronunciation of sounds, specifically consonants, such as s, z, x, d, n, l and th, requires tongue-to-tooth contact. An eden- tulous individual would be unable to make these sounds. Edentulous means to be without teeth. An individual can be partially edentulous, some teeth are missing, or in complete edentulism, all teeth are missing. Difficulties pronouncing speech sounds correctly can also result from malposi- tioned teeth in the mouth, a widening tongue caused by edentulism, and problems with the position of the upper jaw and lower jaw. Mastication Without teeth, the process of chewing, or mastication, of food would be impossible. Mastication breaks down food and is the first step in the process of digestion. The LWBK367_c04_p79-98.qxd 01/07/2009 01:00 AM Page 83 Aptara CHAPTER 4 Dental Terminology 83 four different types of teeth found in the mouth assist in the act of mastication, through tearing, grinding, gnashing, and cutting. Later in this chapter, we will dis- cuss the different types of teeth and their role in the process of mastication. Esthetics One of the first things we notice about other people is their smile. A smile, whether checkPOINT bright and healthy-looking or not, can affect a person’s sense of well-being and self- confidence. The condition of teeth and the lack of teeth that one has can affect self- 1. What are the three esteem. Ideally, teeth should be healthy, fully functioning, clean in appearance, with purposes of teeth? minimal space between them, and of an appropriate size for one’s facial features. PARTS OF A TOOTH A tooth is made up of many parts and tissues. The two main parts of a tooth are the crown and the root. The crown is the part of the tooth that is above the gumline un- less the tooth is impacted or unerupted. The crown of each tooth varies in size, de- pending on the location of the tooth in the mouth and its purpose. The surface of the crown, the part that is visible and accessible during routine dental examination, is referred to more specifically as the clinical crown. The anatomical crown is the part of the tooth that is covered by enamel. The root of the tooth is the portion that is not normally visible and that lies below the gumline in the mouth. Teeth gener- ally have one to three roots, depending on the type of tooth. For example, a molar has two or three roots, whereas an incisor will have only one. Figure 4-1 shows the parts of two types of teeth found in the human mouth. Tissues of the tooth include enamel, dentin, cementum, and pulp. Pulp is found in the center of the tooth and contains its blood supply and nerves. The enamel, dentin, and cementum are layers that surround the pulp of the tooth. These tissues, which make up all teeth, are illustrated in Figure 4-1. Use this diagram as a refer- ence as you read the description of each tissue below. Crown Enamel Enamel Crown Dentin Dentin Neck Pulp cavity Neck Pulp cavity Cement Cement Root Root canal Root Root canal Apical foramen Apical foramen (root foramen) (A) (B) FIGURE 4-1 Anatomy and tissues of the tooth. Reprinted with permission from Moore KL, Dalley AF. Clinical oriented anatomy. 4th ed. Baltimore, MD: Lippincott Williams & Wilkins, 1999. LWBK367_c04_p79-98.qxd 01/07/2009 01:00 AM Page 84 Aptara 84 PART II Communication Enamel is the hard, outer tissue that covers the crown of the tooth. Enamel is made up of mostly calcified inorganic matter, such as calcium hydroxyapatite, and a small amount of organic matter, such as enamel matrix, as well as water. Enamel is the hardest material in the body. Given the amount of chewing, crushing, and grinding of food that that is required of teeth, enamel must withstand great force. The combination of the strength of enamel and softness of the dentin underneath it, as well as the cushioning support of the gums, provides the support for teeth to en- dure such force. However, as strong as it is, enamel is also brittle and can still chip or break and theoretically is incapable of self-repair. If you look at your teeth and those of others, you will notice that the color or shade varies. That is, some people have whiter teeth, whereas others have yellow or gray shades to their teeth. The variations in shades are actually a result of the de- gree of translucency of the enamel. Underneath the enamel in teeth is a layer of a material called dentin. The translucent properties of enamel allow light to pass through which actually reveals the color of the dentin beneath the enamel. The com- bination of enamel and dentin affect the overall color of teeth. There are, however, other contributing factors to tooth coloring, such as disease, antibiotic use, drug use, and external staining caused by certain foods and liquids such as tea, coffee, red wine, or blueberries and tomato sauce. Other factors include cigarette smoking, de- cay, restoration on the teeth, and color variations in dentin. Furthermore, as a per- son gets older, teeth tend to reveal changes in color, which is a result of an increase in the translucency of the enamel. Dentin comprises a large part of the tooth and is the main tissue surrounding the pulp. Most commonly it is yellow material that lies below the enamel and cementum and gives teeth their bulk.