The diagnostic procedure

The diagnosis of caries requires good lighting and dry clean teeth. If heavy deposits of calculus or plaque are present, the mouth should be cleaned before attempting accurate diagnosis. Each quadrant of the mouth should be isolated in turn with cotton-wool rolls and dried with air or cotton-wool pledges. Sharp eyes are necessary to look for the earliest signs of disease, and vision can be enhanced by the use of magnification. Magnifying loupes can be worn on a head band or attached to spectacles. Alternatively, special glasses with telescopes attached can be used, and have the advantage that they can be made to a specific focal length to suit the particular operator. Operative dentistry can only be made easier by the use of magnification. Traditionally a sharp probe was used to detect caries in enamel either by the rough feel of early cavitation on a smooth surface, or by the probe tips wedging between the softened sides of a fissure. This was known as a «sticky fissure». However, a sharp probe can damage an incipient carious lesion, actually causing cavitation in a lesion which might otherwise have been arrested. Further, by carrying microorganisms into the lesion a probe may facilitate the spread of the carious process. Therefore, a probe should not be used in the diagnosis of enamel caries.

Exercise 8. Give the English equivalents for:

ватный тампон; зонд; кариозное поражение на начальной стадии; участок, место; ось; внутри ротовой полости; держатель рентгеновской пленки; точный, правильный; прикрепляться к: рентгеновский луч.

Exercise 9. Read and translate into Russian the following text.

OPERATIVE AND RESTORATIVE DENTISTRY

Tooth destruction can occur from dental caries (decay), attrition or abrasion, erosion and fracture. Dental caries, known more commonly as tooth decay, is the most common cause of tooth destruction. Caries (which literally means «rotten») results from the demineralization of mineralized tooth structures (that is the loss of minerals or inorganic content from enamel, dentin, and cementum).

Demineralization can be reversed if plaque is removed frequently enough through good oral hygiene measures, if sweets in the diet are limited, and minerals (especially calcium in healthy saliva and fluoride) are available for uptake (remineralization) into the porous demineralized tooth. This tug-ofwar between demineralization and remineralization is constant and is the basis for prevention methods that are applied and taught by dental professionals.

Patient education and preventive treatment are important aspects of dental patient care. Prevention and treatment should be based on personalized risk-based assessment of each patient's caries history, which includes their history of fluoride use, their salivary flow rate, and the frequency of sugar uptake (especially snacks). Fluoride applied to teeth in appropriate concentrations has been shown to reduce dental caries incidence because it increases the tooth's resistance to breakdown by caries-forming acids. Therefore, caries prevention includes daily use of fluoride-containing paste and fluoride-containing mouthwashes (either prescription or over-the-counter), as well as office applied fluorides that contain higher concentrations. Further, when saliva flow is reduced (from damage to salivary glands due to radiation therapy, or as a side effect to many medications), the teeth are more susceptible to tooth decay. Artificial saliva or sugarless chewing gum could be used to alleviate this problem. Finally, snacks provide the ingredients that, with certain bacteria found in dental plaque, form acids that contribute to demineralization. Therefore, frequent snacking must be curtailed.

A number of reports have shown a worldwide decrease in the incidence of coronal caries, especially in children and adolescents, ranging from 10 to 60%. However, the number of adults older than 65 is expected to double by 2025, and people are keeping their teeth longer (53% of persons older than 65 still have at least 20 natural teeth). Further, the prevalence of root caries in the elderly is increasing, with one study reporting 75% of elderly women with clinically detectable root caries. Therefore, the restoration of damaged teeth (from caries and other reasons) will continue to be a part of practice of general dentistry for some time to come.

Operative dentistry is the phase of dentistry involving the art and science of the diagnosis, treatment and prognosis of defects in teeth which do not require restorations that cover the entire tooth (full coverage).

Restoring conservative tooth defects, such as those resulting from small carious lesions usually requires placement of intracoronal restorations whose preparations are cut within the tooth and, if located occlusally, are narrower buccolingually than the distance between the cusps.

Restorative dentistry is the phase of clinical dentistry that includes not only the prevention and treatment of defects of individual teeth, but also the replacement of teeth that were lost or never formed. Lost teeth can be replaced using a fixed partial denture (also known as a bridge), a removable partial denture, an implant (surgical insertion or placement of artificial root over which a crown may be constructed), or complete dentures (also known as false teeth). Thus, restorative dentistry involves the restoration of lost tooth structure and/or lost teeth with the ultimate goal of reestablishing a healthy, functioning, and comfortable dentition.

Exercise 10. Find in the text sentences with modal verbs.

GRAMMAR EXERCISES

Exercise 1. Use modal verbs or their equivalents:

1. The deciduous teeth…. appear at about six months after birth.

2. Teeth….. to be kept clean to avoid the development of dental plaque (зубной налет).

3. If a decayed tooth is not treated in time pulpitis... develop.

4. Although the dentist can treat…. dental decay you ….give your teeth the daily care they need.

5. No dentist... to stop a tooth if it is too bad. In this case he... to extract it.

6. When a cavity is present in a tooth the dentist will determine what... to be done to repair the damage.

7. Adults …. thoroughly brush their teeth at least once a day.

8. Poor mouth hygiene leads to infection and the development of tooth decay.

9. The initial lesion of dental caries... develop in the occlusal fissures.

10. In case of caries a dentist... first gain access to it.

11. Caries removal... start in the area of cavitation.

12. Caries lesions... occur both on pits and fissures and smooth surfaces.

13. Sometimes even a dentist. help if disease is neglected.

14. The resistance of enamel to dental caries. be increased by application of fluoride to the tooth surface.

15. Fluoridation of water. make teeth more resistant to caries.

Exercise 2. Translate the following sentences into Russian paying attention to the use of Participles.

1. Poor mouth hygiene during pregnancy (беременность) may result in gum infection known as gingivitis.

2. Left unchecked, the plaque continues to irritate gums making them red, swollen and bleeding.

3. A balanced diet providing a sufficient amount of protein, carbohydrates, fats, vitamins, minerals and water is vital for both dental and general health.

4. Foods containing starches may also cause tooth decay.

5. Limiting the number of between-meal snacks you may avoid the development of tooth decay.

6. You can help your children have healthy teeth teaching them proper preventive measures.

7. Tooth decay, is a pathologic process beginning with plaque formation.

8. If plaque is not removed daily the enamel eventually breaks down and decays.

9. To place a crown the dentist must prepare the tooth reducing it in size so that a replacement crown can fit.

10.Unremoved plaque can irritate gums making them red and painful.

Exercise 3. Put the words in correct order:

1. reports / shown / caries / of / a / incidence / worldwide / coronal / a / have / number / decrease / of / the / in

2. problem / artificial / to / or / gum / this / be / sugarless / used / alleviate / chewing / saliva / could

3. curtailed / must / snacking / be / frequent

4. damaged / the / dentistry / a / restoration / of / general / be / teeth /of / part / practice / should / of

5. appropriate / choice / sometimes / more / restorations / of / may / restoration / a / be / extracoronal

6. welfare / dental / patient / and / restorations / health / enhance / the / can / the / of / general

Exercise 4. From the text «<The diagnostic procedure»point out the sentences with modal verbs and infinitives in the Passive form.

Exercise 5. Translate the text below in written form.

THE DECAY PROCESS

Tooth decay is an ongoing process that begins with plaque, a soft, transparent, sticky layer of harmful bacteria that constantly forms in the mouth. Certain bacteria in plaque use the sugar and starches in the food you eat to produce acids. The sticky plaque holds these acids on the teeth where they can destroy tooth enamel. Each time acid is produced, it attacks the tooth enamel for about 20 minutes. Plaque is most harmful when the bacteria have had time - about 25 hours - to organize into colonies.

After repeated acid attacks, and if plaque is not removed daily, the enamel eventually breaks down and decays. Once that happens, the decay progresses inward to the centre of the tooth. If left untreated, the decay reaches the pulp of the tooth and an abscess forms at the root end, causing pain. At this stage,

the tooth will need endodontic (root canal) treatment. Without treatment, the tooth must be extracted.

Here are some warning signs of dental decay:

- A tooth that is sensitive to heat, cold or sweets.

- Pain when chewing.

- Swelling or drainage at/or below the gumline.

- A brown spot on a tooth.

- A persistent pain in the mouth or sinus area.

If you suspect that you have tooth decay, make a dental appointment without any delay.

SPEECH EXERCISES

Exercise 1. Answer the following questions to the text «Dental Caries and Pulpitis»:

1. When do diseases of the teeth develop?

2. What are the two most common diseases of the teeth?

3. What are the main causes of dental caries?

4. What are the symptoms of caries?

5. What parts of a tooth do carious lesions most frequently affect?

6. What are the symptoms of pulpitis?

7. What complications may pulpitis result in?

8. What does the treatment of pulpitis consist of?

Exercise 2. Speak about caries and pulpitis using questions of Ex. 1 as a plan.

Exercise 3. Complete the sentences with the information from the text «Operative and restorative dentistry»:

1. Caries results from.

2.. is the basis for prevention methods.

3.... are important aspects of dental patient care.

4. Prevention and treatment should be based on.

5. Operative dentistry is the phase of dentistry involving...

6. Restorative dentistry is the phase of clinical dentistry that includes...

Exercise 4. Review the text «Operative and restorative dentistry» to answer the following questions:

1. Why do dentists believe fluoride can reduce dental caries incidence?

2. Why do dentists recommend to cut down on sugar-containing food?

3. Why does demineralization process occur?

4. What is the definition of operative surgery?

5. What is the definition of restorative surgery?

6. Define dental caries.

7. Define dental plaque.

Exercise 5. Read the text. Entitle it.

Modern science tells us that caries originates under the combined effect of microorganisms and sugar. Bacteria absorb on the surface of the teeth due to the acid that occurs in saliva. Every bite of food containing sugar gives the bacteria energy allowing them to multiply and start producing acids. The result is the formation of cavities. The initial lesion of dental caries clinically is a white spot which may become stained brown.

Adults of all ages can suffer from tooth decay. Two of three cavities in people older than 50 involve decay around fillings.

Another type of tooth decay common in older people is root caries. Root caries generally occurs in adults who suffer from periodontal disease, when the roots are exposed. As the root surface is softer than the enamel the decay occurs more easily.

A balanced diet that provides a sufficient amount of proteins, carbohydrates, fats, vitamins, minerals and water is important for both dental and general health. Other methods of dental caries control are: brushing teeth, fluoridation of water and early restoration of carious lesions.

Notes:

a white spot which may become - белое пятно, которое может стать

stained brown коричневым

a filling - пломба

fluoridation of water - фторирование воды

Exercise 6. Answer the following questions to the text in Exercise 5:

1. What causes caries?

2. When does root caries develop?

3. What are the methods of dental caries control?

Exercise 7. Summarise the text using the following introductory phrases: The text is headlined... The text reads about. According to the text...

The main methods of caries control are enumerated...

Exercise 8. Read and translate the text and classify dental caries according to pit and fissure versus smooth surface and describe the pattern of spread of each within enamel and dentin.

(CLASSIFICATION OF CARIOUS LESIONS

There are two broad classifications of tooth decay based on the anatomy of the tooth surface involved: pit and fissure, and smooth surface. The pattern by which the spread of dental caries occurs as it enlarges and deepens differs in these two types.

Pit and fissure carious lesions begin in the depth of pits and fissures which form from incomplete fusion of enamel lobes during tooth development and are nearly impossible to keep clean. Fissures and pits are commonly located on the occlusal surfaces of posterior teeth (molars and premolars), as well as on the lingual surface of maxillary molars, the buccal surface of mandibular molars, and the lingual fossae of maxillary incisors, especially lateral incisors.

In contrast to pit and fissure caries, smooth surface carious lesions occur on the smooth surfaces of the anatomic crown of the tooth in the areas which are least accessible to the natural cleansing action of the lips, cheeks, and tongue. The pattern of spread within enamel for smooth surface caries is different from that for pit and fissure caries since it begins as a relatively broad area of destruction just beneath the outer layer of enamel, but it narrows as it progresses more deeply toward the dentinoenamel junction. Once it reaches dentin, however, it spreads out wider at the dentonoenamel junction, just like pit and fissure caries.

Root surface caries is another type of smooth surface caries that occurs on cementum, most frequently in patients with disease of the periodontium, patients with decreased saliva flow, or in older patients who have had gingival recession which increases the potential for accumulation of caries-forming plaque on the cementum of root surfaces. Treatment in these cases can include polishing the root, applying fluoride (topical or fluoride containing varnishes), and keeping the roots clean through good oral hygiene.

In 1908, Dr. G.V. Black developed a comprehensive method of classifying carious lesions that has been useful when describing specific principles of cavity preparation. The original classifications were G. V. Black Class I, II, III, IV, and V. All pit and fissure type lesions are Class I, whereas Class II, III, IV, and V caries are all smooth surface type lesions.

Notes:

pit ямка, углубление

fissure фиссура зуба

lobe доля

accessible доступный, открытый

gingival recession рецессия десны, атрофия десневого края

smooth гладкий, ровный

polishing полировка, полирование

comprehensive глубокий, всесторонний; тщательный, подробный, детальный

Exercise 9. Study the text «Classification of carious lesions» and fill in the blanks with suitable words from the text. The first letters are given to help you:

1. P... and f... are nearly impossible to keep clean.

2. The s... surfaces of the crown, least a... to cleansing are susceptible to s. surface carious lesions.

3. Pits and fissures result from incomplete fusion of enamel l... during tooth development.

4. Older patients who have g. .. r... are likely to develop root surface caries.

5. Root surface caries can be treated by p... the root, applying fluoride and good oral hygiene.

6. An American dentist G.V. Black made a c... analyses of cavities design and suggested steps of their preparation.