Glossary – The Dentalaw Group

Bacterial plaque: Bacterial plaque is a sticky, almost invisible film which forms on teeth. Plaque is a growing colony of living bacteria. It also contains food debris, saliva and a little bit of all of the chemicals which pass through the mouth. The bacteria of plaque produce toxins or poisons which inflame the gums. This inflammation is the start of periodontal disease. If plaque is not removed daily and properly, it becomes calculus or tartar. This is a hard crust with a rough surface which can only be removed by a dental professional. No toothbrush, dental floss or other home dental device can ever remove calculus or tartar!! If not removed timely, periodontal disease is certain to follow.

Calculus or Tartar: Calculus or tartar is the rough surfaced, hard concretion which develops on teeth which have not had the daily accumulation of bacterial plaque completely removed.

Gingivitis: Gingivitis is the earliest stage of periodontal disease characterized by inflamed, swollen, red, painful or bleeding gums. Often there is no swelling or redness or pain or bleeding; a careful examination by a dentist should result in the detection of gingivitis and the resulting simple treatments.

Orthognathic Surgery: Orthognathic surgery is the surgical correction of congenital, developmental or acquired defects in the way the upper and lower jaws relate to one another and to the cranial base. It corrects facial disharmonies such as “long-face syndrome,” protruding or receding lower jaws or chins, protruding or receding upper jaws, open bites, and severe malocclusion not amenable to conventional and more conservative orthodontic treatment. Orthognathic surgery is performed by dental specialists, called oral and maxillofacial surgeons. Because the surgery is always major surgery and often life-endangering surgery, there are many lawsuits filed each year against oral surgeons for claims of negligence. Oral surgeons are highly skilled and often have to defend themselves in lawsuits because of surgical results which don’t meet unrealistic patient expectations.

Osteoradionecrosis: Osteoradionecrosis is the death of previously radiated bone. Patients who have had radiation treatment to their jaws for cancer become predisposed to this condition. Radiation causes bone to become less cellular, less vascular and have less oxygen. This results in a compromised ability of the bone to heal after a traumatic event. Because radiation also destroys salivary glands and dental decay is more likely to occur in the absence of active salivary flow, a common traumatic event is the extraction of a tooth. Unfortunately, the otherwise innocent removal of a tooth from an irradiated jaw very often results in osteoradionecrosis (ORN) and the loss of the jaw! This dreaded complication is quite preventable and the failure of physicians and dentists to be cautious in treating radiated patients has resulted in great heartache for many patients. The highest dental malpractice verdict in the State of Florida, and the third highest dental malpractice verdict in the entire U.S.A., was an osteoradionecrosis case.

Periodontal Disease: Periodontal disease is the most common disease of man, found in every culture and society throughout the world’s history. It is a progressive inflammatory reaction of the gingiva (gums) and bone to bacterial plaque. It begins as an inflammation of the gingiva, a condition called gingivitis and is characterized by red, swollen, painful or bleeding gums. Gingivitis is often present without any of these signs or symptoms. If undetected and untreated, the inflammation progresses to early, then moderate, then advanced periodontal disease, called periodontitis. Periodontitis is sometimes called “pyorrhea.” Pyorrhea means “flow of pus.” More teeth are lost due to periodontal disease than all other causes combined, at all levels of society. Periodontitis is characterized by progressive destruction of the bone surrounding and holding teeth in their place, resulting in mobility of teeth; foul and fetid breath; teeth appearing to be getting longer (because the bone holding the tooth in place is being lost) and the presence of pus. Gingivitis and periodontitis are easily detectable by a competent dental hygienist and easily diagnosable by a competent dentist. Most importantly, gingivitis and periodontitis are preventable with proper personal oral hygiene supplemented by regular, periodic visits to a dentist for examination and prophylaxis, or cleaning. The term “prophylaxis” derives from “prophylactic,” meaning prevention. Gingivitis and periodontitis are treatable and the extent of the disease often determines the extent of the treatment required. Conservative treatment might include no more than curettage and root surface refinishing, a simple and relatively inexpensive treatment which can be performed by general or family dentists. Surgical treatment, usually performed by a dental specialist called a periodontist, can include bone recontouring, bone and gum grafting and new, very sophisticated treatment to encourage gingival tissue to grow back to their earlier and healthier level. The failure of a general dentist to detect, diagnose, treat or refer a patient for treatment of, periodontal disease may be negligent and such failures are often litigated in dental malpractice actions.

Periodontitis is the stage of periodontal disease, more advanced than gingivitis, characterized by bone loss, tooth mobility and destruction of the narrow band of tissue which attaches to the bone. “Perio” means ‘around’; “dontal” means ‘tooth’; “itis” always means ‘inflammation.’ Periodontitis is the inflammation of the tissues around the teeth.

Prophylaxis: Prophylaxis means protection from disease or a treatment to prevent disease. [Greek “pro-” before + “phýlaxis” protection = prophylàssein] In dental terms, a “prophy” is a dental cleaning designed to protect the patient and prevent periodontal disease and dental caries.