Test 1 Flashcards
parts of tooth assessment 5
dental charting, care planning, communication, legal documentation, forensic use
define dental charting
graphic representation of the condition of the patients teeth observed on a specific date
define care planning
using the collection of data to formulate comprehensive treatment plan
communication is enhanced by _____
accurate documentation
legal documentation
patient records are a legal document admissible in court of law
forensic uses
sometimes used for identification
what are the dentitions?
Primary dentition: 20 teeth total, including 8 incisors, 4 canines, and 8 molars
Permanent dentition: 32 teeth total, 8 including incisors, 4 canines, 8 premolars, and 12 molars
what are the tooth quadrants and associated tooth numbers
right maxillary quadrant: 1-8
left maxillary quadrant: 9-16
right mandibular quadrant: 25-32
left mandibular quadrant: 17-24
anterior teeth vs posterior teeth
- Anterior teeth go from canine to canine
- maxillary anterior: 6-11
- mandibular anterior: 22-27
- posterior teeth go from premolar to molar
- maxillary posterior (right): 1-5
- maxillary posterior (left): 12-16
- mandibular posterior (right): 28-32
what is the tooth designation system for primary/deciduous teeth vs permanent
primary uses letters (A-T)
permanent uses numbers (1-32)
what are the biting surfaces of teeth
anterior teeth (canine to canine): incisal surface
posterior teeth (premolar/molars): occlusal surface
crowns of all teeth have how many surfaces?
5
based on the textbook, what are the 5 surfaces of the teeth
- facial: labial or buccal
- lingual/palatal
- masticatory: occlusal or incisal
- mesial
- distal
facial surfaces can be __ or ____
buccal or labial
define buccal surface
surfaces of premolars and molars that face the cheek
define labial surface
surfaces of incisors and canines that face the lip
palatal surface
towards the palate, used for maxillary teeth (roof of the mouth)
lingual surface
The surface of the tooth toward the tongue. Used for mandibular teeth (bottom of mouth)
what are the proximal surfaces
- mesial: toward the midline
- distal: away from the midline
what are the 3 dentition periods
primary dentition: 6 months to 6 years
mixed dentition: 6yrs-12 yrs
permanent dentition: 12 years on
describe primary dentition (7)
- begins with the eruption of the mandibular central incisor
- ends with eruption of first permanent tooth
- 20 teeth total
- 5 per quadrant (2 incisors, 1 canine, 2 molars)
- calcification begins 4-5 months in fetal life to 3-4 years after birth
- eruption happens in pairs
- jaws are growing
describe mixed dentition
- begins with eruption of permanent mandibular molar
- ends with the loss of the last primary tooth
- both primary and permanent teeth in oral cavity
- jaws are growing (fast)
- awkward stage
what stage are the jaws growing at the fastest rate
mixed dentition
practical application for mixed dentition
- tooth color changes
- halitosis
- size differences
- tooth brush selection
what are the components of permanent dentition 6
- begins with loss of last primary tooth
- ends with eruption of last permanent tooth
- 32 total
- 16 in each arch
- begins to calcify after birth until 25 years of age
- jaw growth slows down and eventually stops
describe incisors 3
- four in each arch, 8 total
- designed to bite and cut
- lingual fossa shaped as a shovel
describe canines (6)
- 2 in each arch, 4 total
- for holding, grasping, piercing, tearing
- longest teeth in the mouth from root to crown
- cornerstone of the mouth
- major influence on ones facial appearance
- have one cusp (stated in textbook)
which teeth are the best anchored
canines
describe premolars (5)
- 4 in each arch, 8 total
- AKA bicuspids (usually have 2 cusps)
- has occlusal edges
- grind food and assist canines in tearing
- only found in permanent dentition
T/F premolars are found in primary dentition
FALSE
describe molars (7)
- 6 in each arch, 12 total
- largest and strongest teeth
- have 4 or more cusps
- grind food
- have occlusal edges
- posteriorly located
- jaw exerts strongest forces onto these teeth
T/F molars look similar to each other
FALSE
describe enamel 4
- covers the crown
- thickest over the crown, gets thinner toward the cervical line
- color: varies with thickness and mineralization, white=thick, yellow=thin
- composition: 96% inorganic matter, 3% water, 1% organic matter
describe dentin (6)
- largest portion of the tooth
- covered by enamel on the crown and cementum on the root
- hard, dense, calcified tissue
- softer than enamel, harder than cementum & bone
- yellow in color, elastic in nature
- Composition: 70% inorganic, 30% organic matter and water
describe the types of dentin (3)
primary dentin: formed before the apex of the tooth is completed
secondary dentin: formed after completion of the apex and will form for the life of the tooth
reparative dentin: laid down in response to caries or trauma
list the components of a tooth from deep to superficial
- pulp
- dentin
- cementum(root) /enamel (crown)
describe cementum 5
- covers the root
- could be voids that expose dentin
- main function is to anchor, attaches tooth to alveolar bone
- thinner at cervical line, thickens toward apex
- composition: 65% inorganic, 23% organic, 12% water
types of cementum
- acellular: covers entire anatomical root
- cellular: presents on apical 3rd of root, can reproduce itself
describe pulp 4
- nourishing
- sensory
- repairs dentin
- main function is to lay down dentin
what is the cementoenamel junction
external line at the neck/cervix of the tooth. separates the enamel of the anatomic crown form the cementum of the anatomic root.
what is the dentinoenamel junction
inner surface of the enamel that meets the dentin.
what is the dentinocemental junction
part where outer line of dentin and inner line of cementum meet.
what is the difference between the anatomic and clinical crown of the tooth
anatomic crown: the actual crown of the tooth that is covered by enamel, remains mostly constant throughout life of tooth, except for presence of attrition and physical wear
clinical crown: the part that you can SEE, above the gingiva, height is determined by the location of the marginal gingiva, can change over time due to recession
when we talk about the crown which are we referring to
anatomical crown
difference between anatomic and clinical root
anatomic: part that is covered by cementum
clinical: part of the root that is visible, can change over time via gingival recession
define eruption
exfoliation
resporation
eruption: moving of a tooth through it’s surrounding tissue (when a tooth pierces the gum)
exfoliation: when you lose a tooth and the roots of the primary teeth are resorbed
resorption: removal of hard tissue/bone
T/F the height of the CEJ curvature is lesser than the mesial side of the tooth than the distal
FALSE, the curvature is GREATER on the mesial side
what is the contact area
interproximal space
part where two adjacent teeth physically touch
gap/space between two teeth
posterior teeth have how many line angles per tooth, name them
8
mesiobuccal, distobuccal, mesiolingual, distolingual, mesio-occlusal, disto-occlusal, bucco-occlusal, and linguo-occlusal
anterior teeth have how many line angles per tooth
6
mesiolabial, distolabial, mesiolingual, distolingual, labioincisal, and linguoincisal
describe roots of the teeth 4
- widest at the CEJ and caper towards the apex
- have indentations or root concavities
- teeth can be single rooted or multiple-rooted with bifurcation or trifurcation
- anchored in the alveolar process (alveolus)
define furcation
dividing point of roots of multirooted tooth
bifurcation - tooth with 2 roots
trifurcation- tooth with 3 roots
succedaneous
nonsuccedaneous
permanent teeth with primary predecessors; premolars, canines, incisors
teeth that do not succeed or replace primary teeth; permanent molars
impaction
unerupted or partially erupted tooth that is positioned against another tooth, bone, or even soft tissue so that complete eruption becomes impossible
edentulous
partially edentulous
anodontia
complete loss of teeth
person is missing most of their teeth, not all
absence of a single tooth or multiple teeth due to lack of initiation; was born without it
what is the purpose of knowing head and neck anatomy? 6
- distinguish normal from abnormal
- examination procedures (diagnosis)
- documentation purposes
- radiology procedures
- administration of local anesthesia
- knowing dental infections
t/f variation from normal should be documented
true, use visualization and palpation
why to know head and neck anatomy (anatomical considerations) for radiology purposes
- treatment planning
- consistency
- film placement: need to know surface anatomy for placement guides at ala tragus and facial midlines
what is wong bakers faces pain rating scale
0 - no hurt
2 - hurts a little
4 - hurts little more
6 - hurts even more
8 - hurts whole lot
10 - hurts worse
what are the functions of the oral cavity 7
- portal entry to body
- aides in digestion and speaking
- imaging
- provides diagnostics
- early warning system
- mucosa acts as a barrier
- self esteem
what is the Surgeon General’s Report on oral health about
“many systemic dieases and conditions have oral manisfestations.”
told healthcare workers and the public ^
teeth grinding can cause:
the enamel to wears down, dentin shows through
what does lack of hard tissue/enamel (superficial covering) tell us
- signs and symptoms of disease
- lifestyle behaviors: smoking/drugs/teeth grinding
- nutritional status
when do we see erosion of teeth?
often seen in patients with EDs like bulimia (chronic vomiting/exposure to stomach acids)
what is anatomical nomenclature
based on the body being in anatomical position; body is erect, arms at the sides, palms and toes facing forward, eyes looking forward
define anterior
posterior
superior
inferior
apex
A- toward the belly (on humans)
P- toward the back (on humans)
S- toward the head
I- toward the feet
apex: the tip of a conical structure
how do we label the tongue surfaces
- like an animal
- top of the tongue is the dorsal side
- bottom of the tongue is the ventral side
- tip of the tongue is the apex
midsagittal/median plane
sagittal plane
coronal/frontal plane
transverse/axial plane
- divides body into equal left and right halves
- divides body parallel to midsagittal plane
- divides body into anterior and posterior parts
- divides body horizontally into superior and inferior parts
which plane is always perpendicular to the midsagittal plane
transverse/axial plane
medial
lateral
proximal
distal
- closest to midline
- farther from midline
- close to the point of origin
- further from the point of origin
ipsilateral
contralateral
superficial
deep
internal
external
- same side of the body
- opposite sides of the body
- closer to the surface
- inward in the body
- inside of a hollow structure
- outside of a hollow structure
the number of bones in the head and neck is usually ____ but specific details can ____
constant; vary
what needs to be noted; variations in individuals or changes
changes, variations are normal
what are the regions of the head (surface anatomy) 12
- frontal
- parietal
- occipital
- temporal
- auricular
- orbital
- nasal
- infraorbital
- zygomatic
- buccal
- oral
- mental
surface anatomy - what does the frontal region consist of? 3
- supraorbital ridge > pain scale visible
- glabella > pain scale visible
- frontal prominence (skin) > broader in males
- don’t get confused with frontal eminence; bony structure in the same area
describe the surface anatomy of the parietal and occipital region
- both covered by the scalp and defined by the deeper skull bones
- important to palpate during extraoral exams because lesions may be covered by hair
describe the surface anatomy of the auricular region
7
auricle: oval flap of the ear, collects sound waves
external acoustic meatus: tube through which sound waves are transmitted
helix: superior and posterior free margin of auricle
lobule: fleshy protuberance of earlobe, inferior part
tragus: anterior to external acoustic meatus
antitragus: flap of tissue opposite of the tragus
intertragic notch: between tragus and antitragus
surface anatomy of the nasal/mental/oral region
root of nose: inferior to glabella
nasal septum: separates the nares by the midline septum; formed by various skull bones and the adjoining nasal septal cartilage
ala: outer nostril/flare
apex: tip of nose
naris: nostrils/hole
nasion: inferior to glabella, where the frontal bone meets the nasal bone
nasolabial sulcus: smile lines
labiomental groove: line between chin and lower lip
oral region consists of 6
lips, oral cavity, palate, tongue, floor of the mouth, and parts of the throat (or pharynx).
parts of the oral region 8
- philtrum = superior to the midline of the upper lip, extending inferiorly from the nasal septum– a vertical groove on the skin (cupid’s bow).
- vermilion border = outlined from the surrounding skin
- upper lip
- tubercle = inferior to the philtrum, the midline of the upper lip terminates unto a thicker area
- labial commissure = where the upper and lower lips meet at each corner of the mouth– an important overall indicator of patient health.
- vermilion zone = darker reddish appearance than surrounding skin (surface of the lip)
- lower lip
- mucocutaneous junction: edge of lips and skin
parotid papilla
buccal mucosa
labial mucosa
maxillary/mandibular vestibules
alveolar mucosa
mucobuccal fold
- parotid papilla = inner part of the buccal mucosa, just opposite the maxillary second molar (covers parotid duct/gland). runs over facial nerve
- buccal mucosa = lines the inner cheek; continuous with labial mucosa; equally pink and thick.
- labial mucosa = lines the inner part of the lips; thick and pink
- maxillary/mandibular vestibule = the upper and lower horseshoe-shaped spaces in the open area of the oral cavity between the lips and cheeks anteriorly and laterally and the teeth and their soft tissue medially and posteriorly
- alveolar mucosa = red thinner mucosa superior to the maxillary arch
- mucobuccal fold = where the pink and thick labial or buccal mucosa meets the red thinner alveolar mucosa
mucogingival junction
- alveolar mucosa - red thinner mucosa superior to the maxillary arch and inferior to mandibular arch
- mucogingival junction = junction between alveolar mucosa and attached gingiva
- attached gingiva = gingiva that tightly adheres to the bone around the roots of the teeth
- The alveolar mucosa is continuous with the labial and buccal mucosa at the mucogingival junction.
structures of the hard palate 7
Maxilla: make up the anterior portion of the palate.
Palatine Bones: two L-shaped bones that contribute to the posterior part of the hard palate.
Median Palatine Suture: center of the hard palate where the two maxillary bones meet
median palatine raphe: median line of tissue superficial to the boney suture
Transverse Palatine Suture: runs horizontally, junction between the maxilla and the palatine bones
Palatine Rugae: ridges or folds that run laterally across the anterior part of the hard palate. Help with eating and assist in speech.
Incisive Papilla: rounded elevation located behind the upper front teeth. superficial to the incisive foramen.
Greater Palatine Foramina: These openings are located in the posterior part of the hard palate and allow the passage of the greater palatine nerves and blood vessels.
difference between hard and soft palate
- hard palate = bony whiter anterior arched palate
- soft palate = yellow, looser, and softer posterior part of the palate
body vs base of the tongue
2/3 of the tongue makes up the body and is free-moving
the base is the posterior 1/3 and is attached to the floor of the mouth
tongue surfaces
- dorsal surface = top surface that has a midline depression.
- ventral surface = underside with visibly large blue blood vessel branches of the deep lingual veins that are close to the surface on each side
lingual tonsils
palatine tonsils
foramen cecum
circumvallate lingual papillae
sulcus terminalis
median lingual sulcus
filiform lingual papillae
fungiform lingual papillae
foliate lingual papillae
- lingual tonsil = posteriorly on the dorsal surface on the tongue base
- palatine tonsil = tonsils between anterior and posterior faucial pillars (clients refer to as tonsils)
- foramen cecum = small pit-like depression; sulcus terminalis points backward toward this foramen and the pharynx
- circumvallate lingual papillae = approximately 10 to 14 in number, anterior side of the sulcus terminalis on the body; contain taste buds at their bases.
- sulcus terminalis = posteriorly on the dorsal surface; V-shaped groove; division that separates the base from the body of the tongue.
- median lingual sulcus = midline depression on the dorsal surface of tongue corresponding to deeper median septum.
- filiform lingual papillae = slender threadlike lingual papillae that give the dorsal surface a velvety, whitish texture and color; NO tase buds.
- fungiform lingual papillae = red mushroom-shaped dots; found in fewer numbers; contain tastebuds.
- foliate lingual papillae - vertical ridges on lateral surface, not well developed, appear as folds/ruffles, contain taste buds
ventral surface of the tongue:
deep lingual veins
plicae fimbriatae: hair like feature under tongue
sublingual caruncle: located at the base of the lingual frenum and anterior to each sublingual fold. contains the duct openings from both the submandibular and sublingual salivary glands
sublingual fold: lateral on each side of the lingual frenum, associated with underlying sublingual salivary glands, opening for the duct
lingual frenum: connect ventral side of tongue to floor of mouth, the string
describe the salivary glands in the mouth
submandibular: under the jaw, opens at sublingual caruncle
sublingual: under the tongue, opens at sublingual caruncle
parotid gland: in the cheeks, opens at the parotid papilla
maxillary tuberosity
retromolar pad
posterior to the most distal maxillary molar
posterior to the most distal mandibular molar
labial frenum
tissue connecting labial mucosa and alveolar mucosa on maxilla and mandible
marginal gingiva
gingival sulcus
interdental gingiva
not directly attached to the underlying bone and can be slightly mobile
space between the marginal gingiva and the tooth surface
gum tissue that fills the spaces between adjacent teeth
t/f the base of the tongue lies within the oral cavity
false, it lies within the oral part of the throat/pharynx
describe the floor of the mouth 3
- mucosal-covered space that extends from the lingual surface of the mandibular alveolar process inferiorly to the ventral surface of the tongue
- posteriorly it extends to the anterior tonsillar pillar
- left and right sides meet at the lingual frenum along the anterior midline
structures that are not always there but not abnormal:
torus: bony growths, that can be mandibular, maxillary, or palatal; bilateral/bilingual/unilateral/multilobular
Fordyce’s granules: small, painless, pale bumps that can appear on the mucous membranes of the oral cavity, particularly on the inner lips, cheeks, and sometimes on the gums.
pigmentation of gingiva: appears on people of color
cross-section of the oropharyngeal anatomy
- nasal cavity
- soft palate
- oral cavity
- nasopharynx = superior to the level of the soft palate and continuous with the nasal cavity (some visible during an intraoral exam)
- oropharynx = between the soft palate and opening of the larynx (visible during an intraoral exam).
- laryngopharynx = located more inferior, close to the laryngeal opening, and thus is not visible during an intraoral examination.
- epiglottis = a flap of cartilage behind the base of the tongue and infront of the oropharynx: At rest, is upright and allows air to pass through the larynx and into the rest of the respiratory system. During swallowing, it folds back to cover the entrance of the larynx, preventing food and liquids from entering the deeper-still trachea and then entering the lungs.
- larynx: anterior to the esophagus, for air
- esophagus: most inferior, for food and water
pharynx
muscular tube that serves both the respiratory and digestive systems
mental region of the face
- mental protuberance, prominence of chin
- labiomental groove, between lower lip and chin
- mid line depression “dimple” on some individuals
fauces
pterygomandibular fold
posterior faucial pillar
anterior faucial pillar
- fauces = opening of the oral region into the oropharynx, formed laterally on each side by folds of tissue created by anterior/posterior faucial pillars
- pterygomandibular fold = vertical fold of tissue, extends from the junction of the hard and soft palates to the medial side of the mandibular ramus, posterior to the most distal mandibular molar and retromolar pad (stretched when the patient widens the mouth).
- posterior faucial pillar: behind palatine tonsil
- anterior faucial pillar: in front of palatine tonsil
