glossary terms

Abscess

Acute or chronic localized inflammation with a collection of pus, associated with tissue destruction and, frequently, swelling; usually secondary to infection.

Abutment

A tooth or implant used to support a prosthesis.

Abutment Crown

see "crown"; "retainer."

Accession

addition of a test specimen, previously collected by a health care provider, to a laboratory specimen collection; recording of essential specimen identification data in a laboratory-maintained file in chronological order of laboratory specimen acquisition; assignment to the specimen of an identification code.

Acid Etching

use of an acidic chemical substance to prepare the tooth enamel and or dentin surface to provide retention for bonding.

Adhesive

any substance that joins or creates close adherence of two or more surfaces.

Administrative Costs

overhead expenses incurred in the operation of a dental benefit program, exclusive of costs of dental services provided.

Administrative Services Only (ASO)

an arrangement under which a third party, for a fee, processes claims and handles paperwork for a self-funded group. This frequently includes all insurance company services (actuarial services, underwriting, benefit description, etc.) except assumption of risk.

Administrator

one who manages or directs a dental benefit program on behalf of the program's sponsor. (See Third-Party Administrator; Dental Benefit Organization.)

Adult dentition

the permanent teeth of adulthood that either replace or are added to the primary dentition.

Adverse Selection

a statistical condition within a group when there is a greater demand for dental services and/or more services necessary than the average expected for that group.

Allogenic

belonging to the same species, but genetically different. See Graft.

Alloplastic

refers to synthetic material often used for tissue augmentation.

Allowable Charge

the maximum dollar amount on which benefit payment is based for each dental procedure.

Alternate Benefit

a provision in a dental plan contract that allows the third-party payer to determine the benefit based on an alternative procedure that is generally less expensive than the one provided or proposed.

Alternative Benefit Plan

a plan, other than a traditional (fee-for-service, freedom-of-choice) indemnity or service corporation plan, for reimbursing a participating dentist for providing treatment to an enrolled patient population.

Alternative Delivery System

an arrangement for the provision of dental services in other than the traditional way (e.g., licensed dentist providing treatment in a fee-for-service dental office).

Alveolar

referring to the bone to which a tooth is attached

Alveoloplasty

surgical procedure for recontouring alveolar structures, sometimes in preparation for prosthesis.

Amalgam

an alloy used in direct dental restorations.

Analgesia

loss of pain sensations without loss of consciousness.

Anatomical Crown

see Crown.

Ancillary

subordinate or auxiliary to something or someone else; supplementary

Anesthesia

a patient's level of consciousness is determined by the provider and not the route of administration of anesthesia. State dental boards regulate the use of anesthesia techniques. local anesthesia – The elimination of sensation, especially pain, in one part of the body by the topical application or regional injection of a drug. regional anesthesia – A term used for local anesthesia; see Local Anesthesia. conscious sedation - a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command and that is produced by a pharmacological or non-pharmacological method or a combination thereof. deep sedation - an induced state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway and respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-harmacological method or a combination thereof. general anesthesia - an induced state of unconsciousness, accompanied by a partial or complete loss of protective reflexes, including the inability to continually maintain an airway independently and respond purposefully to physical stimulation or verbal command, produced by a pharmacologic or non-pharmacologic method or a combination thereof. enteral - any technique of administration in which the agent is absorbed through the gastrointestinal tract or oral mucosa (e. g., oral, rectal, sublingual). parenteral - a technique of administration in which the drug bypasses the gastrointestinal tract (e. g., intramuscular [IM], intravenous [IV], intranasal [IN], submucosal [SM], subcutaneous [SC], intraocular [IO].)

Anomaly

deviation from the normal anatomic growth, development or function; an abnormality.

ANSI/ADA/ISO

designation for standards recognized by the American National Standards Institute/American Dental Association/International Standards Organization.

Anterior

refers to the teeth and tissues located towards the front of the mouth; maxillary and mandibular incisors and canines. The designation of permanent anterior teeth in the Universal tooth numbering system include teeth 6 through 11 (maxillary), and 22 through 27 (mandibular); primary teeth in the Universal tooth numbering system are designated C through H (maxillary), and M through R (mandibular).

Any Willing Provider

legislation that requires managed care organizations (MCOs), such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs) to contract with any providers, from physicians and hospitals to pharmacists and chiropractors, who are willing to meet the terms of the contract.

Apex

the tip or end of the root end of the tooth.

Apexification

the process of induced root development.

Apicoectomy

amputation of the apex of a tooth

Appeal

a request to a dental plan to review a decision that denied or limited the treatment or proposed treatment to the beneficiary of the plan; usually made by the attending dentist on behalf of the plan beneficiary.

Arch, Dental

the curved composite structure of the natural dentition and the residual ridge, or the remains thereof, after the loss of some or all of the natural teeth.

Areas of oral cavity

a two digit numeric system used to report regions of the oral cavity to third-party payers.

Arthrogram

a diagnostic X-ray technique used to view bone structures following injection of a contrast medium into a joint.

Artificial Crown

see Crown.

Assignment of Benefits

a procedure whereby a beneficiary/patient authorizes the administrator of the program to forward payment for a covered procedure directly to the treating dentist.

Attending dentist statement

also known as the ADA Dental Claim Form. A form used to report dental procedures to a third-party payer. The claim form was developed by the American Dental Association.

Audit

an examination of records or accounts to check their accuracy. A post-treatment record review or clinical examination to verify information reported on claims.

Autogenous

see Graft.

Avulsion

separation of tooth from its socket due to trauma (evulsion).