LESSON 2. DISEASES OF THE TEETH. GRAMMAR: MODAL VERBS AND THEIR EQUIVALENTS. PARTICIPLES

Exercise 1. Practice the pronunciation of the following words: pulpitis, primarily, oral hygiene, the whole body, adult, cause, course, character, lesion, carbohydrate, stimuli, severe, gangrene.

Exercise 2. Active vocabulary. Learn the following words:

poor oral hygiene плохая гигиена полости рта

general state of health общее состояние здоровья

a common disease распространенное заболевание

to suffer from страдать (от), болеть чем - либо

consumption (syn. intake) потребление

lesion поражение, повреждение

to occur иметь место, происходить

to cause вызывать, являться причиной

severe pain сильная боль

to spread распространяться

to result in приводить к, вызывать

to result from быть результатом

due to (because of) вследствие, из-за

arrest a disease купировать заболевание

Exercise 3. Translate the following word combinations into Russian before reading the text.

due to poor oral hygiene

diseases may run an acute course

to control dental caries

early treatment of carious lesions

if caries remains untreated

microorganisms can gain entrance into the pulp

mortification and removal of the pulp tissue

Exercise 4. Read and translate the following text into Rusian:

DENTAL CARIES AND PULPITIS

Part I.

INTRODUCTION

Diseases of the teeth develop primarily due to poor oral hygiene but the general state of health is also of some importance. Depending on the state of the whole body diseases of the teeth may run a more acute course and may quickly involve a number of teeth.

Dental caries (tooth decay) and pulpitis are probably the most common of all diseases of the highly developed countries. All groups of population can suffer from tooth decay.

The main causes of dental caries are poor oral hygiene, the character of nutrition (high consumption of sweets), the temperature of the food and physiological state of the human body. The disease begins with decalcification of the enamel and ends in destruction of the hard dental tissues. Carious lesions usually occur in those parts of the teeth that cannot be well cleaned by a toothbrush, the molars being most frequently affected.

If caries is left untreated microorganisms can gain entrance into the pulp and cause its inflammation (pulpitis). During pulpitis teeth are sensitive to chemical, mechanical and thermal stimuli. Spontaneous severe pains are the most characteristic symptom of pulpitis. The pains may spread over the jaw, ear or temple. They may be very severe and last for a long time. Pulpitis may result in gangrene of the pulp and its decomposition.

The treatment of pulpitis must consist in mortification and removal of the pulp tissue and filling the tooth.

Part II.

DENTAL CARIES

Dental caries is a disease of the calcified tissues of the teeth caused by the action of micro-organisms on fermentable carbohydrates. It is characterized by demineralization of the mineral portion of enamel and dentine followed by disintegration of their organic material. As the disease approaches the pulp, it produces changes in the form of reactionary dentine and pulpitis (possibly giving pain), and may result in bacterial invasion and death of the pulp. The infected necrotic pulp then produces further changes in the periapical tissues.

On the other hand, the disease can be arrested in its early stages since it is possible for remineralization to occur. In addition, progress of the disease

to a clinical cavity is not inevitable, and can be completely prevented by relatively simple measures.

Four factors are necessary to produce dental caries:

•  dental plaque

•  a suitable carbohydrate (mainly sugar)

•  a susceptible tooth surface

•  time.

Unfortunately, caries presents symptomatically at a relatively late stage. The patient may feel a 'hole in a tooth' with the tongue, brown or black discoloration or cavities may be seen, or frank pain may be suffered.

Caries, even in dentine, is not painful per se, but cavitation may occasionally cause a mild pain with sweet things or with heat or cold. Normally, the enamel and the necrotic dentine insulate the sensitive dentine and pulp from these stimuli. However, a much more common cause of pain, which may be intense, is pulpitis (the commonest 'toothache') which occurs late in the development of a carious lesion when caries is very close to the pulp or actually exposing it.

There are four approaches to the management of caries:

•  attempt to arrest the disease by preventive measures

•  remove and replace the carious tissues (operative dentistry)

•  a combination of these two approaches

•  extract the tooth.

Early diagnosis of the carious lesion has become even more important since the realization that caries is not simply a process of demineralization but an alternating process of destruction and repair. Saliva is an excellent remineralizing fluid and the balance can be tipped in favour of repair by modifying diet, careful use of fluoride, and removing plaque.

Notes:

disintegration расщепление, распад

inevitable неизбежный, неминуемый

susceptible восприимчивый, чувствительный

insulate изолировать, ограждать

to tip the balance решить исход дела

Part III.

PULPITIS

Pulpitis may be painful or painless, but even the painless form may become painful in response to certain stimuli. For example, the tooth with painless pulpitis may become painful when percussed or may produce pro-

longed pain in response to electrical or thermal stimulation. Pulpitis may produce spontaneous pain, which may become severe.

Pulpitis does not always develop from caries. It may result from trauma, internal resorption or both. Apparently, pulpitis from caries is reversible until the pulp is invaded by microorganisms. Its reversibility then depends on the number and virulence of the organisms and on therapy. Following invasion of the pulp by microorganisms, the prognosis for prolonged pulp viability is poor.

Irreversible pulpitis continues to progress at varying rates through the pulp chamber and along the root canal. This progression leaves the contents of the pulp chamber necrotic or filled with pus and unable to respond to electrical or thermal stimuli. As the disease process passes through the apical foramina, it becomes apical periodontitis. Reversible pulpitis is treated by sedative dressings, while irreversible pulpitis is managed with endodontic therapy or extraction of the tooth.

Notes:

foramina pl. от foramen отверстие

reversible pulpitis обратимый пульпит

irreversible pulpitis необратимый пульпит

VOCABULARY EXERCISES

Exercise 1. Give the English equivalents to the following words and word combinations:

развиваться, из-за, в зависимости от, острое течение, ряд зубов, наиболее распространенное заболевание, прежде всего, потребление сладкого, приводить к, поражать, воспаление, чувствительный, продолжаться, пломбирование зуба.

Exercise 2. Find the synonyms to the following words in the text: intake, caries, because of, a wide-spread disease, to get into the pulp, first of all, to start, to develop.

Exercise 3. Fill in the blanks with suitable words from the active vocabulary:

1. Caries, pulpitis and periodontitis are . of the mouth.

2. The patient was still in bed because his . was bad.

3. You have three teeth with . .

4. Diseases of the teeth ... due to poor oral hygiene.

5. Pulpitis is . by microorganisms that gain entrance to the pulp.

6. In case of ... you should see a dentist immediately.

7. Untreated caries may ... pulpitis.

8. I . a severe toothache and had to see a dentist.

Exercise 4.

A) Translate the following derivatives: dissolve - solvent, solution, insoluble result - resultant

severe - severely, severity

cause - causal, causative, causeless

occur - occurrence, recur, recurrence, recurrent

sense - sensation, sensibility, sensitive

B) Translate the sentences:

1. A lesion is a change in some part of the body caused by an injury or a disease.

2. The earliest clinically visible evidence of enamel caries is a white or brown spot lesion.

3. Modern dentistry states that the best way of managing caries is by prevention.

4. This substance is insoluble in water.

5. The dentist gave her an injection to reduce the sensitivity of the nerves.

6. It is the doctor's duty to relieve the patient's sufferings.

7. It was necessary to extract the causative tooth.

8. Substances which are difficult or impossible to digest are called indigestible.

9. Sensibility is explained as the ability to feel and transmit impulses, impressions, stimuli, etc.

10. Sensation is a kind of feeling as a result of a particular type of stimulation, something of which one becomes aware through the use of one's senses.

Exercise 5. Read and translate the following text and summarize it:

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 pledgets.

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.

Vocabulary to the text

quadrant сектор

to enhance усиливать, увеличивать

pledget тампон

cotton-wool roll круглый ватный тампон

magnification увеличение

magnifying loupe увеличительное стекло, лупа

accurate точный

radiograph рентгеновский снимок

incipient начинающийся, начальный

deposits of calculus твердые зубные отложения

alternatively в качестве альтернативы

probe зонд

to facilitate способствовать, облегчать

operative dentistry одонтопрепарирование, терапевтическая стоматология Exercise 6. 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 7. 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 liter-

ally 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.

As tooth destruction increases in size, extracoronal restorations may be a more appropriate restoration of choice. These larger extracoronal restorations surround and cover all or part of the exposed tooth, and include crowns (also known by many as «caps») or onlays (which have an intracoronal component but also include coverage of cusp tips). Treatment with extracoronal and intracoronal restorations should result in the restoration of proper tooth form, function and esthetics while maintaining the physiological integrity of the teeth in harmonious relationship with the adjacent hard and soft tissues, all of which enhances the general health and welfare of the patient.

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.

Vocabulary to the text

attrition истирание, истертость, стираемость (зубов)

abrasion абразия, (патологическая) стираемость (зубов)

fracture перелом

rotten гнилой, испорченный

erosion (химическая) эрозия эмали и дентина

tug-of-war решительная борьба, схватка

uptake поглощение

alleviate облегчать, смягчать (боль)

curtail сокращать, урезывать, уменьшать

ingredient ингредиент, компонент, составная часть

prevalence распространенность, частота случаев

restorative dentistry реставрационная стоматология

welfare благосостояние, благополучие

ultimate goal конечная цель

literally буквально, дословно

implant имплант(ат)

fixed partial denture несъемный мостовидный протез

bridge мостовидный зубной протез

removable partial denture съемный мостовидный протез

complete denture полный зубной протез

false teeth искусственные зубы

onlay реставрационная вставка

restoration восстановление, реставрация

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.