Dental Jargon
I recently went on a snowboarding trip up to Revelstoke, British Columbia with a couple of friends from the Flathead. This is a seven hour trip each way assuming the weather is good, which is a coin flip in the winter considering the last hour is Roger’s Pass in the Canadian Glacier National Park. There is no commercial flying option that would put us there any faster considering the closest airport is 2 hours from Revelstoke and it would require two flights and a rental car or shuttle to get there.
Either way, one of my travel companions is very good at time management and uses these seven hours to get a lot of work done. Work that is conducted out loud over the vehicle's audio system for all to hear. Not only was he our driver, but quite often during these calls he had a phone in each hand. It was more impressive than terrifying...barely. Said individual is in the world of finance so it’s a lot of jargon and acronyms. Honestly it’s very interesting to me even though it sounds like a different language. I pay close attention then ask him a bunch of questions when the call is over. And just like anyone passionate about their career he was happy to answer my questions.
As dentists, we were instructed in our dental training to limit the amount of dental jargon we use with our patients. Jargon just means terminology specific to your industry that the lay person might not understand. On occasion I will have the more inquisitive patient listen to me discuss treatment with my hygienist or assistant, then ask follow up questions. Like, “what does ‘distal-buccal class five’ mean.” Let’s answer this question for you, the reader.
Every tooth has 5 surfaces. We just made it through the holidays right? So I imagine a lot of amazon boxes being delivered to front porches. When you open your door and see that box you can physically see 5 of its 6 sides if you move around it. The top and the 4 sides. This is how we describe a tooth. These surfaces, like a lot of human anatomy, have names derived from their latin root words. Let’s go through them.
Distal
The term distal is defined as being away from the center of the body. When we refer to the mouth we tend to use the term “midline.” In a healthy mouth full of teeth the distal surface of a tooth is in contact with the tooth behind it. It is a surface that gets cleaned when we floss.
Mesial
Now that we know what distal means we can deduce that mesial means towards the center of the body, or midline. In that healthy mouth full of teeth the mesial surface is in contact with the distal surface of the tooth in front of it. It is the other surface that gets cleaned when we floss.
Lingual
This is the latin term for the tongue. So this describes the teeth surfaces that face the tongue. Right now, rub your tongue against the insides of your teeth. You are touching the lingual surfaces. These surfaces tend to experience the least amount of dental decay due to exposure to greater amounts of saliva which neutralizes acids.
Buccal/Facial
So now we are going to differentiate between the teeth in the back of our mouths and the teeth in the front. Also referred to as posterior and anterior teeth respectively. Posterior teeth are called molars and premolars. These teeth have a buccal surface. Buccal is latin for cheek so obviously this is the surface touching the cheek. Anterior teeth, our canines and incisors, do not touch our cheeks and their forward facing surfaces are called facial surfaces. They are touching our lips but for some reason we do not refer to them as labial surfaces...I wasn’t around when that decision was being made so I can’t tell you why.
Occlusal/Incisal
On to our last surface. This is the functional surface of our teeth. The surface that does all the work when it comes to chewing. This is the top of the box in my box analogy. The surface opposite the surface touching the porch. In the posterior this surface is called the occlusal surface and in the anterior we simply refer to this surface as the incisal surface. Occlusal surfaces grind food while incisal surfaces cut food. Incise is the latin term meaning “to cut.”
Can we answer my patient’s question at this point in my education? What was the question again? It was, “what does distal-buccal class five mean doc.” So we know what distal and buccal mean. So this person has a decaying dental lesion that is large enough to extend into both the buccal and distal surfaces, but what does class five mean?
To be honest, there are five classes of dental lesions and restorations (cavities and fillings for you, the lay person). But we don’t really use them in day to day practice other than class five. So without further adieu, class five means the decay/defect is found at, near, or below the level of the gums. So when I’m doing an exam and telling my hygienist, who is at the computer inputting my treatment plan, that the patient has DO on #13 She/He knows I mean a distal-occlusal on the upper left second premolar. This is a class two restoration but telling her that would be redundant because a DO on #13 can’t be any other class of filling.
So why do I , the dentist, need to specify if a lesion is class five or not? Simply because a buccal/facial or lingual defect can be at or near the gumline, or closer to the occlusal/incisal aspect. Not at or near the gums. Being a class five doesn’t change the cost, but it will help my dental assistant set up my operatory slightly differently as there are few tools that are needed for class five’s that aren’t needed otherwise.
We keep detailed records of all of our patients' fillings so we can know when they were placed, if they were done by myself or another dentist, and lastly, not to get dark, but I often joke with the patient who asks me about these latin terms and what they mean by informing them with a straight face that if we keep good records we will be able to identify their body if they’re otherwise non-recognizable. This has never happened by the way and I hope it never does so be careful out there y’all...head on a swivel alright.
Alright so let me wrap up this tooth surface talk. Healthy teeth don’t hurt. Enamel doesn’t have nerves. The tissue under the enamel does communicate with our nervous system. So if a tooth is starting to be sensitive to cold the enamel is getting thin somewhere. If you notice a tooth being sensitive to sweets it's likely that you have a cavity that has gotten all the way through your enamel. The point I want to drive home is as soon as you notice this, get a dental check-up. What you want is to catch these problems early enough that fixing them includes the least number of tooth surfaces as possible.
This benefits you, the patient, in a lot of ways. One and two, it’s gonna be a cheaper and quicker dental visit. More surfaces = more dentist and assistant time required to repair = more $$. We can all agree we want the dental drill to be in our mouths the shortest amount of time possible, and we want the most amount of dollars to remain in our wallets and bank accounts as possible. Duh. Three, you’re going to experience the least amount of discomfort and avoid a potentially painful and expensive situation if the decay gets into the pulp (nerve) of the tooth.
A small one to three surface filling we discuss in terms of hundreds of dollars while a root canal and crown we start talking in the thousands of dollars. Nobody needs that in their life...keep those cavities small or better yet non-existent. And with all that money you’re going to save, take a ski trip with your friends to Revelstoke. It’s only seven hours away.
Happy New Year by the way!! Pray for Snow!!
Read Dental Jargon by Dr. John F. Miller, DDS, in 406 Woman magazine.