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palate: The hard and soft tissues forming the roof of the mouth that separates the oral and nasal cavities.
palliative: Action that relieves pain but is not curative.
panoramic radiograph: An extraoral projection whereby the entire mandible, maxilla, teeth and other nearby structures are portrayed on a single image, as if the jaws were flattened out.
papoose board: A behavior management technique utilizing immobilization to control the actions of a patient who is receiving dental treatment.
parafunctional: Other than normal function or use.
parenteral: See definition under anesthesia
partial denture: Usually refers to a prosthetic device that replaces missing teeth. See fixed partial denture or removable partial denture.
participating dentist: See contract dentist.
patient: An individual who has established a professional relationship with a dentist for the delivery of dental health care. For matters relating to communication of information and consent this term includes the patient’s parent, caretaker, guardian, or other individual as appropriate under state law and the circumstances of the case.
payer: A self-insured employer, insurance company, governmental agency or other party responsible for payment of health care claims of covered persons.
pediatric dentist: A dental specialist whose practice is limited to treatment of children from birth through adolescence, providing primary and comprehensive preventive and therapeutic oral health care; formerly known as a pedodontist.
pediatric dentistry: Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
pedodontist: See pediatric dentist.
peer review: An evaluation of the quality and conduct of an individual’s work by the individual’s professional equals (peers) in order to resolve questions or disputes regarding the quality, or conduct of the work. Peer review, when applied to dentistry, is a process, consistently structured and implemented by organized dentistry, in which a dentist’s professional equals (peers) resolve questions or disputes (regarding the quality or appropriateness of care provided by the dentist or the fairness of the fee the dentist charged in an individual case) by retrospectively evaluating the quality or appropriateness of care in relation to professional norms or criteria or evaluating the fee charged in relation to the dentist’s fee for the given complexity and level of care provided.
Peer Review Organization (PRO): An organization established by an amendment of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), to provide for the review of medical services furnished primarily in a hospital setting and/or in conjunction with care provided under the Medicare and Medicaid programs. In addition to their review and monitoring functions, these entities can invoke sanctions, penalties, or other corrective actions for noncompliance in organization standards.
percentile: The number in a frequency distribution below which a certain percentage of fees will fall. For example, the 90th percentile is the number that divides the distribution of fees into the lower 90% and the upper 10%, or that fee level at which 90% of dentists charge that amount or less, and 10% more.
periapical: The area surrounding the end of the tooth root.
periapical abscess: See abscess.
periapical cyst: See cyst.
periapical radiograph: A radiograph made by the intraoral placement of film, phosphorous plate, emulsion or digital sensor, for disclosing the apices of the teeth.
pericoronal: Around the crown of a tooth.
periodic oral evaluation: See evaluation.
periodontal: Pertaining to the supporting and surrounding tissues of the teeth.
periodontal abscess: See abscess.
periodontal disease: Inflammatory process of the gingival tissues and/or periodontal membrane of the teeth, resulting in an abnormally deep gingival sulcus, possibly producing periodontal pockets and loss of supporting alveolar bone.
periodontal pocket: Pathologically deepened gingival sulcus; a feature of periodontal disease.
periodontics: Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
periodontist: A dental specialist whose practice is limited to the treatment of diseases of the supporting and surrounding tissues of the teeth.
periodontitis: Inflammation and loss of the connective tissue of the supporting or surrounding structure of teeth with loss of attachment.
periodontium: tissue complex comprising gingival, cementum, periodontal ligament, and alveolar bone which attaches, nourishes and supports the tooth.
periradicular: Surrounding a portion of the root of the tooth.
permanent dentition: Refers to the permanent or adult teeth in the dental arch.
pin: A small metal rod, cemented or driven into dentin to aid in retention of a restoration.
plaque: A soft sticky substance that accumulates on teeth composed largely of bacteria and bacterial derivatives.
point of service: A health plan allowing the member to choose to receive a service from a participating or non-participating provider, usually with different benefits levels associated with the use of participating providers.
pontic: The term used for an artificial tooth on a fixed partial denture (bridge).
porcelain/ceramic: Refers to those non-metal, non-resin inorganic refractory compounds processed at high temperatures (600ºC/1112ºF and above) and pressed, polished or milled – including porcelains, glasses, and glass-ceramics.
post: Rod-like component designed to be inserted into a prepared root canal space so as to provide structural support. This device can either be in the form of an alloy, carbon fiber or fiberglass, and posts are usually secured with appropriate luting agents.
posterior: Refers to teeth and tissues towards the back of the mouth (distal to the canines); maxillary and mandibular premolars and molars. The designation of permanent posterior teeth in the Universal/National tooth numbering system include teeth 1 through 5 and 12 through 16 (maxillary), and 17 through 21 and 28 through 32 (mandibular); primary teeth in the Universal tooth numbering system are designated A, B, I and J (maxillary), and K, L, S and T (mandibular).
post-treatment review: See audit.
preauthorization: Statement by a third-party payer indicating that proposed treatment will be covered under the terms of the benefit contract. See also precertification, predetermination.
precertification: Confirmation by a third-party payer of a patient’s eligibility for coverage under a dental benefit program. See preauthorization, predetermination.
precision attachment: Interlocking device, having a male component integrated into a removable prosthesis that fits precisely into a female component embedded in the body of abutment teeth or implant abutments, to stabilize or retain the prosthesis when it is seated in the mouth.
predetermination: A process where a dentist submits a treatment plan to the payer before treatment begins. The payer reviews the treatment plan and notifies the dentist and patient of one or more of the following: patient’s eligibility, covered services, amounts payable, co-payment and deductibles and plan maximums.
pre-existing condition: Oral health condition of an enrollee which existed before his/her enrollment in a dental program.
Preferred Provider Organization (PPO): A formal agreement between a purchaser of a dental benefit program and a defined group of dentists for the delivery of dental services to a specific patient population, as an adjunct to a traditional plan, using discounted fees for cost savings.
prefiling of fees: The submission of a participating dentist’s full fees for the purpose of establishing, in advance, that dentist’s full fees and the fees in a geographic area to determine benefits under a dental benefit program.
premedication: The use of medications prior to dental procedures.
premium: The amount charged by a dental benefit organization for coverage of a level of benefits for a specified time.
premolar: See bicuspid.
prepaid dental plan: A method of financing the cost of dental care for a defined population, in advance of receipt of services.
prepaid group practice: See closed panel.
pretreatment estimate: See predetermination.
preventive dentistry: Aspects of dentistry concerned with promoting good oral health and function by preventing or reducing the onset and/or development of oral diseases or deformities and the occurrence of oro-facial injuries.
primary dentition: The first set of teeth; see deciduous.
primary payer: The third party payer determined to have initial responsibility in a benefit determination.
prior authorization: See predetermination.
prompt payment laws: Also known as fair claims practice regulations. Enacted state by state, prompt payment laws set standards for the prompt, fair and equitable settlements of insurance claims by requiring that a set amount of interest be paid on “clean claims” that are paid beyond the established timeframe. “Clean claim” means a claim for payment of covered health care expenses that is submitted to a payer on the carrier’s standard claim form using the most current published procedural codes, with all the required fields completed with information sufficient to adjudicate the claim in accordance with the payer’s published filing requirements. These laws need to be analyzed on a case by case basis to determine whether a lawsuit has to be filed by the state department of insurance.
proof of loss: Verification of services rendered or expenses incurred by the submission of claim forms, radiographs, study models, and/or other diagnostic material. Documentary evidence required by a payer to prove a valid claim exists. It usually consists of a claim form completed by the patient’s treating dentist.
prophylaxis: Removal of plaque, calculus and stains from the tooth structures. It is intended to control local irritational factors.
prospective review: Prior assessment by a payer or payer’s agent that proposed services are appropriate for a particular patient, and/or the patient and the category of service are covered by a benefit plan. See preauthorization, precertification, predetermination, second-opinion program.
prosthesis: Artificial replacement of any part of the body.
definitive prosthesis–Prosthesis to be used over an extended period of time.
dental prosthesis–Any device or appliance replacing one or more missing teeth and/or, if required, associated structures. (This is a broad term which includes abutment crowns and abutment inlays/onlays, bridges, dentures, obturators, gingival prostheses.)
fixed prosthesis–Non-removable dental prosthesis which is solidly attached to abutment teeth, roots or implants.
fixed-removable prosthesis–Combined prosthesis, one or more parts of which are fixed, and the other(s) attached by devices which allow their detachment, removal and reinsertion by the dentist only.
interim prosthesis–A provisional prosthesis designed for use over a limited period of time, after which it is to be replaced by a more definitive restoration.
removable prosthesis–Complete or partial prosthesis, which after an initial fitting by a dentist, can be removed and reinserted by the patient.
prosthodontics: Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes.
prosthodontist: A dental specialist whose practice is limited to the restoration of the natural teeth and/or the replacement of missing teeth with artificial substitutes.
provisional: Formed or preformed for temporary purposes or used over a limited period; a temporary or interim solution; usually refers to a prosthesis or individual tooth restoration.
public health dentist: A dentist whose practice is limited to the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts.
public health dentistry: Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.
pulp: Connective tissue that contains blood vessels and nerve tissue which occupies the pulp cavity of a tooth.
pulp cap: See direct pulp cap; indirect pulp cap.
pulp cavity: The space within a tooth which contains the pulp.
pulpectomy: Complete removal of vital and non-vital pulp tissue from the root canal space.
pulpitis: Inflammation of the dental pulp.
pulpotomy: Removal of a portion of the pulp, including the diseased aspect, with the intent of maintaining the vitality of the remaining pulpal tissue by means of a therapeutic dressing.
purchaser: Organization or entity, often employer or union, that contracts with the dental benefit organization to provide dental benefits to an enrolled population.