GlossaryofDentalClinicalandAdministrativeTerms

Therearemanytermsuseddailybydentistsandtheirstaffinthecourseofdeliveringcaretopatients,maintaining
patientrecordsandpreparingclaims.Manytermsarefamiliar,especiallytoexperiencedindividuals.Newdentists
andstaff,however,maynotbeasfamiliarandovertimenewtermscomeintouseandoldtermsarerevisedfor
clarity.
TheADA'sCouncilonDentalBenefitProgramshasincludedaglossaryofdentalclinicalandadministrativeterms
ineacheditionoftheCDTmanual.AlthoughglossaryinformationintheprintedCDTManualservesalegitimate
purpose,theonlineversionoftheGlossaryhastheadvantageofbeingreadilyupdated.Thisonlineglossary
containstheCouncil'smostcurrentsetoftermsanddefinitions.ContentisbasedontheCDT20112012glossary,
withsomechanges(e.g.,definitionsofinlaysandonlays)thatcameaboutafterthemanualwasprinted.
TheCouncilintendstokeepthisglossarycurrent,andincludeitscontentsinthenextCDTmanual.Pleasecheck
thispageforthelatestinformation.Updateswillcontinueaslongasthetermsusedbydentistsandtheirstaff
continuetoexpandandevolve.
ContactInformation
Telephone:ADAMembers,pleaseusethetollfreenumberonthebackofyourmembershipcard
Directdial,312.440.2500
Email:dentalcode@ada.org
(Wordsandtermsinboldaredefinedwithinthisglossary.Clickalettertojumptothatsection.)
A|B|C|D|E|F|G|H|I|J|K|L|M |N|O|P|Q|R|S|T|U|V|W|X|Y|Z

A
absce ss:Acuteorchroniclocalizedinflammation,probablywithacollectionofpus,associatedwithtissue
destructionand,frequently,swellingusuallysecondarytoinfection.
acuteperiradicularoracuteapicalabscessAninflammatoryreactiontopulpalinfectionandnecrosis
characterizedbyrapidonset,spontaneouspain,tendernessofthetoothtopressure,pusformationandeventual
swellingofassociatedtissues.Mayalsobeknownasacuteperiapicalabscess,acutealveolarabscess,
dentoalveolarabscess,phoenixabscess,recrudescentabscess,secondaryapicalabscess.
chronicperiradicularorchronicperiapicalabscessAninflammatoryreactiontopulpalinfectionandnecrosis
characterizedbygradualonset,littleornodiscomfortandtheintermittentdischargeofpusthroughanassociated
sinustract.Mayalsobeknownaschronicalveolarabscess,chronicapicalabscess,chronicdentoalveolar
abscess,suppurativeapicalperiodontitis,suppurativeperiradiucularperiodontitis.
abutme nt:Atoothorimplantfixtureusedasasupportforaprosthesis.

abutme ntcrown:Artificialcrownalsoservingfortheretentionorsupportofadentalprosthesis.
acce ssion:Additionofatestspecimen,previouslycollectedbyahealthcareprovider,toalaboratoryspecimen
collectionrecordingofessentialspecimenidentificationdatainalaboratorymaintainedfileinchronologicalorder
oflaboratoryspecimenacquisitionassignmenttothespecimenofanidentificationcode.
acide tching:Useofanacidicchemicalsubstancetopreparethetoothenamelandordentinsurfacetoprovide
retentionforbonding.
adhe sion:Stateinwhichtwosurfacesareheldtogetherbychemicalorphysicalforcesorbothwithorwithoutthe
aidofanadhesive.Adhesionisoneaspectofbonding.
adhe siv e :Anysubstancethatjoinsorcreatescloseadherenceoftwoormoresurfaces.Intermediatematerialthat
causestwomaterialstoadheretoeachother.
adjunctiv e :Asecondarytreatmentinadditiontotheprimarytherapy.
administrativ e costs:Overheadexpensesincurredintheoperationofadentalbenefitprogram,exclusiveof
costsofdentalservicesprovided.
administrativ e se rv ice sonly(ASO):Anarrangementunderwhichathirdparty,forafee,processesclaimsand
handlespaperworkforaselffundedgroup.Thisfrequentlyincludesallinsurancecompanyservices(actuarial
services,underwriting,benefitdescription,etc.)exceptassumptionofrisk.
administrator:Onewhomanagesordirectsadentalbenefitprogramonbehalfoftheprogram'ssponsor.See
de ntalbe ne fitorganization:thirdpartyadministrator.
adultde ntition:Thepermanentteethofadulthoodthateitherreplacetheprimarydentitionoreruptdistallytothe
primarymolars.
adverseselection.Astatisticalconditionwithinagroupwhenthereisagreaterdemandfordentalservicesand/or
moreservicesnecessarythantheaverageexpectedforthatgroup.
alloge nic:Belongingtothesamespecies,butgeneticallydifferent.Seegraft.
alloplastic:Referstosyntheticmaterialoftenusedfortissueaugmentationorreplacement.
allowable charge :Themaximumdollaramountonwhichbenefitpaymentisbasedforeachdentalprocedureas
calculatedbythethirdpartypayer.
alloy:Compoundcombiningtwoormoreelementshavingpropertiesnotexistinginanyofthesingleconstituent
elements.Sometimesusedtorefertoamalgam.
alte rnate be ne fit:Aprovisioninadentalplancontractthatallowsthethirdpartypayertodeterminethebenefit
basedonanalternativeprocedurethatisgenerallylessexpensivethantheoneprovidedorproposed.
alte rnativ e be ne fitplan:Aplan,otherthanatraditional(feeforservice,freedomofchoice)indemnityorservice
corporationplan,forreimbursingaparticipatingdentistforprovidingtreatmenttoanenrolledpatientpopulation.

alte rnativ e de liv e rysyste m:Anarrangementfortheprovisionofdentalservicesinotherthanthetraditionalway

(e.g.,licenseddentistprovidingtreatmentinafeeforservicedentaloffice).
alv e olar:Referringtothebonetowhichatoothisattached.
alv e oloplasty:Surgicalprocedureforrecontouringsupportingbone,sometimesinpreparationforaprosthesis.
amalgam:Analloyusedindirectdentalrestorations.Typicallycomposedofmercury,silver,tinandcopperalong
withothermetallicelementsaddedtoimprovephysicalandmechanicalproperties.
analge sia:Seedefinitionunderane sthe sia.
anatomicalcrown:Thatportionoftoothnormallycoveredby,andincluding,enamel.
ancillary:Subordinateorauxiliarytosomethingorsomeoneelsesupplementary.
ane sthe sia:Apatient'slevelofconsciousnessisdeterminedbytheproviderandnottherouteofadministrationof
anesthesia.Statedentalboardsregulatetheuseofanesthesiatechniques.TheADAHouseofDelegatesadopted
andhaspublishedanesthesiapolicyandguidelines,whichareavailableonline.
PolicyStatement:TheUseofSedationandGeneralAnesthesiabyDentists(PDF)
GuidelinesfortheUseofSedationandGeneralAnesthesiabyDentists(PDF)
GuidelinesforteachingPainControlandSedationtoDentistsandDentalStudents(PDF)
Selectdefinitionsfromthepolicyandguidelinesfollow.Pleaserefertothecitedsourcesforcompleteandcurrent
information.
M e thodsofAnxie tyandPainControl
analge siathediminutionoreliminationofpain.
de e pse dationadruginduceddepressionofconsciousnessduringwhichpatientscannotbeeasilyarousedbut
respondpurposefullyfollowingrepeatedorpainfulstimulation.Theabilitytoindependentlymaintainventilatory
functionmaybeimpaired.Patientsmayrequireassistanceinmaintainingapatentairway,andspontaneous
ventilationmaybeinadequate.Cardiovascularfunctionisusuallymaintained.
ge ne ralane sthe siaadruginducedlossofconsciousnessduringwhichpatientsarenotarousable,evenby
painfulstimulation.Theabilitytoindependentlymaintainventilatoryfunctionisoftenimpaired.Patientsoften
requireassistanceinmaintainingapatentairway,andpositivepressureventilationmayberequiredbecauseof
depressedspontaneousventilationordruginduceddepressionofneuromuscularfunction.Cardiovascular
functionmaybeimpaired.
localane sthe siatheeliminationofsensation,especiallypain,inonepartofthebodybythetopicalapplicationor
regionalinjectionofadrug.
minimalse dationaminimallydepressedlevelofconsciousness,producedbyapharmacologicalmethod,that
retainsthepatient'sabilitytoindependentlyandcontinuouslymaintainanairwayandrespondnormallytotactile
stimulationandverbalcommand.Althoughcognitivefunctionandcoordinationmaybemodestlyimpaired,

ventilatoryandcardiovascularfunctionsareunaffected.
mode rate se dationadruginduceddepressionofconsciousnessduringwhichpatientsrespondpurposefullyto
verbalcommands,eitheraloneoraccompaniedbylighttactilestimulation.Nointerventionsarerequiredto
maintainapatentairway,andspontaneousventilationisadequate.Cardiovascularfunctionisusuallymaintained.
Route sofAdministration
e nte ralanytechniqueofadministrationinwhichtheagentisabsorbedthroughthegastrointestinal(GI)tractor
oralmucosa(i.e.,oral,rectal,sublingual).
inhalationatechniqueofadministrationinwhichagaseousorvolatileagentisintroducedintothelungsand
whoseprimaryeffectisduetoabsorptionthroughthegas/bloodinterface.
pare nte ralatechniqueofadministrationinwhichthedrugbypassesthegastrointestinal(GI)tract(i.e.,
intramuscular[IM],intravenous[IV],intranasal[IN],submucosal[SM],subcutaneous[SC],intraosseous[IO].)
transde rmalatechniqueofadministrationinwhichthedrugisadministeredbypatchoriontophoresisthrough
skin.
transmucosalatechniqueofadministrationinwhichthedrugisadministeredacrossmucosasuchasintranasal,
sublingualorrectal.
anomaly:deviationfromthenormalanatomicstructure,growth,developmentorfunctionanabnormality.
ANSI/ADA/ISO:Acronymsfororganizationsthatadministerordevelopnationalandinternationalstandards.ANSI
(AmericanNationalStandardsInstitute)isthenationalorganizationestablishedforthepurposeofaccreditingand
coordinatingproductstandardsdevelopmentactivitiesintheUnitedStates.ItisnotaUSgovernmentagency.The
ADA(AmericanDentalAssociation)isanationalstandardsdevelopmentorganizationaccreditedbyANSI.ISO
(InternationalOrganizationforStandardization)isaworldwidefederationofnationalstandardsbodies.Theresults
ofISOtechnicalworkarepublishedasInternationalStandards.EffortsintheUnitedStatesdirectedtowardthe
developmentofISOstandardsarechanneledthroughANSI.
ANSI/ADA/ISOToothNumbe ringSyste m:SeeSpe cificationNo.3950.
ante rior:Mandibularandmaxillarycentrals,lateralsandcuspids.Thedesignationofpermanentanteriorteethin
theUniv e rsal/Nationaltoothnumbe ringsyste mincludeteeth6through11(maxillary),and22through27
(mandibular)primaryteethintheUniversal/NationaltoothnumberingsystemaredesignatedCthroughH
(maxillary),andMthroughR(mandibular).Alsoreferstotheteethandtissueslocatedtowardsthefrontofthe
mouth.
anxiolysis:Thediminutionoreliminationofanxiety.
anywillingprov ide r:Legislationthatrequiresmanagedcareorganizations(MCOs),suchashealthmaintenance
organizations(HMOs)andpreferredproviderorganizations(PPOs)tocontractwithanyproviderswhoarewillingto
meetthetermsofthecontract.
ape x:Thetiporendoftherootendofthetooth.

ape xification:Theprocessofinducedrootdevelopmenttoencouragetheformationofacalcifiedbarrierina
toothwithimmaturerootformationoranopenapex.Mayinvolvetheplacementofanartificialapicalbarrierpriorto
nonsurgicalendodonticobturation.
ape xoge ne sis:Vitalpulptherapyperformedtoencouragecontinuedphysiologicalformationanddevelopmentof
thetoothroot.
apicoe ctomy:Amputationoftheapexofatooth.
appe al:Aformalrequestthataninsurerreviewdeniedorunpaidclaimsforservicesorsuppliesprovided.An
appealcanbefiledbyahealthcareproviderorapatientinanattempttorecoverreimbursementfromathirdparty
payersuchasaprivateinsurancecompany.
arch,de ntal:Thecurvedcompositestructureofthenaturaldentitionandtheresidualridge,ortheremains
thereof,afterthelossofsomeorallofthenaturalteeth.
are asoforalcav ity:Atwodigitnumericsystemusedtoreportregionsoftheoralcavitytothirdpartypayers.
00entireoralcavity
01maxillaryarch
02mandibulararch
10upperrightquadrant
20upperleftquadrant
30lowerleftquadrant
40lowerrightquadrant
arthrogram:AdiagnosticXraytechniqueusedtoviewbonestructuresfollowinginjectionofacontrastmedium
intoajoint.
artificialcrown:Restorationcoveringorreplacingthemajorpart,orthewholeoftheclinicalcrownofatooth,or
implant.
assignme ntofbe ne fits:Aprocedurewherebyabeneficiary/patientauthorizestheadministratoroftheprogram
toforwardpaymentforacoveredproceduredirectlytothetreatingdentist.
atte ndingde ntist'sstate me nt:AnobsoletetermfortheADADentalClaimForm.Seeclaimform.
audit:Anexaminationofrecordsoraccountstochecktheiraccuracy.Aposttreatmentrecordrevieworclinical
examinationtoverifyinformationreportedonclaims.
autoge nous:Seegraft.
av ulsion:Separationoftoothfromitssocketduetotrauma.Seee v ulsion.

badfaithinsurance practice s:Thefailuretodealwithabeneficiaryofadentalbenefitplanfairlyandingood

faithoranactivitywhichimpairstherightofthebeneficiarytoreceivetheappropriatebenefitofadentalbenefits
planortoreceivetheminatimelymanner.Someexamplesofpotentialbadfaithinsurancepracticesinclude:
evaluatingclaimsbasedonstandardswhicharesignificantlyatvariancewiththestandardsofthecommunity
failuretoproperlyinvestigateaclaimforcareandunreasonablyandpurposelydelayingand/orwithholding
paymentofaclaim.Seepromptpayme ntlaws.
balance billing:Billingapatientforthedifferencebetweenthedentist'sactualchargeandtheamountreimbursed
underthepatient'sdentalbenefitplan.
barrie rme mbrane :Usuallyathin,sheetlikeusuallynonautoge nousmaterialusedinvarioussurgical
regenerativeprocedures.
be hav iormanage me nt:Techniquesortherapiesusedtoalterorcontroltheactionsofapatientwhoisreceiving
dentaltreatment.Examplesincludeuseofapapoose board,educationoranxietyrelieftechniques.
be ne ficiary:Apersonwhoiseligibleforbenefitsunderadentalbenefitcontract.Seealsocov e re dpe rson,
insure d,andme mbe r.
be ne fit:Theamountpayablebyathirdpartytowardthecostofvariouscovereddentalservicesorthedental
serviceorprocedurecoveredbytheplan.
be ne fitbookle t:Abookletorpamphletprovidedtothesubscriberthatcontainsageneralexplanationofthe
benefitsandrelatedprovisionsofthedentalbenefitprogram.AlsoknownasaSummaryPlanDe scription.
be ne fitplansummary:ThedescriptionorsynopsisofemployeebenefitsasrequiredbyERISAthatistobe
distributedtotheemployees.
be nign:Themildornonthreateningcharacterofanillnessorthenonmalignantcharacterofaneoplasm.
bicuspid:Apremolartoothatoothwithtwocusps.
bilate ral:Occurringon,orpertainingto,bothrightandleftsides.
biologicmate rials:Agentsthatalterwoundhealingorhosttumorinteraction.Suchmaterialscaninclude
cytokines,growthfactor,orvaccines,butdonotincludeanyactualhardorsofttissuegraftmaterial.Theseagents
areaddedtograftmaterialorusedalonetoeffectaccelerationofhealingorregenerationinhardandsofttissue
surgicalprocedures.Alsoknownasbiologicresponsemodifiers.
biopsy:Processofremovingtissueforhistologicevaluation.
birthdayrule :Whenadependentchild'sparentsbothhavedentalcoverage,thisrulestatesthattheprimary
program(theonewhichpaysfirst)istheonecoveringtheparentwhosemonthanddayofbirthfallsfirstinthe
calendaryear.Thebirthdayruleisthemostcommonrulefordeterminingprimaryv.secondarycoverage,butit
maybesupersededbyacourtordersuchasadivorceagreement.

bite wingradiograph:Interproximalradiographicviewofthecoronalportionofthetooth/teeth.Aformofdental
radiographthatmaybetakenwiththelongaxisoftheimageorientedeitherhorizontallyorvertically,thatreveals
approximatelythecoronalhalvesofthemaxillaryandmandibularteethandportionsoftheinterdentalalveolar
septaonthesameimage.
ble aching:Processoflighteningoftheteeth,usuallyusingachemicaloxidizingagentandsometimesinthe
presenceofheat.Removalofdeepseatedintrinsicoracquireddiscolorationsfromcrownsofvitalandnonvital
teeththroughtheuseofchemicals,sometimesincombinationwiththeapplicationofheatandlight.Bleachinghas
beenachievedthroughshortandlongtermapplicationsofpastesorsolutionscontainingvariousconcentrationsof
hydrogenperoxideandcarbamideperoxide.Normallyappliedexternallytoteethmaybeusedinternallyfor
endodonticallytreatedteeth.
bonding:Processbywhichtwoormorecomponentsaremadeintegralbymechanicaland/orchemicaladhesion
attheirinterface.
bounde dtoothspace :Seetoothbounde dspace .
bridge :Seefixe dpartialde nture .
bruxism:Theparafunctionalgrindingoftheteeth.
buccal:Pertainingtoortowardthecheek(asinthebuccalsurfaceofaposteriortooth).
bundlingofproce dure s:Thesystematiccombiningofdistinctdentalprocedurecodesbythirdpartypayersthat
resultsinareducedbenefitforthepatient/beneficiary.
byre port:Awrittendescriptionoftheserviceprovidedthatispreparedwhentheterm"byreport"isincludedina
procedurecodenomenclaturemayberequestedbyathirdpartypayertoprovideadditionalinformationforclaims
processing.

C
cafe te riaplan:Employeebenefitplaninwhichemployeesselecttheirmedicalinsurancecoverageandother
nontaxablefringebenefitsfromalistofoptionsprovidedbytheemployer.Cafeteriaplanparticipantsmayreceive
additional,taxablecashcompensationiftheyselectlessexpensivebenefits.
calculus:Harddepositofmineralizedsubstanceadheringtocrownsand/orrootsofteethorprostheticdevices.
canal:Arelativelynarrowtubularpassageorchannel.
rootcanalSpaceinsidetherootportionofatoothcontainingpulptissue.
mandibularcanalThepassagewhichtransmitsvesselsandnervesthroughthejawtobranchesthatdistributes
themtotheteeth.
cantile v e re xte nsion:Partofafixedprosthesisthatextendsbeyondtheabutmenttowhichitisattachedandhas
noadditionalsupport.

capitation:Acapitationprogramisoneinwhichadentistordentistscontractwiththeprograms'sponsoror
administratortoprovideallormostofthedentalservicescoveredundertheprogramtosubscribersinreturnfor
paymentonapercapitabasis.
carie s:Commonlyusedtermfortoothdecay.
cariousle sion:Acav itycausedbycaries.
carrie r:Seethirdparty.
case manage me nt:Themonitoringandcoordinationoftreatmentrenderedtopatientswithspecificdiagnosesor
requiringhighcostorextensiveservices.Mayincludecomplextreatmentplansordiscussionbetweenmultiple
practitioners.
Aprocessofidentifyingpatientswithspecialhealthcareneeds,developingahealthcarestrategythatmeetsthose
needs,andcoordinatingandmonitoringthecare,withtheultimategoalofachievingtheoptimumhealthcare
outcomeinanefficientandcosteffectivemanner.
cast:Seediagnosticcastorstudymode l.
cav ity:Missingtoothstructure.Acavitymaybeduetodecay,erosionorabrasion.Ifcausedbycariesalso
referredtoascariouslesion.
ce me ntbase :Materialusedunderafillingtoreplacelosttoothstructure.
ce me ntum:Hardconnectivetissuecoveringtheoutersurfaceofatoothroot.
Ce nte rsforM e dicare andM e dicaidSe rv ice s(CM S):Thefederalagencyresponsibleforadministeringthe
Medicare,Medicaid,State.Children'sHealthInsuranceProgram(SCHIP),HIPAA,andtheClinicalLaboratory
ImprovementAmendments(CLIA)programs.CMSispartoftheU.S.DepartmentofHealthandHumanServices.
ce phalome tricimage :Astandardized,extraoralprojectionutilizedinthescientificstudyofthemeasurementsof
thehead.
ce ramic:se e porce lain/ce ramic.
claim:Arequestforpaymentunderadentalbenefitplanastatementlistingservicesrendered,thedatesof
services,anditemizationofcosts.Thecompletedrequestservesasthebasisforpaymentofbenefits.
claimform:Aform,paperorelectronic,usedtoreportdentalprocedurestoathirdpartypayerinordertofilefor
benefitsunderadentalbenefitprogram.ThepaperclaimformwasdevelopedbytheAmericanDentalAssociation.
claimant:Personorauthorizedproviderwhofilesaclaimforbenefits.Patientorcertificateholderwhofilesaclaim
forbenefits.
claimspayme ntfraud:Theintentionalmanipulationoralterationoffactsorprocedurecodessubmittedbya
treatingdentistresultinginalowerpaymenttothebeneficiaryand/orthetreatingdentistthanwouldhavebeen
paidifthemanipulationhadnotoccurred.

claimsre portingfraud:Theintentionalmisrepresentationofmaterialfactsconcerningtreatmentprovidedand/or
chargesmade,inthatthismisrepresentationwouldcauseahigherpayment.
ClassificationofM e tals:Seeme tals,classificationof(source:ADACouncilonScientificAffairs).
cle ftpalate :Congenitaldeformityresultinginlackoffusionofthesoftand/orhardpalate,eitherpartialor
complete.
cle nching:Theclampingandpressingofthejawsandteethtogetherincentricocclusion,frequentlyassociated
withpsychologicalstressorphysicaleffort.
clinicalcrown:Thatportionofatoothnotcoveredbytissues.
close dpane l:Adentalinsurancebenefitplanwhichrequirestheeligiblepatientstoreceivetheirdentalcarefrom
aspecificdentistwhohascontractuallyagreedtotheterms,paymentsandbenefitsoftheplan.Usuallyonlya
limitednumberofdentistsinanareaareallowedtoparticipateinthesetypesofplans.
close dre duction:Thereapproximationofsegmentsofafracturedbonewithoutdirectvisualizationoftheboney
segments.
CM S:SeeCe nte rsforM e dicare andM e dicaidSe rv ice s.
COB:Seecoordinationofbe ne fits.
CodeonDentalProceduresandNomenclature(Code):Alistingofdentalprocedurecodesandtheirdescriptive
termspublishedbytheAmericanDentalAssociation(ADA)usedforrecordingdentalservicesonthepatient
recordaswellasforreportingdentalservicesandprocedurestodentalbenefitplans.TheCodeisprintedina
manualtitledCurre ntDe ntalTe rminology(CDT).
coinsurance :Aprovisionofadentalbenefitprogrambywhichthebeneficiarysharesinthecostofcovered
services,generallyonapercentagebasis.Thepercentageofacovereddentalexpensethatabeneficiarymust
pay(afterthedeductibleispaid).Atypicalcoinsurancearrangementisoneinwhichthethirdpartypays80%of
theallowedbenefitofthecovereddentalserviceandthebeneficiarypaystheremainderoftheamountduethe
dentist.Percentagesvaryandmayapplytotableofallowanceplansmaximumallowablebenefitplansanddirect
reimbursementprograms.
comple te de nture :Aprostheticfortheedentulousmaxillaryormandibulararch,replacingthefulldentition.
Usuallyincludessixanteriorteethandeightposteriorteeth.
comple te se rie s:Anentiresetofradiographs.Asetofintraoralradiographsusuallyconsistingof14to22
periapicalandposteriorbitewingimagesintendedtodisplaythecrownsandrootsofallteeth,periapicalareasand
alveolarbonecrest(source:FDA/ADAradiographicguidelines).
composite :Adentalrestorativematerialmadeupofdisparateorseparateparts(e.g.resinandquartzparticles).
compoundfracture :Breakinbonewhichisexposedtoexternalcontamination.
compre he nsiv e orale v aluation:Seee v aluation.

Consolidate dOmnibusBudge tRe conciliationAct(COBRA):Legislationrelativetomandatedbenefitsforall

typesofemployeebenefitplans.Themostsignificantaspectswithinthiscontextaretherequirementsforcontinued
coverageforemployeesand/ortheirdependentsfor18monthswhowouldotherwiselosecoverage(30monthsfor
dependentsintheeventoftheemployee'sdeath).
consultation:Inadentalsetting,adiagnosticserviceprovidedbyadentistwherethedentist,patient,orother
parties(e.g.,anotherdentist,physician,orlegalguardian)discussthepatient'sdentalneedsandproposed
treatmentmodalities.
contiguous:Adjacenttouching.
contract:Alegallyenforceableagreementbetweentwoormoreindividualsorentitiesthatconfersrightsand
dutiesontheparties.Commontypesofcontractsinclude:1)contractsbetweenadentalbenefitorganizationand
anindividualdentisttoprovidedentaltreatmenttomembersofanalternativebenefitplan.Thesecontractsdefine
thedentist'sdutiesbothtobeneficiariesofthedentalbenefitplanandthedentalbenefitorganization,andusually
definethemannerinwhichthedentistwillbereimbursedand2)contractsbetweenadentalbenefitorganization
andagroupplansponsor.Thesecontractstypicallydescribethebenefitsofthegroupplanandtheratestobe
chargedforthosebenefits.
contractde ntist:Anydentistwhohasacontractualagreementwithadentalbenefitorganizationtorendercareto
eligiblepersons.
contractfe e sche dule plan:Adentalbenefitplaninwhichparticipatingdentistsagreetoacceptalistofspecific
feesfordentaltreatmentprovided.
contractpractice :Adentalpracticeororganizationthathasacontractualarrangementwithaninsurerforthe
provisionofservicesunderaninsurancecontract.
contractte rm:Usuallya12monthsperiodoftimeforwhichacontractiswrittenandduringwhichagroup's
deductibles,maximumsandotherprovisionsapply.Thismayormaynotbethesameasacalendaryear.Also
knownasthebenefityear.
contributoryprogram:Adentalbenefitprograminwhichtheenrolleesharesinthemonthlypremiumofthe
programwiththeprogramsponsor(usuallytheemployer).Generallydonethroughpayrolldeduction.
coordinationofbe ne fits(COB):Amethodofintegratingbenefitspayableforthesamepatientundermorethan
oneplan.Benefitsfromallsourcesshouldnotexceed100%ofthetotalcharges.
copayme nt:Beneficiary'sshareofthedentist'sfeeafterthebenefitplanhaspaid.
coping:Athincoveringofthecoronalportionofthetoothusuallywithoutanatomicconformity.Custommadeor
prefabricatedthimbleshapedcoreorbaselayerdesignedtofitoveranaturaltoothpreparation,apostcore,or
implantabutmentsoastoactasasubstructureontowhichothercomponentscanbeaddedtogivefinalformtoa
restorationorprosthesis.Itcanbeusedasadefinitiverestorationoraspartofatransferprocedure.
core buildup:thereplacementofapartorallofthecrownofatoothwhosepurposeistoprovideabaseforthe
retentionofanindirectlyfabricatedcrown.

coronal:Referstothecrownofatooth.
cosme ticde ntistry:Thoseservicesprovidedbydentistssolelyforthepurposeofimprovingtheappearance
whenformandfunctionaresatisfactoryandnopathologicconditionsexist[source:ADApolicy"CosmeticDentistry
(1976:850)].
costcontainme nt:Featuresofadentalbenefitprogramoroftheadministrationoftheprogramdesignedto
reduceoreliminatecertainchargestotheplan.
costsharing:Theshareofhealthexpensesthatabeneficiarymustpay,includingthedeductibles,copayments,
coinsurance,andchargesovertheamountreimbursedbythedentalbenefitplan.
cov e rage :Benefitsavailabletoanindividualcoveredunderadentalbenefitplan.
cov e re dcharge s:Servicesandsupplieswhicharereimbursedinwholeorinpartundertheconditionsofthe
dentalbenefitplan,subjecttoallthetermsandconditionsoftheagreementorinsurancepolicy.Chargesare
subjecttoanycontractualagreements,exclusionsandlimitations.Anychargesnotcoveredbytheplanare
considerednoncov e re dcharge s.
cov e re dpe rson:Anindividualwhoiseligibleforbenefitsunderadentalbenefitprogram.
cov e re dse rv ice s:Servicesforwhichpaymentisprovidedunderthetermsofthedentalbenefitcontract.
cracke dtoothsyndrome :Acollectionofsymptomscharacterizedbytransientacutepainexperiencedwhen
chewing.
crown:Anartificialreplacementthatrestoresmissingtoothstructurebysurroundingtheremainingcoronaltooth
structure,orisplacedonadentalimplant.Itismadeofmetal,ceramicorpolymermaterialsoracombinationof
suchmaterials.Itisretainedbylutingcementormechanicalmeans.(AmericanCollegeofProsthodonticsThe
GlossaryofProsthodonticTerms).Seealsoabutme ntcrown,anatomicalcrown,clinicalcrown.
crownle ngthe ning:Asurgicalprocedureexposingmoretoothforrestorativepurposesbyapicallypositioningthe
gingivalmarginandremovingsupportingbone.
culture andse nsitiv ityte st:Clinicallaboratorytestwhichidentifiesamicroorganismandtheabilityofvarious
antibioticstocontrolthemicroorganism.
cure ttage :Scrapingandcleaningthewallsofarealorpotentialspace,suchasagingivalpocketorbone,to
removepathologicmaterial.
Curre ntDe ntalTe rminology(CDT):TheADAreferencemanualthatcontainstheCodeonDentalProcedures
andNomenclatureandotherinformationpertinenttopatientrecordkeepingandclaimpreparationbyadental
officepublishedbiennially(e.g.,CDT20092010).
Curre ntProce duralTe rminology(CPT):Alistingofdescriptivetermsandidentifyingcodesdevelopedbythe
AmericanMedicalAssociation(AMA)forreportingpractitionerservicesandprocedurestomedicalplansand
Medicare.

cusp:Pointedorroundedeminenceonornearthemasticatingsurfaceofatooth.
cuspid:Singlecuspedtoothlocatedbetweentheincisorsandbicuspids.
cyst:Pathologicalcavity,usuallylinedwithepithelium,containingfluidorsoftmatter.
odontogeniccystCystderivedfromtheepitheliumofodontogenictissue(developmental,primordial).
periapicalcystAnapicalinflammatorycystcontainingasaclikeepitheliumlinedcavitythatisopentoand
continuouswiththerootcanal.
cytology:Thestudyofcells,includingtheiranatomy,chemistry,physiologyandpathology.

D
de bride me nt:Removalofsubgingivaland/orsupragingivalplaqueandcalculuswhichobstructstheabilityto
performanevaluation.
de cay:Thelaytermforcariouslesionsinatoothdecompositionoftoothstructure.
de ciduous:Havingthepropertyoffallingofforsheddingatermusedtodescribetheprimaryteeth.
de ductible :Theamountofdentalexpenseforwhichthebeneficiaryisresponsiblebeforeathirdpartywillassume
anyliabilityforpaymentofbenefits.Deductiblemaybeanannualoronetimecharge,andmayvaryinamount
fromprogramtoprogram.Seefamilyde ductible .
de e pse dation:Seedefinitionunderane sthe sia.
de ntalasse ssme nt:Alimitedclinicalinspectionthatisperformedtoidentifypossiblesignsoforalorsystemic
disease,malformation,orinjury,andthepotentialneedforreferralfordiagnosisandtreatment.
de ntalbe ne fitorganization:Anyorganizationofferingadentalbenefitplan.Alsoknownasdentalplan
organization.
de ntalbe ne fitprogram:Thespecificdentalbenefitplanbeingofferedtoenrolleesbythesponsor.
de ntale nrollme ntcre de ntialing:Aformalprocessthatdefinesthestandardsandrequirementsforparticipation
inthirdpartyprograms.Theprocessverifiesprofessionalqualificationsinordertoallowlicenseddentiststo
provideservicestomembersoftheseprograms.
de ntalhome :TheongoingrelationshipbetweenthedentistwhoisthePrimaryDentalCareProviderandthe
patient,whichincludescomprehensiveoralhealthcare,beginningnolaterthanageone,pursuanttoADApolicy.
de ntalpre payme nt:Amethodoffinancingthecostofdentalservicespriortoreceivingtheservices.
de ntalprophylaxis:Seeprophylaxis.
de ntalse rv ice corporation:Alegallyconstituted,notforprofitorganizationthatnegotiatesandadministers
contractsfordentalcare.DeltaDentalPlansandBlueCross&BlueShieldPlansaresuchorganizations.

de ntin:Hardtissuewhichformsthebulkofthetoothanddevelopsfromthedentalpapillaanddentalpulp,andin
thematurestateismineralized.
de ntistry:Theevaluation,diagnosis,preventionand/ortreatment(nonsurgical,surgicalorrelatedprocedures)of
diseases,disordersand/orconditionsoftheoralcavity,maxillofacialareaand/ortheadjacentandassociated
structuresandtheirimpactonthehumanbodyprovidedbyadentist,withinthescopeofhis/hereducation,
trainingandexperience,inaccordancewiththeethicsoftheprofessionandapplicablelaw.
de ntition:Theteethinthedentalarch.
adolescentdentitionInorthodonticcoding,referstothestageofpermanentdentitionpriortocessationof
growth.
deciduousdentitionReferstothedeciduousorprimaryteethinthedentalarch.
permanentdentition(adultdentition)Referstothepermanentteethinthedentalarch.
transitionaldentitionReferstoamixeddentitionbeginswiththeappearanceofthepermanentfirstmolarsand
endswiththeexfoliationofthedeciduousteeth.
de nture :Anartificialsubstituteforsomeorallofthenaturalteethandadjacenttissues.
de nture base :Thatpartofadenturethatmakescontactwithsofttissueandretainstheartificialteeth.
de pe nde nts:Generallyspouseandchildrenofcoveredindividual,asdefinedbytermsofthedentalbenefit
contract.
diagnosticcast:Areplicaofteethandadjoiningtissuescreateddigitallyorbyacastingprocess(e.g.,plasterinto
animpression).Studymodelisanothertermusedforsuchareplica.Diagnosticcastshavevarioususes,most
oftentheexaminationofrelationshipsbetweenoraltissuestodeterminehowthoserelationshipswilleffectformand
functionofadentalrestorationorappliancebeingplannedortodeterminewhethertissuetreatmentormodification
mightbenecessarybeforeapredefinitiveimpressionistakentoensureoptimalperformanceoftheplanned
restorationorappliance.
diagnosticimaging:Avisualdisplayofstructuralorfunctionalpatternsforthepurposeofdiagnosticevaluation.
Maybephotographicorradiographic.
diaste ma:Aspace,suchasonebetweentwoadjacentteethinthesamedentalarch.
dire ctpulpcap:Procedureinwhichtheexposedvitalpulpistreatedwithatherapeuticmaterial,followedwitha
baseandrestoration,topromotehealingandmaintainpulpvitality.
dire ctre imburse me nt:Aselffundedprograminwhichtheindividualisreimbursedbasedonapercentageof
dollarsspentfordentalcareprovided,andwhichallowsbeneficiariestoseektreatmentfromthedentistoftheir
choice.
dire ctre storation:Arestorationfabricatedinsidethemouth.

disce ctomy:Excisionoftheintraarticulardiscofajoint.
displace dtooth:Apartialevulsionofatoothmaybemesial,distal,facial,lingualorincisal.
distal:Surfaceorpositionofatoothmostdistantfromthemedianlineofthearch.
downcoding:Apracticeofthirdpartypayersinwhichthebenefitcodehasbeenchangedtoalesscomplex
and/orlowercostprocedurethanwasreported,exceptwheredelineatedincontractagreements.
dre ssing:Medication,bandagesorothertherapeuticmaterialappliedtoawound.
DRGs(diagnosisre late dgroups):Asystemofclassifyinghospitalpatientsonthebasisofdiagnosis,consisting
ofdistinctgroupings.ADRGassignmenttoacaseisbasedonthepatient's1)principaldiagnosis2)treatment
proceduresperformed3)age4)genderand5)dischargestatus.
drysocke t:Localizedinflammationofthetoothsocketfollowingextractionduetoinfectionorlossofbloodclot
osteitis.
dualchoice program:Abenefitpackagefromwhichaneligibleindividualcanchoosetoenrollineitheran
alternativedentalbenefitprogramoratraditionaldentalbenefitprogram.

E
EarlyandPe riodicScre e ning,DiagnosisandTre atme ntProgram(EPSDT):Afederalprogramthatprovides
comprehensivehealthcareforchildrenthroughperiodicscreenings,diagnosticandtreatmentservices.
ECF:Seee xte nde dcare facility.
e de ntulous:Withoutteeth.
e ligibilitydate :Thedateanindividualand/ordependentsbecomeeligibleforbenefitsunderadentalbenefit
contract.Oftenreferredtoaseffectivedate.
e ligible pe rson:Seebe ne ficiary.
Employme ntRe tire me ntIncome Se curityAct(ERISA):Afederalact,passedin1974,whichestablishednew
standardsandreporting/disclosurerequirementsforemployerfundedpensionandwelfarebenefitprograms.To
date,selffundedhealthbenefitplansoperatingunderERISAhavebeenheldtobeexemptfrommoststate
insurancelaws,althoughthecourtshaveheldthatthestatescanregulatethemedicalcareprovidedundersuch
plans,asbyrequiringmandatoryreviewofadverseHMOdeterminations.
e name l:Hardcalcifiedtissuecoveringdentinofthecrownoftooth.
e ndodontics:Endodonticsisthebranchofdentistrywhichisconcernedwiththemorphology,physiologyand
pathologyofthehumandentalpulpandperiradiculartissues.Itsstudyandpracticeencompassthebasicand
clinicalsciencesincludingbiologyofthenormalpulp,theetiology,diagnosis,preventionandtreatmentofdiseases
andinjuriesofthepulpandassociatedperiradicularconditions.

e ndodontist:Adentalspecialistwholimitshis/herpracticetotreatingdiseaseandinjuriesofthepulpand
associatedperiradicularconditions.
e nrolle e :Individualcoveredbyabenefitplan.Seebe ne ficiary.
e nte ral:Seedefinitionunderane sthe sia.
e ntity:Somethingthatexistsasaparticularanddiscreteunit.Personsandcorporationsareequivalententities
underthelaw.
EOB:Seee xplanationofbe ne fits.
EPSDT:SeeEarlyandPe riodicScre e ning,DiagnosisandTre atme ntProgram.
e quilibration:Reshapingoftheocclusalsurfacesofteethtocreateharmoniouscontactrelationshipsbetweenthe
upperandlowerteethalsoknownasocclusaladjustment.
ERISA:SeeEmployme ntRe tire me ntIncome Se curityAct.
e stablishe dpatie nt:Apatientwhohasreceivedprofessionalservicesfromadentistoranotherdentistofthe
samespecialtywhobelongstothesamegrouppractice,withinthepastthreeyears,subjecttostatelaws.
e v aluation:Thepatientassessmentthatmayincludegatheringofinformationthroughinterview,observation,
examination,anduseofspecificteststhatallowsadentisttodiagnoseexistingconditions.Pleaserefertospecific
oralevaluationcodedescriptorsformorecompletedefinitions.
Ev ide nce Base dDe ntistry:Anapproachtooralhealthcarethatrequiresthejudiciousintegrationofsystematic
assessmentsofclinicallyrelevantscientificdatarelatingtothepatient'soralandmedicalconditionandhistory,with
thedentist'sclinicalexpertiseandthepatient'streatmentneedsandpreferences.
e v ulsion:Separationofthetoothfromitssocketduetotrauma.Seeav ulsion.
e xcision:Surgicalremovalofboneortissue.
e xclusions:Dentalservicesnotcoveredunderadentalbenefitprogram.
Exclusiv e Prov ide rOrganization(EPO):Atypeofpreferredproviderorganizationunderwhichemployeesmust
useprovidersfromthespecifiednetworkofdentiststoreceivecoveragethereisnocoverageforcarereceived
fromanonnetworkproviderexceptinanemergencysituation.
e xfoliativ e :Referstoathinlayerofepidermisshedfromthesurface.
e xostosis:Overgrowthofbone.Seetorus.
e xpirationdate :Indentistry,thedateonwhichthedentalbenefitcontractexpiresthedateanindividualceases
tobeeligibleforbenefits.

e xplanationofbe ne fits:Awrittenstatementtoabeneficiaryfromathirdpartypayer,afteraclaimhasbeen
reported,indicatingthebenefit/chargescoveredornotcoveredbythedentalbenefitplan.
e xte nde dcare facility:Afacilitysuchasanursinghomewhichislicensedtoprovide24hournursingcare
serviceinaccordancewithstateandlocallaws.Severallevelsofcaremaybeprovidedskilled,intermediate,
custodial,oranycombination.
e xte nsionofbe ne fits:Extensionofeligibilityforbenefitsforcoveredservices,usuallydesignedtoensure
completionoftreatmentcommencedpriortotheexpirationdate.Durationisgenerallyexpressedintermsofdays.
e xtraoral:Outsidetheoralcavity.
e xtracoronal:Outsidethecrownofatooth.
e xtraction:Theprocessoractofremovingatoothortoothparts.
e xudate :Amaterialusuallyresultingfrominflammationornecrosisthatcontainsfluid,cells,and/orotherdebris.
F
facial:Thesurfaceofatoothdirectedtoward.thecheeksorlips(i.e.,thebuccalandlabialsurfaces)andopposite
thelingualsurface.
familyde ductible :Adeductiblethatissatisfiedbycombinedexpensesofallcoveredfamilymembers.For
example,aprogramwith$25deductiblemaylimititsapplicationtoamaximumofthreedeductibles,or$75forthe
family,regardlessofthenumberoffamilymembers.Seede ductible .
fascial:Relatedtoasheetorbandoffibrousconnectivetissueenveloping,separatingorbindingtogether
muscles,organsandothersofttissuestructuresofthebody.
fe e :Themonetaryvalueascribedtoaproceduredeliveredbyadentisttoapatient.Therearevarioustermsthat
includethewordorconceptofafeethataredefinedasfollows.
fullfeeThefeeforaservicethatissetbythedentist,whichreflectsthecostsofprovidingtheprocedureandthe
valueofthedentist'sprofessionaljudgment.Acontractualrelationshipdoesnotchangeadentist'sfullfee.Itis
alwaysappropriatetoreportthefullfeeforeachservicereportedtoathirdpartypayer.
maximumplanbenefitThereimbursementleveldeterminedbytheadministratorofadentalbenefitplanfora
specificdentalprocedure.Thismayvarywidelybygeographicregionorbybenefitplanswithinaregion.
usualfeeThefeewhichanindividualdentistmostfrequentlychargesforaspecificdentalprocedureindependent
ofanycontractualagreement.Itisalwaysappropriatetomodifythisfeebasedonthenatureandseverityofthe
conditionbeingtreatedandbyanymedicalordentalcomplicationsorunusualcircumstances.
Usual,CustomaryandReasonableFeesThesearethreeseparatetermsthatareoftenincorrectlyused
interchangeably,synonymouslyorasasingletermabbreviatedas"UCR"whendescribingdentalbenefitplans.
Definitionsofthesethreetermsarepostedonlineathttp://www.ada.org.

feeforserviceAmethodofreimbursementbywhichthedentistestablishesandexpectstoreceivehisorherfull
feeforthespecificservice(s)performed.
feescheduleAlistofthechargesestablishedoragreedtobyadentistforspecificdentalservices.
filling:Alaytermusedfortherestoringoflosttoothstructurebyusingmaterialssuchasmetal,alloy,plasticor
porcelain.
fixe dpartialde nture :Aprostheticreplacementofoneormoremissingteethcementedorotherwiseattachedto
theabutmentteethorimplantreplacements.
fle xible be ne fits:Abenefitprograminwhichanemployeehasachoiceofcreditsordollarsfordistributionamong
variousbenefitoptions,e.g.,healthanddisabilityinsurance,dentalbenefits,childcare,orpensionbenefits.See
cafe te riaplansfle xible spe ndingaccount.
fle xible spe ndingaccount:Employeereimbursementaccountprimarilyfundedwithemployeedesignatedsalary
reductions.Fundsarereimbursedtotheemployeeforhealthcare(medicaland/ordental),dependentcare,and/or
legalexpenses,andareconsideredanontaxablebenefit.
forame n:Naturalopeningintoorthroughbone.
fracture :Thebreakingofapart,especiallyofabonystructurebreakingofatooth.
franchise de ntistry:Referstoasystemformarketingadentalpractice,usuallyunderatradename,where
permittedbystatelaws.Inreturnforafinancialinvestmentorotherconsideration,participatingdentistsmayalso
receivethebenefitsofmediaadvertising,anationalreferralsystem,andfinancialandmanagementconsultation.
fre e domofchoice :Theconceptthatapatienthastherighttochooseanylicenseddentisttodeliverhisorher
oralhealthcarewithoutanytypeofcoercion.
fre num:Musclefiberscoveredbyamucousmembranethatattachesthecheek,lipsandortonguetoassociated
dentalmucosa.
fullfe e :seefe e .
furcation:Theanatomicareaofamultirootedtoothwheretherootsdiverge.

G
gate ke e pe rsyste m:Amanagedcareconceptusedbysomealternativebenefitplans,inwhichenrolleesselecta
primarycaredentist,usuallyageneralpractitionerorpediatricdentist,whoisresponsibleforprovidingnon
specialtycareandmanagingreferrals,asappropriate,forspecialtyandancillarycare.
ge ne ralane sthe sia:Seeane sthe sia.
ge ne ticte st:Laboratorytechniqueusedtodetermineifapersonhasageneticconditionordiseaseorislikelyto
getthedisease.
gingiv a:Softtissuesoverlyingthecrownsofuneruptedteethandencirclingthenecksofthosethathaveerupted.

gingiv e ctomy:Theexcisionorremovalofgingiva.
gingiv itis:Inflammationofgingivaltissuewithoutlossofconnectivetissue.
gingiv oplasty:Surgicalproceduretoreshapegingiva.
glassionome r:Polyelectrolytecementinwhichthesolidpowderphaseisafluoridecontainingaluminosilicate
glasspowdertobemixedwithpolymericcarboxylicacid.Thecementcanbeusedtorestoreteeth,fillpitsand
fissures,luteandlinecavities.Itisalsoknownasglasspolyalkenoatecement,ionicpolymercement,
polyelectrolytecement.
goldfoil:Thinpuregoldleafthatisselfadheringwhencondensedintoacavity.Oneoftheoldestrestorative
techniques,itiscompactedorcondensedintoaretentivecavityform.
graft:Apieceoftissueoralloplasticmaterialplacedincontactwithtissuetorepairadefectorsupplementa
deficiency.
allograftGraftoftissuebetweengeneticallydissimilarmembersofthesamespecies.Donorsmaybecadavers,
livingrelatedorlivingunrelatedindividuals.Alsocalledallogenicgraftorhomograft.
autogenousgraftTakenfromonepartofapatient'sbodyandtransferredtoanother.
guide dtissue re ge ne ration(GTR):Asurgicalprocedurethatusesabarriermembraneplacedunderthe
gingivaltissueandovertheremainingbonesupporttoenhanceregenerationofnewbone.

H
He althCare FinancingAdministration(HCFA):SeeCe nte rsforM e dicare andM e dicaidSe rv ice s.
He althInsurance PortabilityandAccountabilityAct(HIPAA)of1996:AfederallawthatincludesAdministrative
SimplificationProvisionsthatrequireallhealthplans,includingERISA,aswellashealthcareclearinghousesand
anydentistwhotransmitshealthinformationinanelectronictransaction,touseastandardformat.TheHIPAA
standardelectronicdentalclaimalsorequiresuseoftheADA'sCodeonDental.ProceduresandNomenclature
codeset.Papertransactionsarenotsubjecttothisrequirement.
He althM ainte nance Organization(HM O):Alegalentitythatacceptsresponsibilityandfinancialriskfor
providingspecifiedservicestoadefinedpopulationduringadefinedperiodoftimeatafixedprice.Anorganized
systemofhealthcaredeliverythatprovidescomprehensivecaretoenrolleesthroughdesignatedproviders.
Enrolleesaregenerallyassessedamonthlypaymentforhealthcareservicesandmayberequiredtoremaininthe
programforaspecifiedamountoftime.
He althcare Prov ide rTaxonomy:Thecodethatidentifiesthetypeofhealthcareproviderinvolvedinfurnishing
servicestobeneficiaries.
he mise ction:Surgicalseparationofamultirootedtooth.
HIPAA:SeeHe althInsurance PortabilityandAccountabilityActof1996.
histopathology:Thestudyofdiseaseprocessesatthecellularlevel.

holdharmle ssclause :Acontractprovisioninwhichonepartytothecontractpromisestoberesponsiblefor

liabilityincurredbytheotherparty.Holdharmlessclausesfrequentlyappearinthefollowingcontexts:
1)Contracts.betweendentalbenefitorganizationsandanindividualdentistoftencontainapromisebythedentist
toreimbursethedentalbenefitorganizationforany.liabilitytheorganizationincursbecauseofdentaltreatment
providedtobeneficiariesoftheorganization'sdentalbenefitplan.Thismayincludeapromisetopaythedental
benefitorganization'sattorneyfeesandrelatedcostsand
2)Contractsbetweendentalbenefitorganizationsandagroupplansponsormayincludea.promisebythedental
benefitorganizationtoassumeresponsibilityfordisputesbetweenabeneficiaryofthegroupplanandanindividual
dentistwhen.thedentist'schargeexceedstheamounttheorganizationpaysfortheserviceonbehalfofthe
beneficiary.
Ifthedentisttakesactionagainstthepatienttorecoverthedifferencebetweentheamountbilledbythedentistand
theamountpaidbytheorganization,thedentalbenefitorganizationwilltakeoverthedefenseoftheclaimandwill
payanyjudgmentsandcourtcosts.
homologous:Seegraft.
hype rplastic:Pertainingtoanabnormalincreaseinthenumberofcellsinanorganoratissuewithconsequent
enlargement.

I
imaging,diagnostic:Thiswouldinclude,butisnotlimitedto,CATscans,MRIs,photographs,radiographs,etc.
imme diate de nture :Prosthesisconstructedforplacementimmediatelyafterremovalofremainingnaturalteeth.
impacte dtooth:Anuneruptedorpartiallyeruptedtooththatispositionedagainstanothertooth,bone,orsoft
tissuesothatcompleteeruptionisunlikely.
implant:Materialinsertedorgraftedintotissue.
dentalimplantAdevicespeciallydesignedtobeplacedsurgicallywithinoronthemandibularormaxillarybone
asameansofprovidingfordentalreplacement.
endosteal(endosseous):Deviceplacedintothealveolarandbasalboneofthemandibleormaxillaand
transectingonlyonecorticalplate.
eposteal(subperiosteal):Subperiostealimplantthatconformstothesuperiorsurfaceofanedentulousareaof
alveolarbone.
transosteal(transosseous):Devicewiththreadedpostspenetratingboththesuperiorandinferiorcorticalbone
platesofthemandibularsymphysisandexitingthroughthepermucosa.Itmaybeintraoralorextraoral.
implantinde x:Seeradiographic/surgicalimplantinde x.
implantation,tooth:Placementofanartificialornaturaltoothintoanalveolus.

inappropriate fe e discountingpractice s:Intentionallyengaginginpracticeswhichwouldforceadentist,who

doesnothaveaparticipatingprovideragreement,toacceptdiscountedfeesorbeboundbythetermsand
conditionssetforthintheparticipatingprovidercontract.
Someexamplesofinappropriatefeediscountingpracticesinclude:issuingreimbursementcheckswhich,upon
signing,resultinthedentistacceptingtheamountaspaymentinfullusingclaimformswhich,uponsigning,
requirethedentisttoacceptthetermsoftheplan'scontractissuinginsurancecardswhichstatethatthesubmittal
ofaclaimbyadentistmeansthatheorsheacceptsalltermsandconditionssetforthintheparticipatingprovider
contractandsendingcommunicationstopatientsofnonparticipatingdentistswhichstatethatheorsheisnot
responsibleforanyamountaboveusual,customaryandreasonablefeesasestablishedbytheplan.
ince ntiv e program:Adentalbenefitprogramthatpaysanincreasingshareofthetreatmentcost,providedthat
thecoveredindividualutilizesthebenefitsoftheprogramduringeachincentiveperiod(usuallyayear)and
receivesthetreatmentprescribed.Forexample,a70%30%copaymentprograminthefirstyearofcoveragemay
becomean80%20%programinthesecondyearifthesubscribervisitsthedentistinthefirstyearasstipulatedin
theprogram.Mostfrequently,thereisacorrespondingpercentagereductionintheprogramscopaymentlevelif
thecoveredindividualfailstovisitthedentistinagivenyear(butneverbelowtheinitialcopaymentlevel).
incisal:Pertainingtothebitingedgesoftheincisorandcuspidteeth.
incisalangle :Oneoftheanglesformedbythejunctionoftheincisalandthemesialordistalsurfacesofan
anteriortoothcalledthemesioincisalanddistoincisalanglerespectfully.
incisionanddrainage :Theprocedureofincisingafluctuantmucosallesiontoallowforthereleaseoffluidfrom
thelesion.
incisor:Atoothforcuttingorgnawinglocatedinthefrontofthemouthinbothjaws.
indige nt:ThoseindividualswhoseincomefallsbelowthepovertylineasdefinedbythefederalOfficeof
ManagementandBudget(OMB).
inde mnificationsche dule :Seetable ofallowance s.
inde mnityplan:Anonnetworkdentalplanthatreimbursesthememberordentistatacertainpercentageof
chargesforservicesrendered,oftenafteradeductiblehasbeensatisfied.Indemnityplanstypicallyplaceno
restrictionsonwhichdentistamembermayvisit.Indemnityplansarealsoreferredtoasfe e forse rv ice plans.
indire ctpulpcap:Procedureinwhichthenearlyexposedpulpiscoveredwithaprotectivedressingtoprotectthe
pulpfromadditionalinjuryandtopromotehealingandrepairviaformationofsecondarydentin.
indire ctre storation:Arestorationfabricatedoutsidethemouth.
Indiv idualPractice Association(IPA):Alegalentityorganizedandgovernedbyindividualparticipatingdentists
fortheprimarypurposeofcollectivelyenteringintocontractstoprovidedentalservicestoenrolledpopulations.
inlay:Anintracoronaldentalrestoration,madeoutsidetheoralcavitytoconformtothepreparedcavity,which
restoressomeoftheocclusalsurfaceofatooth,butdoesnotrestoreanycusptips.Itisretainedbylutingcement.
(AmericanCollegeofProsthodonticsTheGlossaryofProsthodonticTerms)

insure r:Thepartyinaninsurancecontractthatpromisestopayabenefitifaspecifiedlossoccurs.Usuallyan
insurancecompany.
insure d:Personcoveredbytheprogram.Seebe ne ficiary.
inte ntionalre implantation:Theintentionalremoval,radicularrepairandreplacementofatoothintoitsalveolus.
Inte rnationalClassificationofDise ase s(ICD):Diagnosticcodesdesignedfortheclassificationofmorbidityand
mortalityinformationforstatisticalpurposesfortheindexingofhospitalrecordsbydiseaseandoperationsandfor
datastorageandretrieval.
inte rproximal:Betweentheadjoiningsurfacesofadjacentteethinthesamearch.
intracoronal:Referringto"within"thecrownofatooth.
intraoral:Insidethemouth.
ISOToothNumbe ringSyste m:SeeSpe cificationNo.3950.

J
jaw:Acommonnameforeitherthemaxillaorthemandible.
JO:DesignationoftheANSI/ADA/ISOtoothnumberingsystemonthedentalclaimform.SeeSpe cificationNo.
3950.
JP:DesignationoftheUniversal/Nationaltoothnumberingsystemonthedentalclaimform.

K
ke ratin:Aproteinpresentinallcuticularstructuresofthebody,suchashair,epidermisandhorns.
ke ratinize dgingiv a:Theoralsurfaceofthegingivaextendingfromthemucogingivaljunctiontothegingival
margin.Ingingivalhealth,thecoronalportionofthesulcularepitheliummayalsobekeratinized.

L
labial:Pertainingtooraroundthelip.Seefacial.
laminate v e ne e r:Athincoveringofthefacialsurfaceofatoothusuallyconstructedoftoothcoloredmaterial
usedtorestorediscolored,damaged,misshapenormisalignedteeth.
le aste xpe nsiv e alte rnativ e tre atme nt(LEAT):Atypeofcostcontainmentmeasureusedbymanythirdparty
payers.UnderaLEATclause,whentherearemultipletreatmentoptionsforaspecificcondition,theplanwillonly
payfortheleastexpensivetreatment.
le sion:Aninjuryorwoundareaofdiseasedtissue.
liability:Anobligationtopayanamountinmoney,goods,orservicestoanotherparty.

limitations:Restrictiveconditionsstatedinadentalbenefitcontract,suchasage,lengthoftimecovered,and
waitingperiods,whichaffectanindividual'sorgroup'scoverage.Thecontractmayalsoexcludecertainbenefitsor
services,oritmaylimittheextentorconditionsunderwhichcertainservicesareprovided.Seee xclusions.
limite dorale v aluation:Seee v aluation
line angle :Anangleformedbythejunctionoftwoplanesusedtodesignatethejunctionoftwosurfacesofa
tooth,oroftwowallsofatoothcavitypreparation.
lingual:Pertainingtooraroundthetonguesurfaceofthetoothdirectedtowardthetongueoppositeoffacial.
localane sthe sia:Seedefinitionunderane sthe sia.
locus:Asiteorlocation.

M
mainte nance ,pe riodontal:Therapyforpreservingthestateofhealthoftheperiodontium.
malar:Pertainingtothecheekboneseezygomaticbone .
malignant:Havingthepropertiesofdysplasia,invasion,andmetastasis.
malocclusion:Improperalignmentofbitingorchewingsurfacesofupperandlowerteeth.
manage dcare :Anycontractualarrangementwherepaymentorreimbursementand/orutilizationarecontrolledby
athirdparty.Theterm"managedcare"referstoacostcontainmentsystemthatdirectstheutilizationofhealth
benefitsby:a.)restrictingthetype,levelandfrequencyoftreatmentb.)limitingtheaccesstocareandc.)
controllingthelevelofreimbursementforservices.
mandible :Thelowerjaw.
M arylandbridge :Fixedpartialdenturefeaturingconservativeretainerswhichareresinbondedtoabutments.
maxilla:Theupperjaw.
maximumplanbe ne fitThereimbursementleveldeterminedbytheadministratorofadentalbenefitplanfora
specificdentalprocedure.Thismayvarywidelybygeographicregionorbybenefitplanswithinaregion.
M e dicaid:AfederalassistanceprogramestablishedasTitle XIXundertheSocialSecurityActof1965which
providespaymentformedicalcareforcertainlowincomeindividualsandfamilies.Theprogramisfundedjointlyby
thestateandfederalgovernmentsandadministeredbystates.
me dicallyne ce ssarycare :Thereasonableandappropriatediagnosis,treatment,andfollowupcare(including
supplies,appliancesanddevices)asdeterminedandprescribedbyqualified,appropriatehealthcareprovidersin
treatinganycondition,illness,disease,injury,orbirthdevelopmentalmalformations.Careismedicallynecessary
forthepurposeof:controllingoreliminatinginfection,pain,anddiseaseandrestoringfacialconfigurationor
functionnecessaryforspeech,swallowingorchewing.

me dicame nt:Substanceorcombinationofsubstancesintendedtobepharmacologicallyactive,specially
preparedtobeprescribed,dispensedoradministeredbyauthorizedpersonneltopreventortreatdiseasesin
humansoranimals.
me dicame nt,topical:Pharmacologicalsubstanceespeciallypreparedtobeappliedontissuesoftheoralcavity.
M e dicare :Afederalinsuranceprogramenactedin1965asTitleXVIIIoftheSocialSecurityActthatprovides
certaininpatienthospitalservicesandphysicianservicesforallpersonsage65andolderandeligibledisabled
individuals.TheprogramisadministeredbytheCe nte rsforM e dicare andM e dicaidSe rv ice s(CM S),
previouslyknownastheHealthCareFinancingAdministration(HCFA).
me mbe r:Anindividualenrolledinadentalbenefitprogram.Seebe ne ficiary.
me mbrane :Seebarrie rme mbrane .
me sial:Nearerthemiddlelineofthebodyorthesurfaceofatoothnearerthecenterofthedentalarch.
me tals,classificationof:(source:ADACouncilonScientificAffairs).
Thenoblemetalclassificationsystemhasbeenadoptedasamoreprecisemethodofreportingvariousalloysused
indentistry.Thealloysaredefinedonthebasisofthepercentageofmetalcontentandlistedinorderof
biocompatibility.
HighNobleAlloysNobleMetalContent>60%(gold+platinumgroup*)andgold>40%Au)
TitaniumandTitaniumAlloysTitanium(Ti)>85%.
NobleAlloysNobleMetalContent>25%(gold+platinumgroup*).
PredominantlyBaseAlloysNobleMetalContent)<25%(gold+platinumgroup*).
*metalsoftheplatinumgroupareplatinum,palladium,rhodium,osmiumandruthenium
microabrasion:Mechanicalremovalofasmallamountoftoothstructuretoeliminatesuperficialenamel
discolorationdefects.
microorganisms:Aminutelivingorganism,suchasabacterium,fungus,yeast,virusorrickettsia.
molar:Teethposteriortothepremolars(bicuspids)oneithersideofthejawgrindingteeth,havinglargecrowns
andbroadchewingsurfaces.
moulage :Apositivereproductionofabodypartformedonacastfromanegativeimpression.
mouthguard:Individuallymoldeddevicedesignedprimarilytobewornforthepurposeofhelpingpreventinjuryto
theteethandtheirsurroundingtissues.Sometimescalledamouthprotector.
mucousme mbrane :Liningoftheoralcavityaswellasothercanalsandcavitiesofthebodyalsocalled
"mucosa."

N
NationalAssociationofInsurance Commissione rs(NAIC):Professionalortradeassociationforstate
departmentsofinsurance(http://www.naic.org).
NationalProv ide rIde ntifie r(NPI):Thisisanidentifierassignedbythefederalgovernmenttoallproviders
consideredtobeHIPAAcoveredentities.DentistswhoarenotcoveredentitiesmayelecttoobtainanNPIattheir
discretion,ormaybeenumeratedifrequiredbyaparticipatingprovideragreementwithathirdpartypayer,or
applicablestatelaw/regulation.
AnNPIisuniquetoanindividualdentistordentalentity,andhasnointrinsicmeaning.TherearetwotypesofNPI
availabletodentistsanddentalpractices:
Type 1Indiv idualProv ide rAhealthcarepractitionerwhoisasinglehumanbeing.ALLdentistsareeligibleto
applyforType1NPIs,regardlessofwhethertheyarecoveredbyHIPAA.
Type 2OrganizationProv ide rAhealthcareproviderthatisanorganization,suchasagrouppracticeor
corporation.IndividualdentistswhoareincorporatedmayenumerateasType2providers,inadditiontobeing
enumeratedasaType1.Allincorporateddentalpracticesandgrouppracticesareeligibleforenumerationas
Type2providers.
Onpaper,thereisnowaytodistinguishaType1fromaType2intheabsenceofanyassociateddatatheyare
identicalinformat.AdditionalinformationonNPIandenumerationcanbeobtainedfromtheADA'sInternet
Website:http://www.ada.org/goto/npi.
ne ce ssarytre atme nt:Anecessarydentalprocedureorserviceasdeterminedbyadentist,toeitherestablishor
maintainapatient'soralhealth.Suchdeterminationsarebasedontheprofessionaldiagnosticjudgmentofthe
dentist,andthestandardsofcarethatprevailintheprofessionalcommunity.
nonautoge nous:Agraftfromdonorotherthanpatient.
noncontributoryprogram:Amethodofpaymentforgroupcoverageinwhichthesponsorpaystheentire
monthlypremiumfortheprogram.
noncov e re dcharge s:Seecov e re dcharge s.
nonduplicationofbe ne fits:Termusedtodescribeoneofthewaysthesecondarycarriermaycalculateits
portionofthepaymentifapatientiscoveredbytwobenefitplans.Thesecondarycarriercalculateswhatitwould
havepaidifitweretheprimaryplanandsubtractswhattheotherplanpaid.Forexample,iftheprimarycarrierpaid
80percent,andthesecondarycarriernormallycovers80percentaswell,thesecondarycarrierwouldnotmake
anyadditionalpayment.Iftheprimarycarrierpaid50percent,however,thesecondarycarrierwouldpayupto30
percent.
nonparticipatingde ntist:Anydentistwhodoesnothaveacontractualagreementwithadentalbenefit
organizationtorenderdentalcaretomembersofadentalbenefitprogram.
NPI:SeeNationalProv ide rIde ntifie r.

O
obturate :Withreferencetoendodontics,referstothesealingofthecanal(s)oftoothrootsduringrootcanal
therapyprocedurewithanappropriatelyprescribedmaterialsuchasguttaperchaincombinationwithasuitable
lutingagent.
obturator:Adiscorplatewhichclosesanopeningaprosthesisthatclosesanopeninginthepalate.
occlusal:Pertainingtothebitingsurfacesofthepremolarandmolarteethorcontactingsurfacesofopposing
teethoropposingocclusionrims.
occlusalradiograph:Anintraoralradiographmadewiththefilm,phosphorousplate,emulsionordigitalsensor
beingheldbetweentheoccludedteeth.
occlusalsurface :Asurfaceofaposteriortoothorocclusionrimthatisintendedtomakecontactwithan
opposingocclusalsurface.(TheJournalofProsthodonticDentistryTheGlossaryofProsthodonticTermsJuly
2005,page57)
occlusion:Anycontactbetweenbitingorchewingsurfacesofmaxillary(upper)andmandibular(lower)teeth.
odontoge nic:Referstotoothformingtissues.
odontoge niccyst:Seecyst.
odontoplasty:Adjustmentoftoothlength,size,and/orshapeincludesremovalofenamelprojections.
onlay:Adentalrestorationmadeoutsidetheoralcavitythatcoversoneormorecusptipsandadjoiningocclusal
surfaces,butnottheentireexternalsurface.Itisretainedbylutingcement.(AmericanCollegeofProsthodontics
TheGlossaryofProsthodonticTerms)
ope ne nrollme nt:Theannualperiodinwhichemployeescanselectfromachoiceofbenefitprograms.
ope npane l:Thistypeofdentalbenefitsplanallowscoveredpatientstoreceivecarefromanydentistandallows
anydentisttoparticipate.Anydentistmayacceptorrefusetotreatpatientsenrolledintheplan.Openpanelplans
oftenaredescribedasfreedomofchoiceplans.
ope nre duction:Reapproximationoffracturedbonysegmentsaccomplishedthroughcuttingtheadjacentsoft
tissuesandbonetoallowdirectaccess.
ope rcule ctomy:Removaloftheoperculum.
ope rculum:Theflapoftissueoveranuneruptedorpartiallyeruptedtooth.
oral:Pertainingtothemouth.
oralandmaxillofacialpathologist:Adentalspecialistwhosepracticeisconcernedwithrecognition,diagnosis,
investigationandmanagementofdiseasesoftheoralcavity,jaws,andadjacentstructures.

oralandmaxillofacialpathology:Oralpathologyisthespecialtyofdentistryanddisciplineofpathologythat
dealswiththenature,identification,andmanagementofdiseasesaffectingtheoralandmaxillofacialregions.Itisa
sciencethatinvestigatesthecauses,processes,andeffectsofthesediseases.Thepracticeoforalpathology
includesresearchanddiagnosisofdiseasesusingclinical,radiographic,microscopic,biochemical,orother
examinations.
oralandmaxillofacialradiologist:Adentalspecialistwhosepracticeisconcernedwiththeproductionand
interpretationofimagesanddataproducedbyallmodalitiesofradiantenergyusedforthediagnosisand
managementofdiseases,disordersandconditionsoftheoralandmaxillofacialregion.
oralandmaxillofacialradiology:Oralandmaxillofacialradiologyisthespecialtyofdentistryanddisciplineof
radiologyconcernedwiththeproductionandinterpretationofimagesanddataproducedbyallmodalitiesof
radiantenergythatareusedforthediagnosisandmanagementofdiseases,disordersandconditionsoftheoral
andmaxillofacialregion.
oralandmaxillofacialsurge on:Adentalspecialistwhosepracticeislimitedtothediagnosis,surgicaland
adjunctivetreatmentofdiseases,injuries,deformities,defectsandestheticaspectsoftheoralandmaxillofacial
regions.
oralandmaxillofacialsurge ry:Oralandmaxillofacialsurgeryisthespecialtyofdentistrywhichincludesthe
diagnosis,surgicalandadjunctivetreatmentofdiseases,injuriesanddefectsinvolvingboththefunctionaland
estheticaspectsofthehardandsofttissuesoftheoralandmaxillofacialregion.
oraldiagnosis:Thedeterminationbyadentistoftheoralhealthconditionofanindividualpatientachieved
throughtheevaluationofdatagatheredbymeansofhistorytaking,directexamination,patientconference,and
suchclinicalaidsandtestsasmaybenecessaryinthejudgmentofthedentist.
oralhe althlite racy:Thedegreetowhichindividualshavethecapacitytoobtain,processandunderstandbasic
healthinformationandservicesneededtomakeappropriateoralhealthdecisions.
orthodontist:Adentalspecialistwhosepracticeislimitedtotheinterceptionandtreatmentofmalocclusionand
otherneuromuscularandskeletalabnormalitiesoftheteethandtheirsurroundingstructures.
orthodonticsandde ntofacialorthope dics:Orthodonticsanddentofacialorthopedicsisthedentalspecialty
thatincludesthediagnosis,prevention,interception,andcorrectionofmalocclusion,aswellasneuromuscularand
skeletalabnormalitiesofthedevelopingormatureorofacialstructures.
orthognathic:Functionalrelationshipofmaxillaandmandible.
orthoticde v ice :Apparatususedtosupport,align,preventorcorrectdeformities,ortoimprovethefunctionof
movablepartsofthebody.
OSHA:AbbreviationforOccupationalSafetyandHealthAdministration.FederalagencyintheUSresponsiblefor
makingandenforcingemployeesafetyregulations.
oste oplasty:Surgicalprocedurethatmodifiestheconfigurationofbone.
oste otomy:Surgicalcuttingofbone.

ov e rbilling:Themisrepresentationofafeeashigherthanactualchargesforexample,whenapatientischarged
onefeeandaninsurancecompanyisbilledahigherfeetobenefitthepatient'scopayment,ortoincreaseafeeto
apatientsolelybecausethepatientiscoveredunderadentalbenefitsplan.
ov e rcoding:Reportingamorecomplexand/orhighercostprocedurethanwasactuallyperformed.
ov e rde nture :Aremovableprostheticdevicethatoverliesandmaybesupportedbyretainedtoothrootsor
implants.

P
palate :Thehardandsofttissuesformingtheroofofthemouththatseparatestheoralandnasalcavities.
palliativ e :Actionthatrelievespainbutisnotcurative.
panoramicradiograph:Anextraoralprojectionwherebytheentiremandible,maxilla,teethandothernearby
structuresareportrayedonasingleimage,asifthejawswereflattenedout.
papoose board:Abe hav iormanage me nttechniqueutilizingimmobilizationtocontroltheactionsofapatient
whoisreceivingdentaltreatment.
parafunctional:Otherthannormalfunctionoruse.
pare nte ral:Seedefinitionunderane sthe sia
partialde nture :Usuallyreferstoaprostheticdevicethatreplacesmissingteeth.Seefixedpartialdentureor
removablepartialdenture.
participatingde ntist:Seecontractde ntist.
patie nt:Anindividualwhohasestablishedaprofessionalrelationshipwithadentistforthedeliveryofdental
healthcare.Formattersrelatingtocommunicationofinformationandconsentthistermincludesthepatient's
parent,caretaker,guardian,orotherindividualasappropriateunderstatelawandthecircumstancesofthecase.
paye r:Aselfinsuredemployer,insurancecompany,governmentalagencyorotherpartyresponsibleforpayment
ofhealthcareclaimsofcoveredpersons.
pe diatricde ntist:Adentalspecialistwhosepracticeislimitedtotreatmentofchildrenfrombirththrough
adolescence,providingprimaryandcomprehensivepreventiveandtherapeuticoralhealthcareformerlyknownas
apedodontist.
pe diatricde ntistry:PediatricDentistryisanagedefinedspecialtythatprovidesbothprimaryandcomprehensive
preventiveandtherapeuticoralhealthcareforinfantsandchildrenthroughadolescence,includingthosewith
specialhealthcareneeds.
pe dodontist:Seepe diatricde ntist.

pe e rre v ie w:Anevaluationofthequalityandconductofanindividual'sworkbytheindividual'sprofessional
equals(peers)inordertoresolvequestionsordisputesregardingthequality,orconductofthework.Peerreview,
whenappliedtodentistry,isaprocess,consistentlystructuredandimplementedbyorganizeddentistry,inwhicha
dentist'sprofessionalequals(peers)resolvequestionsordisputes(regardingthequalityorappropriatenessof
careprovidedbythedentistorthefairnessofthefeethedentistchargedinanindividualcase)byretrospectively
evaluatingthequalityorappropriatenessofcareinrelationtoprofessionalnormsorcriteriaorevaluatingthefee
chargedinrelationtothedentist'sfeeforthegivencomplexityandlevelofcareprovided.
Pe e rRe v ie wOrganization(PRO):AnorganizationestablishedbyanamendmentoftheTaxEquityandFiscal
Re sponsibilityActof1982(TEFRA),toprovideforthereviewofmedicalservicesfurnishedprimarilyinahospital
settingand/orinconjunctionwithcareprovidedundertheMedicareandMedicaidprograms.Inadditiontotheir
reviewandmonitoringfunctions,theseentitiescaninvokesanctions,penalties,orothercorrectiveactionsfor
noncomplianceinorganizationstandards.
pe rce ntile :Thenumberinafrequencydistributionbelowwhichacertainpercentageoffeeswillfall.Forexample,
the90thpercentileisthenumberthatdividesthedistributionoffeesintothelower90%andtheupper10%,orthat
feelevelatwhich90%ofdentistschargethatamountorless,and10%more.
pe riapical:Theareasurroundingtheendofthetoothroot.
pe riapicalabsce ss:Seeabsce ss.
pe riapicalcyst:Seecyst.
pe riapicalradiograph:Aradiographmadebytheintraoralplacementoffilm,phosphorousplate,emulsionor
digitalsensor,fordisclosingtheapicesoftheteeth.
pe ricoronal:Aroundthecrownofatooth.
pe riodicorale v aluation:Seee v aluation.
pe riodontal:Pertainingtothesupportingandsurroundingtissuesoftheteeth.
pe riodontalabsce ss:Seeabsce ss.
pe riodontaldise ase :Inflammatoryprocessofthegingivaltissuesand/orperiodontalmembraneoftheteeth,
resultinginanabnormallydeepgingivalsulcus,possiblyproducingperiodontalpocketsandlossofsupporting
alveolarbone.
pe riodontalpocke t:Pathologicallydeepenedgingivalsulcusafeatureofperiodontaldisease.
pe riodontics:Periodonticsisthatspecialtyofdentistrywhichencompassestheprevention,diagnosisand
treatmentofdiseasesofthesupportingandsurroundingtissuesoftheteethortheirsubstitutesandthe
maintenanceofthehealth,functionandestheticsofthesestructuresandtissues.
pe riodontist:Adentalspecialistwhosepracticeislimitedtothetreatmentofdiseasesofthesupportingand
surroundingtissuesoftheteeth.

pe riodontitis:Inflammationandlossoftheconnectivetissueofthesupportingorsurroundingstructureofteeth
withlossofattachment.
pe riodontium:tissuecomplexcomprisinggingival,cementum,periodontalligament,andalveolarbonewhich
attaches,nourishesandsupportsthetooth.
pe riradicular:Surroundingaportionoftherootofthetooth.
pe rmane ntde ntition:Referstothepermanentoradultteethinthedentalarch.
pin:Asmallmetalrod,cementedordrivenintodentintoaidinretentionofarestoration.
plaque :Asoftstickysubstancethataccumulatesonteethcomposedlargelyofbacteriaandbacterialderivatives.
pointofse rv ice :Ahealthplanallowingthemembertochoosetoreceiveaservicefromaparticipatingornon
participatingprovider,usuallywithdifferentbenefitslevelsassociatedwiththeuseofparticipatingproviders.
pontic:Thetermusedforanartificialtoothonafixedpartialdenture(bridge).
porce lain/ce ramic:Referstopressed,fired,polishedormilledmaterialscontainingpredominantlyinorganic
refractorycompoundsincludingporcelains,glasses,ceramicsandglassceramics.
post:Rodlikecomponentdesignedtobeinsertedintoapreparedrootcanalspacesoastoprovidestructural
support.Thisdevicecaneitherbeintheformofanalloy,carbonfiberorfiberglass,andpostsareusuallysecured
withappropriatelutingagents.
poste rior:Referstoteethandtissuestowardsthebackofthemouth(distaltothecanines)maxillaryand
mandibularpremolarsandmolars.ThedesignationofpermanentposteriorteethintheUniv e rsal/Nationaltooth
numbe ringsyste mincludeteeth1through5and12through16(maxillary),and17through21and28through
32(mandibular)primaryteethintheUniversaltoothnumberingsystemaredesignatedA,B,IandJ(maxillary),
andK,L,SandT(mandibular).
posttre atme ntre v ie w:Seeaudit.
pre authorization:Statementbyathirdpartypayerindicatingthatproposedtreatmentwillbecoveredunderthe
termsofthebenefitcontract.Seealsopre ce rtification,pre de te rmination.
pre ce rtification:Confirmationbyathirdpartypayerofapatient'seligibilityforcoverageunderadentalbenefit
program.Seepre authorization,pre de te rmination.
pre cisionattachme nt:Interlockingdevice,havingamalecomponentintegratedintoaremovableprosthesisthat
fitspreciselyintoafemalecomponentembeddedinthebodyofabutmentteethorimplantabutments,tostabilizeor
retaintheprosthesiswhenitisseatedinthemouth.
pre de te rmination:Aprocesswhereadentistsubmitsatreatmentplantothepayerbeforetreatmentbegins.The
payerreviewsthetreatmentplanandnotifiesthedentistandpatientofoneormoreofthefollowing:patient's
eligibility,coveredservices,amountspayable,copaymentanddeductiblesandplanmaximums.

pre e xistingcondition:Oralhealthconditionofanenrolleewhichexistedbeforehis/herenrollmentinadental
program.
Pre fe rre dProv ide rOrganization(PPO):Aformalagreementbetweenapurchaserofadentalbenefitprogram
andadefinedgroupofdentistsforthedeliveryofdentalservicestoaspecificpatientpopulation,asanadjunctto
atraditionalplan,usingdiscountedfeesforcostsavings.
pre filingoffe e s:Thesubmissionofaparticipatingdentist'sfullfeesforthepurposeofestablishing,inadvance,
thatdentist'sfullfeesandthefeesinageographicareatodeterminebenefitsunderadentalbenefitprogram.
pre me dication:Theuseofmedicationspriortodentalprocedures.
pre mium:Theamountchargedbyadentalbenefitorganizationforcoverageofalevelofbenefitsforaspecified
time.
pre molar:Seebicuspid.
pre paidde ntalplan:Amethodoffinancingthecostofdentalcareforadefinedpopulation,inadvanceofreceipt
ofservices.
pre paidgrouppractice :Seeclose dpane l.
pre tre atme nte stimate :Seepre de te rmination.
pre v e ntiv e de ntistry:Aspectsofdentistryconcernedwithpromotinggoodoralhealthandfunctionbypreventing
orreducingtheonsetand/ordevelopmentoforaldiseasesordeformitiesandtheoccurrenceoforofacialinjuries.
primaryde ntition:Thefirstsetofteethseede ciduous.
primarypaye r:Thethirdpartypayerdeterminedtohaveinitialresponsibilityinabenefitdetermination.
priorauthorization:Seepre de te rmination.
promptpayme ntlaws:Alsoknownasfairclaimspracticeregulations.Enactedstatebystate,promptpayment
lawssetstandardsfortheprompt,fairandequitablesettlementsofinsuranceclaimsbyrequiringthatasetamount
ofinterestbepaidon"cleanclaims"thatarepaidbeyondtheestablishedtimeframe."Cleanclaim"meansaclaim
forpaymentofcoveredhealthcareexpensesthatissubmittedtoapayeronthecarrier'sstandardclaimform
usingthemostcurrentpublishedproceduralcodes,withalltherequiredfieldscompletedwithinformationsufficient
toadjudicatetheclaiminaccordancewiththepayer'spublishedfilingrequirements.Theselawsneedtobe
analyzedonacasebycasebasistodeterminewhetheralawsuithastobefiledbythestatedepartmentof
insurance.
proofofloss:Verificationofservicesrenderedorexpensesincurredbythesubmissionofclaimforms,
radiographs,studymodels,and/orotherdiagnosticmaterial.Documentaryevidencerequiredbyapayertoprovea
validclaimexists.Itusuallyconsistsofaclaimformcompletedbythepatient'streatingdentist.
prophylaxis:Removalofplaque,calculusandstainsfromthetoothstructures.Itisintendedtocontrollocal
irritationalfactors.

prospe ctiv e re v ie w:Priorassessmentbyapayerorpayer'sagentthatproposedservicesareappropriatefora

particularpatient,and/orthepatientandthecategoryofservicearecoveredbyabenefitplan.See
preauthorization,precertification,predetermination,secondopinionprogram.
prosthe sis:Artificialreplacementofanypartofthebody.
definitiveprosthesisProsthesistobeusedoveranextendedperiodoftime.
dentalprosthesisAnydeviceorappliancereplacingoneormoremissingteethand/or,ifrequired,associated
structures.(Thisisabroadtermwhichincludesabutmentcrownsandabutmentinlays/onlays,bridges,dentures,
obturators,gingivalprostheses.)
fixedprosthesisNonremovabledentalprosthesiswhichissolidlyattachedtoabutmentteeth,rootsorimplants.
fixedremovableprosthesisCombinedprosthesis,oneormorepartsofwhicharefixed,andtheother(s)
attachedbydeviceswhichallowtheirdetachment,removalandreinsertionbythedentistonly.
interimprosthesisAprovisionalprosthesisdesignedforuseoveralimitedperiodoftime,afterwhichitistobe
replacedbyamoredefinitiverestoration.
removableprosthesisCompleteorpartialprosthesis,whichafteraninitialfittingbyadentist,canberemoved
andreinsertedbythepatient.
prosthodontics:Prosthodonticsisthedentalspecialtypertainingtothediagnosis,treatmentplanning,
rehabilitationandmaintenanceoftheoralfunction,comfort,appearanceandhealthofpatientswithclinical
conditionsassociatedwithmissingordeficientteethand/ororalandmaxillofacialtissuesusingbiocompatible
substitutes.
prosthodontist:Adentalspecialistwhosepracticeislimitedtotherestorationofthenaturalteethand/orthe
replacementofmissingteethwithartificialsubstitutes.
prov isional:Formedorpreformedfortemporarypurposesorusedoveralimitedperiodatemporaryorinterim
solutionusuallyreferstoaprosthesisorindividualtoothrestoration.
publiche althde ntist:Adentistwhosepracticeislimitedtothescienceandartofpreventingandcontrolling
dentaldiseasesandpromotingdentalhealththroughorganizedcommunityefforts.
publiche althde ntistry:Dentalpublichealthisthescienceandartofpreventingandcontrollingdentaldiseases
andpromotingdentalhealththroughorganizedcommunityefforts.Itisthatformofdentalpracticewhichservesthe
communityasapatientratherthantheindividual.Itisconcernedwiththedentalhealtheducationofthepublic,with
applieddentalresearch,andwiththeadministrationofgroupdentalcareprogramsaswellasthepreventionand
controlofdentaldiseasesonacommunitybasis.
pulp:Connectivetissuethatcontainsbloodvesselsandnervetissuewhichoccupiesthepulpcavityofatooth.
pulpcap:Seedire ctpulpcapindire ctpulpcap.
pulpcav ity:Thespacewithinatoothwhichcontainsthepulp.

pulpe ctomy:Completeremovalofvitalandnonvitalpulptissuefromtherootcanalspace.
pulpitis:Inflammationofthedentalpulp.
pulpotomy:Removalofaportionofthepulp,includingthediseasedaspect,withtheintentofmaintainingthe
vitalityoftheremainingpulpaltissuebymeansofatherapeuticdressing.
purchase r:Organizationorentity,oftenemployerorunion,thatcontractswiththedentalbenefitorganizationto
providedentalbenefitstoanenrolledpopulation.

Q
quadrant:Oneofthefourequalsectionsintowhichthedentalarchescanbedividedbeginsatthemidlineofthe
archandextendsdistallytothelasttooth.

R
radicular:Pertainingtotheroot.
radiographic/surgicalimplantinde x:Anappliance,designedtorelateosteotomyorfixturepositiontoexisting
anatomicstructures.
radiograph:Animageorpictureproducedonaradiationsensitivefilm,phosphorousplate,emulsionordigital
sensorbyexposuretoionizingradiation.
re base :Processofrefittingadenturebyreplacingthebasematerial.
re calcification:Procedureusedtoencouragebiologicrootrepairofexternalandinternalresorptiondefects.See
ape xification.
re imburse me nt:Paymentmadebyathirdpartytoabeneficiaryortoadentistonbehalfofthebeneficiary,to
offsetexpensesincurredforaservicecoveredbythedentalbenefitplan.
re implantation,tooth:Thereturnofatoothtoitsalveolus.
re insurance :Insuranceforthirdpartypayerstospreadtheirriskforlosses(claimspaid)overaspecifieddollar
amount.
Re lativ e Value Syste m:Codedlistingofprofessionalserviceswithunitvaluestoindicaterelativecomplexityas
measuredbytime,skill,andoverheadcosts.Thirdpartypayerstypicallyassignadollarvalueperunittocalculate
providerreimbursement.
re line :Processofresurfacingthetissuesideofaremovableprosthesiswithnewbasematerial.
re mov able partialde nture :Aremovablepartialdentureisaprostheticreplacementofoneormoremissingteeth
thatcanberemovedbythepatient.
re sin,acrylic:Resinousmaterialofthevariousestersofacrylicacid,usedasadenturebasematerial,fortraysor
forotherrestorations.

re sinbase dcomposite :Seecomposite .

re sininfiltration:Applicationofaresinmaterialengineeredtopenetrateandfillthesubsurfaceporesystemof
anincipientcarieslesiontostrengthen,stabilize,andlimitthelesion'sprogression,aswellasmaskvisiblewhite
spots.
re tailstore de ntistry:Referstodentalservicesofferedwithinaretail,departmentordrugstoreoperation.
Typically,spaceisleasedfromthestorebyaseparateadministrativegroupthat,inturn,subleasestoadentistor
dentalgroupprovidingtheactualdentalservices.Thedentaloperationgenerallymaintainsthesamehoursof
operationasthestoreandappointmentsoftenarenotnecessary.Consideredtobeatypeofpractice,notadental
benefitplanmodel.
re taine r:
orthodonticretainerAppliancetostabilizeteethfollowingorthodontictreatment.
prosthodonticretainerApartofaprosthesisthatattachesarestorationtotheabutmenttooth,implantabutment,
orimplant.
re trograde filling:Amethodofsealingtherootcanalbypreparingandfillingitfromtherootapex.
re trospe ctiv e re v ie w:Aposttreatmentassessmentofservicesonacasebycaseoraggregatebasisafterthe
serviceshavebeenperformed.
re v ision:Theactofrevisingsecondormoresurgicalprocedureforcorrectionofacondition.
riskpool:Aportionofproviderfeesorcapitationpaymentswithheldasfinancialreservestocoverunanticipated
utilizationofservicesinanalternativebenefitplan.
root:Theanatomicportionofthetooththatiscoveredbycementumandislocatedinthealveolus(socket)where
itisattachedbytheperiodontalapparatusradicularportionoftooth.
residualrootRemainingrootstructurefollowingthelossofthemajorportion(over75%)ofthecrown.
rootcanal:Theportionofthepulpcavityinsidetherootofatooththechamberwithintherootofthetooththat
containsthepulp.
rootcanalthe rapy:Thetreatmentofdiseaseandinjuriesofthepulpandassociatedperiradicularconditions.
rootplaning:Adefinitivetreatmentproceduredesignedtoremovecementumand/ordentinthatisrough,maybe
permeatedbycalculus,orcontaminatedwithtoxinsormicroorganisms.
rubbe rdam:Abarriertechniqueusedtopreventthepassageofsalivaormoisture,ortoprovideanisolated
operativefield.

S
saliv arygland:Exocrineglandsthatproducesalivaandemptyitintothemouththeseincludetheparotidglands,
thesubmandibularglandsandthesublingualglands.

scaling:Removalofplaque,calculus,andstainfromteeth.
sche dule ofallowance s:Seetable ofallowance s.
sche dule ofbe ne fits:Alistingofdentalservicesandthemaximumbenefitamountsaninsurerwillpayforagiven
service.Specificitywillvarybybenefitplan.
se alant:Aresinousmaterialdesignedtobeappliedtotheocclusalsurfacesofposteriorteethtopreventocclusal
caries.
se condopinionprogram:Anopinionabouttheappropriatenessofaproposedtreatmentprovidedbya
practitionerotherthantheonemakingtheoriginalrecommendationsomebenefitplansrequiresuchopinionsfor
selectedservices.
se dativ e filling:Atemporaryrestorationintendedtorelievepain.
se lffunde dplan:Abenefitplaninwhichtheplansponsorbearstheentireriskofutilization.Someplansmaybe
partiallyselffunded,ifthesponsoremploysindemnifiedstoplossinsurancetoprotectagainsttheriskof
unanticipatedhigherutilization.Thirdpartyadministratorsmayprovideclaimsprocessingandotheradministrative
services,withoutbearinganyoftheriskofutilizationoftheplan.
se lfinsurance :Settingasideoffundsbyanindividualororganizationtomeetanticipateddentalcareexpenses
oritsdentalcareclaims,andaccumulationofafundtoabsorbfluctuationsintheamountofexpensesorclaims.
Thefundssetasideoraccumulatedareusedtoprovidedentalbenefitsdirectlyinsteadofpurchasingcoverage
fromaninsurancecarrier.
se mipre cisionattachme nt:Adevice,onecomponentofwhichisfixedtoanabutmentorabutmentsandthe
otherisintegratedintoafixedorremovableprosthesisinordertostabilizeand/orretainit.
se rv ice corporations:Dentalbenefitorganizationsestablishedundernotforprofitstatestatutesforthepurpose
ofprovidinghealthcarecoverage,e.g.,DeltaDentalPlans,BlueCrossandBlueShieldPlans.
se xtant:Oneofthesixrelativelyequalsectionsintowhichadentalarchcanbedivided,forexample:tooth
numbers156111216172122272832.Sometimesusedforrecordingperiodontalcharting.
sialodochoplasty:Surgicalprocedurefortherepairofadefectand/orrestorationofportionofasalivarygland
duct.
sialography:Inspectionofthesalivaryductsandglandsbyradiographaftertheinjectionofaradiopaquemedium.
sialolithotomy:Surgicalprocedurebywhichastonewithinasalivaryglandoritsductisremoved,either
intraorallyorextraorally.
site :Atermusedtodescribeasinglearea,position,orlocus.Forperiodontalprocedures,anareaofsofttissue
recessiononasingletoothoranosseousdefectadjacenttoasingletoothalsousedtoindicatesofttissue
defectsand/orosseousdefectsinedentuloustoothpositions.
space maintaine r:Apassiveappliance,usuallycementedinplace,thatholdsteethinposition.

Spe cificationNo.3950:Thisschema(ANSI/ADA/ISOSpecificationNo.39501984DentistryDesignationSystem
forToothandAreasoftheOralCavity)isdesignedtoidentifyareasoftheoralcavityaswellasuniquelynumber
permanentandprimarydentition.Supernumeraryteetharenotyetidentifiedusingthisstandard.Formore
informationseeAppendixtoSection3ofthisCDTmanual.
splint:Adeviceusedtosupport,protect,orimmobilizeoralstructuresthathavebeenloosened,replanted,
fracturedortraumatized.Alsoreferstodevicesusedinthetreatmentoftemporomandibularjointdisorders.
statisticallybase dutilizationre v ie w:Asystemthatexaminesthedistributionoftreatmentproceduresbasedon
claimsinformation.Inordertobereasonablyreliable,theapplicationofsuchclaimsanalysesofspecificdentists
shouldincludedataontypeofpractice,dentist'sexperience,socioeconomiccharacteristics,andgeographic
location.
stomatitis:Inflammationofthemembranesofthemouth.
stoploss:Ageneraltermreferringtothatcategoryofcoveragethatprovidesinsuranceprotection(reinsurance)
toanemployerforaselffundedplan.
stre ssbre ake r:Thatpartofatoothborneand/ortissueborneprosthesisdesignedtorelievetheabutmentteeth
andtheirsupportingtissuesfromharmfulstresses.
studymode l:Plasterorstonemodelofteethandadjoiningtissuesalsoreferredtoasdiagnosticcast.See
diagnosticcast.
succe dane oustooth:Apermanenttooththatreplacesaprimary(deciduous)tooth.
summaryplande scription:Seebe ne fitplansummary.
supe rnume raryte e th:Extraeruptedoruneruptedteeththatresembleteethofnormalshape.
suture :Stitchusedtorepairincisionorwound.

T
table ofallowance s:Alistofcoveredserviceswithanassigneddollaramountthatrepresentsthetotalobligation
oftheplanwithrespecttopaymentforsuchservice,butdoesnotnecessarilyrepresentthedentist'sfullfe e for
thatservice.
TaxEquityandFiscalRe sponsibilityActof1982(TEFRA):Legislation(PublicLaw97248)affectinghealth
maintenanceorganizationsandtheMedicareandMedicaidprograms.Providesregulationsforthedevelopmentof
HMOriskcontractingwiththeMedicareprogramand,throughamendment,establishednewprovisionsforthe
foundationandoperationofpeerrevieworganizations.
te mporaryre mov able de nture :Aninterimprosthesisdesignedforuseoverlimitedperiodoftime.
te mporomandibular(TM J):Theconnectinghingemechanismbetweenthebaseoftheskull(temporalbone)and
thelowerjaw(mandible).

te mporomandibularjointdysfunction(TM DorTM JD):Abnormalfunctioningoftemporomandibularjointalso

referstosymptomsarisinginotherareassecondarytothedysfunction.
te rminationdate :Seee xpirationdate .
the rape utic:Oforpertainingtotherapyortreatmentbeneficial.Therapyhasasitsgoaltheeliminationorcontrol
ofadiseaseorotherabnormalstate.
thirdparty:Thepartytoadentalbenefitcontractthatmaycollectpremiums,assumefinancialrisk,payclaims,
and/orprovidesotheradministrativeservices.Alsoknownasadministrativeagent,carrier,insurerorunderwriter.
ThirdPartyAdministrator(TPA):Claimspayerwhoassumesresponsibilityforadministeringhealthbenefitplans
withoutassuminganyfinancialrisk.SomecommercialinsurancecarriersandBlueCross&BlueShieldplansalso
haveTPAoperationstoaccommodateselffundedemployersseekingadministrativeservicesonly(ASO)contracts.
thirdpartypaye r:Anorganizationotherthanthepatient(firstparty)orhealthcareprovider(secondparty)
involvedinthefinancingofpersonalhealthservices.
tissue conditioning:Materialintendedtobeplacedincontactwithtissues,foralimitedperiod,withtheaimof
assistingthereturntoahealthycondition.
Title XIX:PortionoftheSocialSecurityActthatprovidesforfederalgrantstothestatesformedicalassistance
programs,commonlyknownasMedicaid.
tomography:AnXraytechniquethatproducesanimagerepresentingadetailedcrosssectionoftissue
structuresatapredetermineddepth.
toothbounde dspace :Aspacecreatedbyoneormoremissingteeththathasatoothoneachside.
torus:Abonyelevationorprotuberanceofbone.Seee xostosis.
trache otomy:Asurgicalproceduretocreateanopeninginthetrachea(windpipe)toaidinbreathing.
transitional:Relatingtoapassageorchangefromoneposition,state,phaseorconcepttoanother.
transitionalde ntition:Referstoamixeddentitionbeginswiththeappearanceofthepermanentfirstmolarsand
endswiththeexfoliationofthedeciduousteeth.
transplantation:Surgicalplacementofbiologicalmaterialfromonesitetoanother.
transplantationoftooth:Transferofatoothfromonesockettoanother,eitherinthesameoradifferentperson.
transse ptal:Throughoracrossaseptum.
tre atme ntplan:Thesequentialguideforthepatient'scareasdeterminedbythedentist'sdiagnosisandisused
bythedentistfortherestorationtoand/ormaintenanceofoptimaloralhealth.
trismus:Restrictedabilitytoopenthemouth,usuallyduetoinflammationorfibrosisofthemusclesofmastication.

tube rosity:Aprotuberanceonabone.

U
unbundlingofproce dure s:Theseparatingofadentalprocedureintocomponentpartswitheachparthavinga
chargesothatthecumulativechargeofthecomponentsisgreaterthanthetotalchargetopatientswhoarenot
beneficiariesofadentalbenefitplanforthesameprocedure.
une rupte d:Tooth/teeththathavenotpenetratedintotheoralcavity.
unilate ral:Onesidedpertainingtooraffectingbutoneside.
Univ e rsal/Nationaltoothnumbe ringsyste m:Asystemthatassignsauniquenumber(from132)topermanent
teeth,andauniqueletter(AT)forprimaryteeth.
upcode :Reportingamorecomplexand/orhighercostprocedurethanwasactuallyperformed.Alsoknownas
overcoding.
Usual,CustomaryandRe asonable Fe e s:Seefe e .
usualfe e :Seefe e .
utilization:Theextenttowhichthemembersofacoveredgroupuseaprogramoverastatedperiodoftime
specificallymeasuredasapercentagedeterminedbydividingthenumberofcoveredindividualswhosubmitted
oneormoreclaimsbythetotalnumberofcoveredindividuals.Also,anexpressionofthenumberandtypesof
servicesusedbythemembersofacoveredgroupoveraspecifiedperiodoftime.
utilizationmanage me nt:Asetoftechniquesusedbyoronbehalfofpurchasersofhealthcarebenefitsto
managethecostofhealthcarepriortoitsprovisionbyinfluencingpatientcaredecisionmakingthroughcaseby
caseassessmentsoftheappropriatenessofcarebasedonaccepteddentalpractices.
utilizationre v ie w,statisticallybase d:Asystemthatexaminesthedistributionoftreatmentproceduresbased
onclaimsinformationandinordertobereasonablyreliable,theapplicationofsuchclaimsanalysesofspecific
dentistsshouldincludedataontypeofpractice,dentist'sexperience,socioeconomiccharacteristics,and
geographiclocation.

V
v e ne e r:Seelaminate v e ne e r.
v e rticalbite wing:Adentalimagewithacentralprojectiononwhichtheteethcanclose,holdingitinavertical
positionfortheradiographicexaminationofseveralupperandlowerteethsimultaneously.
v e rticaldime nsion:Theverticalheightofthefacewiththeteethinocclusionoractingasstops.
v e stibuloplasty:Anyofaseriesofsurgicalproceduresdesignedtoincreaserelativealveolarridgeheight.
v iralculture :Acollectionofspecimenforthepurposeofincubatingavirusforidentification.

W
waitingpe riod:Theperiodbetweenemploymentorenrollmentinadentalprogramandthedatewhenacovered
personbecomeseligibleforagivenbenefit.
waxpatte rn:Awaxformthatisthepositivelikenessofanobjecttobefabricated.
worke r'scompe nsation:Abenefitpaidtoanemployeewhosuffersaworkrelatedinjuryorillness.

X
xe rostomia:Decreasedsalivarysecretionthatproducesadryandsometimesburningsensationoftheoral
mucosaand/orcervicalcaries.
xray:Seeradiograph.

Y
ye ast:Ageneraltermforafungusoccurringasa.unicellular,nucleatedorganismthatusuallyreproducesby
budding.Someyeastsmayreproducebyfission,manyproducingmyceliaorpseudomycelia.

Z
zygomaticbone :Quadrangularboneoneithersideoffacethatformsthecheekprominence.Seemalar.

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