English For Dentists

O.O.
BOHOMOLETS NATIONAL MEDICAL UNIVERSITY
English
for Dentists
Edited by
Associate Professor
L. Avrakhova
Kiev, Book-plus, 2018

Автори:
Л.Я. Аврахова, І.О. Паламаренко, О.В. Голік, Л.К. Москаленко, О.В. Дунаєвська,
В.С. Кушнір
Рецензенти:
Н.В. Біденко – д-р мед. наук, професор, декан стоматологічного факультету НМУ
імені О.О. Богомольця.
Н.О. Федчишин – д-р пед. наук, доцент, завідувач кафедри іноземних мов ДВНЗ
«Тернопільський державний медичний університет імені І.Я. Горбачевського».
English for Dentists – Англійська мова для стоматологів: підручник / Л.Я. Аврахова,
І.О. Паламаренко, О.В. Голік, Л.К. Москаленко та ін.; за ред. Л.Я. Аврахової. –
К.: Книга-плюс, 2018 – 216 с.
Матеріал підручника відповідає вимогам програми «Англійська мова» для студентів

стоматологічних факультетів ВМНЗ ІV рівня акредитації.
Підручник містить 14 основних розділів. Запропоновані оригінальні та адаптовані
тексти зі стоматологічної тематики супроводжуються системою вправ, що сприяє
глибокому осмисленню та різнобічному розумінню прочитаного і розкриває вміння
використовувати лексичний матеріал у діалогічному та монологічному мовленні.
Матеріали підручника забезпечують професійну спрямованість студентів-
стоматологів під час вивчення англійської мови, готують їх до іншомовної комунікації,
читання фахової літератури, складання анотацій та написання рефератів.
Рекомендовано Вченою радою Національного медичного університету

імені О.О. Богомольця як підручник для студентів вищих навчальних закладів –
медичних університетів, інститутів й академій
(протокол №13 від 25.06.2018)
Підп. до друку 08.08.2018. Формат 70х100/16.

Папір офсет. Друк офсет. Наклад 500.
Видавництво «Книга-плюс»
03057, Київ, пр. Перемоги, 34.
Свідоцтво про внесення до Державного реєстру видавців
і розповсюджувачів видавничої продукції
серія ДК № 4904 від 20.05.2015 р.
тел./факс: (044) 492 04 28, (067) 403 55 05
www.book-plus.com.ua
© Аврахова Л.Я., Паламаренко

І.О., Голік О.В., Москаленко Л.К.,
Дунаєвська О.В., Кушнір В.С., 2018
ISBN 978-966-460-109-9 © ТОВ "Книга-плюс", 2018
CONTENTS
PART ONE
UNIT 1: History of Dentistry............................................................................................. 6

Text: History of Dentistry .................................................................................. 7
Grammar: Present Simple; Present Continuous (Active Voice) ........... 11
UNIT 2: Dental Specialties................................................................................................ 17

Text: Dental Specialties ..................................................................................... 18
Grammar: Past Simple; Past Continuous (Active Voice) ........................ 23
UNIT 3: Tooth Anatomy ................................................................................................... 30

Text: Teeth ............................................................................................................ 31
Grammar: Present Simple; Present Continuous (Passive Voice) ....... 35
UNIT 4: Oral Hygiene ........................................................................................................ 41

Text: Oral Hygiene ............................................................................................. 42
Grammar: Past Simple; Past Continuous (Passive Voice) .................... 48
UNIT 5: History Taking ...................................................................................................... 54

Text: Dental History Taking ............................................................................. 55
Grammar: Ways of Expressing Future ......................................................... 60
UNIT 6: Emergencies in Dentistry ............................................................................... 65

Text: Common Medical and Dental Emergencies in Dentistry ......... 66
Grammar: Perfect Tenses (Active Voice) .................................................... 72
UNIT 7: Dental Phobia ..................................................................................................... 79

Text: Dental Phobia ......................................................................................... 80
Grammar: Perfect Tenses (Passive Voice) ................................................. 86
Unit 8: Anesthesia .......................................................................................................... 95

Text: Anesthesia ................................................................................................ 96
Grammar: Modal Verbs .................................................................................. 102
PART TWO
UNIT 9: Dental Caries ....................................................................................................... 109

Text: Dental Caries ............................................................................................. 110
Grammar: The Infinitive ................................................................................... 116
UNIT 10: Preparation and Filling of the Cavity ......................................................... 123

Text: Preparation and Filling of the Cavity .............................................. 124
Grammar: The -ing Form ............................................................................... 129
UNIT 11: Root Canal Treatment ..................................................................................... 135

Text: Root Canal Treatment .......................................................................... 136
Grammar: Reported Speech (Part 1) ......................................................... 141
UNIT 12: Tooth Extraction ............................................................................................... 147

Text: Tooth Extraction ..................................................................................... 148
Grammar: Reported Speech (Part 2) .......................................................... 153
UNIT 13: Periodontal Diseases ....................................................................................... 158

Text: Periodontal Diseases ............................................................................. 159
Grammar: Conditional Sentences (Type 0 and I) ................................... 166
UNIT 14: Dental Prosthetics ........................................................................................... 173

Text: Dental Prosthetics ................................................................................ 174
Grammar: Conditional Sentences (Type II) ............................................ 180
DICTIONARY ........................................................................................................................... 187
REFERENCES ........................................................................................................................... 213

Передмова
Підручник призначений для студентів 1 та 2 курсів стоматологічних

факультетів та відповідає програмним вимогам навчання іноземної мови у
вищих медичних навчальних закладах.
Підручник складається з 14 розділів і укладений у відповідності з програмами
фахових дисциплін і висвітлює основні теми профільних предметів.
Текстовий матеріал, підібраний з оригінальних англійських та американських
стоматологічних журналів, монографій, періодичних видань, достатньо
інформативний і насичений необхідною професійною термінологією.
Система вправ підручника спрямована на осмислення та ефективне
розуміння текстового матеріалу, вироблення мовленнєвої компетенції,
розвиток умінь використовувати лексичний матеріал у діалогічному та
монологічному мовленні.
Підручник ставить за мету забезпечити професійну спрямованість
у навчанні студентів-стоматологів англійської мови, підготувати їх до
іншомовної комунікації, читання, анотування та реферування спеціальної
оригінальної літератури.
Граматичний довідник пропонує стислий виклад базового граматичного
матеріалу з використанням таблиць і схем.
Словник охоплює найбільш вживану професійну лексику в стоматології та
включає транскрипцію медичних термінів.
Підручник містить тексти для самостійного опрацювання, робота з
якими спрямована на вироблення навичок складання анотацій та написання
рефератів.
UNIT 1 HISTORY OF DENTISTRY
LEAD IN
1 Learn the following words.
evidence ['evIdqns] доказ, дані

worm [wE:m] черв’як, гельмінт
hypothesis [haI'pPθIsIs] гіпотеза, припущення
apply [q'plaI] прикладати,
застосовувати
relieve [rI'lJv] полегшувати
remains [rI'meInz] реліквії, сліди минулого
eruption [I'rʌpSn] прорізування (зубів)
barber ['bRbq] перукар
decay [dI'keI] гниття
pull [pVl] тягти, висмикувати
procedure [prq'sJdʒq] процедура
restore [rI'stL] відновлювати
extraction [Ik'strxkSn] видалення
resemble [rI'zembl] бути схожим на,
нагадувати когось/щось
remove [rI'mHv] видаляти
filling ['fIlIN] зубна пломба
derivative [dq'rIvqtIv] похідний
engine ['endʒIn] двигун
reference ['refrqns] посилання
anesthetic ["xnqs'θetIk] знеболюючий
wheel [wJl] колесо
UNIT I: History of Dentistry
2 Before you read the text, try to give some information about these questions:
· What is the probable cause of dental cavity?

· Was dentistry a profession in ancient times?
3 Read the text.
HISTORY OF DENTISTRY
Since prehistoric times when people have had problems with their teeth, there
were always other people to help them.
The earliest history of treating tooth related problems goes back to 7000 BC, where
the Indus Valley Civilization gave us evidence of treating the mouth for tooth decay.
The earliest dental filling, made of beeswax, was discovered in Slovenia and dates
from 6500 BC. The first explanation of tooth decay cause was noted by the Sumerians
around 5000 BC. The hypothesis was that tooth decay was caused by a tooth worm.
A Sumerian text gives the first written reference to dental decay and it dates from
5000 BC. Ancient Egyptian papers describe substances to be mixed and applied to
the teeth to relieve pain.
Early signs of dental prosthetic and surgery were discovered in the remains of
some ancient Egyptians. Hippocrates and Aristotle described not only the eruption
pattern of teeth but treatment of decayed teeth and gums, extraction of teeth with
forceps, and stabilization of loose teeth and fractured jaws by wires. The first use of
dental appliances or bridges comes from the Etruscans 700 BC.
Even through the 19th century dentistry was not a profession. Minor dental proce-
dures were performed by barbers. They usually practiced the extraction of teeth. The
barber dentists pulled teeth to treat decay. Besides, they filled cavities and made false
teeth out of human teeth and cow bone. Instruments for dental extractions were invent-
ed several centuries ago. In the 14th century, Guy de Chauliac was the first to use dental
pelican to perform dental extractions. In medieval times people believed in traditional
remedies. In Germany you were supposed to kiss a donkey to cure your toothache.
By 17th-century French physician Pierre Fauchard started dentistry as a science,
and is known as “the father of modern dentistry”. The basic oral anatomy and func-
tions, signs and symptoms of oral pathology, operative methods for removing decay
and restoring teeth, periodontal disease, orthodontics, replacement of missing teeth,
and tooth transplantation were described in his book “The Surgeon Dentist”. The sci-
entists consider this book the first complete scientific description of dentistry. Pierre
7
PART ONE
Fauchard developed the extensive use of dental prosthesis, the application of dental
fillings for the treatment of dental caries. He stated that sugar derivative acids includ-
ing tartaric acid are responsible for dental decay.
Dentistry was a painful procedure for many years. In the 1790s, a British chem-
ist initiated the experiments on the use of nitrous oxide for pain relief. He called it
“laughing gas.” The “laughing gas” became very popular during the next 50 years, and
is still used in dental practice. 1790 was noted as a remarkable year in dentistry. The
first dental foot engine was constructed by John Greenwood. There was also the first
specialized dental chair invented. In 1905, a German chemist discovered procaine; he
named it Novocain which started the era of “painless dentistry.”
In 1957, John Borden invented a high-speed dental drill, which shortened the
time of tooth preparation for a filling.
Both with Novocain and high speed drill dentistry entered the modern ages.
LANGUAGE DEVELOPMENT
4 Match the events to the dates.
1. The first use of the laughing gas. a) In 1905

2. The invention of dental pelican which was used to b) Dates from 6500 year
perform dental extractions. ago
3. The first use of dental appliances and bridges. c) In the 1790s
4. The discovery of the earliest dental filling. d) 700 BC
5. Novocain was discovered. e) In the 14th century
5 Fill in the correct word(s) from the list below. Use them in the sentences.
teeth anatomy decay missing teeth cavities

appliance procedure teeth method disease
1. to remove __________________ 6. painful _____________________

2. to treat ____________________ 7. dental ______________________
3. to replace __________________ 8. oral ________________________
4. to extract __________________ 9. operative ___________________
5. to fill ______________________ 10. periodontal ________________
8
6 Fill in the gaps with the correct word from the word bank.
sugar dentures extractions caries barber
1. Archaeologists have evidence of dental ____________in teeth from people who

lived around 8000 BC. (decay)
2. Poor people often had better teeth as they had very little _____________in their
diets. (carbohydrates)
3. People’s teeth troubles were treated by their own remedies or by _____________
surgeons. (not professionals)
4. The people who were doing the ________ during the Middle Ages were barbers.
(pulling out the teeth)
5. Today’s __________________ are made of plastic or ceramic. (false teeth)
7 Fill in the correct word derived from the words in bold.
1. In the medieval Europe the rich people were aware of the __________________
(important) of keeping their teeth clean.
2. The work of barbers was focused on _______________ (to extract) any infected
teeth for decreasing pain.
3. The water _______________ (fluoride) era began when in 1945 some American
cities added sodium fluoride to public water systems.
4. New tooth-coloured ____________ (to restore) materials contributed to the era
of esthetic dentistry.
5. Many dental clinics use lasers for the ______________ (to treat) of tooth decay.
6. Sugar control is theoretically the best method in caries _________ (to prevent).
8 Match the English words and word combinations to the definitions.
1. dental filling
2. dental caries
3. barber
4. transplantation
5. prosthesis
6. anesthetic
7. dentistry
8. dental hygiene
9
PART ONE
a. any artificial device that is used in dentistry;

b. replacement of missing teeth;
c. decay of the substance of a tooth;
d. keeping the mouth clean by gargling and mouth washing;
e. non-professional person who can extract teeth;
f. branch of medicine dealing with teeth and gums;
g. the operation of inserting a specially prepared substance into a cavity;
h. an agent that reduces or abolishes sensation.
9 Answer the following questions.

1. What is the earliest evidence of treating tooth decay?
2. When was the first written reference to dental decay found?
3. What was attitude to dentistry during the Middle Ages?
4. What procedures did barbers perform?
5. Who is considered “the father of modern dentistry”?
6. When was the era of “painless dentistry” started?
10 Ask your friend the questions to obtain information about:

· eruption pattern of teeth
· dental extractions
· filling of cavities
· dental pelican
· traditional remedies
· replacement of missing teeth
· restoring teeth
· dental prosthesis
11 Agree or disagree with the following statements. Comment your answer.

1. The first evidence of treating tooth decay dates back to 6500.
2. Hippocrates wrote about extracting teeth with the dental pelican.
3. Dental extractions were primarily performed by barbers.
4. The first complete scientific description of dentistry was made by Guy de
Chauliac.
5. Extensive use of dental prosthesis and dental caries treatment was described
in the book “The Surgeon Dentist”.
6. Dentistry was a painful procedure throughout history.
7. In 1905, a British chemist discovered procaine.
10
GRAMMAR
PRESENT SIMPLE PRESENT CONTINUOUS
We use the Present Simple: We use the Present Continuous:

· for permanent states, repeated · for actions happening now, at the mo-
or habitual actions. ment of speaking.
She works for pharmaceutical He is preparing for the test now.
company. · for fixed arrangements in the near future.
· for general truths and laws of I am meeting him on Friday night.
nature. · for frequently repeated actions with al-
Water freezes at 0 ºC. ways, constantly, continuously.
· for timetables, sport commen- They are always coming late.
taries.
The last train to Paris leaves at Time expressions used with Present Con-
9:10 pm. tinuous: now, at the moment, at present,
this month/week, tonight, still.
Time expressions used with Pres-
ent Simple: always, usually, every Stative verbs describe a state rather than
day/week, as a rule, sometimes, an action and are not used in the Continu-
often, never. ous Tenses: like, love, hate, see, smell, hear,
feel, know, believe, understand, remember,
think, forget etc.
1 Choose the correct tense.

1. More and more people move/are moving to the countryside these days.
2. Hurry up! The train leaves/is leaving at 2:30pm.
3. The medical fees increase/are increasing with every coming year.
4. In old papyrus we can find/are finding information about operation of frac-
tures and dislocations.
5. The dentist usually uses/is using high-speed drill to remove decayed tooth ma-
terial.
6. While brushing the teeth, the person first applies/is applying toothpaste onto
the bristles of the toothbrush.
7. The vertical movement of the toothbrush cleans/is cleaning the small pieces of
food that get stuck between the teeth.
8. They have/are having a party on Saturday afternoon.
11
PART ONE
2 Put in am/is/are/do/does.
1. What _________ she do? She’s a dentist.
2. Unfortunately the situation with air pollution _________ getting much worse.
3. _________the Committee discussing the problems of modern medicine at
present?
4. What _________you doing this evening?
5. The scientists have greatly improved many surgical procedures but some pro-
cedures discovered in prehistoric time _________still in use today.
6. _________new diseases appear with the people’s change of their lifestyles and
environment?
7. The advances in medical science this century have certainly helped to save
millions of lives, however, they _________also causing problems.
8. What _________ dental surgeon deal with?
3 Put the verbs in brackets into Present Simple or Present Continuous.

1. An Egyptian text, the Ebers Papirus, _________ (to refer) to diseases of the
teeth.
2. A medical text in China _________ (to mention) the use of “silver paste”, a
type of amalgam.
3. The dentist _________ (to extract) tooth using wires to stabilize loose teeth.
4. The patient _________ (to suffer) from a severe pain.
5. One of the principal causes of dental caries _________ (to be) high consump-
tion of sugar.
6. Prevention _________ (to become) a primary focus of dentistry at present.
7. Dental practitioner _________ (to provide) up-to-date treatment for a wide
variety of dental problems.
8. There are more than 400 theories which _________ (to try) to explain the
caries.
4 Answer the following questions using Present Simple or Present Continuous.

1. What is the dentist doing now?
2. What are your plans for the holiday?
3. What do you usually do at the weekend?
4. How many times does the dentist recommend to brush your teeth?
5. Who usually provides instructions to extract teeth?
6. What are the changes in dentistry at present time?
12
5 Correct the mistakes.

1. The agency give information to anyone who need it.
2. He goes to a national conference about the environment.
3. What is their plans for Sunday?
4. I don’t think there are place for these things.
5. What does he do at the moment?
6. He is not understanding the simple ideas.
TALKING POINTS
1 Be ready to talk to your friends about:

· achievements of ancient medicine;
· extracting teeth during the Middle Ages;
· ancient medical procedures which are still used.
MORE READING
1 Read the text and make your commentary.

1. The Romans didn’t make any distinction between dental problems and the dis-
eases affecting other organs, did they?
2. Did Celsus give priority to teeth extraction?
3. Did the Romans ignore oral hygiene?
4. How did the Romans perform restoration of carious teeth?
5. What prosthetic appliances were used by the Romans?
DENTISTRY IN ROME
When the medical profession was in its infancy in Rome, dentistry was being
practiced there. The dentistry as a separate profession did not exist among the Ro-
mans but was included as part of medical practice, and Roman physicians made no
distinction between diseases affecting the mouth and teeth and those affecting other
parts of the body. Nor did non-professionals specialize in dentistry, although we have
extensive knowledge of the services performed by Roman barbers.
The encyclopedic Celsus, described in detail the surgical instruments used by the
physicians of his day and included among them forceps and a special instrument
for the roots extraction known as tenaculum. Also Celsus wrote one of the most au-
13
PART ONE
thoritative compendiums of medical knowledge in ancient times. In «On Medicine»,

which has served as a basic text until recent times, he discusses numerous aspects of
dentistry. The toothache, which Celsus describes as «among the worst of tortures»,
was to be treated with a variety of hot poultices, mouth rinses, steam applications,
purgatives and laxatives, and a variety of other remedies. He advised the owner of a
decayed tooth to be in no haste to extract it and if certain remedies previously cited
were of no use. For decayed tooth with small cavity he suggested filling the cavity
with linen thread or lead. He also considered the need for oral hygiene: black stains
on the teeth were to be scraped off and the teeth rubbed with a mixture of pounded
rose leaves, gallnuts, and myrrh, after which the mouth was to be rinsed with pure
wine.
In addition to the treatment of oral diseases and the extraction of teeth, the Ro-
mans were skilled in restoring carious teeth with gold crowns and replacing miss-
ing teeth by means of fixed bridgework. Reference to gold wiring in the Laws of the
Twelve Tables suggests that prosthodontics was practiced in the early Republic. The
prosthetic appliances were fashioned by goldsmiths or other artisans and that they
were then placed in the mouth by the physician, just as dentists and laboratory tech-
nicians share responsibilities today.
The Romans had a high regard for oral hygiene. The use of tooth-cleaning pow-
ders was apparently widespread, and the more involved their preparation and the
more numerous their ingredients, the more highly were they regarded. Although
fancy and superstition dictated the choice of ingredients, the addition of such astrin-
gents as myrrh or niter suggests a desire not only to clean the teeth but to strengthen
them when loose. References have been found to a substance that the Romans called
nitrum, probably either potassium carbonate or sodium carbonate, which was burnt
and rubbed on the teeth to restore their colour.
2 Read the text and be ready to answer the following questions.

1. Why is Pierre Fauchard called “the father of modern dentistry”?
2. When was Fauchard’s book “The Surgeon Dentist” published?
3. What device for extracting teeth was created by Fauchard?
4. What materials did Fauchard propose to use to treat cavities?
5. What appliance did he use for teeth strengthening?
PIERRE FAUCHARD
French physician Pierre Fauchard is widely credited as being the “father of mod-
ern dentistry.” He joined the navy in the late seventeenth century and quickly became
interested in dental ailments. Later he began to practice at the University of Angers
Hospital where he pioneered scientific oral and maxillofacial surgery.
14
In 1728, Fauchard published “The Surgeon Dentist”. His book described basic oral
anatomy, operative dental methods, periodontal disease, tooth transplantation, and
orthodontics. He created various tools for filling teeth, and the pelican forceps which
were used for extracting teeth.
Whereas most dentists at that time extracted decayed teeth, Fauchard attempted
to treat them. He introduced the idea of dental fillings as a way to treat cavities and
suggested using amalgams, such as lead, tin, or sometimes gold for the fillings. He
wrote that a theory that caries is caused by “tooth worm” is wrong, that people should
eat less sugar as dental cavities are caused by sugar derivate acids, such as tartaric
acids.
In Fauchard’s book, he also devoted an entire chapter on how to straighten teeth.
He maintained that “Bandeau,” a horseshoe-shaped piece of metal, could expand the
arch and correct the position of teeth.
At that time, some dentists believed that teeth did not have roots and were spon-
taneously generated. Fauchard disproved the theory of spontaneous tooth genera-
tion and stated that first teeth (milk teeth) separated themselves from their roots. He
investigated methods of replacing lost teeth. His ideas also included holding of the
artificial teeth to healthy ones with wire on thread and with first braces.
3 Read the text about toothbrush’s development and answer the following
questions.
1. When and where was the first toothbrush used?
2. What were the toothbrush bristles made of?
3. When did the first commercially prepared toothbrush start?
4. Who inverted the first electric toothbrush?
5. What were natural animal bristles replaced by?
HISTORY OF TOOTHBRUSH
A variety of oral hygiene aids such as toothpicks, chew sticks linen strips, bird’s
feathers, animal bones have been used since ancient times.
The earliest use of toothbrushes occurred in India and China. The bristle tooth-
brush was found in China during the Tang Dynasty (619-907). In 1223, Japanese
master Dogenkigen noted, that he saw monks in China clean their teeth with brushes
made of horse tail hairs attached to an ox-bone handle. The bristle toothbrush was
spread from China to Europe by travellers. Many toothbrushes were primarily made
with horse or boar bristle and were imported to England.
The first mass-produced toothbrush was developed by William Addis in 1780.
15
PART ONE
In 1850 N. Wadsworth first patented his toothbrush in the United States but mass
production started in 1885.During the 1900s, celluloid handles gradually replaced
bone handles in toothbrushes. Natural bristles were replaced by synthetic materials,
usually nylon, by DuPont in 1938.
The first electric toothbrush was developed in 1939 in Switzerland, but didn’t ap-
pear on the open market until the 1960s. In 1961 a rechargeable cordless toothbrush
was introduced.
In 1987 the first rotary action toothbrush for home use appeared in shops for
the general public. Research shows that these may prove more effective at removing
plaque and preventing gingival bleeding than manual toothbrushes.
16
UNIT 2 DENTAL SPECIALTIES
LEAD IN
conservative [ken'sE:vqtIv] консервативний,

традиційний
endodontics ["endqV'dPntIks] ендодонтія (вивчає будову
і функції тканин пульпи і
дентину)
maxillofacial ["mxk"sIlqV'feISql] щелепно-лицевий
orthodontics ["LTq'dPntIks] ортодонтія (лікування
щелепно-лицьових
аномалій)
caries ['kFqrIz] карієс
periodontology ["perIqdqn'tPlqGI] парадонтологія (вивчення
будови і функцій
пародонту)
paedodontics ["pJdq'dPntIks] дитяча стоматологія
pathology [pq'TPlqGI] патологія
injury ['InGqrI] травма, пошкодження
pulp [pAlp] пульпа
abscess ['xbsqs] абсцес, нарив, гнійник
expose [Ik'spqVz] піддавати. проникати
jaw [GL] щелепа
tumour ['tjHmq] пухлина
malocclusion ["mxlq'klHZn] неправильний прикус
braces [breIsIs] брекет-система,
ортодонтична скоба
appliance [q'plaIqns] пристрій, прилад
dentition [den'tISn] прорізування зубів
PART ONE
mental ['mentl] ментальний, що

стосується розуму
retarded [rI'tRdId] відсталий (розумово)
handicapped ['hxndIkxpt] людина з фізичними
вадами
crown [kraVn] коронка
bridge [brIG] міст
denture ['denCq] зубний протез
2 Before you read the text, try to give some information about these questions:
· Have you ever been a patient of a dentist?

· Were you afraid of pain sensation?
· What do you think about your dentist?
3 Read the text.
DENTAL SPECIALITIES
Dentistry has progressed significantly in recent centuries. And if you have a prob-
lem with teeth you may go and see your dentist.
If a general dentist can’t cope with your problem, he will refer you to practitioners
in one of the following specialties: conservative dentistry, endodontics, oral and max-
illofacial surgery, orthodontics, prosthodontics, periodontology, paedodontics and
oral pathology.
A conservative dentist deals with treatment and prevention of caries and restores
carious or broken teeth conservatively using filling materials.
An endodontist treats oral conditions due to a disease or injury of the dental pulp.
These diseases are: pulpitis, periapical abscesses, non-vital teeth or exposed pulp.
One of the endodontic procedures is root canal treatment (RCT)
An oral surgeon treats and surgically corrects diseases, injuries and defects of the
mouth and jaws. He performs complicated extractions, correction of cleft palate, re-
moval of cysts and tumours, deals with impacted teeth and retained roots of the teeth
as well as inserts implants.
An orthodontist deals with various forms of malocclusion, and misalignment of
the teeth (crowding, overlapping, overbite) and designs corrective and supportive
devices in the form of dental braces, fixed and removable appliances.
18
UNIT 2: DENTAL SPECIALTIES
A paedodontist provides dental care for children and deals with mixed dentition,
prevention of dental caries, and promotes proper oral hygiene in young patients, pre-
vents caries by the application of fissure sealants and varnishes. Besides, the paediat-
ric dentist also treats mentally retarded, non-cooperative or handicapped children.
A periodontist diagnoses and treats the tissues supporting and surrounding the
teeth, including gingivitis and periodontitis, removes calculus from teeth, provides
instruction on how to maintain oral hygiene to avoid such gingival conditions.
A prosthodontist constructs artificial appliances designed to restore and maintain
the oral function by replacing missing teeth or other oral structures with crowns,
bridges, complete and partial dentures, laminate veneers, post-and-cores.
An oral pathologist examines oral tissues for some abnormalities using clinical,
radiographic, or other laboratory procedures necessary to make a diagnosis to pro-
vide treatment or advice regarding the treatment of such abnormalities.
A public health dentist is responsible for the dental health needs of entire com-
munities. He designs and administers large-scale prevention and dental care pro-
grammes. Public health dentists work with local and state health departments to
improve oral health, teach in dental schools and conduct research with preventive
measures. They are also involved in initiating and implementing community fluori-
dation programmes.
4 Match the English words and word-combinations with the definitions.
1. Endodontics
2. Prosthodontics
3. Paedodontics
4. Public dental health
5. Oral pathology
6. Periodontology
7. Oral and maxillofacial surgery
8. Orthodontics
a. a study of dental epidemiology and social health policies

b. care of children’s teeth
c. extractions, implants, and facial surgery
d. straightening of teeth, problems of malocclusion
19
PART ONE
e. root canal therapy and study of diseases of the dental pulp

f. dentures, bridges and the restoration of implants
g. study and treatment diseases of periodontium
h. examination of oral tissues using radiographic, microscopic procedures to
provide diagnosis, advice and treatment
5 Complete the sentences with the words and words combinations.
extractions corrective appliances periapical abscess

departments missing teeth prevention of caries overbite
1. Various filling materials are used for treatment and ___________________.

2. As the patient had _____________ the decision was made to extract the tooth.
3. Though the _______________ are painless at present it is not easy for children
to cope with fear.
4. _______________ may be effectively replaced with crowns, bridges, complete
and partial dentures.
5. The public health dentist teaches in dental schools, local and state
____________________________.
6. ________________ may result in malocclusion and ________________ in
the form of dental braces should be used.
6 What field of dental activity do these specialists deal with?
1. A surgeon ____________________________________________________.
2. A periodontist _________________________________________________.
3. An endodontist ________________________________________________.
4. An orthodontist _______________________________________________.
5. An oral pathologist _____________________________________________.
6. A paedodontist ________________________________________________.
7. A prosthodontist _______________________________________________.
8. A public health dentist __________________________________________.
7 Associate these words with the job of a certain dental specialist.
· pulpitis
· correction of cleft palate
· restoration of carious tooth
20
· tumours
· dental care programme
· gingivitis
· malocclusion
· laboratory procedures
· mixed dentition
· implants
· preventive measures
· crowding of teeth
· partial dentures
· dental braces
8 Choose the correct word or phrase to complete each sentence.
1. Various filling materials are used to

· devitalize the tooth
· make a diagnosis
· restore carious tooth
2. An incomplete wisdom tooth removal resulted in
· severe toothache
· caries prevention
· pain reduction
3. As the condition was very severe the doctor decided
· to refer the patient to a specialist
· to provide a treatment
· to extract the tooth
4. As the patient had pulpitis the decision was made
· to initiate root canal treatment
· to use a painkiller
· to apply corrective devices
5. A dental surgery is equipped with
· composite restorations
· basic set of instruments
· dentures
9 Send your patient to a proper specialist.

Example: You have malocclusion. I’ll refer you to an orthodontist.
a. swollen and bleeding gums
b. two left upper premolars missing
c. crowding of teeth
21
PART ONE
d. overbite
e. periapical abscess
f. missing front teeth
g. cleft palate
1. What does a conservative dentist deal with?

2. What does RCT stand for?
3. What is the difference between public health dentist and oral pathologist?
4. How can you avoid gingivitis?
5. Whom does paediatric dentist deal with?
6. What kind of treatment does a prosthodontist provide?
7. What programmes do public health dentists design?
11 Correct the information in the following sentences.
1. A peadodontist provides diagnosis of some abnormalities, advice and treatment.

2. An endodontist deals with mentally retarded children and patients with emo-
tional problems.
3. A general dentist constructs supportive facial structures.
4. An oral surgeon deals with replacement of missing teeth and overbiting.
5. A prosthodontist designs dentures and other restorative appliances.
6. An oral pathologist deals with malocclusion and teeth overcrowding.
7. An orthodontist performs root canal treatment.
12 What questions would you ask to obtain the following information?
· artificial appliances for teeth restoration

· dental care programmes
· dental braces
· use of clinical, radiographic and microscopic procedures
· construction of artificial appliances
· design and application of corrective and supportive constructions
22
GRAMMAR
PAST SIMPLE PAST CONTINUOUS
We use the Past Simple: We use the Past Continuous:

· for an action which happened at a definite · to describe action in prog-
time in the past. ress at a particular time in
She visited his doctor yesterday. the past.
· for past habits He was preparing for the test
They played volleyball when they were when I phone.
young.
· for actions which happened one after Time words used with the Past
another in the past. Continuous: when, while, as.
He made physical examination and
administered some medicines.
Time expressions used with Past Simple:

yesterday, last night/week/month/year, ago.
1 Choose the correct tense.
1. The endodontist was making/made a root canal treatment.

2. Oral and Maxillofacial Radiology was adopted/was adopting in 2003.
3. Doctor in charge examined/ was examining a newly admitted patient.
4. The students took/were taking examination in biology.
5. The surgeon performed/was performing an abdominal operation yesterday.
6. He took/was taking a special course of studies for two terms.
2 Choose the correct answer.
1. Children with an intense fear of the dentists_________ intensive sedation.

a. were requiring
b. required
c. require
2. He went to the doctor as he _________ weak and tired.
a. felt
b. was feeling
c. feel
23
PART ONE
3. The dentists _________ patients with special problems including develop-

mental disabilities and chronic medical problems.
a. treat
b. were treating
c. treated
4. While the dentist _________ the patient’s oral cavity, the nurse brought X-ray.
a. examined
b. examine
c. was examining
5. The receptionist _________ the office’s phone number available in case a pae-
diatric dental emergency.
a. keeps
b. kept
c. was keeping
6. The hygienist _________ the oral cavity when she noticed carious tooth.
a. wash
b. was washing
c. washed
7. Staff members and dentists _________ closely with parents to develop a per-
sonalized dental care plan.
a. worked
b. work
c. were working
3 Put the verbs into Past Simple, Past Continuous or Present Simple.
1. Maxillofacial surgeon ______________ (to extract) wisdom tooth yesterday.

2. Orthodontist ______________ (to correct) crooked tooth at 12.30 last night.
3. Occlusions ___________ (to define) as the relationship of the teeth to one
another.
4. The surgeon _________ (to perform) reconstructive and cosmetic surgery of
the because of traumatic accident.
5. Prosthodontist _________ (to make) prosthetic teeth during the last visit of
the patient.
6. Peododontist _________ (to tell) the kids funny stories using language which
they could understand.
7. The pediatric dental specialists _________ (to use) behaviour management
and sedation techniques to help the child feel safe and relaxed.
24
4 Answer the following questions using Past Simple or Past Continuous.
1. Who was taking care of the patient’s wisdom tooth?

2. Why was a complete examination of child’s oral cavity performed?
3. Was cosmetic surgery a primary focus of dentistry a few years ago?
4. When was Maxillofacial Radiology adopted?
5. Why was should paedodontist establish friendly relationships with the patient
and his parents?
5 Correct the mistakes.
1. Public health dentists was concerned with achieving optimal dental health.
2. Oral radiologist were taking radiograph and then interpreted it.
3. Root canal treatment were performed by endodontist.
4. Radiology as a new specialty had been adopted in 2003.
5. It were difficult to diagnose abnormalities in the facial structures
6. Maxillofacial surgeons was placing dental implant and renewed tumour in the
facial area.
7. Orthodontist was helping the patient to obtain optimal occlusion.
TALKING POINTS
· responsibilities of dental professionals;

· importance of establishing friendly relationship with the patient;
· handicapped children and problems with delivery of dental care.
MORE READING
1 Read the text and answer the following questions.
1. Is a dental surgeon a licensed professional?

2. What specialists does an auxiliary personnel include?
3. What are duties of a receptionist?
4. What is dental surgery assistant responsible for?
5. What kind of help does a dental hygienist provide?
6. What is a dental technician’s work?
25
PART ONE
DENTAL TEAM
In the British practice a dental surgeon has a degree of a Bachelor of Dental Sur-
gery and his duty is to diagnose, perform, and monitor the dental care of patients.
Auxiliary personnel includes: a receptionist, a dental surgery assistant (DSA), a
dental hygienist and a dental laboratory technician.
A receptionist is a person who creates the image of the practice. He greets and
assists the patients giving information about schedule visits, filling patient’s informa-
tion.
A dental surgery assistant is responsible for preparing patients pre-and postoper-
atively. He should make patients to feel as comfortable as possible in the dental chair
to be prepared for dental treatment.
Typical day duties of the dental assistant:
· to hand instruments and materials to the dentist
· to keep patient’s mouth dry
· to clean, sterilize and disinfect instruments and equipment
· to prepare tray setups for dental procedure
· to prepare materials for taking impressions and restorations
· to remove sutures
· to apply anesthetics to the gums
· to make temporary crowns
· to take radiographs and process the film
A dental hygienist provides clinical and educational services in private dental
offices, schools industrial plants and public health organizations. He performs oral
prophylaxis, conducts caries screening and teaches oral health care. Dental hygienists
clean teeth and examine oral areas, head and neck for the signs of oral diseases.
A dental technician constructs and repairs appliances such as crowns, bridges,
dentures, and orthodontic appliances. Dental laboratory technicians work under the
supervision of a dentist.
1. What does Pediatric dentistry deal with?

2. Why is it important to establish close relationship between the dentist and
patient?
3. What does preventable home care consist of?
4. What are the dentist’s responsibilities?
5. Is tooth decay prevention in the centre of dentist’s attention?
26
PEDIATRIC DENTISTRY
Pediatric dentistry is the branch of dentistry dealing with children from birth
through adolescence. Pediatric dentists are supposed to promote the dental health of
children and educate their parents. The first visit to a dentist should be paid within
six months after the eruption of the first tooth. It is necessary to establish a long-term
friendly relationship between the dentist and the patient. The early oral examina-
tion helps to detect the early stages of tooth decay because it is essential to maintain
oral health, change habits, and provide proper treatment. In addition, parents get the
information on preventative home care (brushing/flossing/fluorides), finger, thumb,
and pacifier habits, recommendations on preventing oral injuries, diet modification,
and growth and development of teeth.
The job is done by highly trained dental assistants, dental hygienist, and lab tech-
nicians. A dentist provides safe and effective dental services. His responsibility is to
control every procedure and prevent potential risks including infection, nerve dam-
age, bleeding, and pain. Responsibilities of a dentist are:
· Diagnosing oral diseases.
· Promoting oral health such as professional cleaning, fluoride application and
disease prevention.
· Treatment planning to maintain or restore the oral health of their patients.
· Interpreting results of X-ray and laboratory tests.
· Safe administration of anesthetics.
· Monitoring growth and development of the teeth and jaws.
· Performing surgical procedures on the teeth, bone and soft tissues of the oral cavity.
· Filling of decaying teeth.
· Treatment of dental injuries, including fractured, displaced, and knocked out teeth.
Tooth decay prevention is their major concern. Pediatric dentists examine the
gums and evaluate throat muscles and nervous system organs including the head,
neck and jaw, the tongue, and salivary glands. They are supposed to reveal lumps,
swellings, ulcers, discolorations. Pediatric dentists are responsible for carrying out
biopsies and tests.
Communication remains an important aspect for a pediatric dentist because it
helps to establish friendly and effective relationship between the dentist and the par-
ents based on mutual trust and confidence.
1. How often does early childhood dental caries happen?

2. What kind of oral health care is provided by pediatric dentists?
3. Are small kids patient and cooperative during a dental examination?
27
PART ONE
4. When should pediatric check-ups begin?

5. Why is good oral hygiene vital to the child’s oral health?
PEDIATRIC DENTISTS
Pediatric dentists are dedicated to the oral health of children from infancy through
the teen years. They have the experience and qualifications to care for a child’s teeth,
gums, and mouth throughout the various stages of childhood.
Children begin to get their baby teeth during the first 6 months of life. By age 6
or 7 years they start to lose their first set of teeth, which eventually are replaced by
secondary, permanent teeth. Without proper dental care, children face possible oral
decay and disease that can cause a lifetime of pain and complications. Today, early
childhood dental caries – an infectious disease – is 5 times more common in children
than asthma and 7 times more common than hay fever.
Pediatric dentists should complete at least four years of dental school and two
additional years of residency training in dentistry for infants, children, teens, and
children with special needs
Pediatric dentists provide comprehensive oral health care that includes the fol-
lowing:
· Infant oral health exams, which include risk assessment for caries in mother
and child.
· Preventive dental care including cleaning and fluoride treatment, as well as
nutrition and diet recommendations.
· Habit counselling ( for example, pacifier use and thumb sucking).
· Early assessment and treatment for straightening teeth and correcting an im-
proper bite (orthodontics).
· Repair of tooth cavities or defects.
· Diagnosis of oral conditions associated with diseases such as diabetes, congeni-
tal heart defect, asthma, hay fever, and attention deficit/ hyperactivity disorder.
· Management of gum diseases and conditions including ulcers, short frenulae,
mucoceles, and pediatric periodontal disease.
· Care for dental injuries (for example, fractured, displaced, or knocked-out
teeth).
Children are not just small adults. They are not always able to be patient and co-
operative during a dental examination. Pediatric dentists know how to examine and
treat children in ways that make them comfortable. In addition, pediatric dentists
use specially designed equipment in offices that are arranged and decorated with
children in mind.
A pediatric dentist offers a wide range of treatment options, as well as expertise
and training to care for the child’s teeth, gums, and mouth. When your pediatri-
cian suggests that your child should receive a dental exam, you can be assured that
28
a pediatric dentist will provide the best possible care. Regular pediatric check-ups
should begin after your child’s first birthday. During a pediatric dental check-up, one
of our skilled pediatric dental specialists will thoroughly examine your child’s teeth
and gums for signs of decay or disease.
1. What does orthodontics primarily deal with?

2. Who contributed to the development of this specialty?
3. What has been discovered by the archaeologists?
4. Is malocclusion a disease?
5. How many people suffer from malocclusion?
6. What is the orthodontist responsible for?
ORTHODONTIA
A special field of dentistry is orthodontia, also known as orthodontics and dento-

facial orthopedics. An orthodontist undergoes special training in a dental school or
college after they have graduated in dentistry. Edward Angle and Norman William
Kingsley pioneered the establishment of orthodontics as a specialty. Orthodontist
deals with the diagnosis, prevention and correction of malpositioned teeth and the
jaws.
The history of orthodontics has been related to the history of dentistry for over
2000 years. Dentistry originated as a branch of medicine. Malocclusion is not consid-
ered a disease, but abnormal alignment of the teeth of upper and lower jaws. The in-
cidence of malocclusion varies. Orthodontic treatment indices classify malocclusions
in terms of severity. Nearly 30% of the global population encounter malocclusion
problems that can be corrected by orthodontic treatment.
In addition to focusing on dental displacement, orthodontic treatment deals with
the control and modification of facial growth. This type of therapy is defined as den-
tofacial orthopedics. In case of severe malocclusions a combination of orthodontics
jaw surgery is required.
In diagnosis and treatment planning, the orthodontist must (1) recognize the var-
ious characteristics of a malocclusion or dentofacial deformity; (2) define the nature
of the problem, including the etiology if possible; (3) design a treatment strategy
based on the specific needs and desires of the individual; and (4) present the treat-
ment strategy to the patient in such a way that the patient fully understands it.
29
UNIT 3 TOOTH ANATOMY
LEAD IN
dentine ['dentJn] дентин

enamel [I'nxml] емаль
gingiva [GIn'GaIvq] ясна
periodontium ["periqV'dPntIem] періодонт
ligament ['lIgqmqnt] зв’язка
cementum [sq'mentqm] цемент
incisor [In'saIzq] різець
canine ['keInaIn] ікло
molar ['mqVlq] кутній зуб
deciduous [dI'sIdjuqs] тимчасовий (про зуб)
cusp [kAsp] горбик, виступ (про зуб)
chop [CPp] подрібнити
shedding ['SedIN] випадіння
UNIT 3: TOOTH ANATOMY
grind [graInd] перетирати, розтирати

tear [tFq] рвати
masticate ['mxstIkeIt] жувати
2 Before you read the text, talk about these questions.
· How many teeth do you have? What are they?

· Why is it important to have different types of teeth?
3 Read the text.
TEETH
Teeth are any of the hard, resistant structures occurring on the jaws. They are used
for biting and masticating food – the first step in the digestion. Teeth also help us say
certain sounds.
A tooth consists of a crown and one or several roots. The crown is visible above
the gum. The root supports the tooth in the jawbone. The periodontal ligament at-
taches the root to the alveolar processes of the jaws. The root is enclosed in the gum
tissue. The shape of the crown and root depends on the individual.
Permanent teeth have identical general structure and are composed of three lay-
ers. An outer inorganic layer of enamel is the most solid tissue in the body covering
the entire tooth crown. The middle layer of the tooth is composed of dentine, which
is less hard than enamel and similar to bone. The dentine is the inner part of the tooth
nourished by the pulp. The pulp contains cells, tiny blood vessels, and a nerve and
is located in the centre of the tooth. The root canal extends through the whole inner
portion of the tooth and gets general nutrition through the apical foramina at the end
of the roots. The root of the tooth is covered by cementum. The latter, together with
periodontal ligaments, alveolar bone, and gingiva (gums) compose the periodontium
– the supporting structure of a tooth.
People have two sets of teeth in their lives, the primary teeth (also called the baby,
milk or deciduous teeth) and the permanent teeth (also called the adult or second-
ary teeth). Most babies are born with no visible teeth – the teeth are forming inside
the gums. The 20 primary teeth (four incisors, two canines, and four molars in each
jaw) begin to erupt about six months after birth. The primary dentition is complete
by age 3. Primary teeth are smaller and whiter, have more pointed cusps and larger
pulp chambers as well as more delicate roots than permanent teeth. Shedding usually
31
PART ONE
begins about age 5 or 6 and by age 14 old primary teeth completely fall out and are
replaced by 32 permanent teeth. The permanent dentition is made up of four incisors,
two canines, four premolars, and six molars in each jaw.
Incisors are frontal teeth adapted for biting, tearing, cutting and chopping. A ca-
nine or cuspid tooth is adjacent to the incisors on each side. It has the function of
tearing food.
The basic function of premolars and molars is to break up food particles. Premo-
lars are responsible for both crushing and grinding the food. Premolars are known as
bicuspids. The molars are involved in grinding and chewing food. The wisdom tooth
can be of various size and number of roots. Incisors, canines, and premolars have one
root whereas premolars have two or three.
4 Complete the table using information from the text.
Type of structure Function

Crown 1.
2. communicates with other body’s systems
Root 3.
4. covers the entire tooth crown
Pulp 5.
6. cut and chop food
7. compose the periodontium
Cuspids 8.
9. masticate food
5 Match the word or word-combinations with the definition.
1. crown a. the layer of living cells under the enamel

2. cementum b. the hardest tissue in the body that covers all of the tooth
crown
3. dentin c. a soft tissue that covers the neck of the tooth
4. root canal d. a tube that moves blood throughout the body
32
5. nerve e. the visible part of the tooth above the gumline

6. blood vessel f. a layer of hard substance that covers the root
7. gum g. a body part that carries messages between the brain and the
body
8. enamel h. a set of narrow spaces inside the root of the tooth
Fill in the gaps with the correct word or word-combination from the word
6 bank.
canines incisors molars premolars wisdom teeth baby teeth
1. The __________________ are the last teeth to grow in. They usually serve no
specific function.
2. The front ________________ are usually the first teeth to appear and the first
to be lost by children.
3. The _____________________ are very pointly compared to other kinds of
teeth. They are the best to tear meat.
4. The ____________________ are located between the canines and molars;
they are usually smaller than the molars; they contain ridges.
5. The ______________________ are shed when their roots are resorbed as the
permanent teeth push toward the mouth cavity in the course of their growth.
6. Food is pushed back to the ____________________ so that it can be ground
up completely.
Read and translate the following statements and say what IT in each
7
statement relates to.
1. IT forms the central soft portion of each tooth and extends through the whole
tooth, and is covered by enamel and by cementum.
2. IT is long and narrow and is known as the pulp chamber.
3. IT is identical to bone but is not as hard as dentine. IT serves as a thin covering
of the root.
4. The biting portion of IT is wide and thin, making a chisel-shaped cutting edge.
5. IT is removed if causing overcrowding in the mouth.
6. IT consists of the mucosal tissue that lies over the mandible and maxilla inside
the mouth.
33
PART ONE
7. IT helps to attach the tooth to surrounding tissues and to allow sensations of

touch and pressure.
8. When IT becomes loose and falls out, the permanent tooth will fill the space.
Find in the text the correct equivalents to the following word-combinations
8
and make sentences with them.
1. підтримувати та утримувати в кістці;

2. прикріплюватися до альвеолярного відростку за допомогою фіброзної
зв’язки;
3. займати всю порожнину в центрі зуба;
4. зв’язуватися з нервовою системою та системою живлення;
5. формуватися в середині ясен;
6. мати відносно більшу пульпову порожнину і дрібні, тонкі корені;
7. використовувати для подальшого перетирання та пережовування.
1. Teeth fulfil the only function. It’s the first step of digestion – mastication.
2. All true teeth have the same general structure and consist of four layers.
3. First dentition usually starts at age 3 or 6 month.
4. Dentine is the hardest tissue similar to bone. It is covered by the pulp.
5. While we chew food, the tongue pushes the food to the teeth and saliva helps
digestion and wets the food.
6. Pulp contains blood vessels and nerves that enter the tooth from a hole at the
apex of the root.
7. The permanent dentition is made up of four incisors, two canines, four premo-
lars, and four molars in each jaw.
8. The number of roots for each type of tooth varies from one for incisors, ca-
nines, and premolars to two or three for molars.
1. How many teeth are there in healthy oral cavity? What are they?
2. What parts does each tooth consist of? What layers are there in the tooth?
3. What kinds of teeth do you know? What function do they serve?
4. Is there any difference between the permanent and temporary teeth?
5. What is supporting structure of the tooth composed of? Speak on each com-
ponent.
6. How and when does secondary eruption happen?
34
GRAMMAR
PRESENT SIMPLE AND PRESENT CONTINUOUS PASSIVE VOICE
We use the Passive when:

· we want to make the object more important
The neck of the root is covered by gum tissue.
· we do not know the active subject:
A new dental clinic is being built not far from here.
We form the Present Simple Passive by the next formula:
am/is/are + Past Participle (Participle II)
A tooth is composed of three essential parts.

Babies are usually born without visible teeth.
We form the Present Continuous Passive by the next formula:
am/is/are + being + Past Participle (Participle II)
A patient is being treated now.

These procedures are always being performed very noisily.
Together with the Passive voice, they often use prepositions by or with.
The root of the tooth is covered by cementum.
There are many sentences in the text containing Passive. Find at least ten
1 of them and write down into your workbook. Translate them into
Ukrainian. What tense are they?
35
PART ONE
Make up your own sentences using words and word-combinations from the
2
tables.
Present Simple:
The hospital equipped with new devices and apparatuses.

Dental instruments is demonstrated to the students.
This new textbook are written by English department teachers.
Students shown the tooth extraction procedure.
Children given instructions on how to brush their teeth.
Present Continuous:
The teeth cleaned at the moment.

Documents is being sighed by our partners.
The cavity are opened by the chief dentist of our clinic.
Look! erupted at last!
The first tooth
3 Make these sentences interrogative starting with the question word in

brackets.
1. Dental anatomy is dedicated to the study of tooth structure. (What?)

2. Most of the crown is composed of dentine with the pulp chamber inside.
(What … of?)
3. Teeth are classified as incisors, canines, premolars (also called bicuspids), and
molars. (How?)
4. Incisors are primarily used for biting pieces from foods. (What … for?)
5. Food is being ground by molars inside the mouth. (Where?)
6. Tooth development is commonly divided into the following stages: the bud
stage, the cap, the bell, and finally maturation. (How many?)
7. The stage, during which a person has a combination of primary and perma-
nent teeth, is known as the mixed stage. (How?)
4 Put the verb in brackets into correct tense form.
1. Enamel becomes damaged by decay if teeth _______________ (not to care)

for properly.
36
2. Pulp is in the centre of all teeth, where the nerve tissue and blood vessels
____________ (to locate).
3. The problems of modern dentistry _______ (to discuss) by the Committee at
present.
4. Sometimes called cuspids, these teeth ________ (to shape) like points (cusps)
and ___________ (to use) for tearing and grasping food.
5. The entire basic tooth structure ____________ (not to make up) of enamel,
because enamel is very rigid and brittle.
6. In some cases, the wisdom teeth ___________ (to remove) surgically, as they
____________ (not to need) to properly chew food.
5 Put the following sentences into passive voice.
1. The blood vessels supply the pulp with nutrients.

2. This patient’s periodontium is not attaching the tooth to surrounding tissues.
3. It is also allowing sensations of touch and pressure to the tooth.
4. Periodontal ligaments are connecting the alveolar bone to the cementum.
5. The gingiva (“gums”) is the mucosal tissue that overlays the jaws.
6. The more permeable form of cementum, cellular cementum, covers about ⅓ of
the root apex.
7. The shape of the crown determines the tooth’s function.
8. The inner tubules are carrying calcium and other minerals from the blood
system into the tooth root for the root’s growth and development.
6 Correct the mistakes. One item doesn’t need to be changed.
1. At about six years of age the deciduous teeth slowly shed one at a time and
replaced by permanent adult teeth.
2. The teeth are aligned in the jaws so that the peaks of one tooth align with the
valleys of its counterpart on the other jaw.
3. Most cavities are occurred on molars and premolars.
4. Radiographically, the pulp tissue does not mineralized and appears radiolu-
cent.
5. The tongue strikes the teeth as certain sounds are making.
6. The [th] sound, for example, is produce by the tongue being placed against the
upper row of teeth.
37
PART ONE
TALKING POINTS
· teeth in your mouth, their accurate number, their correct names and functions;
· your wisdom teeth if you have them, time when they appeared;
· all structures in your oral cavity.
MORE READING
1 Read the text about wisdom teeth and answer the following questions.
1. What are wisdom teeth? When do they usually erupt?

2. What is impacted wisdom tooth? In what cases does it occur? What are the
types of impaction?
3. What are the possible reasons why some wisdom teeth are impacted?
4. How might diet influence the third molar correct eruption?
WISDOM TEETH
With age comes wisdom. Specifically, wisdom teeth.

Human mouth goes through many changes during lifetime. One major dental
milestone that usually takes place between the ages of 17 and 24 is the appearance of
the third molars. Eruption outside of this age range is not uncommon. Historically,
these teeth have been called wisdom teeth because they come through at a more
mature age.
If there is not enough room for the teeth, or they are not aligned properly, they
may never fully erupt. People usually have four: upper left, upper right, lower left,
and lower right. If they don’t, it’s due to their genetic makeup. It’s been estimated that
about 25% of people are lacking one or more.
In dental terminology, an “impacted” tooth refers to one that has failed to fully
erupt (emerge into its expected position). This failure to erupt properly might occur
because:
· There is not enough room in the person’s jaw to accommodate the tooth.
· The tooth’s eruption path is obstructed by other teeth.
· Because the angulation of the tooth is improper.
Depending on the inclination of the impacted wisdom tooth to the long axis of the
adjacent molar, they differentiate horizontal, vertical, mesial, and distal impaction.
The reason why some wisdom teeth are impacted is not an easy question to an-
38
swer. A primary cause simply seems to be a condition of inadequate jawbone space

behind a person’s second molar. Why this lack of space exists is not fully understood.
There does, however, seem to be a correlation between large tooth size and/or the
presence of generalized tooth crowding and having impacted wisdom teeth.
The dietary changes adopted by modern man have been theorized as playing a
role in the incidence of the third molar impaction. It has also been argued that the
coarse nature of stone-age man’s diet, as compared to modern man’s relatively soft
diet, probably required more chewing muscle activity. This activity could have stimu-
lated greater jawbone growth, thus providing more space for wisdom teeth.
Read the text about deciduous and permanent teeth. Be ready to compare
2 them according to the number, structure, and composition. How do these
teeth develop? Should one take care of them?
Deciduous teeth or primary teeth fall out at the age of 6. They are replaced by the
permanent teeth. The primary teeth help a child learn to chew and speak. The decid-
uous and the permanent teeth differ by their composition, structure, and number.
The enamel of the deciduous teeth is thinner. Therefore, the primary teeth are
usually whiter than the permanent teeth and more vulnerable to the primary tooth
decay that can be provoked by sugar intake and inadequate fluoride treatment.
The shape of the teeth is also different. The front permanent teeth usually have
small bumps on the top, known as mamelons. The mamelons wear off over time, if
the teeth fit together evenly. A dentist can also file the mamelons off to make sure the
teeth look even.
The roots of the deciduous teeth are thinner and shorter than the roots of the per-
39
PART ONE
manent teeth. It allows them to dissolve when it’s time for the tooth to fall out as well
as ensures some space for the permanent teeth to form beneath them.
People typically have 20 primary teeth and 32 permanent teeth, including four
wisdom teeth. Part of the reason for the difference in number is that a child’s mouth
is much smaller than an adult’s. Children don’t have enough space for eight to 12
molars in the back of the mouth. As the child grows older, the jaw develops making
the room for the additional permanent teeth.
People are often wrong when they think that the primary teeth don’t need care
or protection. However, it is important to provide regular and delicate care for the
primary teeth as you would care for the permanent set of teeth. If the teeth are lost or
extracted early, they can’t act as space holders and may not leave enough room for the
permanent teeth. A child might also have occlusal problems later.
40
UNIT 4 ORAL HYGIENE
LEAD IN
maintain [meIn'teIn] підтримувати, утримувати

canker ['kxNkq] виразка на слизовій ротової
порожнини; афта
cold sore ['kqVld 'sL] герпетичне висипання на слизовій
ротової порожнини
thrush [TrAS] кандидозний стоматит
aid [eId] допоміжний засіб, пристрій, прилад
inconvenient ["Inkqn'vJnIqnt] незручний

impact ['Impxkt] вплив; мати вплив на, позначитися на
cancer ['kxnsq] рак

pregnancy ['pregnqnsI] вагітність
bristle [brIsl] щетинка
wooden stick ['wVdn stIk] зубочистка
plaque ['plxk] бляшка, пляма, наліт
floss [flPs] зубна нитка; чистити за допомогою
зубної нитки
rinse [rIns] полоскати, промивати
starch ['stRC] крохмаль
fluoride ['flVqraId] фтор
supplement ['sAplImqnt] добавка
PART ONE
· How do you take care of your oral cavity?

· What do you use to keep your mouth healthy?
· What may happen if people don’t keep their mouth clean and healthy?
3 Read the text. Choose the correct answers.
1. What is the main purpose of this text?

a) to explain what fluoride is;
b) to give advice on oral hygiene;
c) to describe the process of tooth decay;
d) to outline proper brushing techniques.
2. What causes plaque to form?
a) sugars;
b) acids;
c) bacteria;
d) tooth decay.
3. How often should one mouthwash?
a) once a day;
b) twice a day;
c) after every meal;
d) never.
4. What is said about fluoride in the text?
a) it kills bacteria in the mouth;
b) it stops you from eating sugars;
c) it makes your teeth stronger;
d) you can get it from your diet.
5. What is inferred from the text?
a) sugary food causes bacteria to form in the mouth;
b) fluoride toothpastes help to get rid of acid in the mouth;
c) people should brush their teeth after every meal;
d) people should use flossing twice a day.
ORAL HEALTH
Good dental or oral care maintains not only healthy teeth, gums and tongue, but
also the whole body. Oral problems, including bad breath, dry mouth, canker or cold
sores, tooth decay, or thrush are all preventable with proper care.
42
UNIT 4: ORAL HYGIENE
Good oral health involves more than just brushing. To keep teeth and mouth
healthy for a lifetime of use, there are important and interconnected aspects that
everyone should know.
· Motivation and understanding one’s oral health needs. Many patients find
oral hygiene aids inconvenient and difficult to use, so motivation must be at a high
level. A doctor has to interest patients in cleaning their teeth by helping them to un-
derstand how important it is and how they will benefit. A patient has to talk with his
dentist (other oral health care specialist, or hygienist) about any special conditions in
his mouth and any ways in which his health conditions affect the teeth or oral health.
For example, cancer treatments, pregnancy, heart diseases, diabetes, dental applianc-
es (dentures, braces) can all impact one’s oral health and may necessitate a change in
the oral care.
· Brushing. People have to brush their teeth at least twice a day, morning and
night. Toothbrushes have bristles ranging from soft to hard, so people have to choose
the one that feels comfortable. There are different techniques of brushing – Stillman’s,
Charter’s, and Bass brushing methods as well as more ordinary circular/roll or side-
to-side ones. There are also interdental (used where there are large areas; the brush
is put back and forth between the space) and interspace brushing methods (used for
irregular teeth but will not clean right between the teeth).
· Interdental cleaning. A doctor has to show patients how to clean the diffi-
cult-to-reach spaces between the teeth. Patients can use interdental wooden sticks
(require large spaces between the teeth and are not very efficient in removing plaque),
dental floss or tape (used when teeth are close together, especially in younger patients,
but may cause damage to the gum if used incorrectly), and interdental or interspace
brushes.
· Mouthwashing. After every brushing, a patient has to rinse the mouth. Af-
ter eating, bacteria accumulate in the mouth; this, in turn, can cause plaque, which
if not removed, combines with sugars and forms acids destroying enamel. In order
to prevent this, good antiseptic mouthwash has to be used after every meal. Mouth
rinses should not be a replacement for brushing or flossing, though, but as an added
hygiene tool. If brushing or rinsing is not available, chewing sugarless gum may help.
· Diet. Only good oral hygiene is not enough to prevent dental and periodon-
tal diseases. Having a healthy well-balanced diet rich in vitamins and minerals (e.g.,
calcium, potassium, phosphorus, iodine, zinc) and reducing the consumption of sug-
ars and starches (e.g., cakes, candies, ice cream, soft drinks, potato chips) are import-
ant in keeping teeth healthy.
· Fluoride. Toothpastes and mouthwashes should contain fluoride which
strengthens the teeth and prevents tooth decay. Using fluoride supplements where
drinking water contains small amount of fluoride plays a significant role in prevent-
ing oral diseases.
43
PART ONE
· Regular check-ups. The standard recommendation is to visit a dentist twice a

year for check-ups and cleanings.
Early demineralization of the tooth can be healed by taking the above steps, but
larger cavities usually need to be filled. Filling teeth does not prevent dental decay.
The whole cycle of decay will start again unless the hygiene is kept, diet controlled,
and a fluoride toothpaste and mouthwash used.
Group the words from the word bank according to the correct headings.
4
Say what you know about them.
check-ups acid toothbrush plaque candies

flossing bacteria fluoride minerals toothpaste
Oral Hygiene Products: Harmful Substances to Teeth:
1. plaque a. something added to complete or make an addition, to correct

a deficiency
2. acid b. the most abundant mineral in the body, found in some foods,
added to others, available as a dietary supplement, and pres-
ent in some medicines
44
3. bristle c. a disease caused by a fungus of Candida, marked by white

patches in the oral cavity; broadly known as candidiasis
4. calcium d. a vesicular lesion that typically occurs in or around the mouth
caused by a herpes simplex virus
5. thrush e. any of various typically water-soluble and sour compounds
that in solution are capable of reacting with a base to form a
salt
6. starch f. a naturally abundant nutrient carbohydrate, found chiefly in
fruits, vegetables and corns
7. supplement g. a sticky usually colourless film on teeth that is formed by and
harbours bacteria
8. cold sore h. a short stiff coarse hair orfilament
6 Read the sentences pairs. Choose which word best fits each blank.
1. apply / remove
a. The hygienist uses this instrument to ________plaque from between the teeth.
b. Kate used a microbrush to ___________the fluoride paste.
2. polish/ clean
a. The hygienist will ________________ Jan’s teeth so they are shiny.
b. The dentist uses various instruments to ____________ your teeth.
3. rinse / floss
a. You have to be careful using ___________ as it may damage your gums.
b. After every meal, it’s necessary to ___________ the mouth.
4. remain / bleed
a. You can brush and floss your teeth until your gums __________,
b. but plaque constantly forming on your teeth can still _________.
5. dissolves / hardens
a. Plaque combines with sugars to create acid which _________the enamel and
causes tooth decay.
b. If plaque is not removed during 48 hours, it ____________ and results in cal-
culus or tartar.
6. healed / filled
a. Early demineralization of the tooth can be ____________ by taking the pre-
ventive measures,
b. but larger cavities usually need to be ____________.
45
PART ONE
7
bank.
pregnancy fluoride mouth rinses hygiene sugars

strengthens accumulates brush maintaining daily
1. If you do snack, ____________ teeth afterward or chew sugarless gum.

2. People need to floss ____________ to get rid of food particles stuck between
their teeth.
3. The dental hygienist explained how plaque _____________ on teeth.
4. Good oral _______________ is a part of ___________________ overall
health.
5. Antibacterial ________________ also reduce bacteria that cause plaque and
gum diseases.
6. The plaque combines with ______________ to create acids which dissolve the
enamel and cause tooth decay.
7. People with special conditions, including ____________ and diabetes, may
require additional instruction and perhaps treatments to keep their mouth
healthy.
8. Fluoride _____________ developing teeth in children and prevents tooth de-
cay in both children and adults.
8
statement relates to.
1. IT is a small painful shallow ulceration of the oral mucous membranes that has
a greyish-white base surrounded by a reddish inflamed area and is character-
istic of aphthous stomatitis.
2. IT is the most common carbohydrate in human diets contained in large
amounts in potatoes, wheat, corn and rice.
3. IT is a biofilm or a sticky colourless mass of bacteria that is commonly found
between the teeth or other surfaces within the mouth.
4. IT is used for irregular teeth but will not clean right between the teeth.
5. You have to do IT after every brushing and every eating.
6. Many toothpastes and mouth rinses contain IT.
7. IT can be used to remove food remains from large spaces between the teeth
but it is not very efficient in removing plaque.
8. IT may start again if you don’t follow doctor’s recommendations on good oral
hygiene and diet.
46
9 Choose appropriate prepositions. Have you ever tried this procedure?
One more rather important step of/by keeping health oral cavity is disclosing. It
shows patients where the plaque is and how to check if it has been removed. Dental
plaque is invisible, but a harmless food dye can be used to show it up/over, letting
the patient see where plaque collects, where it has been left behind/above and where
extra cleaning is needed. Disclosing dyes can be bought at/in the chemists in/at the
form of/on tablets or solutions. Anyone can use plaque-disclosing tablets, but they’re
particularly effective for/to youngsters who haven’t established the best brushing and
flossing habits. Alternatively, vegetable food dyes can be used.
1. Oral health is not related to the overall health of a person.

2. The most important in good oral hygiene is toothbrushing.
3. Fluoride containing mouthwashes can reduce bacteria level.
4. Difficult-to-reach spaces between the teeth should be cleaned with specific
aids.
5. There is no difference between interdental and interspace brushing.
6. Even minor teeth changes require professional treatment in order to prevent
more serious lesions.
1. What may happen if people neglect oral hygiene? What problems may occur?
2. How can general health impact patient’s hygienic regime? What should a doc-
tor recommend?
3. What are the main steps of preventing oral diseases? Name them.
4. Why is motivation important in keeping good oral hygiene?
5. What types of brushing do you know?
6. Do you practice interdental cleaning? What exactly? How often?
7. How do dietary habits influence oral health?
8. What is the role of fluoride in preventing tooth decay?
9. What types of mouthwashes do you know? What is the difference between
them?
47
PART ONE
GRAMMAR
PAST SIMPLE AND PAST CONTINUOUS PASSIVE VOICE
We form the Past Simple Passive by the next formula:

was/were + Past Participle (Participle II)
All wisdom teeth were finally extracted.
Plaque was not removed timely and it turned into tartar.
We form the Past Continuous Passive by the next formula:

was/were + being + Past Participle (Participle II)
That patient’s teeth were being treated for more than a year.
While the patient was being operated, his wife called him many times.
Find the sentences in Passive voice. What tense are they?

1
Translate them into Ukrainian.
1. The patient was being examined for one hour.

2. If you’re an aging adult, you can benefit from preventive dentistry because it
helps you to keep your real teeth.
3. No changes were being observed in patient’s condition for the last two days.
4. Last week this woman visited the clinic complaining of a terrible toothache.
5. The temperature chart was being filled by the nurse when I came in.
6. Some toothpastes contained fluoride.
7. The mouth is a breeding ground for harmful bacteria. Maintaining a clean
mouth benefits your overall health.
Make up your own sentences using words and word-combinations
2
from the tables.
Past Simple:
1. Osteoporosis linked to poor oral health.
2. Flossing or taping was neglected by many today’s visitors.
3. Sealants were applied to the chewing surfaces of the teeth.
4. Gingivitis characterized by bleeding and swollen, or tender
gums.
48
Past Continuous:
1. A new visitor examined thoroughly by the dentist.
2. A long-term decay was being treated successfully.
3. All study rooms were equipped with new training models.
3 Make these sentences interrogative starting with the question word

in brackets.
1. The process of infection was being controlled during the antibiotic treatment.
(When?)
2. A minimum of two dental exams and cleanings each year were recommended
by the American Dental Association. (How many?)
3. This report was being discussed at the conference at 5 o’clock yesterday. (What?)
4. At least two preventive dental visits per year were covered by many insurance
plans in some European countries. (Where?)
5. A fluoride varnish was being completed depending on individual risk for de-
cay. (What?)
6. A wide range of procedures such as teeth whitening, veneers, implants, and
full smile enhancements was offered to a very rich patient. (Who?)
7. An impression was being made by an assistant. (Who?)
4 Put the verb in brackets into correct tense form.
1. They _________(to surprise) by doctor’s announcement during their last

meeting.
2. Did you buy that Atlas of Anatomy? – No, it __________ (to give) to me by my
fellow student.
3. Dentists had to do a lot to save that tooth! – Yes, they _______ (to pay) well for
the treatment.
4. All children __________ (to vaccinate) from 9 am till 2 pm.
5. Can you make an injection? – Oh, yes… I ___________ (to teach) how to do
it while studying at the university.
6. The last Monday lecture_____(to devote) to the problems of preventive den-
tistry.
5 Put the following sentences into passive voice.
1. Dental assistant was cleaning my teeth.

2. Last year Dental faculty of Yale University accepted my cousin.
3. The mother was feeding her baby when the nurse came in.
49
PART ONE
4. A patient didn’t sign consent. His relatives did it.

5. Most people were replacing their toothbrushes three to four times per year or
as the bristles started to fray.
6. Doctor’s words persuaded Nick to undergo comprehensive dental examination.
7. Did you notice any changes in the teeth colour?
8. The new electric toothbrush confused a child greatly.
6 Correct the mistakes. One item doesn’t need to be changed.
1. Four people injured in the yesterday accident.

2. I was shocking by the news about his family.
3. The prevention of plaque accumulation was interested to Professor Davis.
4. This was helped remove bacteria from your mouth and also helped freshen
your breath.
5. At regular recall visits, the hygiene appointment was usually coupled with a
dental examination.
6. During the same visit, a thorough check-up of the teeth and dental restorations
was performed by our dentist.
7. Something unusual was happened yesterday during the lesson.
TALKING POINTS
· purpose of good oral hygiene;

· main aspects of keeping mouth healthy;
· some aids that people use to maintain oral health.
MORE READING
1 Read the text about toothbrushing techniques and fulfil the following tasks.
1. Compare the types of brushing.

2. Say what type of brushing you practice.
3. Imagine your friend has got some oral problems. Recommend him a proper
brushing technique and describe it.
50
TOOTHBRUSHING TECHNIQUES
There are four brushing methods that dental professionals encourage their pa-
tients to use, each addressing different oral health concerns. They’re unlike the con-
ventional ‘scrubbing’, also known as side-to-side method that most patients use which
is damaging to their tooth and gum structure. Instead of harming, these professional
brushing methods actually help to promote the health of the teeth and gums:
Stillman’s Brushing Method
Indications for use: for patients with gingivitis; to remove plaque from above the
gum line.
Method/Technique: the bristles are held at a 45° angle toward the gum line. Half
of the bristles should be covering the gums, and the other half of the bristles should
be on the tooth surface. By making short and light horizontal movements, the plaque
is removed from above the gum line. These motions help to remove plaque and stim-
ulate the gums. Only small groups of teeth can be done at a time. Once an area is
complete, move onto the next set of teeth.
Bass (Sulcular) Brushing Method
Indications for use: for patients with periodontitis; to remove plaque from below
the gum line.
Method/Technique: like Stillman’s, the bristles are held at a 45° angle toward the
gum line. Very slight pressure and vibratory motions are made so that the bristles go
slightly beneath the gum line. Only small groups of teeth can be done at a time. Once
an area is complete, move onto the next set of teeth.
Both Stillman’s and Bass brushing methods can be ‘modified’ by gently sweeping
the bristles away from the gums after performing the instructed brushing method.
Charter’s Brushing Method
Indications for use: for patients with orthodontic braces.
Method/Technique: with the bristles positioned at a 45° angle, direct them so that
they remove plaque from above the brackets and arch wire, then direct them so that
the bristles remove plaque from below the brackets and arch wire. This will ensure
that plaque is removed from all surfaces of the braces.
Circular (Roll) Brushing Method
Indications for use: for young patients; patients with poor manual dexterity; in
combination with any other brushing method; for healthy patients instead of “scrub-
bing” method.
Method/Technique: the bristles are held at a 45° angle toward the gum line. Make
small and light circular shaped brush strokes overlapping each tooth surface until all
surfaces are reached.
For all of these brushing methods, continue to brush the chewing surfaces, as well
as the back of the bottom and front teeth, and the tongue by lightly scrubbing up and
down, being careful not to damage any of the tissues. Also, remember to brush using
a soft bristled toothbrush!
51
PART ONE
2 Read the text about dental plaque and answer the following questions.
1. What factors cause a build-up of plaque? Where does it accumulate the most?
2. What oral problems can plaque deposits result in? What are the signs of this?
3. How can you detect plaque on your oral cavity organs?
4. Why is it important to remove plaque? What may happen if to neglect this?
5. Name the main methods of fighting plaque.
6. What are sealants? How can they help in protecting teeth from aggressive in-
fluence of plaque?
DENTAL PLAQUE
Plaque is very personal. It forms from countless combinations of foods, individual

acid and moisture levels in a person’s mouth, and internal and exterior bacteria from
any number of sources. Back molars, the ridges along dental work, and the lower fac-
es of teeth near the gum line are places where plaque accumulates the most, and these
areas often are harder to get to with a quick brushing. Tooth decay and bad breath are
some obvious signs that plaque bacteria are thriving in a mouth, but these problems
develop long after plaque has started to form.
You can’t see plaque with the naked eye until decay from plaque forms, but you
can feel the sticky film, note some dull sliminess and just know it’s there if you’ve
missed some appointments with the toothbrush. You can use disclosing tablet, which
releases a safe dye that mixes with saliva and attaches itself to areas covered with
plaque bacteria. Some dental professionals use the tablets to teach young children
where they need to steer their toothbrushes, and adults can use the dye after brushing
to see what areas they may be missing.
Removing plaque is important for oral health. The scientists state that bacteria and
acids erode tooth enamel, and contribute to cavities formation. Additionally, plaque
can lead to gum diseases. Soft plaque, if not removed after eating, can harden making
toothbrushing more difficult and less effective at the gum line. Tartar or calculus can
irritate gums and cause bleeding and swollen gums associated with gingivitis. Gums
can recede and create pockets for further accumulation of plaque debris.
Removing the plaque can prevent many of the issues. The best advice for fighting
plaque includes brushing teeth after meals and daily flossing. Toothbrushing reduc-
es the build-up of bacteria. Interdental cleaning, which includes flossing and using
toothpicks, is one of the most effective ways to keep plaque from forming between
teeth and at the gum line. Alcohol-free, fluoride and anti-bacterial rinses can help
remove particles and plaque, as well as freshen breath.
Sealants, made from a plastic material, are applied to the teeth to fill in crevices
and form a layer that protects tooth enamel from decay.
52
Regular professional cleanings and check-ups are important for keeping teeth and
gums healthy. If plaque hardens, toothbrushing is not helpful. Ultrasonic and scaling
tools help remove tartar deposits. Cleaning and removing plaque prevent tooth decay
and gum disease and removes stains.
All of these dental procedures prove effective if accompanied by a healthy diet and
after-meal cleaning. Highly acidic foods and products rich in carbohydrates eat away
tooth enamel. Therefore, brushing thoroughly and flossing regularly can help keep
the mouth clean and healthy.
1. What is the text about? Title it.

2. What did people believe in ancient times?
3. How did different European folklores explain the action of “tooth worms” on
the tooth enamel?
4. Who managed to shatter a myth about a cause of decay? When did it happen?
5. What is a real cause of tooth decay?
The scientific investigations suggest that as early as 5000 B.C. people were search-
ing for the source of tooth decay that was later reported as ‘tooth warms’. In ancient
times, people could not explain the origin of dental problems. They were unable to
recognize tooth decay at the initial stage. There were no dental clinics or dental col-
leges providing dental training or dental treatment. A lack of knowledge resulted in
the myth that cavities formed due to the harmful action of tooth worms occupying
the teeth.
Many people believed that the tooth worm settled on the surface of the tooth to
multiply and create holes. It caused a toothache and the pain subsided once the worm
had a rest. No one could describe the creature. It has taken many different forms over
the years.
It is widely known that worms are not the cause of plaque formation and tooth
decay. In 1674 Antonie van Leeuwenhoek found worm-like, active bacteria while
studying samples from inside his own mouth under his microscope. His informal
studies led to more scientific research into bacteria and the products of their living.
Ancestors of those same bacterial worms are alive and undergoing mutational chang-
es in the 21st century. People worldwide still wish to get rid of them. Nowadays, it’s
well-known that dental plaque, typically the precursor to tooth decay, contains more
than 600 different microorganisms, while Syreptococcus mutans being the primary
causal agent and the pathogenic species responsible for dental caries specifically in
the initiation and development stages. S. mutans is naturally present in the human
oral microbiota, along with at least 25 other species of oral streptococci.
53
UNIT 5 HISTORY TAKING
LEAD IN
history taking ['hIstqrI "teIkIN] збір анамнезу

invaluable [In'vxljVqbql] безцінний
complaint [kqm'pleInt] скарга
complain of [kqm'pleIn qv] скаржитися на
provisional [prq'vIZqnql] попередній, тимчасовий
fear [fIq] страх
onset ['Pnset] початок, поява, напад
dull ache ['dAl 'eIk] тупий ниючий біль
throbbing ['TrPbIN] пульсуючий
shooting ['SHtIN] пронизуючий
swelling ['swelIN] набряк
numbness ['nAmnIs] оніміння
intermittent [Intq'mItqnt] переривчастий, епізодичний
exacerbate [Igz'xsqbeIt] загострювати, підсилювати
alleviate [q'lJvIeIt] полегшувати, зменшувати
(симптоми)
ulceration ["Alsq'reISqn] виразковість

clotting ['klPtIN] згортання крові
contraindication ["kPntrqIndI'keISn] протипоказання
probe ['prqVb] зонд;зондувати
arch [RC] дуга, арка
UNIT 5: HISTORY TAKING
scar [skR] шрам, рубець

prematurity ["premq'tjVqrqItI] передчасність; неправильний
прикус
displacement [dIs'pleIsmqnt] зміщення

tooth wear ['tHT 'wFq] знос, стирання зуба
· Have you ever been questioned by a dentist? What did he/she ask you about?
· Why is patient’s health history important?
3 Read the text.
DENTAL HISTORY TAKING
It is said that over 80 % of diagnoses are made on history alone, a further 5-10%
on examination and the remainder on investigation. It is clear that history and exam-
ination skills remain at the very core of clinical practice.
History taking or medical record, or interview, being the initial step of clinical
examination, is an integral part of any diagnosing and treatment. Its aim is to obtain
invaluable information about patient’s health, complaints, and troubles in order to
establish a provisional or differential diagnosis. It is a planned doctor–patient con-
versation which enables patient to describe his sufferings, feelings and fears. History
taking includes the following:
· General information or demographic data including social and family history;
· Presenting complaints;
· Dental history;
· Medical history (current and past ones).
Demographic data are used to identify the patient and his clinical record. The
minimum data required include the following: name, marital status, date of birth,
occupation, lifestyle, current address and contact telephone numbers.
Presenting complaints. Patients visiting dentist often complain of pain. In order to
establish a diagnosis, it is important to obtain as far as possible a clear description of
the pain. In this case, SOCRATES may help remember the main questions to be asked:
S – site of pain (Ask the patient to demonstrate the place of maximum pain.);
O – onset (Was it gradual or sudden? When did it start? Is the pain affected or
initiated by hot or cold stimuli?);
55
PART ONE
C – character (Get the patient to describe the pain, e.g. dull ache, sharp, throbbing
or shooting.);
R – radiation (Ask the patient if the pain spreads anywhere);
A – associations (Are there any associated symptoms such as swelling, numbness
or pain elsewhere?);
T – timing (Is the pain intermittent or constant? How frequent is it? How long
does it last?);
E – exacerbating and alleviating factors (Is there anything that makes the pain
better or worse?);
S – severity (How intense is it? Does the pain keep the patient awake at night or
wake them from sleep? What treatments has the patient tried and were they effec-
tive?). It is worth asking the patient about the effectiveness of pain-killers or other
medications.
Dental history. It requires data about dental visits, their regularity and frequency,
reasons of visits, and previous treatments. Doctor should also ask about oral hygiene,
all complaints not related to the current one, presence or absence of all natural or
artificial teeth, past dental or maxillofacial traumas, etc.
Past and current medical history. An accurate medical history may reveal condi-
tions relevant to diagnosis of the presenting complaint, for example oral lesions in a pa-
tient taking non-steroidal anti-inflammatory drugs. Patients taking any anticoagulants
or having blood clotting problems require special consideration. Pregnancy might be
a contraindication for some diagnostic procedures (e.g., X-ray) and using anesthesia.
Having completed history taking, usually a provisional diagnosis is established.
After that the doctor has to perform the next stage of clinical examination, which
is physical examination including visual inspection, palpation, percussion, probing,
pulp vitality tests and others. The examination is divided into an extra-oral exam-
ination (it includes visual examination of the head and neck with a special focus on
swellings or deformity, asymmetry of the face, abnormal colour or scars on the skin or
lips), followed by intra-oral examination. The latter starts with checking oral hygiene
and soft tissues condition. The entire oral mucosa should be carefully inspected, any
ulcer of >3 weeks’ duration requires further investigation. Periodontal condition can
be assessed rapidly, using a periodontal probe, pockets >5mm indicate the need for a
more thorough assessment. Doctor has to examine each tooth in turn for caries and
examine the integrity of any restorations present. Occlusion should be checked as well.
This should involve not only getting the patient to close together and examining the
relationship between the arches, but also looking at the path of closure for any obvious
prematurities and displacements. The evidence of tooth wear might also be important.
Afterwards, if it is necessary, the doctor may refer his patient to undergo instru-
mental (X-ray, CT, MRI, etc.) and laboratory (different blood tests or tissue histology
tests) examinations. Only having obtained all the necessary information, accurate
final diagnosis can be established and proper treatment chosen.
56
Group the words from the word bank according to the correct headings.
4
Say what you know about them.
dull MRI deformity swelling shooting asymmetry

intermittent lab tests throbbing probing palpation
percussion pain acute X-ray radiating ulceration
Characteristics of pain: Complaints: Methods of examination:
1. complaint a. an abnormal bodily protuberance or localized enlarge-

ment; edema
2. fear b. an instrument that consists typically of a light slender
fairly flexible pointed metal instrument like a small rod
that is used typically for penetrating and exploring bodi-
ly passages and cavities
3. swelling c. an unpleasant often strong emotion caused by anticipa-
tion or awareness of danger and accompanied by in-
creased autonomic activity
4. numbness d. something (as a symptom or condition) that makes a
particular treatment or procedure inadvisable
57
PART ONE
5. probe e. contact between maloccluded teeth occurring before the

jaws close
6. contraindication f. expression of grief, pain, or dissatisfaction
7. prematurity g. the act or process of removing something from its usual

or proper place or the state resulting from this
8. displacement h. reduced sensibility to touch
6
bank.
pulp vitality tests complaint contraindication

severity general data occupation reason
1. The patient stated the _____________ he came into the clinic was because of
terrible toothache.
2. ________________ include things like a name, a phone number, and a date of
birth.
3. Patient’s allergy to analgesics was a serious ________________ for anesthesia
application.
4. A full primary examination should be completed before returning to the pre-
senting _____________.
5. Some conditions are correlated with age, sex, ethnicity or _____________,
and demographic data may help to diagnose a presenting condition more
easily.
6. The degree of ________________ of a medical problem can be judged by
asking additional questions.
7. ____________________ are important elements of the endodontic evaluation
and assist in revealing the condition of the tooth pulp.
Complete the text about the art of taking a history by choosing appropriate
7 prepositions. Have you ever heard about “white coat syndrome”?
Why can it occur and what may it result in?
History taking requires practice. Patients respond in/on different ways to similar
lines to/of questioning, and it may be necessary to modify questioning style or to ask
the same question several times but in/by different ways out/in order to optimize the
58
information obtained. Although practitioners are all familiar with/by patients who
present their “life story” following the practitioner’s opening question, much import-
ant information may be lost at/by frequent interruptions or curtailing the patient’s
answers. Other reasons for/to poor history giving by/with the patient may include
fear or apprehension about treatment, anxiety around hospital-type situations, the
so-called “white coat syndrome”. A perceived lack on/of confidentiality or an unwill-
ingness to disclose information in front of/to a parent or other family member may
prevent a patient from/out talking freely. Some patients may have a fear or embar-
rassment for/about their condition or what the clinician might say.
8
1. встановити попередній або диференційований діагноз;

2. отримати якомога точніше описання болю;
3. посилити чи послабити біль;
4. перевірити наявність штучних протезів у ротовій порожнині;
5. виявити стани, що пов’язані з діагностуванням наявної проблеми;
6. перевірити цілісність реставрацій у ротовій порожнині;
7. направити пацієнта на подальше інструментальне чи лабораторне
дослідження.
1. History taking is the last and not very important aspect of establishing diagnosis.
2. There is no difference in provisional and final diagnosis.
3. Patient’s social and family history can impact the present condition.
4. Dental problems are never related to medical ones.
5. Patients are always ready to talk about whatever their doctor wants.
6. SOCRATES may help a doctor to arrange questioning about pain.
7. Physical examination is not enough to make an accurate diagnosis and choose
a proper treatment plan.
1. What components does the diagnostic process include?

2. Why does history taking go first? What is the aim of it?
3. What are the main steps in history taking?
4. What is SOCRATES? Explain each letter.
5. Why does a dentist ask about present and past medical history?
6. What does physical examination consist of?
7. What methods of examination do dentists use additionally to physical ones?
59
PART ONE
GRAMMAR
WAYS OF EXPRESSING FUTURE
Future
Present
Future Simple Continuous
Continuous Be + going + to
(will + Verb) (will + be +
(be + Verb + ing)
Verb + ing)
is used for: is used for: is used for: is used for:
· decisions taken · fixed arrange- · planned or · action that
at the moment of ments in the intended action will be hap-
speaking near future in the future pening at a
I’m tired. I think I’m meeting him I’m going to given point
I’ll go to bed on Friday night. visit my dentist in the future
early. We’re sending next Monday. This time
· hopes, fears, our invitations · evidence that next week,
promises, etc. over the next smth will defi- you’ll be
I’m sure he’ll help couple of weeks nitely happen flying back to
you. This tooth is the USA.
· smth may or may shedding. It’s
not happen in going to fall
the future out.
They’ll probably
come again.
1 Identify the tenses in bold. Then match them with their meaning.
1. I’m tired. I think I’ll stop working for a while.

2. Doctors will perform 5D implantations in 10 years’ period.
3. I’m going to visit my friend on Saturday.
4. He hardly studies anymore. He’s going to fail his exams.
5. She’s meeting her scientific supervisor at 5 pm tomorrow.
6. The dental clinic starts working at 9 am and finishes at 7 pm.
a. The speaker intends to do something.

b. The speaker has arranged a definite appointment.
c. The speaker makes a prediction about the future.
60
d. The speaker gives some information about the implantation programme.

e. The speaker has got evidence that something will probably happen.
f. The speaker makes an on-the-spot decision.
2 Fill in the correct Future Tense.
1. I’m sure he __________ (to agree) to show us how this apparatus works.
2. They ____________ (to open) the new laboratory next week.
3. This time tomorrow Professor ___________ (to perform) a very sophisticated
operation.
4. At last we have some free time; we ________ (to go) to the cinema.
5. I can’t come with you this afternoon because I ______ (to accompany) my
sister to the dentist.
6. The exam ___________ (to start) at 9.00.
3 Working in pairs, answer the following questions.
1. What are your plans for the nearest weekend?

2. What will you be doing tomorrow at 6 pm?
3. What are you definitely doing tonight?
4. What will you do in 30 minutes?
5. When do your classes start tomorrow?
4 Fill in will or am going to.
1. A: Your doctor is still busy. Can I help you?

B: No, thanks. I __________ wait for him.
2. A: Have you got any plans for Wednesday morning?
B: Yes, I __________ have my teeth cleaned.
3. A: Will you watch the operation with us?
B: Sorry, I can’t. I __________ attend a seminar on Histology.
4. A: Here are my notes from the lecture.
B: Thanks. I _______ give them back to you tomorrow.
5. A: What time will you be free today?
B: I don’t know. The conference _______finish after 7.00
5 Put the verbs in brackets into the correct future form in the active or passive.
1. This patient ___________ (to be) home this Saturday.

2. She _________ (to move) soon out of intensive care.
3. That means in ten minutes, it _________ (to be) roughly 60 minutes since
your pain first came on.
61
PART ONE
4. _________he (to be able) to go into rehabilitation unit before he comes out?

5. This drug ___________ (to reduce) your pain. Let’s try.
6. In 30 minutes I _________ (to test) pulp vitality. So you can come and see it.
7. The consultant _________ (to make) a round at about 1 pm, so we ________
(to see) him then.
8. I hope things ________ (to come) round.
6 Fill in the blanks with the correct tense.
Before you 1) ________ (take) your exams at the end of this term, there are a few
things you should bear in mind: Once you 2) _________ (know) the exact dates and
times of your exams, it 3) __________ (be) wise to make out a revision timetable for
yourself. Before you 4) ________ (start) revising put all your notes into some kind of
order and whenever you 5) ___________ (come across) any key points write them
on separate pieces of paper. Remember that as long as you 6) _________ (approach)
your exams in a calm and structured way, you 7) __________ (feel) more confident
about what you’re doing.
TALKING POINTS
· steps of clinical examination;

· main aspects of history taking;
· asking about pain;
· intra-oral and extra-oral examination.
MORE READING
1. What is pulp vitality test used for?

2. What forms of pulp vitality testing do you know? When are they used?
3. What is the mechanism of electric stimulus use in pulp vitality testing?
4. What should doctor take into consideration to make the diagnosis?
62
PULP VITALITY TEST

Pulp vitality test is applied to access the state of the pulp. The pulp is the tissue of
the tooth that involves the nerves, the branches of blood vessels and some portion of
connective tissue. Radiography and several vitality tests are used to spot the damaged
tooth, to detect the condition of the pulp, and define the stage of the process taking
place in it. This information helps define the proper treatment option.
Pulp vitality test is also efficient in omitting the possibility of further retreatment
when the restoration is planned. Vitality testing can vary greatly concerning the pa-
tient’s complains and the other factors. The basic components of the test are: electri-
cal, hot, and cold stimuli application. The first stage, as a rule, is thermal testing and
when complaints are recorded the cold stimulation with an ice pencil comes next.
Hot stimulation becomes a crucial part of vitality testing when the patient complains
of hot drinks and food consumption causing pain. In this case the dentist has two
options: either to irrigate the area with a syringe filled with hot water or to apply the
heated gutta percha.
The third method to check the vitality of the pulp is an electronic stimulus given
with the help of an electronic pulp tester and a special type of paste that conducts
electric current. The probe is attached to the tooth and a dental specialist gradually
increases the electric current till the moment it produces pain. This point and the
intensity of the current are recorded.
Staring with the part that is opposite from the point of pain is considered to be
more effective for both a dental professional and a patient, since it helps identify the
natural response to the stimulus. The rating of pain intensity and signalling with
their own hands are the tasks the patients fulfil during the procedure. All dimensions
including reaction time, the intensity and the duration of sensation are taken into
account by a dental professional during establishing the diagnosis.
Reversible pulpitis or an inflammation is diagnosed due to sharp pain reported on
cold stimulation. Irreversible pulpitis is suspected when pain and discomfort do not dis-
appear together with the stimulus removal. When the area is left untreated the necrosis
in form of dental abscess or acute apical periodontitis can arise. It must be considered
that if there is chronic periapical periodontitis or the patient has taken painkillers 12
hours before the procedure no response to the testing is likely to be manifested. To the
treatment options in case of pulpitis belong: root canal therapy and tooth extraction.
2 Read the extract and answer the following questions.
1. When should professional oral health intervention be started?

2. What are periodicity and continuity of professional oral health intervention
based on?
3. What benefits may early examination bring?
4. What are the components of a comprehensive oral examination?
63
PART ONE
Professional dental care is necessary to maintain good oral health. According to

the American Academy of Pediatric Dentistry (AAPD) the initiating professional
oral health intervention in infancy and continuing through adolescence and beyond
is extremely important. The frequency of professional oral health intervention and
services depends on a patient’s individual demands and risk indicators. Each age
group, as well as each child, has certain developmental needs to be addressed at defi-
nite intervals as part of a comprehensive evaluation. Continuity of dental care must
be based on the individual needs of the patient and assures adequate management of
all dental conditions, diseases and injuries. The early dental visit establishing a dental
home care provides a basis upon which a lifetime of oral health care and preventive
education can be built.
It is recommended that the first examination should be at the time of the first
tooth eruption and no later than 12 months of age. The dentition and occlusion de-
velopment should be monitored throughout eruption at regular dental examinations.
Early detection and treatment of oral diseases may improve a child’s oral health, gen-
eral health and school readiness. Delayed diagnosis of dental disease can lead to more
severe problems resulting in more extensive and costly care. Early diagnosis of mal-
occlusions may allow for timely therapeutic intervention.
Components of a comprehensive oral examination involve assessment of:
• General health/growth.
• Pain.
• Extraoral soft tissue.
• Temporomandibular joint.
• Intraoral soft tissue.
• Oral hygiene and periodontal health.
• Intraoral hard tissue.
• Developing occlusion.
• Caries risk.
• Behaviour of child.
The dentist can use additional diagnostic aids, based on the visual examination
(e.g., radiographs, photographs, pulp vitality testing, laboratory tests, study casts).
The most common interval of examination is six months; however, certain patients
may need examination and preventive dental care at more or less frequent intervals,
based on clinical, historical and radiographic findings. Caries and its complications
are among the most common health problems facing infants, children, and adoles-
cents in America. Carious lesions are progressive and, in the primary dentition, are
highly predictive of caries developing in the permanent dentition. Reevaluation and
reinforcement of preventive measures should contribute to improved instruction for
the caregiver of the child or adolescent, repetitive exposure to dental procedures,
potentially alleviating anxiety and fear for children or adolescents.
64
UNIT 6 EMERGENCIES IN DENTISTRY
LEAD IN
emergency [I'mE:GqnsI] надзвичайна ситуація

injury ['InGqrI] травма, пошкодження
disturbance [dIs'tE:bns] захворювання, порушення
prompt [prPmpt] швидкий, невідкладний
fainting ['feIntIN] непритомність, зомління
consciousness ['kPnSqsnIs] свідомість
syncope ['sINkqpI] непритомність
clammy ['klxmI] липкий
pallor ['pxlq] блідість
supine ['sju:paIn] положення на спині
seizure ['sJZq] припадок, приступ
wheezing ['wJzIN] дихання з присвистом
clotting ['klPtIN] згортання крові
adjunctive [q'GANktIv] додатковий
suture ['su:Cq] шов
exacerbation [Igzxsq'beISn] загострення, погіршення
chipped [CIpt] щербатий
dislodged [dIs'lPGd] зміщений, рухливий, відірваний
knocked (out) [nPktaVt] вибитий
PART ONE
2 Before you read the text prepare a list of questions you’d like to get answers
to while covering the topic “Emergencies in Dentistry”.
3 Read the text.
COMMON MEDICAL AND DENTAL EMERGENCIES IN DENTISTRY
An emergency condition in dentistry is an unexpected event that can include ac-

cidental or wilful bodily injury, central nervous system stimulation and depression,
respiratory and circulatory disturbances, as well as allergic reactions. Prompt man-
agement is essential for both medical and dental emergencies. Consequently, dentists
and their staff should be prepared to recognize, respond and effectively deal with
emergency conditions.
Some medical emergencies may take place in a dental clinic during dental treatment.
Fainting is the most common cause of sudden loss of consciousness. It is normally
associated with syncope due to anxiety, fear, fatigue, pain, and the sight of blood or
surgical instruments. Symptoms observed before fainting include clammy skin, pallor,
bradycardia and low pulse volume followed by tachycardia and loss of consciousness.
This medical emergency is usually managed by placing the patient supine with the head
lower than the legs to increase blood flow to the brain. In addition, fainting may be a
result of a medical condition such as hypotension, seizure, hypoglycemia, hyperven-
tilation, allergy, a stroke, or myocardial infarction. If these medical conditions occur
dentists should seek medical support by calling immediately for an ambulance.
Anaphylactic shock is a severe, life-threatening allergic reaction. Causative agents
of anaphylactic shock include latex, penicillin, several drugs such as cephalosporins
and NSAIDS (non-steroidal anti-inflammatory drugs). It should be noted that a true
allergic reaction to an injected local anesthetic has a very low incidence in dentist-
ry. Signs and symptoms observed during anaphylactic shock are facial swelling and
flushing, itching, cold clammy skin, wheezing, dyspnea, abdominal pain, cyanosis
with a rapid and weak pulse, hypotension. It is recommended to lay the patient flat
and raise their legs, give oxygen, administer epinephrine and antihistamine. Then,
the patient should be transported to a nearby hospital.
Prolonged and uncontrolled bleeding is referred to as haemorrhage. Major hae-
morrhages are not common in oral surgery except in patients who have bleeding or
clotting disorders, or those who are on anticoagulants. In patients with mild or severe
bleeding disorders, the goal is to minimize the risk by restoring hemostatic system
to acceptable levels and maintaining hemostasis by local and adjunctive methods.
In patients with drug-induced coagulopathies, drugs may be stopped or the doses
modified. However, uncontrolled and persistent bleeding can occur in some healthy
patients after dental extraction. In this case, a dentist should apply a gelatine throm-
bin sponge or insert sutures.
66
UNIT 6: EMERGENCIES IN DENTISTRY
Patients may face some types of dental emergencies outside a dental clinic due to
a quick exacerbation of dental issues.
Lost filling. In this case advice your patient to rinse out the tooth cavity with warm
water and press a cotton ball firmly into it or use an over-the-counter dental cement.
It is the best to seek medical attention as soon as possible.
Loss of a crown or cap. Missing crown may trigger pain during eating when food
gets in the exposed area. If a crown or cap is displaced placing dental wax or a tem-
porary cap can help ease sensitivity.
Severe toothache. If a severe toothache happens, recommend your patients to im-
mediately rinse their mouth out with warm water and place a cold compress against
their cheek for 20 minutes to alleviate swelling. Remove the compress and let the area
warm up and then re-apply the cold compress. Pain medication should not be used
directly against the gum. It may inflame the gum and do more damage to the teeth.
An immediate visit to a dentist is necessary to check for a bacterial infection.
Chipped or broken tooth. Patients must know that the first thing to do is to save
the chipped or fully dislodged tooth. Then, they should rinse the area inside their
mouth as well as the tooth that has been displaced with warm water. If there is bleed-
ing, some gauze or cotton should be applied to the area for five to 10 minutes. It is
necessary to use a cold compress outside their mouth until the swelling goes down.
At the dentist’s, clinical examination and radiography are followed by fillings with or
without root canal treatment or extraction.
Knocked-out tooth. The best chance of saving a tooth that has been fully removed
from a mouth is to visit a dentist within one hour. Until then, the tooth must be kept
safely and moist in a small container of milk or in water with some salt added.
4 Match the following terms with their definitions.
1. syncope a. sudden loss of consciousness, sensation, and voluntary

motion caused by rupture or obstruction of a blood
vessel of the brain
2. hypoglycemia a. bleeding in a very fast and uncontrolled way
3. hyperventilation b. arrest of bleeding
4. stroke c. hypersensitivity to foreign proteins or drugs
5. myocardial d. loss of consciousness resulting from insufficient blood
infarction flow to the brain
67
PART ONE
6. anaphylaxis e. excessive rate and depth of respiration leading to abnor-

mal loss of carbon dioxide from the blood
7. hemorrhage f. an acute episode marked by the death or damage of heart
muscle due to inadequate blood supply to the heart
8. hemostasis h. abnormal decrease of sugar in the blood
5 Substitute the underlined words with the correct alternatives.
1. Sudden loss of consciousness is usually managed by placing the patient supine.

a) flat on the floor b) in a sitting position c) in a vertical position
2. Signs and symptoms observed during anaphylactic shock are facial swelling and
flushing (A), itching, cold clammy skin, wheezing (B), dyspnea, abdominal pain,
cyanosis (C) with a rapid and weak pulse, hypotension (D).
A. a) bluish skin b) yellowish skin c) redness
B. a) high pitched whistling sound b) crackles c) low pitched sound
C. a) yellowish skin b) bluish skin c) redness
D. a) high blood pressure b) normal blood pressure c) low blood pressure
3. Uncontrolled and persistent bleeding can occur in some healthy patients after
dental extraction.
a) hemostasis b) haemorrhage c) clotting
4. Patients may face some types of dental emergencies outside a dental clinic due to
a quick exacerbation of dental issues.
a) worsening b) improvement c) remission
5. Missing crown may trigger pain during eating when food gets in the exposed area.
a) stop b) cause c) relieve
6. If a severe toothache happens, recommend your patient to place a cold compress
against their cheek for 20 minutes to alleviate swelling.
a) trigger b) cause c) relieve
7. Patients must know that the first thing to do is to save the chipped (A) or fully
dislodged (B) tooth.
A. a) broken b) extracted c) inflamed
B. a) extracted b) luxated c) broken
8. The best chance of saving a tooth that has been fully removed from a mouth is to
visit a dentist within one hour.
a) relieved b) luxated c) knocked out
68
6 Complete the sentences by choosing appropriate prepositions.
Pulp irritation is one of the causes for/of toothaches, as this can occur after/on
a dental treatment. No matter how well a filling or crown is done the materials that
are used to fix the tooth can end on/up causing pain later on. Crowns can sometimes
come out/off or the filling can sometimes come out/off. If a tooth is knocked in/out,
the first thing to do is to look out/for that tooth. When the tooth is found, it should
be gently scrubbed to get rid after/of any dirt or debris. The dentist may be able to put
the tooth back/before in place if the patient arrives in time. If the tooth is fractured,
the treatment will depend of/on how bad the trauma is. Minor fractures can normal-
ly be smoothed out/in using sandpaper.
7 Match the types of dental emergencies in the box to the images a-j.
objects wedged between teeth cracked tooth bitten tongue

problems with braces chipped tooth knocked-out tooth
fractured jaw loose tooth dislodged tooth bitten lip
a b c
d e f g
h i j
69
PART ONE
8
statement relates to. Use the dental terms from the word bank.
a dislodged (luxated) tooth a chipped tooth a loose tooth

a cracked tooth a knocked-out tooth
1. IT has a crack that extends from the chewing surface of the tooth vertically
toward the root and is too small to show up on X-rays.
2. IT is mobile due to periodontal pockets that form around it.
3. IT is an avulsed tooth that has been completely displaced from its socket.
4. IT has been partially pushed into or out of its socket, or sideways, during an
injury.
5. IT has lost a tiny piece of superficial enamel resulting in disfiguring of the
tooth or has a severe fracture.
9 Define dental symptoms and treatment for the following dental emergencies:
1. abscessed tooth a. A tooth waggling around loosely in the mouth, severe

pain, swelling, bleeding. The tooth can be replanted
and repaired. Root canal treatment is needed for per-
manent teeth.
2. cracked tooth b. The gap in the mouth, bleeding, swelling, severe pain,
trouble breathing, fever. It is possible to save a tooth
by putting it back in place as soon as possible (usually
within an hour) followed by root canal treatment.
3. dislodged tooth c. An ache in the bone around the tooth, pain when
chewing, swelling of the gums. The tooth requires
removal of the bacteria from the root canals, their
cleaning, shaping and filling, as well as sealing of the
tooth.
4. knocked-out tooth d. An erratic pain when chewing or pain when a tooth
is exposed to temperature extremes. If the pulp is
involved, the tooth can be treated with a root canal
procedure and a crown.
70
1. A medical emergency in the dental office may be a foreseen event.

2. Patients with dental emergencies can postpone their visit to a dental clinic.
3. Fainting is normally associated with syncope due to anxiety, fear, fatigue, pain,
and the sight of blood or surgical instruments.
4. Loss of consciousness is usually managed by placing the patient in a sitting
position with the head elevated to reduce blood flow to the brain.
5. If a stroke or heart attack occurs dentists should seek medical support by call-
ing immediately for an ambulance.
6. If a crown or cap is displaced nothing can help ease sensitivity.
7. Pain medication should be used directly against the gum.
8. If a patient has a chipped or broken tooth, clinical examination and radiogra-
phy are followed by fillings with or without root canal treatment or extraction.
1. What’s an emergency condition in dentistry? What does it require?

2. What’s the most common cause of a sudden loss of consciousness?
3. What does syncope result from?
4. What symptoms are observed before fainting?
5. How is sudden loss of consciousness managed?
6. What triggers anaphylactic shock?
7. What symptoms are associated with anaphylaxis? What’s first aid?
8. What factors can lead to severe haemorrhage?
9. How can major bleeding be prevented and dealt with in dentistry?
10. What types of dental emergencies can patients face outside a dental clinic?
How can they be managed?
71
PART ONE
GRAMMAR
PERFECT TENSES (ACTIVE VOICE)
We use the Present Perfect Simple to talk about any action that happened at an
unstated time in the past or about any action which started in the past and con-
tinues up to the present, especially with the time expressions such as already, yet,
ever/never, just, etc.
The dentist has already performed root canal treatment. (The exact time is not men-
tioned).
The Present Perfect Simple is also used for an action which has happened within
a specific time period, which is not over at the moment of speaking, such as today,
this morning/afternoon/week/month/year, etc.
This year they have reported numerous cases of caries in children. (The time period
– this year – is not over yet).
He has performed
He has not (hasn’t) performed
Has he performed? Yes, he has /No, he hasn’t
They have reported
They have not (haven’t) reported
Have they reported? Yes, they have/No, they haven’t
1 Read the headlines and write Present Perfect Simple sentences.
1. MANY DENTAL CLIENTS FACE UNEXPECTED EVENTS

2. A COLD COMPRESS HELPS A VICTIM ALLEVIATE SWELLING
3. PROLONGED AND UNCONTROLLED BLEEDING – NOT COMMON IN
ORAL SURGERY
4. DENTISTS SUCCESSFULLY CORRECT JAW DISLOCATIONS
5. THE BEST TEMPORARY RELIEF ALTERNATIVE IS AN EMERGENCY
DENTAL KIT
6. PARENTS FOUND A WAY TO COMFORT THEIR KID
7. DELAYED DENTAL VISITS DON’T WORK
8. HOT AND COLD FOOD AND DRINKS CAUSE CRACKS
72
We use the Past Perfect Simple to talk about any action that happened in the past
before another action (we use the Past Simple here) or before any episode in the
past. We often use it with before, until and after.
The dentist extracted his patient’s dislodged tooth after he had carried out clinical
examination and radiography.
He had carried out

Had he carried out? Yes, he had /No, he hadn’t
He had not (hadn’t) carried out
2 Join the sentences with the words in brackets. Use the correct verb form.
1. The children ate breakfast. They went to brush and floss their teeth. (after)
2. He avoided the dentists. The doctor identified numerous teeth affected by
caries. (because)
3. She didn’t tell the doctor. She lost her consciousness during the tooth prepara-
tion. (that)
4. The patient made an appointment with his dentist for Monday. He fell from his
bike and knocked out his front teeth. (after)
5. She refused to go to the dentist. She heard a lot of horror stories about the
dental treatment in her childhood. (because)
6. The child was safe and comfortable. The dentist decided to use general
anesthesia in the operating room. (after)
7. The doctor registered the child for the procedure. A member of the anesthe-
sia team met with the patient to take his/her vital signs, weight, and medical
history. (before)
8. The child was taken to the recovery room. The dentist completed the
procedures. (after)
We use the Future Perfect to talk about any action that will be finished before a
stated future time or before another future action (we use the Future Simple here).
We often use it with before, until, by, by the time, etc.
They will have finished their meeting by four o’clock this afternoon.
They will have finished
Will they have finished? Yes, they will /No, they won’t
They will not (won’t) have finished
73
PART ONE
3 Put the verbs in brackets into the Future Perfect.
1. The nurse __ (complete) preparing for the manipulation until the doctor
comes.
2. My friend __ (translate) this medical article before you come.
3. By the end of the next week, Steve __ (finish) his treatment.
4. The dentist __ (arrest) the process of inflammation before the operation is
started.
5. The doctor ___ thoroughly ___ (examine) the patient before he makes a deci-
sion on conservative or operative treatment.
6. The patient __ (leave) the hospital by the time another patient comes.
7. They __ (complete) building of a new dental clinic by the next month.
8. The doctor __ (prolong) the course of treatment until the patients recovers
completely.
4 Choose the correct alternative.
1. The dentist ___ some antibiotics as well as some pain-killers after the operation.
a will have prescribed b have prescribed c had prescribed d has prescribed
2. The patient had no feeling in his cheek after the doctor __ the local anesthetic.
a has injected b will have injected c had injected d have injected
3. He __ eating hot food until anesthesia wears off.

a will have avoided b have avoided c had avoided d has avoided
4. I ___ my tooth.
a will have chipped b have chipped c had chipped d has chipped
5. After I __ a dental hygienist, I brushed my teeth three times a day.

a will have visited b have visited c had visited d has visited
6. The mouthwash ___ him to keep his mouth clean and smelling fresh since he
started smoking.
a will have helped b have helped c had helped d has helped
7. Plaque built up after she ___ her teeth properly and regularly.
a won’t have brushed b haven’t brushed c hadn’t brushed d hasn’t brushed
74
Complete the sentences with either the Past Simple or

5
Present Perfect Simple form of the verbs in brackets.
1. Since anesthesia ___ (be) first introduced to the public, it ___ (change) a great
deal.
2. The first anesthetics ___ (be) rather aggressive.
3. Times ___ (change). Anesthetics ___ (become) more refined and powerful.
4. Do you like this dental clinic? I ___ (visit, never) that clinic.
5. My favourite dentist and I __ (know) each other for over fifteen years.
6. I ___ (have, not) this much fun since I ___ (be) a kid.
7. In the last hundred years, anesthesia administration ___ (undergo) many
transformations.
8. In 1905, Alfred Einhorn and his associates in Munich ___ (report) their dis-
covery of procaine.
TALKING POINTS
1 Suggest appropriate behaviour for:
• loss of consciousness
• anaphylaxis
• haemorrhage
• lost filling
• loss of a crown
• severe toothache
• chipped or broken tooth
• knocked-out tooth
You are doing an afternoon shift in the dental clinic. A man in pain has
2
been escorted by his wife here. Ask questions to find out the following:
• general information about the patient
• what happened
• when the accident took place
• patient’s complaints
• any injuries to the face
• any first aid given
• patient’s concerns regarding his problem
75
PART ONE
MORE READING
1. What does a systemic approach to oral-facial injuries include?

2. What care do oral soft tissue injuries require?
3. What traumas, jaw dislocations or jaw fractures, are fairly simple to manage?
Explain your answer.
4. What does the term dental injury refer to?
5. What’s the main goal of dental emergency medicine?
CARE FOR ORAL-FACIAL INJURIES
To efficiently determine the extent and correctly diagnose injuries to the face,
jaws, teeth and associated structures, a systemic approach to trauma is essential. As-
sessment includes a thorough history, visual and radiographic (X-ray) examination,
and physical evaluation. Treatment also takes into consideration the patient’s health
and developmental status.
Most dental injuries can be classified into three broad categories:
Soft tissues: bruises, cuts, lacerations to the lips, cheeks, gums or tongue. These
wounds require careful cleaning to make sure there are no entrapped pieces of tooth
or dirt. If lacerations are extensive, sutures may be necessary. If puncture wounds are
present, antibiotic treatment together with tetanus toxoid shots may be necessary to
prevent serious life-threatening infection.
Jaws: dislocations of the lower jaw and/or fractures of upper or lower jaws. Sim-
ple jaw dislocations are generally fairly simple to correct. Jaw fractures, depending
on extent and location, may necessitate anything from fixation or splinting (joining
together) of a group or groups of teeth to open surgical fixation and pinning under
general anesthesia.
Dental: anything to do with teeth from simple chipping to complex fractures or
avulsions. More serious conditions occur when the teeth are fractured, a term that
refers to a break in the outer protective layers of a tooth, the enamel and dentin. If the
fracture is serious enough to expose the tooth’s inner pulp, immediate attention from
a dentist will be needed to reduce the risk of losing the tooth, by treating the exposed
pulp and nerve tissues.
The main goal is to salvage the affected teeth whenever possible: to maintain
health, function, aesthetics and avoid tooth loss. Modern dentistry is able to employ
the newest and most advanced methods to secure and successfully treat chipped,
fractured, loosened or displaced teeth.
76
2 Read the text. Match the highlighted words or phrases in the text to the
following meanings.
1. Mucus in the sinuses that blocks the flow of air through the passageways.
2. Pressing of the jaws and teeth together in centric occlusion.
3. Prolonged and persistent pain.
4. A painful tooth if hot, cold, sweet or very acidic foods and drinks are taken, or
cold air is breathed in.
5. Rubbing together harshly.
6. Something used to fill a space, cavity.
7. A localized protective response caused by injury or destruction of tissues.
8. Abnormal wearing away of tooth tissue by a mechanical process (tooth
brushing).
POSSIBLE CAUSES OF TOOTHACHE
Pain is a defensive reaction that can range from minor to severe. Toothache is
caused by a reaction of the nerves inside a pulp chamber.
• Sensitivity to hot or cold foods and liquids is present when there is mild decay
in a tooth, a loose filling or an exposed root resulting from gum recession or
toothbrush abrasion. If discomfort lasts only a few seconds, tooth sensitivity
doesn’t signal a serious problem.
• Sensitivity to hot or cold foods after dental treatment may appear due to
inflammation of the pulp tissue inside a tooth.
• Sharp pain experienced when biting down on food can be caused by tooth
decay, a loose filling and a cracked tooth.
• Lingering pain after eating hot or cold foods and liquids may indicate that the
pulp is inflamed or necrotic, and may be irreversibly damaged by deep decay
or injury.
• Dull ache and pressure in the upper teeth and in the sinus area of the face
is often associated with the upper back teeth because they share the same
nerves. Therefore, a simple sinus congestion can cause pain in the upper teeth.
Clenching or grinding can produce similar symptoms.
• Acute and constant pain that is difficult to locate can result from the infected,
inflamed and necrotic pulp if decay spreads to the nerve.
• Constant severe pain and pressure, swelling of the gum and sensitivity to touch
develop when tooth is infected and abscessed.
To avoid emotional, physical and financial stress people should seek early and
timely dental treatment.
77
PART ONE
3 Read the text. Explain the following:
• why it is necessary to have an emergency dental kit at home;

• what items a kit should contain;
• what dentists should inform their patients about before use of emergency
dental kits.
AN EMERGENCY DENTAL KIT
Most of us at one time or another have experienced a dental emergency. It’s some-
thing that’s hard to forget because of the associated discomfort and pain. Dental pain
can be caused by a variety of emergency conditions ranging from toothaches, a loose
crown, a cracked tooth, or a broken or lost filling.
Sudden dental pain can be very intense. While many of us are prepared with
emergency First Aid Kits, how many are prepared with a subset which can deal with
sudden dental pain? When there is no dentist (on a trip, vacation, camping, hiking,
boating), an emergency dental kit may be the best temporary relief alternative until a
more permanent solution to the problem can be found.
An emergency dental kit will typically come with step-by-step instructions (usu-
ally illustrated) on how to treat the most common dental emergencies (such as a tem-
porary filling). A kit usually includes the following items: temporary cement, tem-
porary filling, toothache drops, dental wax, denture repair material, cotton, gauze,
dental floss, gloves, tweezers, and sanitizing wipes.
In addition, the following precautions must be taken:
1. These products should not be used if throbbing pain or swelling is present.
2. Clean hands before and after each use of the materials in the kit.
3. If any of the liquids come in contact with eyes, flush with water and call your
doctor.
4. If rash or itching occurs with use of materials, discontinue and call your phy-
sician.
5. Keep out of reach of children, a consumer must be 18 years or older.
Emergency Dental Kits are designed to provide temporary relief for many of the
most common dental problems when a patient can’t reach their dentist. The compo-
nents of the system are each labelled for safe, easy use. Patients must carefully follow
all directions and see their dentist as soon as possible.
78
UNIT 7 DENTAL PHOBIA
LEAD IN
anxiety [xN'zaIqtI] тривога, занепокоєння

exposure [Ik'spqVZq] контакт, уразливість, піддавання
(впливу)
distress [dIs'tres] страждання, нещастя
fight-or-flight ['faItL'flaIt] реакція боротьби або втечі
perceive [pq'sJv] сприймати
inflict [In'flIkt] заподіяти
embarrassment [Im'bxrqsmqnt] збентеження
intrusive [In'trHsIv] нав’язливий
humiliating [hjH'mIlIeItIN] принизливий
vicarious [vI'kFqrIqs] непрямий
tense [tens] напружений
solution [sq'lHSn] рішення, вирішення
concern [kqn'sE:n] стурбованість
personable ['pE:s(q)nqb(q)l] чудовий, приємний, тактовний
compassionate [kqm'pxS(q)nIt] співчутливий
serene [sI'rJn] спокійний
smell [smel] запах
excessive [Ik'sesIv] надмірний
persistent [pq'sIstqnt] наполегливий
PART ONE
2 Before reading answer the questions that will help you find out a degree of
your fear about dental visits:
1. Do you feel relatively calm before your dental appointment or are you a little
nervous about a visit to the dental office?
2. Do you worry about it days or weeks before the appointment?
3. Are you someone who is actually terrified about dental treatment and worries
about it all the time?
4. Do even those things that make visits more comfortable seem to increase feel-
ing of anxiety and being out of control – like anti-anxiety medication or local
anesthesia?
3 Read the text.
DENTAL PHOBIA
A “phobia” is traditionally defined as an excessive, persistent, sometimes unrea-

sonable, fear. People can fear a specific situation, object or activity. Exposure to the
feared stimulus promotes an immediate anxiety response, which may take the form
of a panic attack. The phobia causes a lot of distress, and impacts on many aspects
of daily life. A distinction has been made between dental anxiety and dental phobia.
Those with dental anxiety will have a sense of uneasiness when it’s time for their
appointments. Dental phobia is an intense fear. The fight-or-flight response occurs
when just thinking about or being reminded of the threatening situation. There are
varying degrees of dental phobia. At the extreme, a person with dental phobia will
avoid dental care at all costs. Others may force themselves to go, but they may not
sleep the night before. Sometimes, people can get sick while they are in the reception
room. People develop dental phobias for many different reasons.
Pain: The fear of pain is most common in adults 24 years and older. This may be
because their early dental visits happened before many of the advances in “pain-free”
dentistry. However, pain caused by a dentist who is perceived as caring is less likely
to result in psychological trauma. Rather, it is pain inflicted by a dentist who is per-
ceived as cold and controlling that has a huge psychological impact.
Feelings of helplessness and loss of control: Many people develop phobias about
situations in which they feel they have no control. When they are in the dental chair,
they have to stay still. They may feel they can’t see what’s going on or predict what’s
going to hurt.
Embarrassment: The mouth is an intimate part of the body and dental treatments
require physical closeness. The hygienist’s or dentist’s face may be a few inches away.
This can make people anxious and uncomfortable.
80
UNIT 7: DENTAL PHOBIA
Negative past experiences or post-traumatic stress: This is characterized by intru-

sive thoughts of the bad experience. Studies suggest that this is true for about 80-85%
of dental phobias. This not only includes painful dental visits, but also psychological
behaviours such as insensitive, humiliating remarks made by a dentist.
Vicarious learning: If a parent is afraid of dentists, children may learn to be afraid
as well. Hearing other people’s horror stories about visits to the dentists or the depic-
tion of “the dentist” in the media can have a similar effect.
Anyone can be affected by dental phobia. Some of the signs of dental phobia in-
clude: feeling tense, having trouble sleeping, getting increasingly nervous, feeling like
crying, increasing anxiety at the sight of dental instruments or white-coated person-
nel in the dentist’s office, feeling physically ill at the thought of a dental visit, a panic
attack, having trouble breathing.
As the solution to the patients’ fears today’s dentistry offers sedation and anesthe-
sia, as well as highly-trained, able to answer all questions and concerns, personable,
kind and compassionate dental specialists. The dental offices are especially designed
to provide their patients with a serene environment, in which all necessary work is
performed without any bad memory of the procedures, smells or unpleasant sounds.
4 Match the following words or word-combinations with their definitions.
1. phobia a. a defense reaction, involving an increase in blood

pressure and heart rate and a redistribution of the
blood away from viscera to the striated muscles
2. response b. sudden onset of intense fear or terror accompanied by
dyspnea, dizziness, sweating, trembling, chest pain,
palpitations
3. vicarious learning c. a meeting at a specific time and place, planned in
advance
4. fight-or-flight reac- d. an abnormal and irrational fear of a specific thing or
tion situation despite the awareness and reassurance that it
is not dangerous
5. sedation e. loss of sensation, caused by administration of a drug
or other medical intervention
6. panic attack f. a reaction of an organism to a specific stimulus
81
PART ONE
7. anesthesia g. the act of calming by administration of a medication

to relieve anxiety and discomfort
8. appointment h. learning through indirect experience
Paraphrase the underlined parts of each sentence using the words

5
and phrases from the word bank.
private degrading comments struggle or escape

mental or physiological relaxation nearness
calm and peaceful atmosphere pain insensibility distressing
be afraid of painless suffering
1. People can fear a specific situation, object or activity.

2. The phobia causes a lot of distress.
3. The fight-or-flight response occurs when just thinking about or being
reminded of the threatening situation.
4. Because of recent advances in dentistry doctors can offer a pain-free and less
traumatic experience than even five or 10 years ago.
5. The mouth is an intimate part of the body and dental treatments require
physical closeness.
6. Negative past experiences not only include painful dental visits, but also psycho-
logical behaviours such as insensitive, humiliating remarks made by a dentist.
7. As the solution to the patients’ fears today’s dentistry offers sedation and
anesthesia.
8. The dental offices are especially designed to provide their patients with
a serene environment.
Many people are scared of/with the sight of instruments being put out/into their
mouths. The internet is full with/of stock photos of scary scenes where dentists come
at their patients from the front with instruments held to/in their faces! The reality
is that dentists work under/in such a way that you can’t really see the tools. Of/af-
ter course, you may wish to see them beforehand and have them demonstrated to/
on you. At/for example, many people find that having a better look on/at the drill
takes the fear away/under. Some people find that simply closing their eyes works for/
about them while receiving dental care. In/on the other hand, there are people who
like to see exactly what is going on, in which case you can ask your dentist to show
you what they are doing by/with the help of mirrors.
82
7 Use the sentences A-H to answer questions 1-8.
1. Who goes pale through fear? A. When Michael looked at the dental
2. Who is extremely sad? operatory equipment, he broke out in
3. Who feels nervous and unable to a cold sweat.
stand still? B. Jane is always scared to death days or
4. Who has a problem that is worrying weeks before her dental appointment.
him/her? C. Stefan goes white as a sheet when he
5. Who was in a state of shock or fear? hears the sound of the drill.
6. Who feels excited and tense? D. Sights, sounds and smells associated
7. Who is extremely frightened? with dentistry make Valerie keyed up.
8. Who is unable to move through fear? E. Jack is rooted to the spot every time
he is asked to take a seat in the dental
chair.
F. Thomas always feels like a cat on hot
bricks when he is worried that the
handpiece might slip and injure him.
G. Megan usually postpones her visits
to the dentist but it only worsens the
problem she has on her mind.
H. Sophia is as miserable as sin because
she is afraid of pain she might experi-
ence during dental treatment.
8 Correct the idioms in these sentences.
1. Vibration and light pressure caused by the drill make some patients rooted to
the ground.
2. She dreamed she’d had her tooth extracted and woke up in a hot sweat.
3. Many people develop phobias about situations in which they feel they have no
control, especially when they are in the dental chair and they have to stay still.
A defense reaction makes them feel like a cat on a hot cooker.
4. When the doctors take sharp instruments, many patients are sentenced to
death.
5. At the sight of dental instruments people with dental phobia can go white as
snow.
6. In some cases the reason for dental phobia is extremely costly dental treat-
ment. That’s why some patients avoid visits to the dentist even having their
decayed teeth in their head.
83
PART ONE
7. She is as miserable as weather because of her loose and chipped tooth that
makes her ugly.
8. White-coated personnel in the dentist’s office make some very sensitive pa-
tients clued up.
9 Group the words and phrases in accordance with the given categories.
In some cases one word can be used more than once.
Soft, warm, kind, trustworthy, friendly, fresh and clean, sit or stand with a
straight back, understanding, welcoming, neat, combed, cordial, calm, slow,
genuine, short styles, sparkling, sincere, with the head up, encouraging, well-
cut, pleasant, optimistic, reassuring, deliberate, directed at the patient, positive,
traditional medical attire, ponytails, well-groomed, professional, confident.
Personal characteristics of a dental professional

Eyes Facial
Voice Hairdo Gestures Posture Smile Clothes
expression expression
Define what factor causes dental fear in the following patients.

10
Explain your choice.
1. I know what the dentist is going to do. I’ve been there and done that – I’m
scared!
2. My teeth are bad and rotten. I am worried that they are the worst the dentist
has ever seen.
3. My tooth is so sensitive and painful. I am sure that I’ve got a huge problem. It
is going to hurt.
4. I know what happens when I go to the dentist. When I was a kid, my parents
always put off their visits to the dentist and told me lots of horror stories about
smells, sounds and sights in the dentist’s office. I’m so terrified I feel sick even
today when I’m a grown-up.
5. I hate lying in the dental chair because I can’t see the instruments. I have no
idea what the doctor is going to do next. I’m at a loss because their actions are
unpredictable. I feel helpless and unprotected.
6. I’ve got a displaced tooth. It is loose. But I won’t go to the dentist. I can’t afford
to pay dental fees. I’ve got fear of having not enough money to cover my dental
expenses. And the situation may appear rather embarrassing.
Possible options: pain, feelings of helplessness and loss of control, embarrassment,

negative past experiences or post-traumatic stress, vicarious learning, costly dental
services.
84
In each pair, select the word or phrase that is more preferable in the
11
conversation with the patient. Explain your choice.
Cancellation – change in the schedule; waiting-room – reception room; pull –

remove or extract; drill – prepare the tooth; uncomfortable – hurt, pain; treatment
room – operatory.
1. Phobia is traditionally defined as a short-term, reasonable fear.

2. Those with dental anxiety will have a sense of panic when it’s time for their
appointments.
3. The fight-or-flight response occurs when just thinking about or being remind-
ed of the threatening situation.
4. Pain caused by a dentist who is perceived as cold and controlling is less likely
to result in psychological trauma.
5. When patients are in the dental chair, they can see what’s going on or predict
what’s going to hurt.
6. A physical closeness, when the hygienist’s or dentist’s face is a few inches away,
can make people anxious and uncomfortable.
7. Negative past experiences include painless dental visits, friendly and cordial
remarks made by a dentist.
8. Vicarious learning is getting knowledge through indirect experience.
1. What is a traditional definition of phobia?

2. What distinction has been made between dental anxiety and dental phobia?
3. How can different degrees of dental phobia be described?
4. How can “fight-or-flight response” and “panic attack” be defined?
5. What factors contribute to the development of dental phobia?
6. When do patients feel helpless and embarrassed?
7. What negative past experiences can have a great impact on the patient’s be-
haviour?
8. What is vicarious learning or indirect experience?
9. What are the signs of dental phobia?
10. What does today’s dentistry offer as the solution to the patients’ fears?
85
PART ONE
GRAMMAR
PERFECT TENSES (PASSIVE VOICE)
We form The Present Perfect Passive by the next formula

Have/has + been + Past Participle (Participle II)
It has been performed
It has not (hasn’t) been performed
Has it been performed? Yes, it has /No, it hasn’t
They have been reported
They have not (haven’t) been reported
Have they been reported? Yes, they have/No, they haven’t
Root canal treatment has already been performed by the dentist.
Numerous cases of caries in children have been reported this year.
We form The Past Perfect Passive by the next formula

Had + been + Past Participle (Participle II)
It had been carried out
Had it been carried out? Yes, it had /No, it hadn’t
it had not (hadn’t) been carried out
The dentist extracted his patient’s dislodged tooth after clinical examination and ra-
diography had been carried out.
We form The Future Perfect Passive by the next formula

Will have + been + Past Participle (Participle II)
It will have been finished
Will it have been finished? Yes, it will /No, it won’t
It will not (won’t) have been finished
Their meeting will have been finished by four o’clock this afternoon.
1 Complete the sentences with the correct alternatives.
1. Your teeth ___ today by the time your doctor meets you in the examination
room.
a are cleaned b will be cleaned c have been cleaned d will have been cleaned
86
2. Two cavities ___ just ___ by Dr. Peterson.

a had been filled b will have been filled c have been filled d has been filled
3. He came in yesterday for his check-up after his teeth ____

a were flossed b had been flossed c are being flossed d has been flossed
4. The flat floss tape __ already __ by the dental hygienists.

a is recommended b will be recommended c has been recommended
d have been recommended
5. Tooth decay was identified between the teeth after X-ray ____.
a was ordered b had been ordered c will have been ordered d has been ordered
6. The protective apron __ by the patient by the time the dentist starts taking
X-rays.
a has been put on b was put on c had been put on d will have been put on
7. In addition to cleaning the patients ___ additional care including tooth whit-
ening.
a will have been offered b have been offered c has been offered
d had been offered
8. Before my sister had her wisdom tooth removed, a dental appointment __ by

her.
a had been set up b has been set up c will have been set up d was set up
2 Complete the story with the correct passive form of the verbs in brackets.
A visit to the dentist’s office ___ (arrange) by James’s mother for today because he
has a toothache on the right side of his mouth. Before he asked his mother to help
him, some medicine ___ (buy) by him at the drug store. No dental appointments ___
(set up) by James because he is afraid of dentists.
After X-rays of his teeth ___ (take) by a technician, the dentist identified three
cavities. The tooth that has a large cavity ___ (extract) by the time the patient is ready
to have two other cavities drilled. The pain ___ (cause) by the tooth that can’t be filled.
The tooth ___ just ____ (remove) by the dentist. James is clinching with fear. The
dentist told him to relax, but he can’t. What can he do? How can he relax?
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PART ONE
3 Write passive questions.
Many patients had been affected by dental phobia before new anesthetics
were discovered.
Had many patients been affected by dental phobia before new anesthetics
were discovered?
1. Many patients had been affected by dental phobia before new anesthetics were
discovered.
2. As the solution to the patient’s fear he has been offered sedation by a well-
trained dentist.
3. The child’s anxiety has been increased at the sight of the dental instruments.
4. The patient left the treatment room after some humiliating remarks had been
made by the dentist.
5. Design and restoration of his office will have been completed by the time the
first patients set up their dental appointments.
6. The toothache hasn’t been relieved by any analgesics, so she is calling the dentist.
4 Change the sentences from active to passive.
1. Many people have developed phobias about situations in which they feel they
have no control.
2. The pain stopped after he had bought the medicine at the drug store.
3. My child has eaten a lot of candies.
4. Jane will have brushed and flossed her teeth by the dental appointment.
5. Before I bought a dental insurance, I had covered my latest expenses by cash.
6. James will have relaxed his body and mind by the time the doctor starts fixing
his teeth.
7. The dentist has calculated an appropriate dose of the local anesthetic.
8. The patients have perceived him as a caring dentist.
88
TALKING POINTS
1 Find out a degree of your patient’s dental fear by asking him/her the questions.
Dental Questionnaire
1. If you had to go to the dentist tomorrow for a check-up, how would you feel
about it?
a. I would look forward to it as a reasonably enjoyable experience.
b. I wouldn't care one way or the other.
c. I would be a little uneasy about it.
d. I would be afraid that it would be unpleasant and painful.
e. I would be very frightened of what the dentist would do.
2. When you are waiting in the dentist's office for your turn in the chair, how do you
feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
3. When you are in the dentist's chair waiting while the dentist gets the drill ready to
begin working on your teeth, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
4. Imagine you are in the dentist's chair to have your teeth cleaned. While you are
waiting and the dentist or hygienist is getting out the instruments which will be
used to scrape your teeth around the gums, how do you feel?
a. Relaxed.
b. A little uneasy.
c. Tense.
d. Anxious.
89
PART ONE
Scoring the Dental Anxiety Scale

a = 1, b = 2, c = 3, d = 4, e = 5 Total possible = 20
Anxiety rating:
• 9 – 12 = moderate anxiety but have specific stressors that should be discussed
and managed
• 13 – 14 = high anxiety
• 15 – 20 = severe anxiety (or phobia). It may be manageable with the Dental
Concerns Assessment.
2 Ask your patient to rank his/her concerns or anxiety over the dental procedures.
DENTAL CONCERNS ASSESSMENT
Level of Concern or Anxiety

Don’t
Low Moderate High
know
1. Sound or vibration of the drill 1 2 3 4
2. Not being numb enough 1 2 3 4
3. Dislike the numb feeling 1 2 3 4
4. Injection ("Novocain") 1 2 3 4
5. X-rays 1 2 3 4
6. Probing to assess gum disease 1 2 3 4
7. The sound or feel of scraping during teeth
1 2 3 4
cleaning
8. Jaw gets tired 1 2 3 4
9. Cold air hurts teeth 1 2 3 4
10.Not enough information about procedures 1 2 3 4
11. Root canal treatment 1 2 3 4
12. Extraction 1 2 3 4
13. Fear of being injured 1 2 3 4
14. Panic attacks 1 2 3 4
15. Not being able to stop the dentist 1 2 3 4
16. Not feeling free to ask questions 1 2 3 4
17. Not being listened to or taken seriously 1 2 3 4
18. Being criticized, put down, or lectured to 1 2 3 4
19. Smells in the dental office 1 2 3 4
90
20. I am worried that I may need a lot of

1 2 3 4
dental treatment
21. I am worried about the cost of the dental
1 2 3 4
treatment I may need
22. I am worried about the number of ap-
1 2 3 4
pointments
23. I am embarrassed about the condition of
1 2 3 4
my mouth
24. I don't like feeling confined or not in
1 2 3 4
control
25. Other 1 2 3 4
3 After the Dental Concerns Assessment:
• Put your patient at ease by suggesting him/her some strategies to overcome

fear.
• Describe the attitude dentists should cultivate toward their patients to elimi-
nate their clients’ phobias.
• Provide some tips on how to deal with smells, sounds and sights in the dental
office.
MORE READING
1 Read the text and explain the following statements:
• Dentistry can offer a less traumatic, pain-free experience than even five or 10
years ago.
• Less cutting, less blood, less need for significant sedation.
• Doctors must be able to disclose the unknown to their patients.
PAIN-FREE DENTISTS: FACT OR FICTION
Because of recent advances in dentistry doctors can offer a less traumatic, pain-
free experience than even five or 10 years ago.
Lasers: The most significant development is the increased use of lasers. It is most
commonly used for soft tissue or gum surgery. Patients experience far less discomfort
than during traditional surgical intervention. Less cutting, less blood, and less need
for significant sedation are required.
91
PART ONE
Electric, rather than air-driven drills: Some people cringe at the sound of the
high-pitched whine of the drill. New, high-end drills are not only less noisy, but they
vibrate less.
Sharper drill burrs: Today most dentists use disposable burrs (drill bits for teeth)
when they have to drill. Sharper burrs mean smaller, more precise cuts, which means
less potential damage to the tooth.
Beyond Novocain: In the old days Novocain was the only anesthetic in dentistry.
Now dentists have an array of more effective local anesthetics to choose from. Lido-
caine, for example, makes your gums more numb and, if the procedure requires it, for
a longer period of time without needing multiple shots.
Bubble-gum-scented laughing gas: For minimally invasive procedures, nitrous
oxide is considered quite safe and a kid's dream. Some grownups like the sweet scents
too. Moreover, due to lasers and improved drill bits, more procedures can be con-
ducted with nitrous than ever before.
Widespread use of composites or porcelain: These tooth-coloured fillings not
only look better than the old metal fillings that used to be standard, they are better for
your teeth. In order to fit a metal filling, the dentist must dig deep and wide enough
into the tooth. This ultimately weakens the tooth, which may start cracking and then
require a crown. Dentists don't have to drill as much tooth with composites, because
they are bound to the tooth with adhesive.
Kinder, gentler dentists: Dentists should communicate in a calming way. When
children or older people see masks, instruments and lights they instinctively have a
fear. Doctors must be able to disclose the unknown to their patients.
2 Read the text. Are these sentences true or false?
1. Fear doesn’t prevent us from self-harm.

2. People never avoid dental care because they believe that all dental treatment is
painless.
3. Knowledge can be a powerful weapon against fear.
4. All dental procedures are done with anesthesia.
5. If anesthesia is needed, strong topical anesthetics are used to reduce the dis-
comfort associated with injections.
6. The doctor doesn’t check whether the patient’s mouth is as numb as possible
during treatment.
7. Communication between the dentist and patient is of the utmost importance.
92
DEALING WITH PAIN
Most people are afraid of pain or injury. Fear prevents us from causing self-harm
and helps keep us safe. People try to avoid a situation or environment that they be-
lieve can be painful.
Knowledge can help cope with fear. The first step in the fight against fear is gath-
ering accurate and detailed information. It is necessary to find out the truth about
dental procedures.
Dental treatment is primarily painless. However, sometimes it can cause a mi-
nor discomfort that can be reduced by many tools the dentists have at their disposal
during different procedures.
The dentists develop and evaluate the treatment plan to decide if anesthesia is
needed. Many dental procedures can be painless even without anesthesia, using
modern dental techniques and equipment. The patients with shallow cavities found
on the side or biting surface of the teeth can be treated with a dental laser or an air
abrasion unit, a device that removes tooth decay by a spray of an air-and-powder
mix. This equipment ensures painless treatment of cavities without anesthesia. If an-
esthesia is indicated, topical anesthetic gels are administered to significantly reduce
the discomfort caused by the injection. To provide the best treatment ever dentists
prefer to use very thin needles and inject the solution slowly to make the area numb.
The dentist should be able to understand the patient’s expectations, be qualified
enough to promote and improve their dental health. Achievement of these goals re-
quires effective communication between the dentist and the patient.
3 Read the text. Answer the questions:
• What can avoidance of routine dental care cause in children?

• What conduct of the dentist is directly related to the development of dental
fear in children?
• What are the ways to improve dental visits for children?
• In what cases does a Pedodontist treat children?
PREVENTING DENTAL FEAR IN CHILDREN
Many people who avoid dental care as adults remember traumatic experiences at
the dentist as children. People neglect dentists because of fear. The absence of regular
dental check-ups can lead to severe and painful infections of the teeth and gums,
fractures and discolorations, as well as bad breath. The behaviour of the dentist is
directly related to the development of dental fear in children and adults. The past
experience may be associated with pain and humiliation. The painful sensations fade
93
PART ONE
quickly but insensitive comments are remembered by children up to their adulthood.

Dentists should offer improved and up-to-date dental care to children.
The dentist should be able to adapt to the needs of each individual child by being
patient and caring during treatment. This will prevent further anxiety development.
Dentists should educate and encourage young parents to bring their children to
the dentist when they are two years old, sometimes even earlier, if there is any visible
discoloration of the primary teeth or if the child is experiencing pain. The earlier the
child is examined by the dentist, the better treatment outcomes are achieved.
Confidence is built when the child can tolerate the first dental procedure. There-
fore, if dental treatment is required, the dentist should start with the procedure that
is easiest.
The dentist should not administer local anesthesia for simple fillings. Modern
technologies can effectively remove mild decay from the surface of the tooth without
any injection of anesthetic solution and feeling of numbness.
The dentist should apply conservative treatment for children’s primary teeth. It
takes less time, causes less discomfort and contributes to better perception of the
dentist by the baby.
Audio and video systems in the treatment room help children cope with the clini-
cal setting and enjoy the dental visit. A small reward after successful treatment evokes
some positive feelings in the child.
Pedodontist treats children who need extensive dental care or cannot be effective-
ly managed by the family dentist.
94
UNIT 8 ANESTHESIA
LEAD IN
anesthesia ["xnIs'TJzIq] анестезія

sedation [sI'deISn] вплив заспокійливим засобом,
седативний ефект, седація,
заспокійливе, снодійне
inject [In'Gekt] вводити парентерально
ester ['estq] ефір
amide ['eImaId] амід
invasive [In'veIsIv] інвазивний
topical ['tPpIkql] місцевий
local ['lqVk(q)l] місцевий
penetration [penq'treIS(q)n] проникнення
roadblock ['rqVdblPk] бар’єр
vasodilator [veIzqdaI'leItq] судинорозширювальний
препарат
vasoconstrictor [veIzqkqn'strIktq] судинозвужувальний препарат
threshold ['TreShqVld] поріг (напр. больовий)
drug-induced ['drAg In'djHst] медикаментозний
complication ["kPmplI'keISn] ускладнення
disadvantage ["dIsqd'vRntIG] недолік
advanced [qd'vRnst] прогресивний, занедбаний (про
хворобу)
PART ONE
indicated ['IndIkeItId] показаний (препарат,

процедура)
administration [qdmInIs'treISn] застосування
depress [dI'pres] пригнічувати
2 Before reading explain the following terms in your own words:
• Anesthesia (local and general)

• Anesthetics (injectable and topical)
• Anesthesia team
• Sedation
3 Read the text.
ANESTHESIA
The administration of local anesthesia, sedation and general anesthesia is an inte-

gral part of dental practice.
Local anesthesia causes the temporary loss of sensation in some part of the body.
It is produced by a locally injected solution. It does not depress the level of con-
sciousness. The invention of local anesthetics with the development of nerve block-
ade injection techniques marked a new era of patient comfort. Local anesthesia al-
lows to perform extensive and invasive dental procedures. Dental anesthetics form
two groups: esters and amides. Esters are no longer used as injectable anesthetics.
However, benzocaine is used as a topical anesthetic. Amides are used as injectable
anesthetics in combination with lidocaine that is also known as a topical anesthetic.
Topical anesthetics numb the area to a depth of 2-3 mm and reduce the discomfort of
the initial penetration of the needle into the mucosa. Topical anesthetics are available
in gel, liquid, ointment, patch, and spray forms. Injectable local anesthetics create a
chemical roadblock between the source of pain and the brain by blocking the sodium
channel of a nerve. Local anesthetics are vasodilators and are absorbed into the cir-
culation. Overdose with local anesthetics can result in CNS depression, convulsions,
elevated heart rate, and high blood pressure. Vasoconstrictors are added to injectable
local anesthetics to counteract the vasodilatory action and prolong their action.
Sedation is most appropriate for people with dental fear but may also be used when
the patient has a low pain threshold, can’t sit still in the dental chair, has very sensitive
teeth or needs extensive treatment. Sedation helps patients relax during dental pro-
cedures. Minimal sedation is a minimally depressed level of consciousness produced
96
UNIT 8: ANESTHESIA
by a pharmacological method (inhalation of nitrous oxide or “laughing gas”, pills).

The patient’s ability to respond to tactile stimulation and verbal commands is main-
tained. Ventilatory and cardiovascular functions are not affected. Moderate sedation
is a drug-induced depression of consciousness during which patients respond pur-
posefully to verbal commands, either alone or accompanied by light tactile stimula-
tion, may slur their words when speaking and not remember much of the procedure.
Deep sedation is a drug-induced depression of consciousness during which patients
can be on the edge of consciousness or even unconscious. The ability to independent-
ly maintain ventilatory function may be impaired.
General anesthesia is rarely used for dental treatment nowadays. One of the rea-
sons for this is that IV conscious sedation works so well for nearly everyone, and is
extremely safe. Each general anesthetic carries a certain amount of risk. This means
that general anesthesia is only performed in hospitals or specialist clinics where the
necessary safety equipment is available. Apart from the risk of serious complications,
general anesthesia has a few major disadvantages:
– It depresses the cardiovascular and respiratory systems.
– Laboratory and instrumental tests are required.
– Very advanced training, an anesthesia team, and special equipment and facili-
ties are needed.
– The patient can’t drink or eat for 6 hours before the procedure.
– It’s expensive.
– It does not reduce dental anxiety.
However, general anesthesia can be useful or even indicated for certain situations.
When conscious IV sedation doesn’t work or oral maxillofacial surgery of certain
type must be conducted, general anesthesia is the best option.
4 Match the following words or word-combinations with their definitions.
1. roadblock a. the level at which someone experiences pain
2. overdose b. circulation and exchange of gases in the lungs that is

basic to respiration
3. pain threshold c. a group of medical specialists, including physician
anesthesiologist, anesthesiology resident physician,
anesthesiologist assistant and nurse anesthetist
responsible for an appropriate anesthesia
administration
97
PART ONE
4. ventilatory function d. personal protective and emergency response devices
5. tactile stimulation e. a barrier created to block the passage of certain

substances or impulses
6. safety equipment f. the specialty of dentistry which includes the diag-
nosis, surgical treatment of diseases, injuries and
defects of the oral and maxillofacial region
7. anesthesia team g. the application of a stimulus in the form of touch
8. oral maxillofacial h. too great an amount of medicine
surgery
5 Complete the sentences. Choose the best answers.
1. Overdose or misuse of anesthetics can lead to a loss of coordination, lethargy,

disorientation, unresponsiveness indicating panic attack / CNS depression/
CNS overstimulation.
2. Repeated painful procedures may result in increased pain threshold / normal
tolerance of pain / decreased pain thresholdin infants.
3. When the patient is under the effect of moderate sedation and doesn’t respond
to verbal commands, electrical stimulation / tactile stimulation / visual stim-
ulation is needed.
4. Anesthesia team specialists must have elementary / intermediate / advanced
training in the provision of anesthesia care.
5. General anesthesia is rarely used for dental treatment nowadays because it is
only performed in hospitals or specialist clinics where refrigerators / general
anesthetics / safety equipment is available.
6. Some patients with low pain threshold may require an application of the local
anesthetic / topical anesthetic / general anesthetic before the administration
of local anesthesia.
7. Injectable local anesthetics create a wall / obstacle / roadblock between the
source of pain and the brain.
8. Vasoconstrictors are added to injectable local anesthetics to facilitate / coun-
teract / promote the vasodilatory action and stop / block / prolong their action.
The “hot” tooth or irreversible pulpitis can be one of/at the most frustrating prob-
lems to/for any dental practitioner. Antibiotic therapy to/toward reduce inflamma-
98
UNIT 8: ANESTHESIA
tion may be the best course on/of action. When such a course is not an option, the
first step in/to working through/under this situation is to deliver an appropriate
nerve block injection. If all out of/of the surrounding soft tissues are numb, but the
tooth itself is still sensitive, use about/of an intraosseous technique is recommended.
Use the prompts to write questions. Then interview your patient who is to
7
receive local anesthesia in order to evaluate his/her health.
1. you/ ever/ a local or topical anesthetic/ have/ received?

2. there/ any/ were/ reactions/ adverse?
3. you/ any pain/ are/ at this time/having?
4. severe /the pain/ is?
5. have/ how long/ you/ the pain/ had?
6. you/ about/ the dental treatment/ nervous/ are?
7. any medicine or drugs/ you/ have/ during/ the past two years/ taken?
8. you/ to/ are/ any foods or drugs/ allergic?
9. any bleeding problems/ you/ have/ do?
10. have/ or problem/ any chronic disease/ you/ do/ condition?
11. you/ easily/ do/ bruise?
12. you/ pregnant/ are?
8 Use the words A-F to answer questions 1-6.
1. What term stands for the range of A. Syringe

equipment or instruments used to B. Cartridge holder
administer anesthesia? C. Armamentarium
2. What item is used as a small contain- D. Anesthesia machine
er for the anesthetic solution? E. Needle
3. What long hollow pointed item made F. Cartridge
of stainless steel is inserted into the
body to introduce an anesthetic?
4. What instrument is used for injecting
and spraying anesthetic solutions?
5. What item is described as a metal
frame or container holding cartridg-
es?
6. What equipment is used for inhala-
tion anesthesia?
99
PART ONE
Complete the description of good communication practice using the words

9
in the box.
important avoid eye relaxed reassuring terminology quickly

ease friendly sit smile close
The clinician initiates communication with the patient by speaking in a _____

manner during anesthesia administration. Imagine the patient is a ____ family mem-
ber or friend and treat him or her as you wish to be treated yourself. Always try to
put your patient at ____ and make them feel ___. If possible, ____ at the same level
as the patient. The expression on your face is _____, so _____and maintain ____con-
tact with your patient. When you talk, don’t rush the patient or speak too ____ and
always use a _____ open tone of voice. The subject matter can range from describing
the process in patient friendly ____, to storytelling or even counting. _____ words
like shot, pain, hurt and injection.
Match the photos a-f with the provisions of the anesthesia administration
10
protocol 1-6.
a b c
d e f
100
UNIT 8: ANESTHESIA
1. Apply the topical anesthetic at the site of preparation.

2. Stabilize the patient’s head and retract the soft tissues with the fingers of the
weaker hand and administer the anesthetic.
3. Prepare the topical anesthetic.
4. Position the patient in the dental chair.
5. The assistant passes the uncapped syringe behind the patient’s head.
6. Dry teeth and gums and remove any debris around the site of needle penetration.
11 Practice saying the instructions 1-6 from the previous exercise in the
correct order.
1. Local anesthesia is the temporary loss of sensation or pain in the whole body
with depressing the level of consciousness.
2. The advent of local anesthetics with the development of nerve blockade injec-
tion techniques allows more extensive and invasive dental procedures.
3. Esters are widely used as injectable anesthetics.
4. Topical anesthetics are available in injection solutions.
5. Local anesthetics are vasodilators and are absorbed into the circulation.
6. Overdose with any anesthetic is completely safe and harmless.
7. Sedation is most appropriate for people with dental fear because it helps pa-
tients relax during dental procedure.
8. General anesthesia can be performed by any dentist; it doesn’t require any spe-
cial preparation of the patient, as well as any necessary safety equipment.
1. What effects are produced by local anesthesia?

2. How are esters and amides used in modern dentistry?
3. What is the action of topical anesthetics and injectable local anesthetics?
4. What protocol questions should the dentist ask his patient before local anes-
thesia?
5. What instructions should be followed during local anesthesia administration?
6. What can overdose with local anesthetics result in?
7. When is sedation indicated?
8. What characteristics help the dentists identify the degrees of sedation?
9. Why is general anesthesia rarely used for dental treatment nowadays?
10. What medical specialists work in an anesthesia team?
11. When is general anesthesia indicated?
101
PART ONE
GRAMMAR
MODAL VERBS
We use must for

• written rules: All patients must wear overshoes.
• things which we think are important to do: I must have my teeth checked.
• strong advice: You must stop drinking alcohol.
We use mustn’t when something is
• forbidden by rule/law: You mustn’t smoke.
• an obligation (personal preference): I must take care of my child’s milk teeth.
We use have to to talk about
• necessity: I have to make an appointment before visiting a dentist.
We use don’t have to
• when something isn’t necessary: You don’t have to pay for a general examination.
We use should or ought to to talk about
• duty or give advice: You ought to calm down your child first. You should try
another toothpaste.
We use can and could for
• ability in the present/past: I can manage one dental case in 45 minutes.
I couldn’t cope with fear, but now I can.
• possibility: You can have your tooth extracted now.
• permission or requests: Can we talk about your bad habits? Can I get a dis-
count on my treatment?
We use the correct form of be able to for ability, in tenses where there is no appro-
priate form of can: I’ll be able to receive you at my office next Monday.
We use may for
• possibility: You may lose your tooth if it’s not restored.
• asking permission (more formal): May I have a look at your health insurance
card?
• giving/refusing permission (formal): You may not leave your coats and bags
here.
Paraphrase the following statements with a modal verb which has the
1
same meaning.
1. I feel it’s important for us to relieve pulp irritation.

2. It is possible for me to save a tooth by putting it back in place as soon as possi-
ble followed by root canal treatment.
102
UNIT 8: ANESTHESIA
3. Stop using whitening toothpastes frequently.

4. Too abrasive components are likely to damage your enamel.
5. He is able to treat his patient’s tooth with a root canal procedure and a crown.
6. Do you mind if I come for MRI next Monday?
7. It’s necessary for me to pay for X-ray to reveal cracks on the surface of the
tooth enamel.
8. I advise you to place a cold compress against your cheek for 20 minutes to
alleviate swelling.
2 Complete the sentences with the correct alternatives.
1. We … forget it’s our clinic’s 10th anniversary next month. (don’t have to/can’t/
mustn’t)
2. You …have a discount on your treatment plan. (mustn’t/don’t have to/can’t)
3. Clients …pay for dental services at private clinics. If they don’t pay, they won’t
get any treatment. (can/have to/don’t have to)
4. … I see a manager of the clinic? (must/should/can)
5. If this treatment is effective, I think dentists … use it more in their practice.
(can/should/may)
6. Patients … use their credit cards to cover all their expenses. (must/can/
shouldn’t)
7. I’ll be on holiday in the mountains so I … visit you in your clinic. (won’t be
able to/mustn’t/couldn’t)
8. I …forget about my next check-up. – The dentist will be waiting for me.
(can’t/must/oughtn’t to)

3 Complete the sentences with the correct verbs. Use the clues in brackets.
1. Hello doctor, …. (request) you help me?

2. You … (prohibition) listen to them. You … (advice) seek professional medical
help at the dentist’s.
3. Even junior dentists … (ability) treat uncomplicated caries.
4. Your child … (possibility) have abnormal occlusion if he doesn’t have solid
food in his diet.
5. Patients … (written rule) leave their coats in the cloak-room before they enter
the examination room.
6. … (asking formal permission) we submit our documents to get a license?
7. I … (external obligation) buy this expensive toothpaste because my dentist
has recommended it to me.
8. You … (duty) take care of your child’s oral health to avoid dental problems
later.
103
PART ONE
TALKING POINTS
In the groups, prepare a report on the administration of the local

1
anesthetics and present it to your fellow students. Remember to talk about:
• mental preparation of the patient;
• position of the patient in the dental chair;
• preparation of the tissue;
• relieving discomfort with the topical anesthetic;
• stabilization of the patient’s head;
• communication;
• basic injection technique.
2 Suggest your tips on how to avoid:

• pain and discomfort during dental treatment;
• increasing anxiety in the child caused by the anticipation of receiving a “shot”;
• carrying negative feelings toward dentistry into adulthood.
MORE READING
Read the text and provide a brief description of the most significant events
1
in the following chronological order:
• 1859
• September, 1884
• November, 1884
• 1905
• 1943
HISTORY OF LOCAL ANESTHETICS DEVELOPMENT
The first local anesthetic widely used in dentistry was cocaine. Peruvian Indians
had found that chewing leaves of the coca plant produced exhilaration and relief
from fatigue and hunger. Later much research was conducted in Europe to describe
the properties of the coca leaf extract. In 1859, Albert Niemann refined the coca ex-
tract to the pure alkaloid form. He named this new drug “cocaine.” Niemann discov-
ered the anesthetic effect of cocaine. The substance numbs the nerves of the tongue.
In September of 1884, Carl Koller performed the world’s first operation using local
anesthesia. It was induced by topical cocaine and used on a patient undergoing glau-
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UNIT 8: ANESTHESIA
coma correction. The famous American surgeon William Halsted was the first doctor
to inject cocaine for nerve blockade during dental procedure, and it happened in No-
vember 1884. Despite its much promising effects in pain management, cocaine had
substantial drawbacks, such as addiction and a short duration of action.
In 1905 in Munich Alfred Einhorn discovered procaine, an ester-based synthetic
local anesthetic. Procaine was immediately recognized as a safe substitute for co-
caine. Procaine marked the beginning of the modern era of regional anesthesia.
In 1943, Nils Löfgren, a Swedish chemist, synthesized a new amide-based local
anesthetic substance and named it “lidocaine.” Lidocaine was more potent and less
allergenic than procaine. The advantages of the amide-based anesthetic agents led to
their gradual and complete replacement of the ester-based anesthetics in dental use.
A wide range of local anesthetics available today enables dentists to choose and
administer an anesthetic with specific properties such as time of onset and duration,
hemostatic control, and degree of cardiac side effects. Dentists match an anesthetic
for each individual patient and for each specific dental procedure.
2 Read the text and choose the best alternatives.

1. The text is about
a symptoms of complications of local anesthesia
b ways of administration of local anesthesia
c reasons for overdose of local anesthetic in children
d indications for use of anesthesia
e most common complications of local anesthesia and how to prevent them
2. Most ___ drug reactions occur within 5–10 minutes of injection.
a favourable b beneficial c adverse d unpredictable e unexpected
3. ____ signs of the central nervous system response include muscle twitching,
tremors, talkativeness, slowed speech and shivering followed by overt seizure
activity.
a subjective b initial c immediate d objective e delayed
4. As blood plasma levels of the anesthetic increase, _____of the myocardium
occurs.
a excitation b stimulation c hyperactivity d death e depression
5. Local anesthetic toxicity is preventable by _____
a measuring blood pressure.
b following proper injection technique.
c communicating with the patient.
d distracting the patient’s attention.
e proper relaxation and comfortable position in the dental chair.
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PART ONE
6. In dentistry paresthesia affects _______

a neck and lower jaw
b cheeks and lips
c cheeks and upper jaw
d tongue and lips
e tongue and neck
7. Clinicians should be knowledgeable of maximum dosages based on _______.

a time of the day
b dental procedure
c weight
d patient’s mood
e patient’s complaints
COMPLICATIONS OF LOCAL ANESTHESIA
Anesthetic toxicity (overdose). Young children are more likely to experience tox-
ic reactions because of their lower weight. Most adverse drug reactions occur with-
in 5-10 minutes of injection. Local anesthetic overdose affects the nervous system
causing excitation followed by depression. In rare cases the cardiovascular system is
involved.
Early symptoms of the central nervous system include dizziness, anxiety and con-
fusion followed by diplopia, tinnitus, drowsiness and numbness or tingling. Over-
dose is signalled by muscle twitching, tremors, talkativeness, slowed speech and shiv-
ering followed by seizures. Unconsciousness and respiratory arrest may occur.
The cardiovascular system responds to local anesthetic overdose with increased
heart rate and blood pressure, vasodilatation followed by depression of the myocardi-
um with subsequent fall in blood pressure. Bradycardia and cardiac arrest may occur.
Local anesthetic overdose can be prevented by proper injection technique. Clini-
cians should calculate maximum dosages based on weight. After injection the patient
should be examined for any toxic response because early recognition and interven-
tion ensure successful outcome.
Allergic reactions to injectable amide local anesthetics are rare. However, some
patients may have a reaction to the bisulfite preservative. It is usually added to an-
esthetics containing epinephrine or to benzocaine topical anesthetics. Allergies are
manifested by urticaria, dermatitis, angioedema, fever, photosensitivity and anaphy-
laxis.
Postoperative soft tissue injury. Accidental biting or chewing of the lip, tongue
or cheek is a problem observed in children. Dentists should recommend the patients
to abstain from food intake as soft tissue anesthesia lasts for up 4 hours after local
anesthesia administration.
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UNIT 8: ANESTHESIA
Paresthesia is the persistence of anesthetic symptoms beyond the expected dura-

tion. The tongue and lips are the most common areas affected. Most cases resolve in
8 weeks without treatment.
Some preventive measures can be taken to prevent local anesthesia complica-
tions:
• Select a local anesthetic with appropriate duration of action.
• Inform the patient about the risk of injury if the patient bites, chews on the
lips, tongue and cheek. They should delay eating and drinking hot liquids after
the treatment.
• Soft tissue trauma is managed by reassuring the patient and parent to allow up
to a week for the injury to heal. The area should be kept moisturized by petro-
leum jelly or antibiotic ointment. It helps to prevent drying, cracking and pain.
Read the text. Suggest an appropriate title to the article.

3
Explain your choice.
High levels of dental caries, challenging child behaviour, and parent expectations
support a need for sedation in pediatric dentistry. Sometimes, sedation can result
in death or permanent neurological damage. Physiologic effects vary significantly
depending upon a wide range of factors, including medication, dose, delivery route,
and patient characteristics. The youngest children and those with more complicated
medical backgrounds appear to be at greatest risk.
To reduce complications, a renewed focus on health care quality and safety has
been supported, including advanced training and improvements in patient monitor-
ing. Safe and appropriate case analysis and adequate dosing is also paramount. The
greatest successes are achieved by focusing on safety before the sedation appoint-
ment. Preparation begins with appropriate case selection. Using a standard form for
presedation, patient assessment helps eliminate dangerous complications.
Selection of medications is a critical component of the sedation plan. When possi-
ble, consideration should be given to sedatives with available reversal agents.
Oral sedation is the most popular route of administration among pediatric den-
tists. However, today practitioners are administering modern drugs in new ways with
high levels of success. One alternative is transmucosal (intranasal, sublingual, buccal)
route. The benefits of this route include direct absorption of drugs into the systemic
circulation, avoidance of hepatic first pass metabolism, increased bioavailability, and
faster onset compared with oral sedation. Transmucosal administration also results
in less discomfort.
Providing quality dental care to young children can be a challenge. Pediatric den-
tal sedation allows the clinician to provide treatment in a way that is minimally trau-
matic and preserves the child’s trust. Although sedation is an effective tool to manage
107
PART ONE
pediatric anxiety, adverse treatment outcomes may appear. Therefore, practitioners

should strive to reduce patient risk by carefully selecting patients who are medically
optimized for sedation and instilling a culture of safety into clinical practice. Parent
preferences and high levels of pediatric dental disease lead to growing demand for
sedation. This is an exciting opportunity to increase sedation success by improving
behavioural selection parameters, administration of modern drugs and routes, and
providing the services of anesthesiologists in outpatient settings.
108
UNIT 9 DENTAL CARIES
LEAD IN
communicable [kq'mju:nIkqbl] заразний, інфекційний,

контагіозний
demineralization ['dJ"mInqrqlaI'zeIS(q)n] демінералізація
(втрата мінералів)
dissolution [dIsq'lHS(q)n] розчинення
recession [rI'seSqn] рецесія м’яких тканин
(спадання ясен)
restorative [rI'stO:rqtIv] відновлювальний
eliminate [I'lImIneIt] усувати, знищувати
breakdown ['breIkdaVn] розпад
food debris [de(i)bri:] залишки їжі
ongoing ['PngqVIN] тривалий
xerostomia [zIerq'stqVmIq] сухість у роті, ксеростомія
fermentable [fɜ:ˈmentǝbl] здатний до бродіння
contribute to [kǝnˈtribju:t] сприяти
PART TWO
remineralization [ri:ˈmin(ǝ)r(ǝ)laiźeiʃn] ремінералізація

erosion [I'reVZn] ерозія, роз'їдання
exposed [Ik'spqVzd] відкритий, оголений
drainage ['dreInIG] дренаж, пов’язка
heal [hi:l] лікувати, зцілювати,
загоюватися
• What causes dental caries?

• What happens if caries goes untreated?
3 Read the text paying attention to the words in bold.
DENTAL CARIES
Dental caries (tooth decay) is an infectious and communicable disease that caus-
es demineralization and dissolution of the dental tissues with the formation of a
cavity. It is the worldwide health concern, affecting humans of all ages. Dental caries
is the single most common chronic disease in children, however, due to recession of
the gingival tissues, many older adults experience root caries. Caries has afflicted hu-
mankind since the beginning of recorded history. Since the late nineteenth century,
dentists have been fighting tooth decay by drilling out the decayed tooth structure
and filling the tooth with a restorative material. Although this treatment eliminates
decay that is already present, it does nothing to lower levels of bacteria in the mouth
that may cause additional caries. The cause of caries is bacteria breakdown of the
hard tissues of the teeth (enamel, dentin and cementum). This occurs due to acid
made from food debris on sugar on the tooth surface. It is an ongoing process that
begins with the plaque, a colourless, soft, sticky layer of harmful bacteria (the mu-
tans streptococci (MS) (Streptococcus mutans) and the lactobacilli (LB)) that are re-
sponsible for caries. Plaque is the most dangerous when bacteria group into colonies
within 24 hours. After repeated attacks, if the plaque is not removed, the enamel
eventually breaks down and decays. Once that happens the decay progresses inward
to the centre of the tooth.
A decayed tooth is sensitive to heat, cold or sweets and brown spots signal a de-
cayed area. The tooth decay causes pain when chewing. The rate at which caries de-
110
UNIT 9: DENTAL CARIES
velops varies from person to person and depends on many factors such as oral bac-
terial flora, dietary sugars, eating habits, fluoride and salivary flow. There is general
agreement among scientists that frequent consumption of fermentable carbohydrate
foods and drinks contribute to the development of caries.
One of the most important factors in pathogenesis of caries is a high-carbohy-
drate diet, as well as lack of fluoride, and chronic dryness of the mouth from the lack
of saliva (xerostomia). Saliva is like a miracle fluid that provides physical, chemical,
and antibacterial protective measures for the teeth. It can take months or even years
for a carious lesion to develop. Carious lesions occur when more minerals are lost
(demineralization) from the enamel than are deposited (remineralization). There
are four different stages of dental caries. As caries progresses through the stages, the
damage to a tooth becomes worse.
• In stage one, acid created by bacteria in plaque begins to cause erosion of tooth
enamel. The formation of a tiny cavity in pits and fissures of tooth surfaces
occurs. The small cavity is painless and there are no noticeable symptoms.
• In stage two, the cavity gets deeper. It reaches the dentin under the enamel and
starts to spread. There will be some sensitivity to sweet, cold, or hot foods and
beverages.
• In stage three, the cavity is advanced. The tooth begins to weaken due to the
cavity spreading. The tooth may show discoloration and the patient may be-
gin to feel pain.
• In stage four, the tooth is very weak and fractures can develop. These fractures
can cause a tooth to break. Once this happens, a root canal may be needed to
prevent infection of the dental pulp.
Carious lesions can occur in four general areas of the tooth, as follows:
1 Pit-and-fissure caries occurs primarily on occlusal surfaces, on buccal and lin-
gual grooves of posterior teeth, and on lingual pits of the maxillary incisors.
2 Smooth surface caries occurs on enamel surfaces, including mesial, distal, fa-
cial, and lingual surfaces.
3 Root surface caries occurs on any surface of the exposed root.
4 Secondary caries, or recurrent caries, occurs on the tooth that surrounds a res-
toration.
If left untreated, dental decay reaches the pulp of the tooth and an abscess forms
at the root end causing pain. At this stage the root will need endodontic treatment;
otherwise it must be extracted. The purpose of treatment is to stop the loss of mineral
so that the disease is cured. Changing the microflora by topical fluorides, reducing
the amount of dietary sugars, decreasing the frequency of eating, use of fluorides or
increasing the amount of salivary flow can help the healing process.
111
PART TWO
4 Fill in the correct words from the list below. Use the words only once.
restorative salivary to affect carious

bacterial food to contribute to
responsible for
1 ____________ humans 5 ____________ debris

2 ____________ breakdown 6 ____________ lesion
3 ____________ caries 7 ___________ development of caries
4 ____________ flow 8 ___________ material
5 Fill in the correct word from the list below.
progresses provides beverages stop

experience consumption lower ongoing
1. Many adults _________root caries due to recession of the gingival tissues

(feel).
2. Tooth decay is an_________process that starts with the plaque containing
much harmful bacteria (continuous).
3. Scientists believe that frequent_________of fermentable carbohydrate foods
leads to the development of caries (intake).
4. As caries_________through the stages, the damage to a tooth becomes worse
(develops).
5. The purpose of caries treatment is to_________the loss of mineral to cure the
disease (arrest).
6. In stage two of dental caries people can have sensitivity to sweet, cold or hot
foods and_________ (drinks).
7. Filling the tooth doesn't _________levels of bacteria in the mouth that may
cause additional caries (reduce).
8. Saliva is like a miracle fluid that___ physical, chemical and antibacterial pro-
tective measures for the teeth (gives).
6 Read the sentences and choose the correct words.
1. The dentist noticed a cavity forming in a pit / fracture of the tooth.

2. People may not notice cavity symptoms / caries until it is advanced.
112
3. Formations / Discoloration of a tooth can indicate the presence of a cavity.

4. Acid in soft drinks can cause discoloration / erosion of tooth enamel.
5. The hygienist spotted the early formation / sensitivity of a cavity.
6. The patient had a pit / cavity that had gone untreated for too long.
7 Match the following English word combinations with the Ukrainian ones.
1. to afflict humankind a. виникати на поверхні оголеного кореня
2. a sticky layer of harmful bacteria b. зменшити споживання цукру
3. to cause pain when chewing c. занедбана стадія карієсу
4. to contribute to caries d. уражати людство

development
5. to weaken due to the cavity e. викликати біль при жуванні
spreading
6. to occur on the surface of the f. липкий прошарок шкідливих бактерій
exposed root
7. to reduce the amount of dietary g. сприяти розвитку карієсу
sugars
8. an advanced stage of caries h. ставати слабшим через поширення
порожнин
8 Look at the words in bold in the text and try to explain their meaning.
9 Fill in the gaps with the correct word or word-combination from the word
bank.
caries advanced fracture spread weaken fissures

sensitivity
1. If you don’t treat the infection, it will _________________ .

2. The hygienist noticed the patient had a wide _________________ in one of
his teeth.
3. The patient feels some ___________________in her teeth when she eats an
ice-cream.
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PART TWO
4. A small crack can develop into a _________________ ,then cause the tooth to
break.
5. This cavity is already in its ______________________ stages, so we must treat
it now.
6. Cavities can _____________________ teeth and cause them to break.
7. Dental ___________are more common now, as our diet contains more sugar.
10 Match the definitions with the terms.
1. Carious a. Slight pain in the teeth, especially when eating hot or

cold food
2. Demineralization b. Mineral used in dental products to make teeth more
resistant to decay
3. Sensitivity c. Bacteria that produce lactic acid from carbohydrates
4. Fluoride d. Replacement of minerals in the tooth
5. Lactobacilli e. Dryness of the mouth caused by reduction of saliva
6. Plaque f. White spots, brown spots, decay on tooth surfaces
7. Remineralization g. Soft deposit on teeth that consists of
bacteria and bacterial by-products
8. Xerostomia h. Loss of minerals from the tooth
11 Choose the proper continuation on the right.
Stage 0 extensive loss of dental tissue

Stage 1 moderate spread into the dentine
Stage 2 enlarged, with weakened cusps and/or cutting edges of the incisors
Stage 3 early stages of lesions signalled by residual stains
Stage 4 minimal spread into the dentine
12 Say whether the following statements are true or false.
1. Scientists believe that caries is not an infectious disease so it isn't a worldwide

problem.
114
2. Filling a tooth doesn't help reduce the level of bacteria in the mouth.
3. After recurrent attacks of caries, the enamel ultimately breaks down if the
plaque isn't removed.
4. The contributing factor in pathogenesis of caries is chronic dryness of the
mouth due to lack of saliva.
5. It usually takes a couple of weeks for a carious lesion to appear.
6. The second stage of caries is characterized by sensitivity to cold or hot, and
sweet food as well as drinks.
7. Smooth surface caries occurs on buccal and lingual grooves of posterior teeth.
8. Untreated caries results in abscess forming at the root and provoking pain.
13 Match the definitions of caries with its medical form.
1. This type of caries progresses slowly and is localized in the outer layer of the
tooth.
2. This type of caries is reversible, a cavity begins with the white spot.
3. This type of caries begins on the bone-tissue covering the cementum.
4. This type of caries is in the grooves on the chewing surface.
5. This type of caries is characterized by demineralization of enamel and a cloak
layer of dentine with formation of cavity within a cloak dentine.
6. This type of caries is characterized by demineralization of all layers of enamel
with formation of defect.
7. This type of caries is characterized by disintegration and demineralization of
intact dentine zone and changes in the pulp.
Word bank: smooth surface caries, pit and fissure caries, root caries, caries in enam-
el, deep caries, superficial caries, middle caries
14 Answer the following questions:
1. What is dental caries?

2. What age groups are affected by caries? Why?
3. What causes dental caries?
4. What is dental plaque? Why is it responsible for tooth decay?
5. What are the stages of caries development?
6. When do the symptoms of caries occur? What are they?
7. What are the most common areas of the tooth for carious lesions to occur?
8. How can caries be classified?
9. What is the purpose of dental caries treatment?
10. What happens if caries goes untreated?
115
PART TWO
GRAMMAR
THE INFINITIVE
We use to-infinitive: We use the infinitive without to:
• to express purpose. e.g. She went to • after modal verbs: can, could,
a dentist to treat pulpitis. may, might, should, will, would,
• after would love, would like, would prefer. must etc. e.g. He should see the
e.g. I’d love to have a perfect smile. dentist immediately. Can you
• after certain adjectives: glad, difficult, help me with removal of dental
happy, sorry, etc. e.g. I was happy to get rid calculi?
of severe toothache. • after feel, hear, make, let etc.
• after certain verbs: agree, advise, appear, e.g. The dentist made me brush
arrange, decide, demand, expect, hope, teeth twice a day to remove
intend, learn, manage, need, offer, plan, dental plaque.
prepare, promise, refuse, seem, teach, want,
wish, etc. e.g. A dentist managed to arrest
progressive caries. She promised to reduce
the consumption of sugar to avoid cavities.
• in the expressions: to tell the truth, to begin
with, to be honest, to start with, to sum up.
etc. e.g. To tell the truth, I don’t like to rinse
the mouth.
1 Find out the verbs which go with the to-infinitive and the infinitive without to.
must learn teach agree expect would like may

would prefer make want hope will let
2 Choose the correct option.

1. The dentist advised me follow/to follow a strict oral hygiene.
2. Yesterday she agreed to visit/visit a surgeon to extract an abscessed tooth.
3. An oral hygienist makes his patients undergo/to undergo a dental examination
twice a year.
4. Acid produced by sugar-loving bacteria in plaque appear to erode/erode tooth
enamel.
5. The patient will to feel/feel some sensitivity when eating hot, cold or sweet
food and drinks.
116
6. Root canal procedures are necessary prevent/to prevent the spread of infection
in the dental pulp.
7. A pedodontist always teaches children to brush/brush their teeth two times a day.
8. He offered remove/to remove dental plaque to prevent cavity formation.
3 Rephrase the following sentences as in the example.
E.g. He must use teeth-whitening products if he has discoloration in his teeth.

I want you to use teeth-whitening products in case of dental discoloration.
1. A dental hygienist must explain how to stop caries developing. – I want….
2. A dentist must sterilize dental instruments after each use. – I recommend….
3. They must teach their patients to rinse the mouth after eating. – I want….
4. People mustn’t eat too much sugary food to avoid cavities formation. – I don’t
advise….
5. You mustn’t eat sweet food to prevent erosion in teeth. – I don’t recommend….
6. Dentists must use a tool for cutting bone during the surgical extraction. – They
want…
4 Cross out the unnecessary words.
1. If you don’t treat the infection, it will to spread rapidly.

2. The cavity spreads further and it to seems to weaken the tooth.
3. You should to see a dentist who will detect the formation of caries.
4. We will to help you improve your oral health.
5. Fractures may to develop when biting down, if the cavity is under a filling.
6. The dentist must to fill the tooth with an amalgam.
7. Toothache and swelling will to stop after the procedure.
8. The cavity fracture can to result in a large crack in the tooth.
5 Make sentences from the words in the columns.
My mother wants to remove food debris

A hygienist advised not to share his toothbrush
The teacher made his patients to become an orthodontist
The dentist warned me to follow her recommendations
My aunt would like her students to treat avulsed teeth
A dental assistant expects her son perform tissue graft to treat gingivitis
An oral surgeon promised us to wear braces
Their supervisor let cut down eating sweet food
117
PART TWO
6 Fill in the gaps with one of the adjectives from the box.
difficult impossible frustrated

sorry helpful safe happy
1. It’s _________ to save his broken tooth. It’s too late.

2. It was very _________ to perform flap surgery lifting gums to remove tartar
beneath.
3. He was _________ to know about the fungal infection of the mouth.
4. A woman was _________ to hear that her mouth was filled with large blisters
full of fluid.
5. Is it _________ to use a gas that eliminates pain and creates feelings of plea-
sure?
6. It was _________to take antifungals to treat thrush (oral candidosis).
7. The dentist was _________ to treat an advanced stage of caries.
TALKING POINTS
Prepare a speech about the development of dental caries and how to prevent it.
Imagine you are talking to primary school students. Talk about the following:
Bacteria present in the mouth – diet harmful to teeth: sugars, slow clearing foods
– snacking between meals – improper or no oral hygiene habits harmful to teeth –
plaque – acids – enamel – dentine – pulp – treatment with restoration – endodontic
treatment – extraction
MORE READING
1 Read the text and answer the questions.

1. What is the objective of dental caries treatment?
2. What type of anesthesia is used to relive dental pain?
3. What restorative materials are employed? Speak on them.
4. What is endodontic treatment? When is it recommended?
TREATMENT OF DENTAL CARIES
The researchers substantiate the goal of caries treatment aimed at preserving tooth
structures and prevention of their further destruction. Aggressive treatment of incip-
ient carious lesions using filling, placed into the sites with superficial damage to the
118
enamel, is controversial as far as they may heal themselves. If a filling is performed,

it will have to be redone in any case, as it becomes a vulnerable site for further decay.
Early treatment is thought to be quicker and not so expensive than treatment of
extensive decay. To relieve pain or anxiety during treatment dentists use local anes-
thetics such as nitrous oxide or other medications. A dental drill is usually used to
remove big portions of decay from a tooth. A spoon is employed to get rid of decay
gently, when the damage to the dentin reaches the pulp. Some dentists prefer remove
dental caries using a laser as an effective up-to-date technique.
Restorative materials include the following: dental amalgam, composite res-
in, porcelain and gold. Composite resin and porcelain can be created to match the
colour of patient`s natural teeth, that is why they are used much more commonly.
Composite restorations are considered to be not as strong as dental amalgam and
gold. Amalgams are prevalent and advisable restoration for posterior areas due to
great chewing forces. When the decay is extensive enough, a crown maybe needed.
This restoration appears identical to a cap and it`s placed onto the remainder of the
natural crown of the tooth. As a rule crowns are often made of gold, porcelain, or
porcelain fused to metal.
Such crowns are available to be placed over the tooth in children. These are usu-
ally made of stainless steel metal, although there are some aesthetic materials as well.
Actually, teeth are shaved down to make room for the crown, however, more recently,
stainless steel crowns have been used to seal decay to arrest the progression of lesions.
This technique is known as the Hall Technique which works by means of depriving
the bacteria of nutrients in the decay and making their environment less susceptible.
It is a minor invasive method employed to treat decay in children that does not re-
quire any local anesthetic injections.
1. What is early childhood caries?

2. What are its basic causes?
3. What is another name for tooth decay in children? Speak on it.
4. What children are more commonly afflicted with ECC?
EARLY CHILDHOOD CARIES
Early childhood caries (ECC) is an infectious disease that can happen in any fam-
ily. Many children live with the constant pain of decayed teeth and swollen gums. In
some states, ECC affects one third of preschool children. ECC is a transmissible dis-
ease because bacteria present in the parent`s or caregiver`s mouth are passed to the
child. Parents should substitute healthful foods and snacks for those that are sugary,
119
PART TWO
starchy, or sticky. If a baby sleeps with a bottle, the chances of decay are greater. Baby
bottle tooth decay is another term for ECC.
Tooth decay is the single most prevalent disease of childhood. Untreated tooth
decay in children results in pain and infection. Children who suffer from ECC of-
ten miss school or are unable to concentrate when they are in school. ECC can also
affect a child`s ability to sleep and overall health and well- being. One of the types
of decay is rampant caries that indicates an advanced decay on multiple surfaces of
many teeth. Rampant caries may be observed in young patients with xerostomia,
poor oral hygiene, drug-induced dry mouth, and excessive sugar consumption. If
rampant caries is induced by radiation to the head and neck, it may be classified as
radiation- induced caries. Problems can occur due to the self- destruction of roots
and the entire tooth resorption. Children at 6-12 months of age are at high risk of
developing dental caries. For other kids aged 12-18 months, dental caries affects pre-
dominantly primary teeth.
ECC is common among families of lower socioeconomic status. The rate of un-
treated dental disease among low-income children aged two to five years is almost
five times higher than seen in high-income families. ECC is more common among
particular ethnic groups, in those families who have limited access to dental care,
are in areas where water fluoridation is lacking. ECC is also more common among
children with special needs.
Many children with severe ECC must be hospitalized for treatment, and this can
be very expensive. Early childhood caries can be prevented by providing appropriate
education for parents and oral health- care for the child.
2 Read the text about caries prevention and answer the following questions.
1. What are the main preventive procedures?

2. How can diet affect the teeth? What role do calcium and fluoride have on the teeth?
3. What effect do dental sealants have?
PREVENTION OF CARIES
Personal hygiene care involves adequate daily brushing and flossing. The goal
of oral hygiene is to diminish any etiologic agent of oral disease. The initial focus
of brushing and flossing is to remove and prevent the build-up of plaque or dental
biofilm. Dental floss removes plaque from areas where proximal caries is likely to
develop. Other concomitant oral hygiene means include interdental brushes, water
picks and mouthwashes.
Professional hygiene is composed of regular dental examination and professional
cleaning. Sometimes, to remove plaque completely is too difficult, and a dentist or a
120
dental hygienist help may be required. Apart from oral hygiene, radiographs may be
taken while visiting a dentist to reveal likable dental caries development in high-risk
areas of the oral cavity.
Frequent sugar intake is much more significant than the amount of sugar con-
sumed. If sugar and other carbohydrates are present, bacteria in the mouth produce
acids which demineralize the enamel, dentin and cementum. The more commonly
teeth are exposed to such environment; the more likely dental caries is to appear.
Consequently, it is recommended to minimize snacking as far as it creates an ongo-
ing supply of nutrition for acid-producing bacteria in the mouth. Besides that sticky
food such as candies, cookies, potato chips, and crackers tend to adhere to teeth and
keep longer. However, dried fruits such as raisins and fresh fruit such as apples and
bananas disappear from the oral cavity fast and are not considered to be a risk factor.
Another way to prevent caries is the use of dental sealants. A sealant is a thin plas-
tic- like coating applied to the chewing surfaces of the molars to prevent the penetra-
tion of food debris inside pits and fissures. It helps deprive resident plaque bacteria
of carbohydrate as well as prevent the formation of pit and fissure caries. Tradition-
ally, sealants are usually applied on the teeth of children, as soon as the teeth erupt.
Sealants can wear out with time and fail to protect pits and fissures from access of
food and bacterial plaque. That is why they need to be replaced and must be checked
regularly by dental professionals.
Calcium, found in milk and green vegetables, and fluoride are often recommend-
ed to prevent dental caries. Streptococcus mutans is the leading cause of tooth decay.
Low concentration fluoride ions act as bacteriostatic therapeutic agents. High con-
centration fluoride ions have proved to be bactericidal.
Topical fluoride is more highly recommended than systemic intake such as by
tablets or drops to protect surface of the teeth. Standard fluoride toothpaste is much
more effective then low fluoride toothpaste, however, rinsing should be avoided. Wa-
ter fluoridation also lowers the risk of tooth decay.
3 Read the text about pulpitis development and answer the following questions.
1. What is pulpitits? What are its causes?

2. What are the types of pulpitis? Give their clinical picture.
3. What are the possible complications of pulpitis?
4. How to manage pulpitis?
PULPITIS
Pulpitis is an inflammation of the dental pulp resulting from untreated caries,

trauma, heavy biting forces or multiple restorations. It is characterized by tooth sen-
121
PART TWO
sitivity that arises from the excess blood flow to the tooth. Pulpitis can occur when
caries progresses deeply into the dentin or a tooth requires multiple invasive pro-
cedures. Pulpitis is generally divided into two types: reversible and irreversible. Re-
versible pulpitis is the condition where the pulp is inflamed because it is actively re-
sponding to an irritant. The symptoms and signs of reversible pulpitis include sharp
sensitivity to cold, sweets and to biting. There is no low-grade ache, painful response
to stimuli is short-term, and swelling is usually absent. Normally, the tooth can still
detect a mild electrical stimulus. Irreversible pulpitis is a condition where the pulp
is completely damaged. Most commonly, the decay that has reached the pulp of the
tooth introduces bacteria into the pulp. The pulp tissue is still alive but it can’t heal
and will ultimately result in necrosis or death of the pulp tissue. It is characterized
by prolonged sensitivity to cold or heat, and sometimes sweets. This type of pulpitis
is often accompanied by a continuous low-grade ache aggravated by these stimuli.
Sometimes, swelling may be present. So, the nerve tissue is still living but will not
stay alive due to the presence of irreversible inflammation in the tooth. Diagnosis is
based on clinical findings and is confirmed by an X-ray. Prolonged painful response
to stimuli supports a diagnosis of irreversible pulpitis. Irreversible pulpitis requires
root canal treatment to alleviate symptoms and arrests the inflammation. Sometimes
it is necessary to localize the infection with antibiotics before endodontic treatment.
If it is not an option, the tooth may need to be extracted. In reversible pulpitis, the
pulp is not necrotic and repair requires only drilling and filling as well as the use of
non-steroidal anti-inflammatory medication. The complications of pulpitis mainly
depend on the type of teeth affected. Actually, pulpitis can result in apical periodon-
titis, periapical abscess, osteomyelitis of the jaw, purulent sinusitis, meningitis, brain
abscess, mediastinitis, pericarditis and empyema.
122
UNIT 10
PREPARATION AND FILLING

OF THE CAVITY
LEAD IN
alleviate [q'lJvIeIt] полегшувати

even out ['Jvqn] вирівнювати, згладжувати
repair [rI'pɛq] відновлювати
composite ['kPmpqzIt] композит, суміш
porcelain ['pO:slIn] порцеляна
amalgam [q'mxlgqm] амальгама для зубної пломби
silver [ˈsIlvq] срібло
inlay [ˈInleI] зовнішня вкладка для пломбування
зубів
onlay ['PnleI] внутрішня вкладка для
пломбування зубів
hurt [hE:t] пошкоджувати зуб, завдавати болю
numb [nAm] онімілий, нечутливий; оніміти
glassionomer [glRs QI'Lnqmq] склоіономер
atraumatic [ˌeItrLˈmxtIk] атравматичний
resin [ˈrezIn] композит (зубопротезна пластмаса)
tap [txp] стукати
unremarkable [AnrIˈma:kqbl] непримітний
bonding [ˈbPndIN] зв’язок
save [seIv] зберігати, рятувати
PART TWO
2 Before you read the text, talk about these questions:
• What happens when a dentist fills a tooth?

• What different substances can dentists use to fill teeth?
3 Read the text.
PREPARATION AND FILLING OF THE CAVITY
A cavity preparation is a mechanical procedure that removes caries or existing

restorative materials and a limited amount of healthy tooth structure to receive and
retain filling materials within the cavity. Cavities can occur on one or more surfac-
es and can be of various sizes ranging from very small to those that include all five
surfaces of the tooth. Cavities can be divided into simple and compound. A cavity
which occurs on the surface of the tooth is called simple. A cavity is considered to be
a complex one when three or more surfaces are involved. Cavities may be classified
according to the location of carious lesions.
A dental filling is a type of restorative dental treatment used to repair minimal
tooth fractures, tooth decay or damaged surfaces of the teeth. Filling materials, which
include composite, gold, porcelain, ceramic, silver or amalgam may be used to even
out tooth surfaces for better biting or chewing. There are also composite fillings,
made of plastic and glass. A filling can be helpful in three ways:
• it stops food, air and water from entering the cavity alleviating discomfort and
pain.
• it stops the decay from growing deeper and prevents a tooth abscess.
• it can help save the tooth, so the person can use it for many years.
One of the most common oral health problems is decay. Enamel loss is a common
component of tooth decay, and may result in tooth sensitivity. In many cases, sensi-
tivity caused by enamel loss will be significantly improved or completely eliminated
by placing an appropriate dental filling material. A dentist will examine the teeth us-
ing a dental probe as well as take an X-ray to determine the extent and exact location
of the cavity and decay. Based on the medical history, location of the cavity, esthetic
needs, biting force, durability, cost, number of visits, the dentist will determine the
best filling option, whether it is direct composite bonding, amalgam (silver), gold or
inlays/onlays created in a dental laboratory. When a tooth hurts, there is no need to
take it out. There may be a way to treat and keep it. Otherwise, a cavity must not be
filled if there is an abscess in the tooth. The clinical signs of abscess include swollen
face, permanent pain and a severe toothache on tapping the tooth. If you cover up
an abscessed tooth with some filling material, it will make the problem worse. Some
124
UNIT 10: PREPARATION AND FILLING
OF THE CAVITY
pressure usually builds up inside the filled tooth resulting in even more pain and
swelling. However, if root canal treatment can’t be performed, an abscessed tooth
must be extracted immediately. So, swelling of the face or gums is unremarkable. If it
hurts only when eating or drinking something cold or sweet, or when breathing cold
air, the decay is deep enough for the nerve to feel temperature changes. The tooth can
be saved by filling the cavity as soon as possible.
First, the dentist will numb the area with a local anesthetic. The dentist will then
use a drill to remove the decay. He or she will probe and clean the area to check all the
bacteria and decay has gone. If the decay is deep, the dentist will apply glass ionomer
to fill the area. Then the dentist will add the filling material in layers, using a special
light to cure each layer. Then the dentist will shape the material and polish the final
restoration.
Dentists make most fillings in one appointment, but indirect fillings require two
visits. A patient will receive a temporary filling on the first appointment, and a per-
manent one on the second visit.
A permanent filling is made to last for many years. A dental worker trained in At-
raumatic Restorative Treatment (ART) can fill the cavity with a sticky material called
glass ionomer or an experienced dental worker can shape the cavity with a dental
drill and fill it with a combination of materials called amalgam or composite.
A cement filling is a temporary filling meant to last only for a few months. It helps
the person feel more comfortable until it is possible to get a permanent filling.

4
1. відновити пошкоджену a. to save a tooth by filling

поверхню зубів
2. розгладити поверхню зуба b. to numb the area with local anesthesia
3. призвести до чутливості зубів c. to examine teeth using a dental probe

4. полегшити біль та дискомфорт d. to shape the cavity with dental drill
5. спричинити біль і припухлість e. to even out tooth surface
6. врятувати зуб за допомогою f. to result in tooth sensititvity
пломбування
125
PART TWO
7. провести обстеження за g. to cause pain and swelling

допомогою зонду
8. знеболити ділянку за h. to repair damaged surface of the teeth
допомогою місцевого
анестетика
9. сформувати порожнину бор i. to alleviate pain and discomfort
машиною
5 Fill the blanks with the correct words:
filling restoration numb anesthetic

probe cure shape glass ionomer enamel loss
1. Dentists use _____________ to protect the nerve under the tooth.

2. The dentists used a local anesthetic to _____________ the area.
3. Dr. Smith will _____________ the area to check there’s no more decay.
4. The dentist is going to ______________ the filling so that it fits correctly.
5. A light is used to _____________ each layer of filling.
6. Jane needs to see a dentist because her _____________ has come out.
7. The hygienist will clean the tooth and then the _____________ will be
complete.
8. A common component of tooth decay that may result in tooth sensitivity is
____________.
6 Place the words from the word bank under the correct headings.
gold temporary indirect permanent ceramic

amalgam porcelain composite silver resin
Types of Filling Filling materials
126
OF THE CAVITY
7 Match the following terms with their definitions.
1. glass ionomer a. the process of returning something to its original condi-

tion or something that has been returned to its original
condition
2. composite b. the slow destruction of something due to natural,
chemical changes
3. amalgam c. a filling fitted where a large part of the tooth is missing
4. restoration d. a material made from several different substances
5. indirect filling e. a painful swelling containing pus
6. temporary filling f. a weak dental cement made from calcium aluminosilli-
cate glass and a liquid
7. decay g. a type of filling that is fitted for a short time while an
indirect or other filling is being made elsewhere
8. abscess h. a mixture of mercury and another metal, often used to
fill teeth
A person must know how to take care for/of the filling so it won’t break. It is for-
bidden to eat or drink anything in/for one hour to let the filling get hard and strong.
Try to use that tooth for biting after/before getting a cement filling till/until there is a
permanent filling, the cement and sides of the cavity are weak. If the tooth hurts more
after the filling is placed, it may result from/in an abscess. If a dentist can’t extract
the tooth immediately because of swelling, take off/out the filling to relieve pressure.
After finishing, first the dentist should scrape the dried material from/out the tools.
Then instruments must be scrubbed in/with soap and water and left for/within 20
minutes in disinfectant.
9 Read the steps of placing the cement filling and put them in correct order.
1. Lift out the decay. You must remove all the decay from the edges of the cavity.
2. Mix the cement, it is much easier to use thick and non-sticky cement.
3. Keep the cavity dry, because the cement stays longer inside a dry cavity. Change
the cotton whenever it becomes wet.
127
PART TWO
4. Remove the extra cement from around the cavity and the tooth before it gets
too hard. It is important to look closely around the tooth for loose pieces of
cement to avoid gums soreness.
5. Press cement into the cavity and spread it over the floor of the cavity and into
corners. Decay stops growing only when the cement covers it completely and
tightly.
1. A dental filling is a type of restorative dentistry treatment to repair major dam-

aged surfaces of teeth.
2. All filling materials are used to smooth dental surfaces to improve biting and
chewing.
3. One of the most widespread oral health problems which is revealed during
ordinary cleaning is pulpitis.
4. If you experience intense toothache, the tooth must be extracted.
5. If you cover up an abscessed tooth with filling, pressure will build up inducing
more pain and swelling.
6. If the decay is deep, a dentist will apply an amalgam to fill the area.
7. Indirect fillings usually require several appointments to a dentist.
8. A permanent filling is inserted for a short period of time.
11 Answer the following questions:
1. What is cavity preparation? What is a dental filling?

2. What are the causes of tooth sensitivity?
3. How does a dentist determine the best filling?
4. What happens during filling treatment?
5. What are the clinical signs of abscess? How to manage it?
6. What are the steps of filling a cavity?
7. What are the types of filling material?
8. What type of filling requires two visits?
9. What is the difference between a permanent and a temporary filling?
10. In what way can a filling be useful?
128
OF THE CAVITY
GRAMMAR
THE –ing FORM

We use the –ing form:
• as a noun(as a subject of the sentence);

E.g. Filling a cavity is a reliable way to treat caries.
• after verbs such as like, love, enjoy, prefer.
E.g. I hate going to a dentist.
• after certain verbs such as: dislike, finish, hate, imagine, involve, forgive,
keep, mention, mind, miss, practice, report, risk, stand, can’t stand, suggest.
E.g. My mother suggested removing dark stains from food and coffee.
• after a preposition.
E.g. The dentist is good at performing gingivoplasty.
• after expressions: I’m busy, it’s no use, can’t help, what about…? how about…?
E.g. It’s no use trying to repair broken teeth.
1 Say which of the following verbs go with the –ing form.
finish dislike appear promise decide keep

suggest forgive refuse seem can’t stand hate
love expect would like prefer advise enjoy
make feel
2 Choose the correct option.

1. I want to improve/improving the appearance of the mouth.
2. To drink/drinking too much coffee will stain a person’s teeth.
3. This pedodontist is really good at socializing/to socialize with children.
4. I attempt to eating/to eat less sweet food.
5. She can’t stand rinsing/to rinse the mouth with water.
6. The dentist suggests to put/putting a cold compress on the face to reduce swelling.
7. My dentist will finish inserting/to insert indirect filling next time.
8. What about probing/to probe the area to check if all bacteria and decay have gone?
129
PART TWO
3 Put the verb in brackets in either the –ing form or the infinitive.
1. A dentist offered me _________ (control) gum bleeding following his pre-
scription.
2. (Clean)_________ regularly can stop gum disease from getting worse.
3. She needs _________ (treat) painful mouth sores immediately.
4. The dentist seems _________ (reveal) the lump on the patient’s tongue.
5. She can’t stand _________ (give) any local anesthetics.
6. I hope _________ (prevent) dental cavities by using fluoride toothpastes.
7. The hygienist managed _________ (save) my broken teeth by performing or-
thognathic surgery.
8. I always look forward to _________ (fix) my teeth by braces.
4 Fill the gaps with a preposition and an –ing form.
by with using making

for of sealing protecting
of in being hurt extracting
in at removing changing
1. This drilling machine is used _________ _________.

2. You can make your teeth white _________ _________ teeth-whitening prod-
ucts.
3. I’m always afraid _________ _________ by a dentist.
4. The dentist is busy _________ _________ the area with gutta percha.
5. He’s thinking _________ _________ an option of proper filling material.
6. The hygienist is interested _________ _________ the nerve of the tooth.
7. A hygienist says there is no point _________ _______ composite resin filling.
8. An oral surgeon is really good _________ _________ impacted wisdom teeth.
TALKING POINTS
1 With a partner, act out the roles below. Then, switch roles.
Student A: You are a dentist. Talk to student B about:

• Fillings that are available
• The advantages of each material
• The disadvantages of each material
Student B: You are a patient. Talk to Student A about filling options.
130
OF THE CAVITY
Use the conversation from Task1 to fill out the summary of two filling
2
options.
Type of material:
Advantages:_____________________________________
_______________________________________________
Disadvantages:___________________________________
_______________________________________________
Type of material:
Advantages:____________________________________
______________________________________________
Disadvantages:__________________________________
______________________________________________
MORE READING
1. What are the advantages and disadvantages of composite, porcelain and amal-
gam fillings?
2. Which of the fillings are the most durable?
3. Which types of filling are thought to be safe?
DENTAL FILLINGS
Dental composites also called “white fillings” are a group of restorative materials
used in dentistry. Crowns and in-lays can be made in the laboratory from dental com-
posites. These materials are similar to those used in direct fillings and are tooth-co-
loured. As with other composite materials, a dental composite typically consists of a
resin-based matrix, which contains a modified methacrylate or acrylate. Inorganic
filler such as silica, quartz or glass are added to reduce polymerization shrinkage. The
filler particles give the composites wear resistance as well.
There are a number of pros and cons associated with composite, porcelain, and
amalgam. In addition to having a more pleasing and natural tooth-like appearance,
131
PART TWO
porcelain and composite fillings have the potential advantage of not containing mer-
cury or other metals that may contribute to sensitivity or toxicity. Mercury toxicity
from amalgam fillings is a controversial subject, though no research has been able
to show any risks of having mercury as a component of amalgam fillings. However,
many patients do have metal sensitivity and some have reported a metal taste after
the placement of amalgam. Dental amalgam is widely used because it is easy to fabri-
cate the plastic material into rigid direct fillings. High copper amalgam has got better
corrosion resistance and it is less susceptible to creep. Amalgam is now basically used
for posterior teeth.
Porcelain and composite previously were not as durable as amalgams. However,
dental manufacturers have made great strides in improving the strength of composite
resin materials to the effect that composite fillings now have the potential to be used
for all teeth, including molars. Furthermore, composite materials often require less
tooth preparation. However, amalgam fillings serve much longer than porcelain and
composite. Composite fillings shrink with age and may pull away from the tooth al-
lowing leakage. If leakage is not noticed early, recurrent decay may occur. All fillings
require preparation of the affected tooth, but less preparation is usually needed for
porcelain or composite. Typically, this means that less healthy tooth structure has to
be removed when placing a composite.
Porcelain and gold are used for indirect restorations like crowns and onlays.
Traditional porcelains are brittle and are not always recommended for molar resto-
rations. Some hard porcelains cause excessive wear on opposing teeth. Porcelain or
composite restorations require the use of additional equipment, and the procedure
itself requires up to 50 percent more time than the amalgam filling procedure. These
factors contribute to the higher costs associated with porcelain and composites.
1. What is Atraumatic Restorative Treatment (ART)?

2. What is glass ionomer?
3. What are the basic steps of insertion a permanent filling?
HOW TO PLACE A PERMANENT FILLING USING ATRAUMATIC

RESTORATIVE TREATMENT
Atraumatic Restorative Treatment (ART) is a method to place a permanent filling

avoiding the employment of an expensive dental drill. This technique was invented in
Tanzania, East Africa, and currently, it is being used by dental workers worldwide.
The process for placing a permanent filling using ART is identical to placing a
temporary cement filling, but instead of cement you apply a sticky material called
132
OF THE CAVITY
glass ionomer. Once glass ionomer is in the cavity, it produces fluoride and helps
prevent new cavities formation. Glass ionomer is costly, but sometimes local gov-
ernments provide it at a lower cost. A package of glass ionomer usually comes in
combination with a bottle of liquid and a bottle of powder that you mix together for
ART. It is important to store glass ionomer in cool place. After you have removed the
decay, clean the cavity so that the glass ionomer will stick well. The most effective
way to do this is by means of the liquid from glass ionomer. Glass ionomer cement
is one of the class materials frequently employed in dentistry as filling materials and
luting cements. These materials are based on the reaction of silicate glass powder and
polyalkenoic acid. These tooth-coloured materials were introduced in 1972 for the
use as restorative materials for anterior teeth. They bond chemically to dental hard
tissues and release fluoride for a relatively long period. The desirable properties of
glass ionomer cements make their useful materials in the restoration of carious le-
sions in low-stress areas such as smooth-surface and small anterior proximal cavities
in primary teeth mainly in primary teeth. They do not need to be put in layer by layer,
like composite fillings.
One should put a piece of cotton inside the cavity during mixing the glass iono-
mer. Keep an eye on the glass ionomer not to stick to other tooth or squeeze and hurt
the gum. It is necessary to mix the glass ionomer on piece of smooth glass just before
using it. The mixture should become dense and smooth like a chewing gum. Then
one should take the cotton out from inside the cavity which must be absolutely dry.
If the cotton around the tooth is wet, one should replace it. The cavity must be filled
with the glass ionomer immediately. Extra glass ionomer must be removed from the
tooth before it gets too hard. When it gets hardened in less than 1 minute, ask a pa-
tient to close the teeth gently. Finally, the extra filling must be scraped away from that
place using the filling tool and be checked again.
3 Read the text and find out the following information.
1. What is dental preparation? What are its types?

2. What is tooth preparation? What are the steps of tooth preparation?
3. What are direct and indirect restorations? What is the difference between
them?
DENTAL RESTORATION
A dental restoration or a dental filling is a management used to regain the func-

tion, integrity, and morphology of the structure of a missing tooth resulting from
caries or external trauma as well as the replacement of such structure supported by
dental implants. They are of two broad types: direct and indirect, those are further
133
PART TWO
classified by location and size. Restoration of a tooth requires two steps: preparing the
tooth for placement of restorative materials and their insertion. The prepared tooth
ready for placement of restorative materials is called a tooth preparation. Prepara-
tions may be intracoronal and extracoronal.
Intracoronal preparations serve to hold restorative material within the confines of
the structure of the crown of the tooth. Examples include all classes of cavity prepa-
ration for composite or amalgam as well as those for gold and porcelain inlays. Extra-
coronal preparations provide a core upon which restorative material will be placed to
bring the tooth back into functional and aesthetic structure, for example crowns or
onlays as well as veneers.
The technique of direct restorations involves placing a soft filling into the pre-
pared tooth and building up the tooth. The advantage of direct restorations is that
they usually set quickly and can be placed in a single procedure. As for indirect res-
torations, they are fabricated outside the mouth using the dental impressions of the
prepared tooth. Common indirect restorations include inlays and onlays, crowns,
bridges and veneers. They are often done using gold or ceramics in two separate visits
to the dentist.
134
UNIT 11 ROOT CANAL TREATMENT
LEAD IN
root canal [ˈruːt kəˌnæl] депульпування зуба та

видалення нерва
crack [kræk] тріщина, щілина
chip [tʃɪp] надщерблення
syringe [sɪˈrɪndʒ] шприц, розпилювач
omit [əʊˈmɪt] уникати
punch [pʌntʃ] накладати
dam [dæm] тонка гумова прокладка
vinyl [ˈvaɪnəl] вініл
clamp [klæmp] скоба, кліпса
file [faɪl] пульпекстрактор

bleach [bliːtʃ] гідрохлорид
кальцію,відбілювач
dissolve [dɪˈzɒlv] ліквідовувати, знищувати
PART TWO
gutta percha [ɡʌtəˈpɜːtʃə] гутаперча

cone [kəʊn] штифт
verify [ˈverɪfaɪ] підтверджувати, перевіряти
seal [siːl] герметизувати, пломбувати
over-the-counter [ˌəʊvəðəˈkaʊntər] безрецептурний
schedule [ˈʃedjuːl] запланувати
Consider the statements and elicit your attitude towards what is meant
2
by them:
• During a root canal treatment the tooth's roots are removed.

• If a tooth doesn't hurt, it doesn't need a root canal treatment.
• Root canal treatment requires multiple appointments to complete.
3 Read the text.

ROOT CANAL TREATMENT
A root canal treatment is an endodontic procedure used to repair and save the
tooth with inflamed and infected pulp or soft tissue inside the root canal. Among
possible causes are: a deep decay, repeated dental procedure, a crack in the tooth,
defective materials.
The main target of a root canal treatment is to remove all the contaminants inside
the tooth and to prevent any further infection by sealing the tooth. Performing a root
canal treatment an endodontist or a dentist removes the pulp tissue within the tooth.
The success of a root canal treatment depends greatly upon making the patient
comfortable. Consequently, the local anesthetic is administered into the gum line,
moreover it is strongly recommended to use a topical numbing gel applied to the
injection side to reduce any discomfort the needle may cause.
Next step is the injection of a local anesthetic with the syringe just below the tooth
receiving a root canal treatment. Afterwards, the patient is given a few minutes to
relax and for patient’s mouth to become completely numb. The patient's mouth is
numb, the tooth is isolated, and since the patient's saliva contains contaminants and
the germs' introduction into the treatment area must be omitted. In this case a tooth
is punched with the rubber dental dam (a thin sheet of rubber or vinyl) with a hole
cut in it to place it on the tooth. The procedure enables to exclude possible move-
ment. Then the tooth is dried up with an air-water syringe.
136
UNIT 11: ROOT CANAL TREATMENT
Once the tooth is prepared, an endodontist creates the access to the tooth using a
drill. The next step is to clean and shape the tooth canal using a root canal file. At this
point the dentist must measure the depth of the canal using a combination of X-ray
and specialized equipment. Otherwise, a failure in measurement can put the tooth at
risk of reinfection. The canal of the tooth is cleaned with the sodium hypochlorite,
commonly referred to as bleach which is left for several minutes, in order to assure
that all the bacteria in tissue of the tooth have been dissolved. The bleach is removed
with the suction from the tooth. To continue, the rubber compound known as gutta
percha cone is placed into the root canal. The gutta percha is packed into a tooth
canal with a plugger and its access is removed by a heated instrument. Afterwards
additional X-ray is taken. Once the dentist verifies that the canal has been sealed a
filling or crown is placed depending on the location of the tooth. Later on the patient
may experience some mild sensitivity and discomfort that can be relieved by using
some over-the-counter pain medications.
Make word combinations matching the words from the first column to those
4
of the second, translate them.
1. endodontic a) materials
2. defective b) anesthetic
3. local c) dam
4. air-water d) cone
5. root canal e) procedure
6. gutta percha f) medications
7. over-the-counter g) syringe
8. dental h) file
5 Arrange the following pieces of information in order they appear in the text.
the aim of a root canal treatment 1.

possible causes of a root canal treatment 2.
placing a filling or crown 3.
137
PART TWO
localization of the treatment area 4.

cleaning and shaping the root canals 5.
filling the root canal with gutta percha 6.
reassuring the depth of the root canals 7.
avoiding discomfort during treatment 8.
sealing the canal 9.
6 Find the definitions for the items from the box.
drill rubber dental dam numbing gel air-water syringe root canal
file bleach plugger gutta percha cone
1. .................... is a topical anesthesia administered to avoid feeling the needle

gliding in.
2. .................... is a thin piece of latex placed over the tooth or teeth during dental
procedures.
3. .................... is defined as a dental device that supplies a focused stream of com-
pressed air, water, or a combination of both.
4. .................... is an instrument for making or enlarging a hole in a bone or in a
tooth.
5. ................... is a small, metal instrument with spiralled blades, used for cleaning
and shaping a pulp canal.
6. ....................is a pale-green, crystalline compound of NaOCl.
7. .................... is a compound designed to fit the shape of a root canal.
8. .................... is a dental instrument used for condensing materials during a
dental treatment.
7 Match the indications for a root canal treatment with their descriptions.
deep decay a line on the surface of a tooth along which it has

split
repeated dental procedure tooth filling materials that might have been deficient
initially or have deteriorated
138
defective materials the case when the inner seal is placed when a root
canal erodes
a crack or chip in the root the infection that spreads rapidly and affects deeper
layers of the tooth
a missed root canal the case when one of the canals is missed allowing
the bacteria to remain and spread in it
Create the lists of the words, word combinations and phrases to be used for
8
description of the main points of a root canal treatment.
Preparation for
Performing a root Post-treatment Important
a root canal
canal treatment procedures to remember
treatment
1. 1. 1. 1.
2. 2. 2. 2.
3. 3. 3. 3.
... ... ... ...
Ask about signs and symptoms that may indicate the necessity of a root
9
canal treatment.
Do you feel ...? pain

Does it interfere with ...? chewing, eating sweets, drinking cold water
Does your tooth react to ...? tenderness in the nearby bone and gum tissue
Have you noticed ...? hot and cold stimuli
Explain the steps of a root canal treatment to a patient.

10
Use the following linking elements:
The main aim of __________________________________________________

Firstly, it is necessary to_____________________________________________
In addition, ______________________________________________________
The second step will be _____________________________________________
The next is to_____________________________________________________
139
PART TWO
After that ________________________________________________________

___________ must be continued with __________________________________
Finally, __________________________________________________________
At the end _______________________________________________________
Must be remembered that___________________________________________
________________________________________________________________
________________________________________________________________
11 Answer the questions.
1. When is a root canal procedure indicated?

2. When should a root canal treatment be applied?
3. Who performs a root canal treatment?
4. What difficulties may a root canal treatment present to a dentist?
5. How to organize a root canal treatment?
6. What are the implicated risks of a root canal treatment?
Reconsider the popular myths and miss-conceptions, support your points

12 of view with information you have already learnt. Make use of the phrases
from the box.
Myth 1: During a root canal treatment the tooth's roots are removed.
Myth 2: If a tooth doesn't hurt, it doesn't need a root canal treatment.
Myth 3: Teeth that go through root canal treatment are eventually lost or pulled.
Myth 4: Tooth extraction is better option than having a root canal treatment.
Myth 6: At the end of a root canal treatment a crown is placed.
I don't agree
The idea seems to be correct, but as a future dentist I
I would like to tell that
I must admit that
I have another point of view
I think / consider / believe / suppose / assume that
To my mind
My view / opinion / belief / impression / conviction is that
Actually, there is nothing
I have no doubt that
140
GRAMMAR
REPORTED SPEECH (PART 1)
Direct speech is the exact words someone used. Reported speech is the exact
meaning of what someone said, but not the exact words.
Reporting statements: Reported statements are introduced with say or tell. Invert-
ed commas are omitted, and that is optional in the reported sentence.
Direct Speech Reported Speech
Present Simple Past Simple

"A dentist performs the procedure," A nurse said (that) a dentist performed the
a nurse said. procedure.
Present Continuous Past Continuous

"A dentist is performing the procedure," A nurse said (that) a dentist was performing
a nurse said. the procedure.
Past Simple Past Perfect

"A dentist performed the procedure," A nurse said (that) a dentist had performed
Past Continuous Past Perfect Continuous

"A dentist was performing the A nurse said (that) a dentist had been
procedure," a nurse said. performing the procedure.
Future Simple Future in the Past

"A dentist will perform the procedure," A nurse said (that) a dentist would perform
Future Continuous Future Continuous in the Past
"A dentist will be performing the A nurse said (that) a dentist would be
Present Perfect Past Perfect

"A dentist has performed the procedure," A nurse said (that) a dentist had performed
141
PART TWO
Present Perfect Continuous Past Perfect Continuous

"A dentist has been performing the A nurse said (that) a dentist had been
procedure, " a nurse said. performing the procedure.
Past Perfect Past Perfect
"A dentist had performedthe procedure, " A nurse said (that) a dentist had performed
Past Perfect Continuous Past Perfect Continuous
"A dentist had been performingthe A nurse said (that) a dentist had been
Match the pronouns, time and place words and expressions with their
1
possible counterparts in reported sentences:
1) tonight, today a) that night, that day

2) now, at the moment b) then, at that time, at that moment
3) yesterday c) the previous night
4) last night d) the day before
5) two days ago e) two days before
6) tomorrow f) that week
7) this week g) the following day, the next day, the day after
8) here h) that
9) this i) there
10) these j) those
2 Underline the correct option.
1. I thought it is / was pretty painless.

2. A lady told a dentist that she experiences / experienced sharp pain.
3. A doctor told the patient that the second premolar has required / had required
the X-ray.
4. Julie said she has been waiting / had been waiting for an hour.
5. Mr. Locke told me that he will visit / would visit the dentist the next day.
6. The assistant said that they will be waiting / would be waiting till the following
day.
7. The sign on the dentistry told them that they have to be / had to be happy.
8. The specialists said his tooth will survive / would survive the procedure.
142
3 Complete the reported sentences with correct tense forms of the verbs.
1. “There is nothing painful,” a child said.
A child said (that) there … nothing painful.
2. “He was an excellent specialist,” his patients said.
His patients said (that) he … … an excellent specialist.
3. “The dentist is performing the operation at the moment,” chair side assistant
said.
A chair side assistant said (that) the dentist … …… operation at that moment.
4. “The doctor has been operating since morning,” a patient said.
The patient said (that) the doctor … … …… since morning.
5. “An intern has demonstrated an excellent performance of the root canal treat-
ment,” a physician said.
A physician said (that) an intern … …… an excellent performance of the root
canal treatment.
7. “The procedure will be rather painless,” an orthodontist said.
An orthodontist said (that) the procedure … … rather painless.
4 Report the following sentences.

1. "I am not currently having an endodontic procedure," John said.
2. "The insurers will cover the expenditures next week," the receptionist said.
3. "Lack of information is the main reason of delaying a dental treatment in this
area," the expert said.
4. "The tooth will require the additional X-ray after an endodontic procedure,”
an intern said.
5. "A number of patients suffering from toothache has been registered," the inter-
viewer said.
7. "Mr. Lames will be receiving the panoramic X-ray tomorrow at this time," a
nurse said.
TALKING POINTS
You are invited to a meeting of a local community. Your main task is to
1 cover the issues of a root canal treatment. Educate the members of the
community about:
1. A root canal procedure is not the end of your tooth’s healthy outlook.
2. Pros and cons of a root canal procedure.
3. Options after a root canal treatment.
143
PART TWO
MORE READING
1 Read and translate the text.
A ROOT CANAL ACCOMPLISHMENT
After a root canal therapy has been completed, the tooth will still require some
type of permanent dental restoration. A crown is an option that may supply the fin-
ishing touch after a root canal treatment by sealing the tooth and strengthening it for
the long term. But a crown isn’t necessary in every case.
A root canal treatment without crown placement may be perfectly fine for incisors
and canines that are not severely excavated, due to the fact that front teeth tend to
experience less physical stress in comparison with premolars and molars. In fact, the
crowning of front teeth after a root canal treatment is effective in severely damaged
or extensively excavated canines and incisors to strengthen them.
Though a root canal treatment saves a tooth from decay, it can also weaken the
tooth. That is why the teeth with large cavities stay vulnerable to being fractured even
after the treatment has been completed successfully.
Crowning is particularly required for the premolar teeth and molars which are
extensively involved in chewing. Also crowns help the severely fractured teeth gain
their natural outlook. It is important to remember, that whether the teeth are covered
by crowns or filled without them, they are still vulnerable to decay.
Read the text about retreatment of a tooth after endodontic procedure.

2
Pay attention to indications for endodontic retreatment.
ENDODONTIC RETREATMENT
With proper care, even teeth that have had root canal treatment can last a lifetime.
But sometimes, a tooth that has been treated doesn't heal properly and can become
painful or diseased months or even years after treatment. If the tooth fails to heal
or develops new problems, it has the second chance. An additional procedure may
support healing and save the tooth. If the patients are experiencing dental pain or
discomfort in a previously treated tooth, they have to visit an endodontist and discuss
the retreatment.
As occasionally happens with any dental or medical procedure, a tooth may not
heal as expected after initial treatment for a variety of reasons:
– narrow or curved canals were not treated during the initial procedure;
144
– complicated canal anatomy remained unrevealed during the procedure;

– the accomplishment of crowning or other restoration took some extra time to
be completed;
– the restoration did not prevent salivary contamination of the inner surface of
the tooth.
In other cases, a new problem can arise in a tooth that was successfully treated.
For example: 1) new decay can expose the root canal filling material to bacteria, caus-
ing an infection in the tooth; 2) a loose, cracked or broken crown / filling can cause
the bacteria to affect the tooth; 3) a tooth sustains a rather deep fracture.
During retreatment, an endodontist will reopen the tooth and remove the filling
materials that were placed in the root canals during the first procedure. The endo-
dontist then carefully examines the tooth, looking for additional canals or an infec-
tion. The dental specialist removes any infection, cleans and shapes the canals. The
opening is sealed with a temporary filling. Once the tooth heals, a new filling or
crown is placed on the tooth to protect it.
If nonsurgical retreatment is not an option, the endodontic surgery should be
considered. This surgery involves making an incision to allow access to the tip of the
root. Endodontic surgery may also be recommended in conjunction with retreat-
ment or as an alternative.
3 Read the text and sort out the factors causing accidents of different categories.
ENDODONTIC ACCIDENTS
An endodontic treatment can be complicated due to a variety of reasons. The

most common are the lack of theoretical knowledge, professional skills and experi-
ence, low quality instruments or materials, variable anatomical factors. The accidents
provoked by these factors fall into several categories:
1) accidents caused by access to the tooth undergoing an endodontic treatment;
2) instrumentation related accidents;
3) obturation related accidents.
The first category of endodontic accidents involves different cases. One of them is
when a wrong tooth is treated. Sometimes some additional canals or those not easily
reachable are left without treatment. Also damage to a previously placed crown can
occur or a perforation that causes communication between a pulp cavity and the
external tooth surface is created. Also the tooth can fracture during an endodontic
procedure.
The second category of endodontic accidents includes the situations when the size
of an endodontic instrument does not fit the size of a root canal and, as a result, dif-
ferent parts of the tooth can become perforated (inappropriate use of Gates-Glidden
145
PART TWO
burs), the root canal can be obstructed (dental instruments separate or break), the
root canal file can't reach the apical terminus (unique anatomical structure of a root
canal).
The third category of endodontic accidents encompasses the situations when:
1) over- or underextended root canal fillings are made; 2) nerve paresthesia occurs;
3) there is a vertical root fracture.
To conclude, a successful endodontic treatment requires a set of issues met.
Among them is an excellent educational background, first class professional training
and a high quality of instruments and materials used while a procedure.
146
UNIT 12 TOOTH EXTRACTION
LEAD IN
recourse [rɪˈkɔːs] рішення

indication [ˌɪndɪˈkeɪʃən] показання
retained [rɪˈteɪnd] неправильно розвинений
adjacent [əˈdʒeɪsənt] суміжний
loosen [ˈluːsən] розхитувати
malposed [ˌmælˈpəʊzd] неправильно розміщений
malignancy [məˈlɪɡnənsɪ] злоякісне утворення
brittle [ˈbrɪtl] лабільний
socket [ˈsɒkɪt] заглиблення в щелепній кістці
inevitably [ɪˈnevɪtəblɪ] неминуче
malpractice [ˌmælˈpræktɪs] професійна некомпетентність
sequential [sɪˈkwenˌʃəl] послідовний
spongy [ˈspʌnðʒɪ] пористий
disturbed [dɪˈstɜːbd] тривожний
Discuss with your group mates the signs on the dental clinics
2
and answer the questions:
• What is meant by these signs?

• How do they refer to the extraction of the teeth?
• How would you react to the signs?
PART TWO
3 Read the text.
TOOTH EXTRACTION
When a tooth cannot be repaired with a filling or a crown because of an accident

or extensive decay and there is too much damage to it, an extraction may be the best
recourse. Some other indications for removing the tooth are: extra teeth that block
the other teeth from coming in, retained baby teeth (shark teeth), malposed, cracked
teeth and teeth damaged by radiation therapy procedures and chemotherapy.
Depending upon the situation simple or surgical tooth removal procedures are
among the options. As a rule, the first type of extraction is selected in case when the
tooth or at least its definite portion remains in the mouth. The tooth is being gradual-
ly loosened with an elevator and the forceps are used to remove the tooth. The second
method is a rather complex procedure that is applied in the circumstances like: bro-
ken, cracked or fragile teeth, impacted teeth (wisdom teeth), teeth with curved roots
or those with retained root tips.
Regardless of the procedure's type the dentist must carefully study the patient's
medical history, analyze the data of a panoramic X-ray, and interpret the blood
counts. To the contraindications for tooth extraction belong: heavy exposure to ra-
diation, proximity to jaw fracture or the area of malignancy, bisphosphonate thera-
py resulting in ostechemonecrosis, brittle uncontrolled diabetes, end-stage of renal
and liver disease (ESRD and ESLD), uncontrolled leukemia, lymphoma, cardiac dys-
rhythmias, cerebrovascular accidents (CVA). As well as the first or the last trimester
of pregnancy, hemophilia, long-term corticosteroids or immunosuppressant intake
are inevitably taken into account.
The forthcoming manipulation is planned and discussed in order to estimate the
possible risk consequences, to exclude the malpractice cases, and reduce anxiety.
The procedure of pulling the tooth out presupposes several sequential steps. The
first is the tooth numbing where a dental injection (a local anesthetic) is commonly
used, though patients with some psychological conditions and children under the
age of four may additionally require intravenous anesthesia. The second step is the
extraction process. To remove the tooth, the dentist must expand its socket (the place
where the root is encased in the bone) by rocking a tooth back and forth. Hence the
bone structure is relatively spongy, side-to-side pressure compresses it and helps sep-
arate the root from the ligament. Finally, when enough space is created the tooth can
be removed easily.
After the tooth has been removed the place of extraction is covered with a piece
of gauze and the patient keeps it for 30 minutes in order to create the pressure and
form a blood clot that shouldn't be disturbed. To reduce swelling the ice packs can be
applied. Additionally, soft and cool foods are recommended. An extraction side may
148
UNIT 12: TOOTH EXTRACTION
be rinsed carefully with salt water the next day after the procedure. As a rule swelling
and bleeding are relieved within a day or two. The healing process lasts for at least
two weeks.
4 Complete the table with the words from the text.
extensive
teeth
lesion
removal
impacted
X-ray
counts
malpractice
sequential
pressure
clot
Form the lists of basic words, word combinations, phrases from the text that
5
are used to describe a tooth extraction procedure:
conscious sedation, general anesthesia, to expend the socket, to rock a tooth back
and forth (side-to-side pressure), to bite on a piece of gauze, gentle rinse, ini-
tial healing, to estimate the possible risk consequences, to reduce anxiety, tooth
numbing, dental injection, intravenous anesthesia, to loosen the tooth with an el-
evator, an accident or extensive decay, surgical tooth removal procedure, to study
the medical history, to analyze the data of a panoramic X-ray, to interpret the
blood counts
Pre-extraction Extraction Post-extraction
149
PART TWO
Put the stages of a tooth extraction process in the correct order.

6
Discuss them.
assessment of the tooth condition 1) The first step is ..................

collection of tests' results and X-ray images
2) The second step is .............
selection of the extraction procedure
reviewing the patient's medical history 3) The third step is ................
discussion of the future extraction with the
4) The fourth step is ..............
patient
pain management 5) The fifth step is ..................
pulling the tooth out
6) The sixth step is .................
providing side-to-side pressure
post-manipulation procedures 7) The seventh step is ............
home care
8) The eighth step is ..............
9) The ninth step is ................
10) The tenth step is .............
7 Match the contraindications for tooth extraction with their definitions.
Definition
is a disease caused by the effect of bisphos-
pho-nates.
occurs when the liver has sustained severe dam-
age, usually over the course of many years, and
is in the process of failing completely. • End-stage of leaver disease
• Hemophilia
is an abnormal heart beat: the rhythm may be • Cardiac dysrhythmia
irregular the heart rate may be low or high. • Cerebrovascular accident
• Osteonecrosis of the jaw
(brain stroke) is a condition when the blood
flow to a part of the brain is stopped either
by a blockage or the rupture of a blood vessel.
is an inherited bleeding disorder in which
a per-son lacks or has low levels of clotting
proteins and the blood doesn’t clot properly.
150
Complete the post-extraction recommendations with the prepositions

8
from the box.
of in to with after of out at with
Consult your dentist or a maxillofacial surgeon in case when after the tooth
extraction:
• The swelling gets worse instead __ getting better.

• You complain __ fever, chills or redness
• You have trouble __ swallowing
• You have uncontrolled bleeding __ the area
• The area continues to ooze or bleed __ the first 24 hours
• Your tongue, chin or lip feels numb more than 3 __ 4 hours after the procedure
• The extraction site turns __ very painful – this may be a sign that you are
dealing __ a dry socket.
• If it points having an infection, your dentist usually will prescribe antibiotics
to overcome it.
Name the functions of the following instruments and equipment items.
9
Use the example below:
e.g: The function of the needle holder is to hold a suture needle.
dental chair with

the tilts a) to provide stability and support
mouth prop b) to remove tooth from bony socket
tongue/cheek retractor c) to remove tissue or debris from bony socket
scalpel d) to loosen a tooth or its root (s) from bony socket
straight elevator e) to grasp and stabilize soft tissue flaps
tissue retractor f) to deflect and retract the periosteum from bone
tissue forceps g) to cut and remove excess or diseased soft tissue
151
PART TWO
bone curette h) to hold suture needle
extraction forceps i) to close incision site
tissue scissors j) to cut soft tissue
suture k) to hold tongue and cheek away from surgical site
needle holder l) to keep mouth open during extensive procedures
Think over the following opinions. Are they correct?

10
Support your point of view.
1. There is always an alternative to a tooth extraction.

2. The decision to perform an extraction is usually made on the spot.
3. General anesthesia is better option than a local numbing.
4. Side-to-side pressure is a useless method in the process of pulling out the
tooth.
5. The place of extraction does not require additional care.
6. A profuse bleeding within 24 hours after the procedure is a normal sign after a
tooth extraction.
7. A tooth extraction can be performed using only forceps.
11 Answer the questions.
1. When is a tooth extraction required?

2. What are the indications for removing of a tooth?
3. What are the types of tooth extraction?
4. When is a surgical extraction of a tooth indicated?
5. What are the contraindications for a tooth extraction?
6. How many stages does the process of a tooth extraction involve?
7. What recommendations are given after a tooth extraction?
Prepare a short report on the tooth extraction using the following linking
12
elements:
Today I would like to talk about ______________________________

Firstly, the dentist collects ___________________________________
Then all the issues must be __________________________________
A simple extraction requires__________________________________
Also, the following methods can be used_________________________
152
Conditions like _____________________________ must be awarded special

attention, otherwise_________________________________________
After the tooth has been removed______________________________
GRAMMAR
REPORTED SPEECH (PART 2)
Reporting Questions, Commands, Requests, Suggestions

In reported questions affirmative word order is used and the question mark as a
rule becomes a full stop. Tenses, pronouns, adverbs of time and place change as in
the statements.
Direct Questions Reported Questions:

1) usually begin with verbs: ask, inquire or ex-
pression want to know;
2) if (whether) is used (when the direct question
begins with an auxiliary or a modal verb)
A dentist asked a girl, A dentist asked if a girl was allergic to penicillin.

"Are you allergic to penicillin?"
A dentist asked me, A dentist wanted to know whether he spelled it
"Do I spell it correct-ly?" correctly.
Commands, Requests, Reported Commands, Requests,
Suggestions Suggestions:
1) to tell+sb + to infinitive (to report
commands);
2) to ask or to beg + sb + to infinitive (to report
requests);
3) to suggest + -ing form (to report suggestions)
"Come to the dentistry in two A receptionist told me to come to the dentistry in

hours," a receptionist said. two hours.
"Please, don't talk," he said. He asked me not to talk.
"You'd better take painkillers," A dentist suggested taking painkillers.
a nurse said.
153
PART TWO
1 Identify the sentences as commands, requests or suggestions.
1. "Shall we stay in the hospital for an hour?"_____________

2. "You'd better go to bed after having a tooth extraction."______________
3. "Let's discuss the procedure?"_______________
4. "Can you open the window it’s stuffy here."_________
5. "May I leave the dentistry immediately?"____________
6. "Don't come in, the room is still occupied."_____________
7. "Shall I start the procedure?" _____________
8. "Can I have your registration card and health insurance?"____________
Complete the reported questions, requests, suggestions, and commands with
2
Past Simple of the verbs in the brackets.
1. She (to refuse) _________ to put down my mobile number.
2. The maxillofacial surgeon (to apologize) ______ for delaying of a procedure.
3. A nurse (to ask) ________about my past medical history.
4. An assistant (to remind) ________ me to rinse my mouth with salt water.
5. Mr. Locke (to insist on) ________ performing administration of general anes-
thesia.
6. Mike (to promise) _________ that he wouldn't forget about the appointment.
7. A teacher (to demand) __________ to keep silence.
3 Turn the following questions into Reported Speech.

1. A nurse asked, “Were you vaccinated?”
2. “Will he take these medicines?” a student asked.
3. “Did this drug relieve the pain?” a doctor asked.
4. “Is Ann recovering?” Linda asked.
5. “Did you go to the hospital yesterday?” mom asked.
Turn the following questions, requests, suggestions and commands into
4
Reported Speech.
1. "May I leave the room, please?" asked the student.

2. "Shall we go to the dentistry this week?" said a mother.
3. She asked him, “Was the doctor having an appointment when you arrived?”
4. "Let's discuss some issues," said a chair side assistant.
5. "Don't touch the sterile equipment!" said the surgeon.
6. "Did you see the test results yesterday?" asked an intern.
7. "Shall I raise the tilt?" an assistant asked a patient.
154
TALKING POINTS
You have just registered for the participation in The International Conference
for Dentists “Tooth Extractions: Challenges of the 21st century”. Prepare a short
report (3 - 5 minutes’ duration) touching upon the issues of the session you have
chosen.
Sessions:
1) Methods of teeth extraction

2) Alternatives to the tooth extraction
3) Undergoing post-extraction period successfully
MORE READING
1 Read the text and be ready to discuss the following issues:
• Reasons for changing the nature of the routine extraction

• Surgical techniques
• Peculiarities of each surgical extraction method
SURGICAL EXTRACTIONS
The flow of the routine extraction that has been primarily planned by a dentist
may unexpectedly change because of the tooth’s crown snapping. In cases like this
a conservative extraction turns to a surgical one. Surgical approach may also be an
option while dealing with a broken or cracked tooth, some anatomical problems (ab-
normal shape and size of the roots), impacted teeth, and dense structure of the bone.
There are three surgical techniques the surgeons apply commonly during surgical
extraction. The first is raising a gum tissue flap. Making a flap enables getting an
access to the jawbone or to a severely damaged tooth. During the procedure the flap
of the gum tissue is created and then it is peeled back. After the extraction the gum
tissue is returned to its place and stitched.
The next technique is trimming of the bone or bone grafting. The fragments of
the bone are removed around the place of their connection with the tooth’s root. The
methods of trimming vary. When the bone is situated around or within the socket
of a tooth it can be simply removed by a dental drill. In cases where the surgeon can
see directly into aspects of the tooth's socket, the bone is considered to be easily ac-
cessible and the dental professional can reach it by trimming alongside and around
155
PART TWO
the tooth. This is a rather quick and plain way of creating an access for the surgical
forceps and elevators.
Sectioning of the teeth is the third among the most common methods used
during the tooth extraction procedure. This method is effective in decreasing of the
level of difficulty. Sectioning or splitting is applied for making an extraction proce-
dure simpler, thus enabling each part of a tooth to be removed separately. A dental
drill or handpiece is the most popular instrument to be used in sectioning procedure
nowadays, in comparison with the mallet and chisel, that were preferably selected
in past. The process presupposes continuous rinsing of the working area with water
to wash out the fragments created during the procedure and to lower the amount of
bone-traumatizing heat. Upon completion of the sectioning the surgeon teases indi-
vidual pieces out with the forceps and elevators. The area is carefully dressed.
2 Read the text and answer the following questions:
1. What aspects does a post-surgical care include?

2. What risks does the neglecting of post-surgical care pose to the patient's health?
3. What is the order the post-surgical care procedures come in?
POSTOPERATIVE CARE
Postoperative care is the management of a patient after surgery. This includes

medical services provided during the immediate postoperative period.
Patients who have procedures done in a day-surgery center usually require only a
few hours of care by health care professionals before they are discharged to go home.
If post-anesthesia or postoperative complications occur within these hours, the pa-
tient must be admitted to the hospital.
The goal of postoperative care is to prevent complications such as infection, to
promote healing of the surgical incision, and to return the patient to a state of health.
Some postoperative recommendations include: smoking cessation and use of a
straw. These actions are effective in order to avoid displacement of the blood clot.
Otherwise a condition of a dry socket can develop. This occurs when a blood clot
does not close the place of extraction or it leaves the wound prematurely. The con-
dition can be defined as one that creates an access of food particles and air to the
underlying bone. Additionally, it is usually accompanied by severe pain and unpleas-
ant odour. In case of dry sockets pain appears three days after surgery. Dry socket
is reported to accompany up to 30% of cases of impacted teeth removal and other
complicated extractions. Smoking and birth control pills intake increase the risk of
developing a dry socket. The treatment of a dry socket involves medicated dressing
to relieve the pain and promote the healing.
156
3 Read and translate the text. Explain why the items of information
are underlined.
POST-EXTRACTION PERIOD
The gum tissue usually heals in 3–4 weeks, whereas the bone can take up to 8
months to heal completely. Despite the fact that new bone formation begins as early
as one post-operative week, it may require 6 to 8 months the tooth's socket to fill in
and to become smooth over the shape of the bone.
All these processes vary from person to person, and depend on how easy or dif-
ficult the tooth removal was. Also the healing will be influenced by the initial size
of the wound. For example, the sockets of smaller diameter in single-rooted teeth
(such as lower incisors) may appear mostly healed over by the end of two weeks. The
same goes for baby teeth. Wider and deeper wounds left by comparatively larger teeth
(canines, premolars) or multi-rooted ones (molars) will require a greater amount of
time to heal over.
During the first week after the extraction, the blood clot that was originally formed
will be colonized and ultimately replaced by granulation tissue (a kind of primordial
highly-vascularized collagen-rich tissue). Then, as a next stage, mesenchymal cells
("adult" stem cells) will begin to organize within this granulation tissue. They will
ultimately differentiate into more specialized types of cells such as bone tissue. Since
the new tissues that form during this time frame are quite vascular (contain a large
number of blood vessels), they are likely to bleed easily in case of eating solid food.
The fact that it takes as long as 6 to 8 months for the bulk of the jawbone's heal-
ing process to take place, it doesn't mean that a patient has to wait that long until
the empty space can be filled in with a replacement tooth. With some types of res-
torations (dental bridges, partial dentures, some kinds of dental implants) there is
typically a healing 'wait' period (usually 1–3 months) that must be adhered to for
the best results. But even if this wait period is required, there should be some type
of temporary tooth or appliance that can be placed or worn until that point in time
when the jawbone's healing has advanced enough that a permanent replacement can
be made.
157
UNIT 13 PERIODONTAL DISEASES
LEAD IN
release [rI'lJs] виділяти, відпускати

worsen ['wE:sqn] погіршувати
immunosuppression [ImjVnqVsq'preSn] пригнічення імунітету
malnutrition [mxlnjV'trISn] недоїдання
pus [pAs] гній
breath [breT] дихання
sore [sL] виразка
misaligned [mIsq'laInd] зміщений
discourage [dIs'kArIG] перешкоджати
by-product ['baI"prPdAkt] побічний продукт
tissue graft ["tIsjH'grRft] пересадка тканини
outlook ['aVtlVk] перспектива, вигляд
scaling ['skeIlIN] видалення зубного каменю
root planing ["rHt'pleInIN] вирівнювання поверхні
кореня зуба
tartar ['tRtq] зубний камінь
pocket ['pPkIt] карман, кишеня
puberty ['pjHbqtI] статеве дозрівання
inflame [In'fleIm] запалювати
diabetes [daIq'bJtJz] діабет
2 Before you read the text, discuss the questions below.
• What causes periodontal diseases?

• What forms are periodontal diseases divided into?
• What are the most common signs of advanced periodontitis?
UNIT 13: PERIODONTAL DISEASES
3 Read the text.
PERIODONTAL DISEASES
Periodontal disease is a common, complex, inflammatory disease characterized

by the damage of tooth-supporting tissues of the periodontium including periodon-
tal ligament and alveolar bone.
Periodontal disease is caused by bacteria in dental plaque. In an effort to get rid of
the bacteria, the cells of immune system release substances that inflame and damage
the gums, periodontal ligament or alveolar bone. Some factors increase the risk of
developing gum disease. They are poor oral hygiene, smoking, genetics, pregnancy,
diabetes, chemotherapy drugs, steroids, oral contraceptives and stress.
Different classifications of periodontal diseases have been used over the years.
Traditionally, periodontal diseases have been divided into two major categories:
gingival diseases and periodontal diseases. The former includes diseases that at-
tack only the gingiva, whereas the latter includes diseases that involve the supporting
structures of the tooth.
One of the following forms of periodontal disease may be diagnosed depending
on a patient’s age and symptoms. Gingivitis is recognized as the mildest and the most
common form of periodontal disease, it is characterized by inflamed gum tissues.
Untreated gingivitis increases the risk of developing serious periodontal problems
in future. Gingivitis is reversible with professional treatment and good oral hygiene.
Diabetics, pregnant women, and steroid users face increased risks of developing gin-
givitis. Chronic Periodontal Disease is diagnosed when gingivitis develops into a
full-blown periodontal disease. The gum and bone tissues worsen at a steady pace,
and this is generally associated with people over the age of 40. This is the most fre-
quently occurring form of periodontitis and is characterized by pocket formation
and/or recession of gingiva. Progression of attachment loss usually occurs slowly. Ag-
gressive Periodontal Disease involves a rapid worsening of symptoms. Loss of bone
and tissue attachment is considerably faster, and this form of gum disease is associat-
ed with diabetics and smokers. Aggressive forms of disease usually affect young indi-
viduals at or after puberty and may be observed during the second or third decade of
life. Necrotizing Periodontal Disease involves tissue death and rapid destruction of
periodontal ligament and alveolar bone. It develops in people with existing medical
conditions such as chronic stress, HIV, immunosuppression and malnutrition.
All periodontal diseases have similar symptoms but they may vary depending
on the form of the condition. In gingivitis red and swollen gums, gums that easily
bleed while brushing and flossing, receding gum line, bad breath can be observed.
When gingivitis has advanced to the more serious condition known as periodontitis
the symptoms are pus between gums and teeth, sores in the mouth, swollen, bright
159
PART TWO
red gums, persistent bad breath, loose teeth, a change in the fit of partial dentures,
spaces developing between teeth causing periodontal pockets to form. The final stage
of gum disease is the most severe, and is characterized by actual loss in the bone and
loss of periodontal tissues that support teeth. This results in the shifting and loosen-
ing of teeth, and tooth extraction may become necessary to remove further infection.
Symptoms include chronic bad breath, swollen and bleeding gums, severe receding
gums, deep periodontal pockets, loose and misaligned teeth.
To determine the severity of periodontitis a dentist may review a medical history,
examine the mouth, measure the pocket depth (periodontitis may be suspected if
pockets are deeper than 4 mm), take dental X-rays to check for bone loss in regions
where deeper pocket depths are detected.
Treatment may be performed by a periodontist, a dental hygienist or a dentist.
The goal of periodontitis treatment is to clean the pockets around teeth and prevent
damage to surrounding bone. If periodontitis isn’t severe, treatment may include less
invasive procedures including scaling, root planing, antibiotics.
• Scaling removes tartar and bacteria from the tooth surfaces and beneath the
gums.
• Root planing smoothes the root surfaces discouraging further build-up of tar-
tar and bacteria, and removes bacterial by-products.
• Topical or oral antibiotics are prescribed to control bacterial infection.
In advanced periodontitis treatment may require dental surgery such as flap sur-
gery (pocket reduction surgery), soft tissue grafts, bone grafting, tissue-stimulat-
ing proteins.
More than one in three people over the age of thirty have a form of periodontal dis-
eases that has advanced beyond gingivitis. The outlook is good if periodontal disease
is recognized early and treated aggressively. Quitting smoking is very important for
periodontal therapy to be successful. Lifelong maintenance will be required once the
disease is controlled. Daily brushing and flossing (morning and night) and regular vis-
its for professional cleaning can help prevent periodontitis or treat it at an early stage.
Match the English words combinations with the Ukrainian ones and make
4
sentences of your own.
1. запалювати та пошкоджувати ясна a) supporting structures of the teeth

2. позбавлятися бактерій b) soft tissue grafting
3. підтримуючі структури зуба c) change in the fit of dentures
160
4. втрата кріплення кістки та d) to result in shifting and loosening

тканини of teeth
5. видалити зубний камінь з поверхні e) loss of bone and tissue attachment
зуба
6. пересадка м’яких тканин f) to get rid of the bacteria
7. зміна положення зубного протезу g) to remove tartar from the tooth
surface
8. призводити до зміщення та h) to inflame and damage the gums
розхитування зубів
5 Complete the following sentences according to the text.
1. Traditionally, periodontal diseases have been divided into two major catego-
ries __________.
2. The factors increasing the risk of developing gum diseases are ____________.
3. Gingivitis is recognized as ___________.
4. Chronic periodontal disease is diagnosed when gingivitis ____________.
5. Aggressive forms of disease usually affect ____________.
6. The final stage of gum disease is the most severe, and is characterized by
___________.
7. The goal of periodontitis treatment is ____________.
8. To determine the severity of periodontitis a dentist may ___________.
9. If periodontitis isn’t severe, treatment may include___________.
10. Topical or oral antibiotics are prescribed to __________.
6 Fill in the gaps with the correct words or phrases from the list below.
pockets plaque periodontal diseases children

reversible flossing bleeding range
1. The build-up of________below the gumline causes the gums to become in-
flamed.
2. When the disease progresses, the _______deepen leading to gum tissue and
bone destruction.
3. Chronic periodontitis predominantly affects adults, but aggressive periodonti-
tis may occasionally occur in________.
4. In the earliest stage of________, gingivitis, the infection affects only the gums.
161
PART TWO
5. Daily brushing and_________, when done correctly, can help to remove most
of the plaque from your teeth.
6. Gingivitis is _________with professional treatment and good oral home care.
7. Treatment options ________from nonsurgical therapies to control the growth
of bacteria to surgery to restore supportive tissues.
8. The symptoms of gum disease include ________and swollen gums, persistent
bad breath, receding gums, formation of deep pockets between teeth and gums.
7 Match the terms with the definitions.
1. Gingival recession a) is a pathologically deepened gingival sulcus.

2. Pocket b) is the exposure in the roots of the teeth caused by a
loss of gum tissue.
3. Scaling c) is the specialized tissues that both surround and sup-
port the teeth, maintaining them in the maxillary and
mandibular bones.
4. Periodontium d) is a type of dental cleaning that reaches below the
gumline to remove plaque build-up.
5. Pus e) is the leading method for treating and repairing peri-

odontal pockets if they can’t be removed by cleaning
and scaling.
6. Flap surgery f) is used to replace lost bone tissue and encourage
natural bone growth, to create a stable base for dental
implant placement.
7. Bone grafting g) is an exudate, formed at the site of inflammation
during bacterial or fungal infection.
Fill in the table and discuss the differences between all forms
8
of periodontal diseases.
Symptoms Treatment
Gingivitis
Chronic periodontal disease
Aggressive periodontal disease
Necrotizing periodontal disease
162
9 Read the case history and make the correct diagnosis.
1. Nina is a 28-year-old female. She reports swollen gingivae that are tender and
bleed easily while brushing. She does not smoke and has no history of peri-
odontal disease. She has started taking an oral contraceptive recently.
2. A 48-year-old male patient, diagnosed with type 2 diabetes was undergoing
drug treatment with metaformin. The patient came into the dental clinic be-
cause of gingival inflammation with bleeding and suppuration, mobility and
pain of one tooth.
3. A 15-year-old male patient came to the department of periodontology. Both
the attached and marginal gingivae were red and acutely inflamed. Pus was
concentrated around many teeth. In spite of this the patient had no carious
lesions and no restorations. The radiographs revealed almost total loss of the
alveolar bone. The pocket depth was about 6-7 mm.
4. A 27-year-old male patient was admitted to hospital with a chief complaint of
severe pain and bleeding in the gums along with difficulty in eating. There was
a history of gums swelling for three months, tobacco use and intense stress
were contributing factors. Extraorally the patient presented enlarged lymph
nodes and slight fever. On intraoral examination poor oral hygiene was no-
ticed with gross accumulation of dental plaque. Examination of the gingivae
revealed necrosis of the papillae.
Keys: chronic periodontal disease, gingivitis, aggressive periodontal disease,

necrotizing periodontal disease.
Identify the progression of gum diseases arranging the stages in the right
10
order.
a. The infection under the gums begins to dissolve healthy jawbone,

creating pockets around the teeth. The depth of pockets is about
1-4 mm.
b. Gums get inflamed, loosening their attachment to the tooth and
exposing previously covered enamel.
c. Gums become irritated by the toxins produced by the bacteria of
dental plaque and tartar that have accumulated on teeth and gums
as a result of poor oral hygiene.
d. Greater inflammation and swelling of the gums are observed. Gums
begin to separate from teeth below the cemento-enamel junction,
gums bleed when probing or brushing.
163
PART TWO
e. Teeth become so mobile and the bone loss so severe that in many
cases they can’t be saved and have to be extracted.
f. Gums are pink and the gum line firmly attaches all the teeth.
g. Bacteria that were allowed to grow, spread and cause damage have
destroyed the connective tissues that support the teeth.
11 Replace the underlined words with the synonyms from the box.
1. Chronic periodontitis may be a result of chronic gingivitis, usually because of

accumulation of plaque and calculus.
2. The gingiva detaches from the tooth, the periodontal membrane and alveolar
bone are damaged, and an abnormal gap develops between the tooth and gum.
3. The severity of periodontal disease refers to the amount of periodontal liga-
ment fibers that have been lost, termed clinical attachment loss.
4. The most common viral infections causing gingival lesions are herpes simplex
virus type 1 and 2, and varicella-zoster virus.
5. The invention of microscope allowed later studies performed in the 19th centu-
ry to report the histological structures and features of periodontal lesions.
6. Bacterial plaque, a sticky, colourless membrane that develops over the surface
of teeth, is the most common cause of periodontal disease.
7. Chronic periodontitis is associated with prolonged inflammation, which has
negative effects on the entire body and health.
8. Hormonal changes occurring during pregnancy, menopause and puberty
make gums more sensitive, which makes it easier for gingivitis to develop.
Say whether the following statements are true or false.

12
Comment on your answer.
1. Periodontal disease is an inflammation of the dental pulp resulting from trau-

ma, multiple restorations or untreated caries.
2. Poor oral hygiene, smoking, genetics, pregnancy, diabetes, medications, in-
cluding steroids contribute greatly to the development of periodontal diseases.
3. Untreated gingivitis decreases the risk of developing serious periodontal prob-
lems in the future.
4. Aggressive form of periodontal diseases is generally associated with people
over the age of 40.
5. The final stage of gum disease is the most severe and is characterized by actual
loss in the bone and loss of periodontal tissues that support your teeth.
164
6. Chronic periodontal disease develops in people with existing medical condi-

tions such as chronic stress, HIV, immunosuppression and malnutrition.
7. The goal of periodontitis treatment is to clean the pockets around teeth and
prevent damage to surrounding bone.
8. Root planing smoothes the root surfaces discouraging further build-up of tar-
tar and bacteria, and removes bacterial by-products.
9. To detect the severity of periodontitis the dentist should measure the pocket
depth and take dental X-rays to check for bone loss in regions where there are
deeper pocket depths.
10. Treatment of gum diseases may be performed by a periodontist, an endodon-
tist or a dentist.
• Causes and signs of periodontal diseases

• Different forms of gum diseases
• Symptoms severity of all forms of periodontal diseases
• Diagnostic review
• Treatment of mild periodontitis
• Treatment of progressive periodontal diseases
• Important factors influencing the outcome of periodontitis treatment
1. What is periodontal disease characterized by?

2. What factors increase the risk of developing gum diseases?
3. What forms of periodontal diseases may be diagnosed? What is the difference
between them?
4. What symptoms are observed in gum diseases? What does the severity of them
depend on?
5. How should a periodontist determine the stage of periodontitis?
6. What is the primary goal of gum diseases treatment?
7. What procedures are performed if periodontitis isn’t severe?
8. How can a dental specialist manage with advanced periodontitis?
9. What is the outlook for patients suffering from periodontal diseases?
165
PART TWO
GRAMMAR
CONDITIONAL SENTENCES
(TYPE 0 AND I)
Conditional Sentences are also known as

Conditional Clauses or If Clauses.
They are used to express that the action in the main clause
(without if) can only take place if
a certain condition (in the clause with if) is fulfilled.
There are four types of Conditional Sentences (type 0, I, II).
1 Study the table. Pay attention to:
• the differences in the usage of type 0 Conditional and type I Conditional;

• grammar tenses used in if-clause and main-clause;
• translation of the sentences.
Type It is used to talk

If clause Main clause
of Conditional about:
REAL or possible If gum tissues gingivitis is often
situations; scientific are inflamed, diagnosed.
facts; statements that
refer to general truths. Present Simple Present Simple
REAL situations in If I have a broken I will go to the
which the outcome is tooth, dentist as soon as
likely (but not guaran- possible.
teed) to happen in the
future. Present Simple Future Simple
Match the parts of the sentences. Pay attention which clause
2
(if clause / main clause) goes first.
1. If gingivitis is advanced, a) if periodontal tissues are severely affected.

2. If you take steroids or oral b) if the dentist observes deeper pockets depths
contraceptives, in oral examination.
166
3. You may need dental X-rays c) bone grafting will be performed.
4. If periodontitis destroys the d) the risks of gum diseases developing will

bone surrounding the tooth, increase.
5. Dental treatment will require e) if you don’t neglect regular dental visits.
tissue-stimulating proteins
6. You won’t have peridontitis f) periodontal pockets are formed.
Fill in the gaps with correct forms of the verbs in brackets to make sentences
3
of type 0 Conditional and type I Conditional.
1. If the patient __________(to complain of) severe pain and bleeding in the
gums, the dentist _________(to suspect) some form of periodontal disease.
2. You ______(not to have) periodontal diseases if you _______(to avoid) the
factors increasing the risks of their developing.
3. You ________(to suffer from) persistent bad breath if gingivitis _________(to
develop).
4. If gingivitis _________(to progress), chronic periodontitis resulting in tooth
loss _________(to be diagnosed).
5. You _________(to take) X-rays if the dentist ________(to detect) progressive
tooth damage.
Look at the following prompts and make Conditional sentences
4
of types 0 and I.
e.g. If you are over the age of 40, you are more likely to develop chronic
periodontitis.
1. You / over the age of 40 / more likely / develop / chronic periodontitis.

2. Examination / reveal / receding gums / you / need / urgent treatment.
3. The risks / aggressive periodontitis / increase / a person / a smoker.
4. You / need / flap surgery / mild gingivitis / develop.
5. You / take / oral contraceptives / the risks / having gum diseases / higher.
5 Complete the sentences.
1. The dentist will use a dental probe if_____________.

2. Oral antibiotics in periodontitis are prescribed if ____________.
167
PART TWO
3. If you neglect the rules of oral hygiene, __________.

4. Aggressive periodontitis is more likely to develop in adolescence if ________.
5. The plaque and tartar build-up will be removed and controlled if _________.
6. Dental surgery is recommended if___________.
7. If gingivitis is diagnosed early, ___________.
TALKING POINTS
1 Talk about periodontal diseases using the following information:
– Definition
– Symptoms
– Types
– Examination
– Treatment
– Outlook
Explain the patient suffering from chronic periodontal disease the necessity
2
to treat this pathology as soon as possible using such phrases as:
The first thing that needs to be said is ... .

It is necessary to stress that… .
I am afraid that… .
I should warn you that… .
I am deeply convinced that… .
One cannot deny that … .
Furthermore, you should not forget that … .
It goes without saying that you… .
MORE READING
1. What common etiologic agents are removed by periodontal therapy?

2. What are the indications for scaling and root planing?
3. What do scaling and root planing procedures involve?
168
PERIODONTAL SCALING AND ROOT PLANING
The goal of scaling and root planning is to remove etiologic agents which cause
inflammation to the gum tissue and surrounding bone. The etiologic agents removed
by this conventional periodontal therapy involve dental plaque and tartar (calculus).
These non-surgical procedures which completely cleanse the periodontium, work
very efficiently for people suffering from gingivitis (mild gum inflammation) and
moderate/severe periodontal disease. Scaling and root planning can be applied both
as a preventative measure and as a stand-alone treatment. These procedures are used
as a preventive measure for a patient suffering from periodontitis. Here are some rea-
sons why these dental procedures may be indicated: disease prevention, tooth protec-
tion, aesthetic effects, and better breath. Scaling and root planing treatments are only
accomplished after a thorough examination of the oral cavity. The dentist should take
X-rays, conduct visual examinations and make a diagnosis before recommending or
beginning these procedures. Local anesthetic may be used depending on the current
condition of the gums, the amount of calculus present, the depth of the pockets and
the severity of the periodontitis.
Scaling is the procedure which is usually performed with specific dental instru-
ments and may include an ultrasonic scaling tool. The scaling tool removes calculus
and plaque from the crown and root surfaces. In many cases, the scaling tool involves
an irrigation process that can also be used to deliver an antimicrobial agent below the
gums that can help decrease oral bacteria.
Root Planing is a specific treatment which is used to remove cementum and sur-
face dentin that is embedded with unwanted microorganisms, tartar and toxins. The
root of the tooth is literally smoothed to accelerate the healing process. Having clean,
smooth root surfaces helps bacteria and microorganisms from easily colonizing in
future. Following these deep cleaning procedures, the gingival pockets may be treat-
ed with antibiotics. This will mitigate irritation and help the gum tissues to heal
quickly. During the next appointment, the dentist will thoroughly examine the gums
again to see how well the pockets have healed. If the gum pockets are still deeper
than 3mm, additional and more intensive treatments may be prescribed.
1. What are the links between systemic health and periodontal diseases?
2. What is the role of periodontitis in the pathogenesis of some systemic diseases?
3. How may periodontal problems influence pregnancy outcome?
169
PART TWO
PERIODONTAL DISEASE RELATING TO SYSTEMIC CONDITIONS
For many years physicians and dentists have paid much attention to their own
respective fields, specializing in medicine pertaining to the body and the oral cavity,
respectively. Historically, diseases of the oral cavity have been viewed separately from
those of the rest of the body. In recent years, however, efforts have been made to
recognize oral health as an integral part of overall health. For example, the number
of teeth is a significant and independent risk indicator for early mortality and poorer
general health status.
Recent discoveries have strongly suggested that oral health may be indicative of
systemic health. Nowadays the gap between allopathic medicine and dental medicine
is quickly closing, due to considerable findings supporting the association between
periodontal disease and systemic conditions such as cardiovascular disease, type 2
diabetes mellitus, osteoporosis and adverse pregnancy outcomes. Significant effort
has brought many advances in detecting the etiological and pathological links be-
tween this inflammatory dental condition and other conditions. Therefore, patients
diagnosed with periodontal disease can be at higher risk due to a compromised im-
mune system. Infectious and opportunistic microbes which are responsible for peri-
odontal infection may bring a burden onto the rest of the body. Furthermore, these
microorganisms can release products eliciting an inflammatory response. Periodon-
tal lesions are continually renewing reservoirs for the systemic spread of bacterial
antigens, Gram-negative bacteria and other proinflammatory mediators.
In addition, decayed teeth are particularly harmful for children's growth and de-
velopment, and can severely compromise their health. The link between childhood
oral diseases and obesity has been demonstrated by their increasing prevalence and
the significant adverse effect on the child's present and future oral and systemic
health. Studies have shown that there is a significant association between preterm
birth and/or low birth weight and periodontitis, irrespective of race and maternal
age. It has also been stated that periodontitis appears to be an independent risk factor
for poor pregnancy outcome and preliminary evidence suggests that periodontal in-
tervention may reduce this adverse pregnancy outcome. Recently, it was discovered
that pregnant women with periodontal disease are more likely to develop gestational
diabetes mellitus than pregnant women with healthy gums. Asthma and epilepsy are
also being associated with higher caries experience. Therefore, there is a reason to
hope that the strong evidence from these investigations may guide scientists towards
greatly improved treatment of periodontal infection that would also ameliorate these
systemic diseases.
Hence, researchers must continue not only to disclose more information about
the periodontal and systemic diseases correlations but also to focus on positive as-
sociations resulting from periodontal disease treatment as a means of ameliorating
systemic diseases.
170
Read the text about aggressive form of periodontitis and answer the
2
following questions.
1. What three primary characteristics does the aggressive periodontitis possess?

What categories is it divided into?
2. What individuals does aggressive periodontitis mostly affect?
3. What is juvenile periodontitis characterized by?
4. What does the management of aggressive periodontitis include?
AGGRESSIVE PERIODONTITIS
Aggressive periodontitis is used as a general term to describe a heterogeneous

group of periodontal diseases occurring in younger individuals who may or may
not be otherwise healthy. Aggressive periodontitis was defined by the International
Workshop for the Classification of Periodontal Diseases according to three primary
characteristics: absence of systemic conditions that might contribute to periodontal
disease, rapid loss of clinical attachment and alveolar bone and family predisposition.
Overwhelming evidence suggests that genetic factors play a role in host susceptibil-
ity to periodontal diseases. A number of systemic conditions such as diabetes and
cardiovascular disease have been implicated in the development of periodontitis in
susceptible patients. It is thought that the most significant effect of these systemic
conditions is alteration of the host immune response. Aggressive periodontitis can
be viewed as two categories of periodontitis that may have overlapping etiologies and
clinical presentations: (1) a localized form (localized aggressive periodontitis [LAP])
and (2) a generalized form (generalized aggressive periodontitis [GAP]).
Aggressive periodontitis of the primary dentition can develop in a localized form
but is usually seen in the generalized form. LAP is localized attachment loss and alve-
olar bone loss only in the primary dentition in an otherwise healthy child. The exact
time of onset is unknown, but it usually arises around or before 4 years of age, when
the bone loss is usually seen on radiographs around the primary molars and incisors.
Abnormal probing depths with minor inflammation of the gums, rapid bone loss
have been demonstrated at the affected sites of the child’s dentition. Abnormalities
in host defenses (e.g., leukocyte chemotaxis), extensive proximal caries facilitating
plaque accumulation and bone loss, and a family history of periodontal diseases have
been associated with LAP in children. As the disease progresses the periodontium of
a child shows signs of gingival inflammation with ulceration of the gingival margin.
Aggressive localized periodontitis, also known as juvenile periodontitis, primarily
affects the first molars and incisors. Black male teenagers exhibit the highest predis-
position to this disease. The genetic links associated with aggressive periodontitis are
much stronger than with chronic periodontital disease. It is important to know the
171
PART TWO
family history of periodontal disease, particularly early loss of teeth, as this may be
significant in making the periodontal diagnosis.
Historically, patients with aggressive periodontitis have experienced poor out-
comes, and radical treatments were often implemented. More recently, however, the
effectiveness of surgical and nonsurgical periodontal therapy has been demonstrated.
The goal of the first step in periodontal therapy is to decrease or eliminate signifi-
cantly the microbial load, as well as factors that contribute to periodontal disease.
Typical systemic antibiotic regimens have included amoxicillin and metronidazole,
although other classes of antibiotics are also proving to be effective. The second step
of periodontal therapy involves surgical procedures with the intention of improv-
ing the prognosis of teeth (or their replacements) and enhancing esthetics. This is
accomplished via a number of surgical options, including resective procedures and
regenerative flaps with grafts.
172
UNIT 14 DENTAL PROSTHETICS
LEAD IN
suitable ['sjHtqbl] відповідний, придатний

substitute ['sAbstItjHt] заміняти; заміна, замісник
strengthen ['streNTqn] посилювати, зміцнювати
frail [freIl] крихкий
self-esteem ["selfq'stJm] самооцінка
stiff [stIf] жорсткий
removable [rI'mHvqbl] знімний
veneer [vI'nIq] вінір, облицювання зуба
fixed [fIkst] незнімний, закріплений
maintain [meIn'teIn] підтримувати, утримувати
gap [gxp] прогалина
intact [In'txkt] неушкоджений, цілий
anchor ['xNkq] закріпляти
dentifrice ['dentIfrIs] зубний порошок, зубна паста
harsh [hRS] жорсткий
sodium fluoride ["sqVdIqm'flVqraId] фторид натрію
impact ['Impxkt] вплив; мати вплив на,
позначитися на
PART TWO
consequence ['kPnsIkw(q)ns] наслідок, результат

alloy ['xlOI] сплав
titanium [tAI'teInIqm] титановий сплав
2 Talk about the following questions before reading the text.
• Why should lost teeth be restored?

• What techniques to replace lost teeth are there in modern dentistry?
3 Read the text paying attention to the words and phrases in bold.
DENTAL PROSTHETICS
Prosthodontics or dental prosthetics is an area of dental specialty focused on

the restoration and replacement of teeth using suitable substitutes such as crowns,
bridges, veneers and dental implants. The primary goal of it is to restore chewing
function and aesthetic look. Usually dental prosthesis is required when tooth crown
is affected by caries, teeth are sealed with large sealants or when teeth are worn or
they are lost. Dental prosthetics comprises restoration of lost teeth, restoration of
chipped or broken teeth, strengthening of weak, frail or dead teeth, and improvement
of the aesthetic tooth appearance.
Losing teeth can cause more than health problems. It directly affects self-esteem
as tooth loss has destructive impact on a person’s smile and the way the face looks.
The other consequences of tooth loss are speech problems, avoiding certain foods
because of chewing problems, stiff jaws and problems with relaxation, weakening of
other teeth. There are many options to prevent all those problems and to replace lost
teeth. In this case a prosthodontist is a specialist one has to deal with.
Teeth can be restored by using two types of dental prosthetic appliances: remov-
able and fixed. A dental prosthetic appliance is an intraoral prosthesis used to restore
the defects in oral cavity such as missing teeth, missing parts of teeth, and missing
soft or hard structures of the jaw and palate. Removable prosthodontics includes re-
placing missing teeth and tissue with appliances that the patients themselves can take
in and out of their mouth, such as complete dentures (which replace an entire arch of
missing teeth) and partial dentures (which replace one or more missing teeth). Fixed
prosthodontics includes replacing missing and/or broken teeth and tissue with res-
torations that the patient cannot take in and out, such as veneers, crowns, bridges and
implants, inlays and onlays.
Certain factors usually determine the choice of treatment between removable and
fixed dental prosthesis. They include a number of missing teeth, patient preference,
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UNIT 14: DENTAL PROSTHETICS
soft tissue and bone support, costs. Removable prosthesis is given as an option when
all teeth are lost in the lower or upper jaw. The area where the teeth are placed in or-
der to function properly is an important determiner of whether one will have fixed or
removable dental implants. Removable teeth are easy not only to maintain but also to
clean. Removable teeth are mainly acrylic in nature without a base, permanent teeth
have bridges or crowns and are made using a combination of gold and porcelain.
Partial and complete dentures are removable and replace several (partial) or all
(complete) missing teeth. Since they are not fixed, they are not so comfortable as
implants or bridges, and do not help to chew foods as effectively.
Veneers may be a good choice when tooth colour is undesirable and bleaching
doesn’t help. The most natural-looking and durable veneers are made from porcelain,
but composite materials are more economical. They can be applied in cases where the
aim is to improve the appearance of teeth rather than to repair damage from decay.
Crown (also known as a cap) is a tooth-shaped cover that goes on top of the ex-
isting tooth. When there is little of tooth structure remaining or most of the tooth
consists of filling material, then making a crown is indicated.
Bridge is a structure that replaces missing tooth and is fixed on the neighbouring
teeth. Bridge is indicated when teeth surrounding the gap are destroyed and need
crowns. When neighbouring teeth are intact or have small defects, then it is better to
replace a missing tooth with an implant.
An implant is an artificial root that is anchored to the bone and covered with a
crown. It feels like a real tooth and does not require other teeth for support. Implants
are made of titanium and other materials that are well accepted by the body. Dental
implants are considered to be the best and most comfortable tooth replacement solu-
tion. They are also the most expensive.
Inlays and onlays (fillings made in dental lab) can be made from gold alloy or
porcelain fitted to a cavity in a tooth and cemented into it. An inlay is used when a
damaged area is confined to the space within the cusps of a tooth, while an onlay is
designed to cover the cusps and the sides of the tooth.
To protect dental appliances everyone has to be aware of the following key points
on choosing safe home-care products. Toothpaste or gel needs to be low abrasive.
Dentifrice with stannous fluoride, sodium fluoride, baking soda and smoker's tooth-
paste must be avoided. Bleaching and whitening products are particularly harsh and
forbidden completely. The implant can accumulate plaque too, so it is necessary to
take good care of dental prosthesis following the rules of oral hygiene.
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PART TWO
Fill in the correct words from the list below.

4
Make up sentences of your own using these word combinations.
tissue denture filling bleaching

to restore appliance to accumulate fixed
1) _____________ dental prosthesis

2) soft ________ support
3) partial ___________
4) ___________ material
5) ___________ toothpaste
6) ____________ plaque
7) removable dental __________
8) _________ chewing function
5 Choose the appropriate word or word combination.
1. Dental prosthesis is required when tooth crown is affected/influenced by car-

ies, teeth are filled with large sealants or when teeth are worn or they are lost.
2. A dental prosthetic appliance is an intraoral technique/prosthesis used to re-
store the defects in oral cavity such as missing teeth, missing parts of teeth, and
missing soft or hard structures of the jaw and palate.
3. Complete/partial dentures replace an entire arch of missing teeth.
4. Permanent teeth have bridges or crowns and are made using a combination of
silver/gold and porcelain.
5. Veneers are made from porcelain and they are used mainly for the front teeth/
molars.
6. When there is little of tooth structure remaining or most of the tooth consists
of filling material, then making a crown/ bridge is indicated.
7. An inlay/onlay is used when the damaged area is confined to the space within
the cusps of a tooth.
8. Bleaching and whitening products are particularly harsh/gentle on dental
prostheses.
176
6 Match the term with the definition.
1. Prosthodontics a) is a removable prosthesis that replaces all teeth within an

arch.
2. Complete b) is a thin shell of medical-grade ceramic that is attached to
denture the front surfaces of teeth for an immediate smile trans-
formation.
3. Dental veneer c) is an area of dental specialty focused on the restoration
and replacement of teeth.
4. Prosthetic d) is a fixed dental restoration used to replace missing teeth
appliance by joining an artificial tooth to adjacent teeth or dental
implants.
5. Bridge e) is used to restore intraoral defects such as missing teeth,
missing parts of teeth, and missing soft or hard structures
of the jaw and palate.
6. Crown f) is an artificial tooth root that is placed
into your jaw to hold a replacement tooth or bridge.
7. Implant g) is an artificial restoration that fits over the remaining part
of a prepared tooth, giving it the shape of a natural tooth.
7 Complete the text choosing the appropriate prepositions.
TYPES OF DENTURES
Dentists can fit you with full or partial dentures, depending on whether one is
missing all or just a few of/from your teeth. Complete dentures are for those patients
who have lost all of their natural teeth in/for the upper or lower jaw, or both. Partial
dentures are for those who have lost some teeth, but don't want to get dental im-
plants or bridges. Removable partial dentures are held in place by/of natural teeth,
gums, and a connective structure made of/from plastic and metal. Conventional den-
tures are those that are placed once the bones and gums have healed after/before
the removal of natural teeth. Immediate dentures are placed as soon as the natural
teeth are removed. With immediate dentures, the patient need not face the world
without/with teeth, can eat normally much sooner than with conventional dentures,
and does not have the speech problems associated from/with the normal denture
process. However, since healing of the gums and jaw will change the fit of immediate
177
PART TWO
dentures, the patient will typically need a new set in/for about six months. Natural
looking cosmetic dentures are made with modern ceramic porcelain teeth. They have
a more natural looking support structure and are truly difficult to distinguish from/
for real teeth.
8 Replace the underlined words with the synonyms from the box.
repair neighbouring dentures requirements

substituting supplementary suffer improvements
1. Bridges on natural teeth have become increasingly rare as they need an inva-
sive preparation of the adjacent teeth and, in the case of problems, are difficult
to repair.
2. Old restorations that don't meet the functional and aesthetic demands must be
replaced.
3. If you’ve had any bone loss, a dental procedure known as bone grafting may be
performed to regenerate the lost bone.
4. Crucial factors to a good long-life performance of dental prostheses are strength,
intraoral ageing resistance and fatigue resistance.
5. Fixed prosthodontics involves replacing the damaged or missing teeth with
crowns and bridges which are cemented into a patient’s mouth.
6. Developments in the field of implantology have increased the options available
for the partially edentulous patient but have also made treatment planning
more complex.
7. Many people who wear a partial denture eventually experience loosening of
other natural teeth remaining in the mouth.
8. Sometimes patients who need dentures also need additional surgery because
of extra bone growth.
9 Define the indications for three types of dental restoration.
crown bridge implants
1. A badly broken or decayed tooth needs to be strengthened because this cannot

be done with a filling alone.
2. Both of the central incisors have suffered irreparable damage as a result of
trauma. The patient has high aesthetic and functional demands.
3. One or more teeth are missing from the dental arch.
178
4. When all teeth are missing, the only traditional solution available is a full re-
movable denture.
5. The root-filled teeth must be covered and protected.
6. The patient has one lost incisor and is interested in the most cost-effective,
long-term solution with the best aesthetic result.
7. Back teeth are missing and the patient cannot afford expensive restorations.
Your patient has asked implants to improve an aesthetic look of teeth.
10 Answer the patient’s questions and explain the key aspects the patient is
interested in. Compile the dialogues.
• Can I have implants?

• What are the advantages of implants?
• Are there any risks of this procedure?
• How long does the whole procedure last?
• What will you do exactly?
• Does the body ever reject an implant?
• How long will dental implants last?
• Is dental implant surgery painful?
• What drugs should be taken after the procedure?
• How long will it take for my mouth to heal?
• How should I take care of my implants?
• How much does the whole procedure cost?
• Prosthodontist as a specialist
• Types of dental prosthetic appliances
• Factors influencing the option of treatment
• Partial and complete dentures
• Fixed prosthodontics
• Dental appliances maintenance and care
12 Agree or disagree with the statements. Comment on your answer.
1. Dental implants are considered to be the most expensive and most comfort-
able tooth replacement solution.
2. Partial and complete dentures are removable but replace only one missing
tooth.
3. A number of missing teeth, patient preference, soft tissue and bone support,
ability to clean and maintain, costs determine the choice of treatment between
removable and fixed dental prosthesis.
179
PART TWO
4. Veneers are a good choice but they can’t restore the desirable tooth colour and
bleaching may be needed.
5. An inlay is used when the damaged area is confined to the space within the
sides of a tooth, while an onlay is designed to cover the cusps of it.
6. Whitening products are particularly harsh on dental prostheses, so they are
forbidden completely.
7. Complete dentures replace missing teeth with appliances that the patients
themselves cannot take in and out of their mouth without professional help.
8. Losing your teeth can cause such health problems as speech disturbance, chew-
ing problems, stiff jaws and problems with relaxation, weakening of other teeth.
1. What is prosthodontics? What does it comprise?

2. What can tooth loss result in?
3. What is a dental prosthetic appliance?
4. What is the difference between removable and fixed prosthesis?
5. What factors determine the choice of proper dental prosthetic appliance?
6. When are complete or partial dentures indicated?
7. What is the difference between a crown and a bridge?
8. Why are implants considered to be the best tooth replacement solution?
9. What are onlays and inlays used for?
10. What are the key points of dental prostheses protection and care?
GRAMMAR
CONDITIONAL SENTENCES
(TYPE II)
1 Study the table. Pay attention to:

• grammar tenses used in if-clause and main-clause;
• translation of the sentences.
Type It is used to talk

If clause Main clause
of Conditional about:
II dream situations or If I had veneers, my smile would be
situations which are shining.
often unreal Past Simple Future-in-the-Past
(were)
180
Match the parts of the sentences. Pay attention which clause

2
(if clause / main clause) goes first.
1. If I were younger, a) if I bought low abrasive dentifrice.

2. If I had a fractured tooth, b) dental crown would be placed to restore it.
3. My denture would serve c) I wouldn’t suffer from so many dental
longer problems.
4. If the implants didn’t d) it would be easier to take care of them.
accumulate plaque,
5. If I lost my tooth, e) if I didn’t know their harmful effect on
dental prostheses.
6. I would have to deal with a f) if I needed to replace my lost tooth.
prosthodontist
7. I wouldn’t mind to use bleach- g) I would choose this method of dental
ing products restoration.
8. If dental implants suited my h) I would need a partial denture.
budget,
3 Fill in the gaps with correct forms of the verb.
1. I _______speech problems (to suffer from), if I _______most teeth (to lose).

2. If I ______a dental appliance (to have), I ______ specific rules of oral hygiene
(to follow).
3. If my tooth_______ severely affected with caries (to be), I ______ dental res-
toration (to need).
4. If implants _____ cheaper (to cost), I ______ this option of dental restorative
techniques (to choose).
5. If my teeth______(to be worn out), dental prosthesis ______(to be inserted).
6. If I ______ to be a prosthodontist (to want), I ______ this profession for sure
(to master).
7. If the patient _______ dental problems (to face), professional treatment
________(to be recommended).
8. If you _______ the complexity of dental restorative procedures (to realize),
you _______ natural teeth (to take care of).
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PART TWO
4 Complete the sentences with your own ideas using the correct tenses.
1. If I were a prosthodontist, I _________.

2. You would have implants restoration if you_________.
3. He wouldn’t lose his teeth if he ____________.
4. If I wanted to improve an aesthetic look of my teeth, I ________________.
5. Modern dentistry wouldn’t be so advanced if modern technologies_______.
6. If I had a fractured tooth, I__________________.
7. He would prefer a complete denture if he ______________________.
8. If I chose dental specialty, I ____________.
Choose the appropriate form of the verb. Types 0, I, II of

5
Conditional sentences are used.
1. If you _______ (to follow) the routine of oral hygiene, you will have no dental
problems.
2. If I ________ (to be) you, I would pay attention to the results of new clinical
trials.
3. If he didn’t follow the doctor’s recommendations, he _______ (to need) a
crown restoration.
4. A soft toothbrush is used if you _______ (not to want) to damage the implant
and surrounding tissue.
5. If dental porcelain were a strong material, it _______ (to be used) to restore
severely damaged teeth.
6. If implants _______ (to cost) less, I would afford this restorative treatment.
7. If your teeth _______ (to be) worn or broken, dental specialist is required to
deal with.
TALKING POINTS
Make a list of arguments for and against implant restoration.
1
Arrange a brief discussion on this topic touching on the following aspects:
– indications
– side effects
– aesthetic look
– cost
– durability
182
MORE READING
1. Why do porcelain veneers rank among the most popular procedures in cos-
metic dentistry?
2. What was the history of veneer restoration in dentistry?
3. What are indications and contraindications for porcelain veneer restoration?
PORCELAIN VENEERS
Porcelain veneers are thin shells of medical-grade ceramic that are attached to
the front surfaces of teeth to get an immediate smile transformation. These cosmetic
dental enhancements are made from advanced material that closely resembles the
appearance of natural enamel and individually crafted for each person. Porcelain ve-
neers are considered to be one of the most trusted and popular procedures in cos-
metic dentistry.
Although veneers have become especially popular in the past decades, they origi-
nated during the early days of the film industry nearly one hundred years ago. In the
late 1920s, Dr. Charles Pincus, a famous Hollywood dentist, conceived of veneers as
a way to improve actors' and actresses' smiles on the screen. He would temporarily
use false fronts to the stars' teeth, giving them the stunning smiles that rapidly be-
came a trademark of Hollywood beauty. However, he lacked the technological skills
to permanently affix the porcelain. In the late 1960s, Dr. Michael Bunocore created a
stronger bonding surface for dental sealants and restorations. In 1982, J.R. Calamia
and R.J. Simonsen used Dr. Bunocore's techniques to the application of porcelain
veneers. Suddenly, everyone who wished to have the stunning Hollywood smiles had
access to it. Modern types of porcelain veneers are more sophisticated, stronger and
reflect light similarly to natural dental enamel.
People who are considering porcelain veneers are typically looking to address nu-
merous structural or cosmetic problems with their teeth such as gaps between teeth,
minor misalignment, cracks and discoloration. In order to have porcelain veneers pa-
tients should have good periodontal and overall oral health, have enough amount of
healthy enamel, as dentists usually remove some enamel before placing veneers. Ve-
neers can be made from several kinds of dental porcelain. Nevertheless the thin por-
celain is not strong enough to repair severely damaged teeth. Veneers are a perfect way
to restore teeth with minor structural destruction. If a patient has a broken tooth, large
cracks, or severe dental decay, a crown may be the best solution to restore these inju-
ries. Dental implants or bridges can replace missing teeth. Veneers can help to restore
a patient's smile and dental functionality when combined with restorative treatment.
183
PART TWO
It is important to emphasize that there is no recovery time after receiving porce-

lain veneers. Patients will be able to drive themselves home from the office, and they
also can immediately go about their daily routine including work and physical activ-
ity. After the enamel removal patients may temporarily feel some mild discomfort.
For about a week, they may need to avoid very cold or hot foods, as well as extreme-
ly crunchy, chewy or hard food. When this primary sensitivity wears off, patients
should be able to return to their ordinary dietary habits. Veneers last about 10 years
on average but their lifespan may increase significantly over the next several years
because dental porcelain becomes stronger and more durable. Of course, veneers,
like natural teeth, are still easily destroyed and susceptible to any damage. If a veneer
breaks or comes off, a patient should carefully store all missing pieces and bring them
to the dental office as soon as possible for repair and/or reattachment.
1. What are the guidelines for post-surgical implant home care?

2. What are the rules of routine implant maintenance?
3. Why is it necessary to follow specific rules of oral hygiene having implants?
FOCUS ON IMPLANT HOME CARE
Good oral hygiene must take place before, during, and after placement of dental
implants to ensure the health of the implant. Dental implants won’t decay, but one
can have gum tissue disease around implants if they are not taken care of. Patients are
concerned about what kind of maintenance their implants will require.
Hygienists can prepare patients by providing home-care recommendations based
on the individual treatment case. This begins with post-surgical home-care guide-
lines to ensure the patient feels comfortable and confident until they return for rou-
tine implant maintenance.
Home care begins immediately with post-surgical guidelines to maintain a healthy
field and to initiate healing. Post-surgical home-care includes drinking only clear
liquids for the rest of the day, taking antibiotics and pain medication as prescribed
and recommended, eating soft foods for the first few days of healing, avoiding wear-
ing a temporary prosthesis or denture to let the gum tissue heal, using an extra-soft
toothbrush to clean the dentition, using salt-water rinses or an antiseptic rinse, limit
physical activity during the first 24-48 hours after surgical intervention. Swelling can
be reduced by placing an ice pack on the affected side at 30 minute intervals during
the first 48 hours after surgery. Patients should avoid smoking completely, as it tends
to slow the process of healing and may contribute to infection and prolonged dis-
comfort.
184
Several studies have been conducted regarding what type of toothbrush is the
most effective in routine maintenance care of implants. The results show no signif-
icant difference between sonic, electric, or manual toothbrushes. The main focus
needs to be on adaptation to the prosthesis and the patient's dexterity. The patient
should brush the implants twice daily to remove bacterial plaque with a low-abrasive
dentifrice. A soft toothbrush should be used; options include a manual brush, elec-
tric or sonic brush. There are many types of floss on the market, and generally it is
highly recommended to use unwaxed tape or implant-specific floss in order to pro-
tect the tissue surrounding the implant. It is highly recommended for patients to use
oral irrigators for the reduction of plaque/biofilm, inflammation, and hard-to-reach
emergence profiles around implants. The patient should use a nonmetal tip one to
two times daily, and, if inflammation is present, add a diluted non-alcohol antimicro-
bial rinse (chlorine dioxide or chlorhexidine gluconate). It is recommended to avoid
chewing hard foods, ice or other hard objects, since this could damage your crown.
For most patients, a visit to the dentist every 6 months may be adequate. However,
considering your new implants and teeth, a follow up every 4 months may be better
until recommended otherwise by a dentist.
Read the text about the prosthodontics specialist training in the USA
4
and answer the following questions.
1. Why is prosthodontics specialty in great demand today?

2. What are the four steps of training to become a prosthodontist in the USA?
3. How is it possible to receive a board certification? What is it necessary for?
HOW TO BECOME A PROSTHODONTIST IN THE USA
Recent findings have estimated that every year nearly 300,000 people have dental
implants placed inside their mouths in the United States. Whether it's due to an acci-
dent, to restore a congenital defect, or simply due to old age, the reality is that cosmet-
ic dentistry has developed greatly over the past several years. This responsibility falls
on the limited community of passionate dental specialists known as prosthodontists.
The students’ interest level of learning how to become a prosthodontist is also sig-
nificantly increased. Prosthodontics deals with restoring damaged teeth or replacing
missing teeth with artificial devices such as dentures, crowns, bridges, veneers and
dental implants.
In order to practice as a prosthodontist, a candidate has a prolonged training with
further receiving board certification from the American Board of Prosthodontics.
The candidates begin their first step of educational path focusing on general stud-
ies in the biological sciences including biology, chemistry, physics, physiology and
185
PART TWO
human anatomy. Future prosthodontists also complete core studies in written com-
munications, mathematics, and in most cases, psychology and sociology. The second
step of the educational path is to become a licensed Doctor of Dental Surgery (DDS)
or Doctor of Dental Medicine (DDM). A candidate completes this step at an accred-
ited Dental College or University. The first two years of study focus on learning basic
dental sciences and procedures that are taught in both the classrooms and in labora-
tories. The students work in groups learning how to diagnose and treat adult patients
under direct supervision during the final two years. Once the candidate has com-
pleted the dental school examinations, they will become a DDS (Doctor of Dental
Surgery) or a DMD (Doctor of Medicine in Dentistry). In order to become a licensed
specialist to practice dentistry in the United States, a candidate must complete the
National Board Dental Examinations, as administered through the American Den-
tal Association. This implies the third step of training. Each US State has special
licensing requirements to practice in their state, and requires dentists to continue
their study in order to maintain their licensing through attending educational semi-
nars and classes. The fourth step of education is to complete residency training. The
residency training to become a prosthodontist starts directly after graduation from
dental college and successful completion of the NBD exam. During this residency
lasting for 3 years candidates receive intensive on-hands training in several fields
of this specialty including removable prosthodontics, fixed prosthodontics, implant
prosthodontics, maxillofacial prosthetics. Once the residency has been completed,
the candidate will have the chance to sit before the American Board of Prosthodon-
tics in order to receive board certification. This examination is extremely difficult and
profound, as it includes written, oral and clinical examinations — all of which must
be passed with high standards to obtain the board certification.
According to the Bureau of Labor Statistics the average salary of a prosthodontist
is nearly $110,000 annually. The professional prosthodontist can be a saviour to those
who want to have a perfect smile or keep it looking great, or who has experienced a
traumatic injury or who needs restorative treatment of congenital defects.
186
DICTIONARY
abnormality ["xbnL'mxlItI] n аномалія, вада розвитку

a tad [q 'txd] adv трішки, ледве
abscess ['xbsqs] n абсцес, нарив, гнійник
access ['xksqs] n доступ
accommodate [q'kPmqdeIt] v влаштувати
accompany [q'kAmpqnI] v супроводжувати
accomplish [q'kPmplIS] v виконувати, завершувати
accumulation [q"kjHmjV'leISn] n накопичення
acid ['xsId] n кислота
acrylate ['xkrIleIt] n акрилат
addiction [q'dIkSn] n залежність
adhere [qd'hIq] v приклеювати, прилипати,
закріпитися
adhesive [qd'hJsIv] adj липкий
adjacent [q'GeIsqnt] adj прилеглий, сусідній
adjunct ['xdZANkt] n допоміжний засіб
adjunctive [q'GANktIv] adj додатковий
adjust [q'GAst] v прижимати
administer [qd'mInIstq] v призначати (ліки)
administration [qdmInIs'treISn] n застосування
adolescence ["xdq'lesns] n підлітковий період,
юність
adopt [q'dPpt] v приймати, засвоювати
advanced [qd'vRnst] adj прогресивний,
занедбаний (про хворобу)
advent ['xdvent] n поява
adverse ['xdvE:s] adj несприятливий,
шкідливий
aesthetic [Js'TetIk] adj естетичний
affect [q'fekt] v уражати, впливати
DICTIONARY
affirmative [q'fE:mqtIv] adj стверджувальний

affix [q'fIks] v кріпити
afflict [q'flIkt] v уражати, хвилювати
afford [q'fLd] v дозволяти собі
affordable [q'fLdqbl]] adj доступний
aggravate ['xgrqveIt] v погіршувати
aid [eId] n допоміжний засіб,
пристрій, прилад
ailment ['eIlmqnt] n хвороба, нездужання
alignment [q'laInmqnt] n вирівнювання,
регулювання
alleviate [q'lJvIeIt] v полегшувати, зменшувати
(симптоми)
allow [q'laV] v дозволяти
alteration ["Lltq'reISqn] n зміна
amalgam [q'mxlgqm] n амальгама для зубної
пломби
ameliorate [q'mJlIqreIt] v полегшувати,
поліпшувати
amide ['eImaId] n амід
anchor ['xNkq] v закріпляти
ancient ['eInS(q)nt] n стародавній, древній
anesthesia ["xnIs'TJzIq] n анестезія
anesthetic ["ænəs'θetɪk] adj знеболюючий;
n анестезуючий засіб
angina [xn'GaInq] n стенокардія, грудна жаба
angulation ["xNgju'leISqn] n викривлення, кут нахилу
anticipate [xn'tIsIpeIt] v очікувати
anticipation [xn"tIsI'peIS(q)n] n очікування, передчуття
anti-inflammatoty ["xntI in'flxmqtqrI] adj протизапальний
anxiety [xN'zaIqtI] n тривога, занепокоєння
anxious ['xNkSqs] adj тривожний
188
DICTIONARY
apparently [q'pxrqntlI] adj очевидно

appear [q'pIq] v з’являтися
appearance [q'pIqrqns] n зовнішній вигляд, поява
appliance [q'plaIqns] n пристрій, прилад,
інструмент
apply [ə'plaI] v прикладати,
застосовувати
appointment [q'pPIntmqnt] n консультація
apprehension ["xprI'henSqn] n тривоги, погане
передчуття
approach [q'prqVC] n підхід
appropriate [q'prqVprIeIt] adj відповідний, належний
arch [RC] n дуга, арка
arrangement [q'reInGmqnt] n домовленість, згода
arrest [q'rest] n зупинка; vзупиняти
artificial ["RtI'fIS(q)l] adj штучний
assessment [q'sesmqnt] n оцінювання, перевірка
assume [q'sjHm] v припускати
assure [q'SVq] v пересвідчуватися
attach [q'txC] v прикріпляти, приєднувати
attachment [q'txCmqnt] n прикріплення
attend [q'tend] v відвідувати
attire [q'taIq] n вбрання
available [q'veIlqbl] adj доступний
avulsed [q'vAlst] adj видалений
awareness [q'wFqnIs] n усвідомлення
bacilli [bq'sIlaI] n бацили, бактерії
bacillus [bq'sIlqs] n паличка, бацила
bacteria [bxk'tIqrIq] n бактерії, мікроби
bactericidal [bxk'tIrIqsaIdl] adj бактерецидний
bacterium [bxk'tIqrIqm] n бактерія, мікроб
189
DICTIONARY
bad breath [bxd breT] n неприємний запах з рота

(халітоз)
barber ['bRbə] n перукар
beverage ['bevqrIG] n напій
biofilm [baIqV'fIlm] n біоплівка
bleach [blJC] v відбілювати
bleed ['bli:d] v кровоточити
bleeding ['bli:dIN] n кровотеча, крововилив
blood clot [blʌd klɒt] n кров’яний згусток, тромб
bond [bPnd] v зв’язувати, скріплювати
bone marrow ['bqVn'mxrqV] n кістковий мозок
brace [breIs] n скоба, брекет-система
breakdown ['breIkdaVn] n розпад
breath [breT] n дихання
bridge [brIG] n міст
bristle [brIsl] n щетинка
brittle ['brItl] adj нестабільний
buccal ['bAkql] adj щічний
bulk [bʌlk] n корпус, основна маса
by-product ['baI"prPdAkt] n побічний продукт
calcium ['kxlsIqm] n кальцій
calculus ['kxlkjVlqs] n камінь, в т.ч. зубний
cancer ['kxnsq] n рак
canine ['keInaIn] n ікло
canker ['kxNkq] n виразка на слизовій
ротової порожнини; афта
carbohydrate ["kRbqV'haIdreIt] n вуглевод
caries ['kFqrIz] n карієс
causative ['kLzqtIv] adj причинний, каузальний
cavity ['kxvItI] n порожнина
cementum [sq'mentqm] n цемент
190
DICTIONARY
ceramic [sq'rxmIk] n кераміка; adj керамічний

chamber ['CeImbq] n камера
chipped [CIpt] adj щербатий
chisel-shaped ['CIz(q)l 'SeIpt] adj долотоподібний,
різцевидний
choice [CPIs] n вибір, відбір
chop [CPp] v подрібнити
clammy ['klxmI] adj липкий
cleanse [klenz] v очищати, дезінфікувати
clench [klenC] v стискати
clenching ['klenCIN] n стискання
clotting ['klPtIN] n згортання крові
coarse [kLs] adj грубий (про їжу)
cold sore ['kqVld 'sL] n герпетичне висипання
на слизовій ротової
порожнини
colonize ['kPlqnaIz] v освоювати, населяти
communicable [kq'mju:nIkqbl] adj заразний, інфекційний,
контагіозний
compassionate [kqm'pxS(q)nIt] adj співчутливий
complain of [kqm'pleIn qv] v скаржитися на
complaint [kqm'pleInt] n скарга
complete [kqm'plJt] v завершувати
complete blood [kqm'plJt'blAd"kaVnt] n загальний аналіз крові
count
complication ["kPmplI'keISn] n ускладнення
composite ['kPmpqzIt] n композит, суміш
compound ['kPmpaVnd] adj складний; nсполука
comprehensive ["kPmprI'hensIv] adj всебічний
compromise ['kPmprqmaIz] v ставити під загрозу
compulsory [kqm'pAlsqrI] adj обов’язковий
conceive [kənˈsiːv] v розуміти, вважати
191
DICTIONARY
concern [kqn'sE:n] n стурбованість

conduct [kqn'dAkt] v вести, проводити
conductor [kqn'dAktq] n провідник
confidence ['kPnfIdqns] n впевненість
confident ['kPnfIdqnt] adj впевнений
confine [kqn'faIn] v обмежувати
confront [kqn'frAnt] v протистояти
congenital [kqn'GenItl] adj природжений,
вроджений
congestion [kqn'GesCqn] n закупорка, застій
consciousness ['kPnSqsnIs] n свідомість
consequence ['kPnsIkw(q)ns] n наслідок, результат
conservative [kqn'sE:vqtIv] adj консервативний,
традиційний
constant ['kPnstqnt] adj постійний
consumption [kqn'sAmpSn] n споживання
contaminant [kqn'txmInqnt] n забруднююча речовина
contraindication ["kPntrqIndI'keISn] n протипоказання
contribute [kqn'trIbju:t] v сприяти
conventional [kqn'venSqnl] adj традиційний, звичайний
convey [kqn'veI] v передавати
conviction [kqn'vIkS(q)n] n переконання
convulsions [kqn'vAlSnz] n судоми
cordial ['kLdIql] adj добрий, сердечний
core [kL] n стержень, серцевина
correction [kq'rekSn] n корекція
correlation ["kPrq'leISn] n взаємозв’язок,
співвідношення
cotton ['kPtn] n вата
counseling ['kaVnslIN] n консультування
counteract ["kaVntqr'xkt] v протидіяти
course [kLs] n перебіг (захворювання)
192
DICTIONARY
crack [krxk] n тріщина

craft [krRft] v виготовляти
create [krI'eIt] v створювати
creep [krJp] v склеювати
crevice ['krevIs] n зубоясенна борозна,
щілина між яснами та
зубом
cringe [krInG] v щулитися (від страху)
crown [kraVn] n коронка
crunchy ['krAnCI] adj хрусткий
cure [kjVq] v вилікувати;
n лікування, ліки
curtail [kE:'teIl] v скорочувати, урізати
curved ['kE:vd] adj викривлений,
підігнутий
cusp [kAsp] n горбик, виступ (про зуб)
damage ['dxmIdZ] n ушкодження
deal [dJl] v мати справу (з)
debris ['de(I)brJ] n залишки, відмерлі
тканини
decay [dI'keI] n гниття
deciduous [dI'sIdjuqs] adj тимчасовий (про зуб)
decompose [dJkqm'pqVz] v розчинятися
defective [dI'fektIv] adj бракований
defense [dI'fens] n захист
deformity [dI'fLmItI] n дефект, вада
demand [dI'mRnd] v вимагати; n потреба
demineralization ['dJ"mInqrqlaI'zeIS(q)n] n демінералізація (втрата
мінералів)
dense [dens] adj ущільнений
dentifrice ['dentIfrIs] n зубний порошок, зубна
паста
193
DICTIONARY
dentine ['dentJn] n дентин

dentition [den'tISn] n прорізування зубів
denture ['denCq] n зубний протез
deposit [dI'pPzIt] n накопичення
depress [dI'pres] v пригнічувати
deprive [dI'praIv] v позбавляти
depth [depT] n глибина
derivative [dI'rIvətIv] adj похідний
destruction [dI'strAkSn] n руйнування
detect [dI'tekt] v встановлювати, визначати
detection [dI'tekSn] n виявлення
deteriorate [dI'tIqrIqreIt] v псуватися, погіршуватися
dexterity [deks'terItI] n спритність, вправність
diabetes [daIq'bJtJz] n діабет
diluted [daI'lHtId] adj розведений
disadvantage ["dIsqd'vRntIG] n недолік
discharge [dIs'CRG] v виписувати (з лікарні)
disclosing [dIs'klqVzIN] n фарбування нальоту
discoloration ["dIskAlq'reIS(q)n] n знебарвлення
discourage [dIs'kArIG] v перешкоджати
disinfectant ["dIsIn'fektqnt] n дезінфікуючий засіб
dislodge [dIs'lPG] v видаляти, витісняти,
переміщати
dislodged [dIs'lPGd] adj зміщений, рухливий,
відірваний
displacement [dIs'pleIsmqnt] n зміщення
dissolution [dIsq'lHS(q)n] n розчинення
dissolve [dI'zPlv] v руйнувати, розчинювати
distress [dIs'tres] n страждання, нещастя
disturbance [dIs'tE:bns] n захворювання,
порушення
dizziness ['dIzInIs] n запаморочення
194
DICTIONARY
drainage ['dreInIG] n дренаж, пов’язка

drawback ['drLbxk] n недолік
dress [dres] v перев’язувати (рану)
drowsiness ['draVzInqs] n сонливість
drug-induced ['drAgIn'djHst] adj медикаментозний
dryness ['draInqs] n сухий, сухість
dull ache [dAl eIk] n тупий ниючий біль
durability ["djV(q)rq'bIlItI] n довговічність, термін
експлуатації
duration [djV'reISn] n тривалість
dye [daI] n барвник, контрастна
речовина
ease [Jz] v полегшувати
electric current [I'lektrIk 'kArqnt] n електричний струм
elevate ['elIveIt] v піднімати
elicit [I'lIsIt] v викликати, виявляти,
встановлювати
eliminate [I'lImIneIt] v усувати, знищувати
elucidate [I'lHsIdeIt] v з’ясовувати
embarrassment [Im'bxrqsmqnt] n збентеження
emergency [I'mE:GqnsI] n надзвичайна ситуація
emit [I'mIt] v випускати
emphasize ['emfqsaIz] v акцентувати,
наголошувати
employ [Im'plPI] v використовувати
empyema ["empaI'Jmq] n емпієма (накопичення
гною в порожнині)
enamel [I'nxml] n емаль
endodontics [endqV'dPntIks] n ендодонтія (вивчає будову
і функції тканин пульпи і
дентину)
engine ['enGIn] n двигун
195
DICTIONARY
enhance [In'hRns] v покращувати,

збільшувати
enhancement [In'hRnsmqnt] n удосконалення,
поліпшення
ensure [In'SVq] v забезпечувати,
гарантувати
enter ['entq] v входити, вступати
erode [I'rqVd] v роз’їдати, руйнувати
erosion [I'reVZn] n ерозія, роз’їдання
erratic [I'rxtIk] adj нестабільний
eruption [I'rApSn] n прорізування (зубів)
essence ['esqns] n значення
essential [I'senSl] adj істотний, необхідний
ester ['estq] n ефір
evaluate [I'vxljVeIt] v оцінювати
evaluation [IvxljV'eISn] n огляд, оцінювання
even out ['Jvqn] v вирівнювати,
розгладжувати
eventually [I'venCVqlI] adv зрештою
evidence ['evIdqns] n доказ, дані, свідчення
evoke [I'vqVk] v викликати
exacerbate [Igz'xsqbeIt] v загострювати,
підсилювати
exacerbation [Igzxsq'beISn] n загострення, погіршення
excessive [Ik'sesIv] adj надмірний
exclude [Ik'sklHd] v виключити
exhibit [Ig'zIbIt] v показувати, виставляти
experience [Ik'spIqrIqns] n досвід
exploration [eksplq'reISn] n дослідження, розвідка
expose [Ik'spqVz] v піддавати, проникати
exposed [Ik'spqVzd] adj відкритий, оголений
196
DICTIONARY
exposure [Ik'spqVZq] n контакт, уразливість,

піддавання (впливу)
extend [Ik'stend] v розширювати
extensive [Ik'stensIv] adj просторий,
великий, значний,
широкомасштабний
extraction [Ik'strxkSn] n видалення
exudate ['eksjVdeIt] n виділення, ексудат
fabricate ['fxbrIkeIt] v виробляти, виготовляти
facilitate [fq'sIlIteIt] v сприяти, полегшувати
failure ['feIljq] n недостатність
fainting ['feIntIN] n непритомність, зомління
favourable ['feIvqrqbl] adj сприятливий
fear [fIq] n страх
fight-or-flight ['faItL'flaIt] n реакція боротьби або
втечі
filling ['fIlIN] n зубна пломба
fixed [fIkst] adj незнімний, закріплений
flap [flæp] n клаптик, частина тканини
flat [flxt] adj плаский,
горизонтальний
floss [flPs] n зубна нитка; v чистити за
допомогою зубної нитки
fluoride ['flVqraId] n фтор
flush [flAS] n рум’янець, почервоніння
(обличчя)
flushing ['flASIN] n промивка
foil [fPIl] n фольга
fragile ['frxGaIl] adj слабкий, крихкий
frail [freIl] adj крихкий
fungal ['fANgql] adj грибковий
gap [gxp] n прогалина
197
DICTIONARY
gauze [gLz] n марля

genetics [Gq'netIks] n генетика
gentle [Gentl] adj м’який, лагідний
gingiva [GIn'GaIvq] n ясна
gingivitis [GInGI'vaItIs] n запалення ясен
glass ionomer [glRs QI'Lnqmq] n склоіномер
glide [glaId] v ковзати
glove [glAv] n рукавичка
graft [grRft] n пересадка (шкіри),
трансплантат
grind [graInd] v перетирати, розтирати
guidelines ['gaIdlaInz] n директиви, вказівки
gutta percha ["gAtq 'pE:Cq] n гутаперча
handicapped ['hxndIkxpt] n людина з фізичними
вадами
handpiece ['hxnd"pJs] n наконечник
harmful ['hRmfVl] adj шкідливий, небезпечний
harsh [hRS] adj жорсткий
hay fever [heI 'fI:vq] n сінна лихоманка
heal [hJl] v лікувати,
зцілювати,загоюватися
heterogeneous [hetq'rPGInqs] adj неоднорідний
history taking ['hIstqrI "teIkIN] n збір анамнезу
humiliating [hjH'mIlIeItIN] adj принизливий
hurt [hE:t] v пошкоджувати зуб,
завдавати болю
hygiene ['haIGI:n] n гігієна
hyperemia [haIpqr'JmIq] n почервоніння, гіперемія
hypothesis [haI'pPTIsIs] n гіпотеза, припущення
immunosuppression [ImjVnqVsq'preSn] n пригнічення імунітету
impact ['Impxkt] n вплив;v мати вплив на,
позначитися на
198
DICTIONARY
impacted [Im'pxktId] adj ретенований

(неповністю прорізаний),
вдавлений
impaction [Im'pxkSn] n ретенція (затримка
прорізування)
impair [Im'pFq] v погіршувати
implement ['ImplImqnt] v реалізовувати,
здійснювати
implicate ['ImplIkeIt] v приховувати, мати на
увазі, припускати, залучати
impression [Im'preSn] n відбиток, зліпок
impromptu [Im'prPmptjH] adj спонтанний
incase [In'keIs] v вкладати, обгортати
incidence ['InsId(q)ns] n захворюваність
incipient [In'sIpIqnt] adj початковий
incisor [In'saIzq] n різець
inconvenient ["Inkqn'vJnIqnt] adj незручний
indicate ['IndIkeIt] v вказувати, зазначати
indicated ['IndIkeItId] adj показаний (препарат,
процедура)
indication [IndI'keISqn] n показання
indirect [IndI'rekt] adj непрямий
inevitable [I'nevItqbl] adj невідворотний
infancy ['InfqnsI] n ранній дитячий вік
(до 12 місяців)
infer [In'fE:] v робити висновок
inflame [In'fleIm] v запалювати
inflict [In'flIkt] v заподіяти
ingredient [In'grJdIqnt] n складова частина,
інгредієнт
inherited [In'herItId] adj успадкований
initial [I'nIS(q)l] adj початковий
inject [In'Gekt] v вводити парентерально
199
DICTIONARY
injury ['InGqrI] n травма, пошкодження

inlay ['InleI] n зовнішня вкладка для
insensibility [In"sensq'bIlItI] n нечутливість
insensitive [In'sensItIv] adj нечутливий
instill [In'stIl] v вселяти (надію, страх),
прищеплювати
insufficient [Insq'fISqnt] adj недостатній
intact [In'txkt] adj неушкоджений, цілий
intake ['InteIk] n споживання
integral ['Intqgrql] adj цілісний
integrity [In'tegrItI] n цілісність, відсутність
пошкоджень
integument [In'tegjVmqnt] v покривати
intend [In'tend] v мати намір щось зробити
interfere [Intq'fIq] v заважати, втручатися
intermittent [Intq'mItqnt] adj переривчастий,
епізодичний
intervention [Intq'venS(q)n] n втручання
intrusive [In'trHsIv] adj нав’язливий
invaluable [In'vxljVqbql] adj безцінний
invasive [In'veIsIv] adj інвазивний
invent [In'vent] v винаходити, створювати
iodine ['aIqdJn] n йод
irreparable [I'repqrqbql] adj непоправний
irreversible ["IrI'vE:sqbql] adj незворотній
irrigate ['IrIgeIt] v промити, оросити
irrigation [IrI'geISqn] n зрошення, промивка
jaw [GL] n щелепа
juvenile ['GHvqnaIl] adj юнацький,
неповнолітній
kit [kIt] n аптечка
200
DICTIONARY
knocked (out) [nPktaVt] adj вибитий

laceration [lxsq'reISn] n розрив
leakage ['lJkIG] adj протікання, витік
lesion ['lJZqn] n ураження
lethargy ['leTqGI] n млявість
license ['laIsqns] v видавати ліцензію
ligament ['lIgqmqnt] n зв’язка
lingering ['lINgqrIN] adj затяжний, ниючий
liquid ['lIkwId] n рідина
local ['lqVk(q)l] adj місцевий
loose ['lHs] adj незакріплений, вільний,
рухливий
loosen ['lHsqn] v розхитувати
lubricate ['lHbrIkeIt] v змащувати
luting ['lHtIN] n пломбування зуба
тимчасовою пломбою
maggot-like ['mxgqt "laIk] adj личинкоподібний
maintain [meIn'teIn] v підтримувати, утримувати
maintenance ['meInt(q)nqns] n підтримка, утримання
malignancy [mq'lIgnqnsI] n злоякісне утворенння
mallet ['mxlIt] n молоток (хірургічний)
malnutrition [mxlnjV'trISn] n недоїдання
malocclusion [mxlq'klHZn] n неправильний прикус
malposition [mxlpq'zISn] n неправильне положення
mamelon ['mxmIlPn] n мамелон (горбик, виступ
на ріжучій поверхні різця)
mandible ['mxndqbl] n нижня щелепа
margin ['mRGIn] n край
marital status ['mxrItl 'steItqs] n сімейний стан
masticate ['mxstIkeIt] v жувати
matrix ['meItrIks] n форма
maxilla [mxk'sIlq] n верхня щелепа
201
DICTIONARY
maxillofacial [mxk'sIlqV'feISql] adj щелепно-лицевий

measure ['meZq] n міра, засіб
mental ['mentl] adj ментальний, що
стосується розуму
mercury ['mE:kjVrI] n ртуть
mesial ['mJzIql] adj серединний, медіальний
milestone ['maIlstqVn] adj епохальний, знаковий,
важливий
misaligned [mIsq'laInd] adj зміщений
mobility [mqV'bIlItI] n рухливість
moist [mPIst] adj вологий
moisture ['mPIsCq] n волога
molar ['mqVlq] n кутній зуб
multiple ['mAltIpl] adj чисельний,
багаторазовий
neat [nJt] adj акуратний
needle [nJdl] n голка
neglect [nI'glekt] v нехтувати
node [nqVd] n вузол
non-steroidal anti- ['nPn'stIqrOIdql " n нестероїдні
inflammatory drugs xnti-In'flxmqtqri протизапальні препарати
'drAgz]
noticeable ['nqVtIsqbl] adj помітний, примітний
numb [nAm] adj онімілий, нечутливий;
v оніміти
numbness ['nAmnIs] n оніміння
nutrients ['nju:trIqnts] n поживні речовини
objective [qb'GektIv] n мета
observe [qb'zE:v] v спостерігати, оглядати
obturation ["PbtjVq'reISn] n закривання отвору
occlusal guard [q'klHsl'gRd] n капа
occupation [Pkju'peISn] n рід занять, професія
202
DICTIONARY
occur [q'kE:] v траплятися

odor ['qVdq] n запах
ointment ['PIntmqnt] n мазь
omit [qV'mIt] v пропускати
ongoing ['PngqVIN] adj тривалий
onlay ['PnleI] n внутрішня вкладка для
onset ['Pnset] n початок, поява, напад
ooze [Hz] v кровити, підтікати
opportunistic [PpqtjH'nIstIk] adj умовно-патогенний
option ['PpSn] n вибір
orthodontics [LTq'dPntIks] n ортодонтія (лікування
щелепно-лицьових
аномалій)
outcome ['aVtkAm] n результат
outlook ['aVtlVk] n перспектива, вигляд
overlapping [qVvq'lxpIN] adj частково схожий
overwhelming [qVvq'welmIN] adj переконуючий,
переважаючий
pace [peIs] n темп
paedodontics ["pJdq'dPntIks] n дитяча стоматологія
pallor ['pxlq] n блідість
palpation [pxl'peISn] n пальпація, прощупування
palpitation ["pxlpI'teISn] n серцебиття
panoramic x-ray ["pxnq'rxmIk'eksreI] n ортопантомограма
paresthesia ["pxris'TJzIq] n парестезія
pathology [pq'TPlqGI] n патологія
penetration [penq'treIS(q)n] n проникнення
perceive [pq'sJv] v сприймати
percussion [pq'kASn] n перкусія, простукування
perform [pq'fLm] v виконувати
performance [pq'fLmqns] n виконання, проведення
203
DICTIONARY
periodontitis ["perIqVdqn'taItIs] n періодонтит

periodontium ["periqV'dPntIem] n періодонт
periodontology ["perIqVdqn'tPlqGI] n парадонтологія
(вивчення будови і функцій
пародонту)
permeable ['pE:mIqbl] adj здатний до
проникнення, проникний
permit [pq'mIt] v дозволяти
persistent [pq'sIstqnt] adj наполегливий
personable ['pE:s(q)nqb(q)l] adj чудовий, приємний,
тактовний
phosphorus ['fOsfqrqs] n фосфор
picks [pIks] n зубочистки
plaque ['plxk] n бляшка, пляма, наліт
pocket ['pPkIt] n карман, кишеня
polyalchenoic acid ["pPlI'xlkq'nqVIk' xsId] adj поліалкеноєва кислота
porcelain ['pO:slIn] n порцеляна
pose ['pqVz] v становити
positioning [pq'zISqnIN] n розміщення
posterior [pP'stIqrIq] adj задній
potassium [pq'txsIqm] n калій
precise [prI'saIs] adj точний
predisposition ["prJdIspq'zISn] n схильність
pregnancy ['pregnqnsI] n вагітність
preliminary [prI'lImInqrI] adj попередній
prematurity ["premq'tjVqrqItI] n передчасність;
неправильний прикус
preserve [prI'zE:v] v зберігати
preterm [prJ'tE:m] adj передчасний
preventive [prI'ventIv] adj профілактичний,
превентивний
primordial [praI'mLdIql] adj первинний
204
DICTIONARY
probe ['prqVb] n зонд; v зондувати

procedure [prq'sJGq] n процедура
prolong [prq'lPN] v продовжувати,
пролонгувати
promote [prq'mqVt] v сприяти, підтримувати
prompt [prPmpt] adj швидкий, невідкладний
prop [prPp] n розширювач
propensity [prq'pensItI] n схильність
prove ['prHv] v доказувати, доводити
provide [prq'vaId] v постачати, забезпечувати
provisional [prq'vIZqnql] adj попередній, тимчасовий
provoke [prq'vqVk] v провокувати
proximity [prPk'sImItI] n наближеність
puberty ['pjHbqtI] n статеве дозрівання
pull [pVl] v тягти, висмикувати
pulp [pAlp] n пульпа
puncture ['pANkCq] n прокол
pure [pjVq] adj чистий
purulent [pjʊrVlqnt] adj гнійний
pus [pAs] n гній
quit [kwIt] v покидати, залишати
range [reInG] v варіювати, різнитися
rank [rxNk] v класифікувати
rash [rxS] n висип
reassurance ["rJq'SVqrqns] n запевнення,
пересвідчення
reassure ["rJq'SVq] v пересвідчитися,
запевнювати
recede [rI'sJd] v відступати, відхилятися
recession [rI'seSqn] nрецесія м’яких тканин
(спадання ясен)
reconsider ["rJkqn'sIdq] v переосмислювати
205
DICTIONARY
recourse [rI'kLs] n альтернатива

recreational drug ["rekrI'eIS(q)nql 'drAg] n вуличний (клубний),
легкий наркотик
refer [rI'fE:] v відноситися
reference ['refqrqns] n посилання
refine [rI'faIn] v очищувати, покращувати
reflect [rI'flekt] v відображати
refuse [rI'fjHz] v відмовляти
regard [rI'gRd] v вважати, розглядати
reinfection ["rJIn'fekSn] n повторна інфекція
reinforcement ["rJIn'fLsmqnt] n підсилення, підкріплення
reinstate ["rJIn'steIt] v відновлювати
release [rI'lJs] v виділяти, відпускати
relief [rI'lJf] n полегшення
relieve [rI'lJv] v полегшувати
remains [rI'meInz] n реліквії, сліди минулого
removable [rI'mHvqbl] adj знімний
remove [rI'mHv] v видаляти
repair [rI'pɛq] v ремонтувати,
відновлювати
replace [rI'pleIs] v заміняти
replacement [rI'pleIsmqnt] n заміна
replant ["rJ'plRnt] v встановити зуб
require [rI'kwaIq] v вимагати
resemble [rI'zembl] v бути схожим на,
нагадувати
residue ['rezIdjH] n відходи, залишки
resin ['rezIn] n композит (зубопротезна
пластмаса)
respond [rI'spPnd] v відповідати, реагувати
response [rI'spPns] n реакція
responsible [rI'spPnsqbl] adj відповідальний
restoration ["restq'reISn] n відновлення
206
DICTIONARY
restorative [rI'stO:rqtIv] adj відновлювальний

restore [rI'stL] v відновлювати
retain [rI'teIn] n затримувати
retarded [rI'tRdId] adj відсталий (розумово)
retention [rI'tenSqn] n утримання, затримка
reveal [rI'vJl] v виявляти
reversible [rI'vE:sqbl] adj зворотній
ridge [rIG] n гребінь (альвеолярний)
rigid ['rIGId] adj жорсткий
rinse [rIns] v полоскати, промивати
roadblock ['rqVdblPk] n бар’єр
root planing ["rHt'pleInIN] n вирівнювання поверхні
кореня зуба
rotten ['rPtn] adj гнилий
rub [rAb] v втирати
rule out ['rHl 'aVt] v виключити, відхилити
rupture ['rApCq] v розриватися; n розрив
salary ['sxlqrI] n заробітна плата
salivary ['sxlIvqrI] adj слинний
salvage ['sxlvIG] v рятувати
sandpaper ['sxnd"peIpq] n наждачний папір
scaling ['skeIlIN] n видалення зубного
каменю
scar [skR] n шрам, рубець
schedule ['SedjHl] v запланувати
scraping ['skreIpIN] n чистка, зіскрібання,
зіскоблювання
scrubbing ['skrAbIN] n тертя щіткою
seal [sJl] v пломбувати, закривати
sealant ['sJlqnt] n сілант, герметик, м’який
пломбуючий матеріал
207
DICTIONARY
sedation [sI'deISn] n вплив заспокійливим

засобом, седативний ефект,
седація, заспокійливе,
снодійне
seek [sJk] v шукати, звертатися за
seizures ['sJZqs] n судоми, напад
self-esteem ["selfq'stJm] n самооцінка
sensibility ["sensq'bIlItI] n чутливість
sequential [sI'kwenSl] adj послідовний
serene [sI'rJn] adj спокійний
setting ['setIN] n установка, оточення
severity [sI'verItI] n тяжкість (напр. перебігу
хвороби, випадку)
shallow ['SxlqV] adj поверхневий,
неглибокий
shape ['SeIp] v надавати форму,
препарувати (порожнину)
share [SFq] v ділити
shave down ['SeIv'daVn] v спилювати (зуб)
shedding ['SedIN] n випадіння
shell [Sel] n оболонка
shiver ['SIvq] v тремтіти
shooting ['SHtIN] adj пронизуючий
shot [SPt] n укол
shrink [SrINk] v зморщуватися, зсихатися
significantly [sIg'nIfIkqntlI] adv значно
sincere [sIn'sIq] adj щирий
single-rooted ['sINgql'rHtId] adj з одним коренем
slight [slaIt] adj незначний
sliminess ['slImInIs] n слизькість, липкість
smell [smel] n запах
smooth [smHD] adj гладкий
snack [snxk] n перекус
208
DICTIONARY
socket ['sPkIt] n гніздо

sodium fluoride ["sqVdIqm'flVqraId] n фторид натрію
sodium hypochlorite ['sqVdIqm" n гіпохлоритнатрію
haIpq'klLraIt]
solid ['sPlId] n твердаречовина
solution [sq'lHSn] n рішення, вирішення
sore [sL] n виразка
soreness ['sLnqs] n чутливість
source [sLs] n джерело
species ['spJSJz] n вид, різновид
spot [spPt] n пляма, місце
spread [spred] v поширювати,
розповсюджувати
squeeze [skwJz] v стискати
stain [steIn] n пляма
starch ['stRC] n крохмаль
steady ['stedI] adj стійкий, постійний
stem cell ['stem"sel] n стовбурова клітина
stiff [stIf] adj жорсткий
still [stIl] adj нерухомий, спокійний
stitch [stIC] n шов
stomachache ['stAmqk"eIk] n біль у шлунку
straight [streIt] adj прямий
strengthen ['streNTqn] v посилювати, зміцнювати
striated ['straIetId] adj смугастий
strive [straIv] v прагнути
stroke [strqVk] n удар, натиск, окремий рух
чи зусилля; інсульт
study cast ['stAdI 'kRst] n гіпсова модель зубного
ряду
stunning ['stAnIN] adj приголомшливий,
незрівнянний
209
DICTIONARY
substance ['sAbstqns] n речовина

substitute ['sAbstItjHt] v заміняти;
n заміна, замісник
suit [sjHt] v пристосовувати,
задовольняти
suitable ['sjHtqbl] adj відповідний, придатний
sulcus ['sAlkqs] n борозна
superstition ["sjHpq'stISn] n забобон
supervision ["sju:pq'vIZn] n нагляд, догляд
supine ['sju:paIn] n положення на спині
supplement ['sAplImqnt] n добавка
supply [sqp'laI] v постачати
suppuration [sApjV'reISn] n нагноєння
surgeon ['sE:Gqn] n хірург
surround [sq'raVnd] v оточувати
susceptibility [sq"septq'bIlItI] n чутливість
susceptible [sq'septqbql] adj спийнятливий,
чутливий
sustain [sq'steIn] v витримувати
suture ['su:Cq] n шов
sweat [swet] n піт
swelling ['swelIN] n набряк
swing [swIN] n коливання
swollen ['swqVlqn] adj набряклий
syncope ['sINkqpI] n непритомність
taper ['teIpq] v зжимати, ущільнювати
target ['tRgIt] n мета
tartar ['tRtq] n зубний камінь
tear [tFq] v рвати
temporarily ['tempqrqrIlI] adv тимчасово
temporize, ['tempqraIz] v відкладати
temporise
210
DICTIONARY
tender ['tendq] adj делікатний, обережний

tense [tens] adj напружений
tetanus ['tetqnqs] n правець
thorough ['TArq] adj ретельний
threshold ['TreShqVld] n поріг (напр. больовий)
thrive ['TraIv] v розмножуватися,
процвітати
throbbing ['TrPbIN] adj пульсуючий
thrush [TrAS] n кандидозний стоматит
tilt [tIlt] n поверхня з нахилом
time frame ['taIm"freIm] n період часу
tingle ['tINgl] n пощипування,
поколювання
tinnitus ['tInItqs] n шум у вухах
tissue graft ["tIsjH'grRft] n пересадка тканини
tolerate ['tPlqreIt] v терпіти
tool [tHl] n інструмент
tooth wear ['tHT 'wFq] n знос, стирання зуба
toothache ['tHTeIk] n зубний біль
topical ['tPpIkql] adj місцевий
trademark ['treIdmRk] n товарний знак
transplantation ["trxnsplRn'teISn] adj пересадка,
трансплантація
trembling ['tremblIN] n тремтіння
trigger ['trIgq] v викликати, запускати,
провокувати
trimming ['trImIN] n відсікання
trustworthy ['trAst"wE:DI] adj довірливий
tumour ['tjHmq] n пухлина
tweezer ['twJzq] n пінцет
twitch [twIC] v смикатися
ulcer ['Alsq] n виразка
ulceration ["Alsq'reISqn] n виразковість
211
DICTIONARY
unbearable [An'bE:rqb(q)l] adj нестерпний

undergo ["Andq'gqV] v проходити
uneasiness [An'JzInIs] n неспокій
unresponsive ["AnrI'spPnsIv] adj нечуйний, байдужий
unveil ["An'veIl] v розкривати, викривати
urticaria [E:tI'keqriq] n кропив’янка
utilize ['jHtqlaIz] v використовувати
vasoconstrictor [veIzqkqn'strIktq] n судинозвужувальний
препарат
vasodilator [veIzqdaI'leItq] n судинорозширювальний
препарат
vicarious [vI'kFqrIqs] adj непрямий
visceral ['vIsqrql] adj вісцеральний
visual inspection ['vIZVql In'spekSn] n візуальний огляд
vitality test [vaI'txlItI "test] n тест на життєздатність
vulnerable ['vAlnqrqbl] adj уразливий
wavelength ['weIvleNT] n довжина хвилі
weaken ['wJkqn] v ослабляти
wear off ['wFq 'Of] v стирати, зношувати
well-groomed ["wel'grHmd] adj доглянутий
wheel [wJl] n колесо
wheezing ['wJzIN] n дихання з присвистом,
стридор
whine [waIn] v хникати, рюмсати
wipe ['waIp] n серветка
wiring ['waIqrIN] n скріплення металевим
дротом
wooden stick ['wVdn stIk] n зубочистка
worm [wE:m] n черв’як, хробак, гельмінт
worsen ['wE:sqn] v погіршувати
xerostomia [zIerq'stqVmIq] n сухість у роті, ксеростомія
zinc [zINk] n цинк
212
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3) / www.dentalaegis.com/id/2011/03/allergy-and-anaphylaxis
REFERENCES
24. Ladley-Finkbeiner B. Communication in the Dental Office: Part I—Verbal and Nonverbal Com-
munication / B. Ladley-Finkbeiner, W. Leeuw //American Dental Assistants Association / adaa.
cdeworld.com/courses/20216-Communication_in_the_Dental_Office:Part_I--Verbal_and_Non-
verbal_ Communication
25. Lange R.T. Clinical evaluation of ceramic inlays compared to composite restorations / R.T. Lange, P.
Pfeiffer // Operative Dentistry, 2009. − 34(3). − P. 263−272.
26. Longman Dictionary / www.ldoceonline.com/
27. McCabe J.F. Applied Dental Materials / John F. McCabe, W.G. Walls Angus. − Blackwell Publishing
Ltd., 2008. − P. 182.
28. McCarter S. Medicine. Oxford English for Careers / S. McCarter. – Oxford University Press, 2014. –
143 p.
29. Merriam-Webster Online: Dictionary and Thesaurus https://www.merriam-webster.com/dictio-
nary
30. Murphy R. English Grammar in Use: A Self-Study Reference and Practice Book for Intermediate
Students / R. Murphy. – New York: Cambridge University Press, 1998. – 328 p.
31. Nelson T.M. Pediatric Dental Sedation: Challenges and Opportunities / T. M. Nelson // Dovepress.
– 2015. – P. 97-106. / www.dovepress.com/pediatric-dental-sedation-challenges-and-opportuni-
ties-peer-reviewed-fulltext-article-CCIDE
32. Pallesen U. Composite resin fillings and inlays. An 11-year evaluation / U. Pallesen, V. Qvist // Clin.
Oral. Invest., 2003. − 7. − P. 71–79.
33. Southam J.C. Oral pathology (2nd ed.) / J.C. Southam, J.V. Soames // 2. Dental Caries. − Oxford:
Oxford Univ. Press, 1993.
34. Symonds M. S. English for Nursing / M. S. Symonds, R. Wright. – Volume 2. – Pearson Education
Limited, 2011. – 80 p.
35. The Free Dictionary /medical-dictionary.thefreedictionary.com
36. Touger-Decker R. Sugars and dental caries // R. Touger-Decker, C. van Loveren // The American
Journal of Clinical Nutrition, 2003. −78 (4). − P. 881–892.
37. Wong A. Raisins and oral health / A. Wong, D.A. Young, E.D.E. Wong, L. M. Water, R. Ashley, M.T.
Booth / Journal of Food Science, 2013. − 78 Suppl. − P. 1750−3841.
THE SELECTED TEXTS ARE BASED ON THE FOLLOWING WEBSITES:
38. Aggressive periodontitis / www.sciencedirect.com

39. American Association of Endodontists / www.aae.org
40. American Board of Pediatric Dentistry /www.abpd.org
41. American Dental Association/www.ada.org/en
42. Camping Survival / www.campingsurvival.com/deemdekidrst.html
43. Causes and treatment of gingivitis / www.medicalnewstoday.com
44. Colgate Oral Care Centre / www.colgate.com/en-us
45. Cosmetic treatments. Inlays-onlays / www.ethosdentalgroup.com
46. Crown (dentistry) / en.wikipedia.org
47. Davis Dental Care /www.davisdentalcarenewmarket.com
48. Dear Doctor. Dentistry & Oral Health/ www.deardoctor.com
49. Dentagama. Dental Social Network /www.dentagama.com/news
50. Dental Fear Central / www.dentalfearcentral.org
51. Dental Fear Central / www.dentalfearcentral.org
52. Dental Orthopedics /www.dentalorthopedics.com
53. Dental prosthesis / en.wikipedia.org
54. Dental prosthesis / www.dentalart.ee
55. Dentalcare.com / www.dentalcare.com
214
REFERENCES
56. Elcivics / www.elcivics.com/lifeskills/dentist.pdf

57. Emergency Dentist / www.emergencydentist.co.uk
58. Encyclopedia Britannica /www.britannica.com
59. Endodontic Specialists / www.arootcanalspecialist.com
60. Focus on implant home care / www.rdhmag.com
61. Gingivitis / www.mayoclinic.org
62. Gingivitis and Periodontal Disease (gum disease) / www.webmd.com
63. Health Line / www.healthline.com
64. Health Promotion Board: Dental Caries / www.hpb.gov.sg/hpb/default.asp? pg_id=865&aid=198.
65. How to become a prosthodontist / www.doctorly.org
66. Intelligent Dental / www.intelligentdental.com
67. Live Strong / www.livestrong.com
68. Local Anesthesia in Dentistry / www.endoexperience.com/filecabinet/Clinical% 20Endodontics/
Anesthesia/Local%20Anesthetics%20in%20Dentistry.pdf
69. Medscape / www.emedicine.medscape.com
70. Modern Survival Blog /www.modernsurvivalblog.com/survival-kit/an-emergency-dental-kit/
71. Mouth Healthy. American Dental Association / www.mouthhealthy.org/en/az-topics/a/anesthe-
sia-and-sedation
72. Oral and Maxillofacial Surgery Instruments / www.downloads.lww.com/wolterskluwer_vi-
talstream_com/sample-content/9781608316380_Mitchell/samples/Chapter11.pdf\
73. Oral Care /www.webmd.com/oral-health/default.htm
74. Oral Health Foundation /www.dentalhealth.org/
75. Oral Surgery Catalogue / www.miltex.com/prodinfo/Brochures/dental/ oralsurg/Catalog%20-%20
Oral%20Surgery.pdf
76. Periodontal disease and systemic conditions: a bidirectional relationship / europepmc.org
77. Periodontal diseases therapy / www.myfairfaxdental.com
78. Periodontal diseases: causes and prevention / www.colgate.com
79. Periodontal scalingand root planing / www.greenwooddentalcare.com
80. Periodontitis / www.mayoclinic.org
81. Periodontitis / www.mayoclinic.org
82. Periodontitis / www.nchmd.org
83. Porcelain veneers / www.tysonsdentalesthetics.com
84. Prevention and management of dental caries in children: Dental clinical guidance / www. sdcep.
co.uk.
85. Prosthetic dentistry / www.dantuharmonija.lt
86. Ready Nutrition / www.readynutrition.com
87. Saber Ingles / www.saberingles.com.ar/idioms/emotions.html
88. Surgery Squad / www.surgerysquad.com
89. Today's Dentistry / www.todaysdentistry.us
90. Tooth Decay / www.med.nyu.edu/patientcare/patients/library/article.hrml? ChunkIID=11496.
91. Tooth Loss Options: Partial, Bridge, or Implant / www.dayodental.com
92. Tooth replacement options / www.ada.org
93. Tooth replacement options / www.moderndentistry.com.au
94. Types of gum disease / www.perio.org
95. Waterfront Endodontics / www.hoodriverwaterfrontendodontics.com
96. WebMD / www.dictionary.webmd.com
97. What is gingivitis? Signs and symptoms / www.colgate.com
98. What is gingivitis? Symptoms, causes, and treatment / www.crest.com
99. Wikipedia, the Free Encyclopedia /en.wikipedia.org/wiki
215
REFERENCES
WEB LINKS TO ILLUSTRATIONS
100. Animated Teeth / www.animated-teeth.com

101. Dental implants / www.westeugenedentist.com
102. Dentalcare.com / www.dentalcare.com
103. Filling teeth / www.time4smile.eu.com
104. Google / www.google.com.ua
105. Gum disease / www. dentistryfortheentirefamily.com
106. The stage of caries development / www.shutterstock.com
107. Tooth extraction / www.azebrauskiene.lt
108. Yahoo / www. images.search.yahoo.com/search/images
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O.O.

BOHOMOLETS NATIONAL MEDICAL UNIVERSITY

Kiev, Book-plus, 2018

Матеріал підручника відповідає вимогам програми «Англійська мова» для студентів

Рекомендовано Вченою радою Національного медичного університету

Підп. до друку 08.08.2018. Формат 70х100/16.

© Аврахова Л.Я., Паламаренко

UNIT 1: History of Dentistry............................................................................................. 6

UNIT 2: Dental Specialties................................................................................................ 17

UNIT 3: Tooth Anatomy ................................................................................................... 30

UNIT 4: Oral Hygiene ........................................................................................................ 41

UNIT 5: History Taking ...................................................................................................... 54

UNIT 6: Emergencies in Dentistry ............................................................................... 65

UNIT 7: Dental Phobia ..................................................................................................... 79

Unit 8: Anesthesia .......................................................................................................... 95

UNIT 9: Dental Caries ....................................................................................................... 109

UNIT 10: Preparation and Filling of the Cavity ......................................................... 123

UNIT 11: Root Canal Treatment ..................................................................................... 135

UNIT 12: Tooth Extraction ............................................................................................... 147

UNIT 13: Periodontal Diseases ....................................................................................... 158

UNIT 14: Dental Prosthetics ........................................................................................... 173

DICTIONARY ........................................................................................................................... 187

REFERENCES ........................................................................................................................... 213

Підручник призначений для студентів 1 та 2 курсів стоматологічних

1 Learn the following words.

evidence ['evIdqns] доказ, дані

· What is the probable cause of dental cavity?

3 Read the text.

4 Match the events to the dates.

1. The first use of the laughing gas. a) In 1905

teeth anatomy decay missing teeth cavities

1. to remove __________________ 6. painful _____________________

sugar dentures extractions caries barber

1. Archaeologists have evidence of dental ____________in teeth from people who

7 Fill in the correct word derived from the words in bold.

8 Match the English words and word combinations to the definitions.

a. any artificial device that is used in dentistry;

9 Answer the following questions.

10 Ask your friend the questions to obtain information about:

11 Agree or disagree with the following statements. Comment your answer.

We use the Present Simple: We use the Present Continuous:

1 Choose the correct tense.

3 Put the verbs in brackets into Present Simple or Present Continuous.

4 Answer the following questions using Present Simple or Present Continuous.

5 Correct the mistakes.

1 Be ready to talk to your friends about:

1 Read the text and make your commentary.

thoritative compendiums of medical knowledge in ancient times. In «On Medicine»,

2 Read the text and be ready to answer the following questions.

1 Learn the following words.

conservative [ken'sE:vqtIv] консервативний,

mental ['mentl] ментальний, що

· Have you ever been a patient of a dentist?

3 Read the text.

4 Match the English words and word-combinations with the definitions.

a. a study of dental epidemiology and social health policies

e. root canal therapy and study of diseases of the dental pulp

5 Complete the sentences with the words and words combinations.

extractions corrective appliances periapical abscess

1. Various filling materials are used for treatment and ___________________.

6 What field of dental activity do these specialists deal with?

7 Associate these words with the job of a certain dental specialist.

8 Choose the correct word or phrase to complete each sentence.

1. to remove 6. painful ___