№ 3. At the Dentist. Perfect Tenses. The Pronouns “one-ones”.                                

At the Stomatological Polyclinic

 Dental aid is usually rendered at stomatological polyclinics. As a rule a stomatological polyclinic is well-planned and comfortable. It has all modern conveniences. There are many dental surgeries, a laboratory, an X-ray room, an electropathic room and other rooms here. Many specialists work here. They perform all kinds of dental work: the treatment of diseases of the dental pulp, extractions and the performance of laboratory tests, correcting the bite, the treatment of gum diseases, the design and fit of bridgework and dentures to replace missing teeth, all kinds of restorative work. Before the treatment of a disease it is necessary to make a diagnosis, determine its aetiology, pathogenesis as well as the symptoms by which it can be revealed.

     A number of different procedures are used to establish a diagnosis: history taking, physical examination, which includes visual examination, palpation, laboratory studies, instrumental studies, for example, X-ray examination and others.

     Dental treatment is at times a very painful procedure. If a cavity is discovered at an early stage, the tooth can be set right without any pain. Only when it is neglected the patient has some unpleasant sensations. Dentists try to do something about this. They envolve new methods of dental treatment and new anodynes. Soon people will forget all about their fears.

At the Dental Surgery

     The dentists treat the patients at dental surgeries. A modern dental surgery is a large and light hall. One can see some universal equipment here to fulfil the needs of the dentist. First of all there are units including engines with arm-chairs for the patients. These are quite modern easy-to-use dental unit systems. The patients can sit or lie in the arm­chair. There are also small chairs for the dentists, they are movable and comfortable; There is an instrument table or an instrument holder near every arm-chair. It can be easily moved to be at the dentist’s disposal. You can see some instruments on it. Usually there is a tray with a set of instruments such as: an explorer, a mixing pad, a pincett, a dental mirror, a probe and some others.

     There are also instrument cupboards with many instruments in them. We can see temporary filling materials, composites, cements, glass-ion-omers, bonding systems for restoration work; reamers, files; paper and guttapercha points, seals for endodontics; splints, trays, matrixes, impression materials for orthopaedic work; dental cotton rolls, rubber dams, prophy pastes, a saliva ejector for hygienic purposes. Hygiene is very important in the work of a dentist, that’s why all the instruments are carefully cleaned or disinfected.

Dental examination

A dental examination is part of an oral examination: the close inspection of the teeth and tissues of the mouth using physical assessment, radiographs, and other diagnostic aids. Dental care begins with this assessment, and is followed by diagnosis, planning, implementation, and evaluation. The examination identifies tooth decay and evaluates the health of the gums and other oral tissues. The fit of dentures and bridges (if any) are evaluated. The patient’s bite and oral hygiene are also assessed. The dentist then recommends the best treatment options to the patient.

Precautions

Before a dental examination patients with heart-valve disease must take antibiotics to prevent bacteria that may spread into the bloodstream from causing endocarditis. Hypertensive patients may need to have their blood pressure measured. Many dentists prefer not to examine patients who have active herpes sores on or near the mouth. To maintain a sterile environment, dentists and their assistants use gloves and masks.

Description

A dental examination is part of a comprehensive oral examination to evaluate the mouth, jaw, and teeth. Comprehensive evaluations are usually combined with a dental cleaning, x rays, and other diagnostic tests. If a new patient presents with an emergency, the situation will be evaluated and treated first. Once the emergency is over, an appointment for a complete oral examination will be scheduled.

The examination begins with a review of the patient’s complete medical and dental history, which is usually a form or questionnaire completed by the patient. Once the dentist is familiar with any special conditions that may affect the patient during the exam—heart disease, relevant allergies, or the use of medications such as blood thinners—the examination and cleaning can proceed.

Teeth

The dentist or dental hygienist uses instruments such as a mouth mirror, periodontal probe, and explorer to examine the teeth. Every tooth is checked for cavities; the conditions and positions of the teeth, both erupted and impacted, are noted; previous treatments, such as crowns and other restorations, are evaluated. The dentist’s observations are recorded on a tooth chart. The jaw joint and bite are evaluated, since an irregular bite can lead not only to excessive wear on the teeth but other dental problems as well. The fit of dentures and bridges, if worn, are inspected. Dentists frequently order other diagnostic tests such as x rays, blood tests, and dental casts as well.

Gums

The dentist or hygienist evaluates the gingiva, or gum tissue, for periodontal disease by checking for loose teeth, bone loss, and bleeding, swollen, or receding gums. A periodontal probe measures the depth of the pocket around each tooth. If the gums are healthy the pocket will be less than three millimetres deep. Pockets of four millimetres or more indicate periodontal disease. The deeper the pocket, the greater the chance for tooth loss unless treatment is begun.

Tissues of the mouth

An oral cancer screening is part of the dental examination. The dentist feels the lymph nodes on the face and neck, and checks the entire oral cavity—including the hard and soft palates, tongue, cheeks, lips, and floor of the mouth—for irregularities. If caught early, many types of oral cancer can be treated successfully.

Patient education

Oral exams often include instructing the patient in flossing and brushing techniques, the use of fluoride toothpastes, and the prevention of tooth damage from contact sports and other activities. Patient concerns can also be discussed during a counseling session.

Aftercare

The patient will be advised that the teeth may be tender after a thorough cleaning and examination, and ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be recommended to alleviate the discomfort. This tenderness usually subsides within a day or two.

Complications

Complications from an oral examination are rare, although the tissues and teeth may be sore for a few days.

Results

An oral examination should give the dentist a good idea of the patient’s oral health. Once this is established, a complete treatment program can be scheduled and maintained.

 

VIDEO

At the Dentist

 

Dental care

Dental health begins with a good prenatal diet, since teeth begin to form during the third fetal month. At approximately six months of age, the first of the primary teeth erupt. The permanent teeth erupt between six and twelve years of age. The teeth developed in the upper jaw, or maxilla, are called the maxiliary teeth. The lower teeth, those developed in the mandible, are called the mandibular teeth. Each tooth consists of three parts: the crown, the neck and the root. Anterior teeth include four incisors and the two canines in either jaw. Posterior teeth are situated on either side in each jaw next to the canine teeth and include the premolar (bicuspid) and molar teeth.

The major factors in dental health are brushing the teeth regularly, eating an adequate diet, applying fluoride or drinking fluoridated water in order to prevent cavities. All the surfaces should be brushed for 3 minutes within 10 minutes after eating. Flossing between the teeth is essential. The diet should be balanced, adequate in amount, and low in foods containing sugars and starches.

Each person should obtain regular dental care in order to avoid many common dental problems. The starting point for any dental examination is visual examination of the oral cavity, including the vestibule, the tongue and sublingual area, and the hard and soft palates, as well as inspection of centric occlusion. Instruments commonly used for the examination are probes, mouth mirrors and mouth lamps. Various drills, extraction forceps, spatulas and mixers for filling material are among the common dental instruments.

The symptoms of common oral and dental disorders include pains of various degrees of intensity, mouth odour, cavities, and other oral and dental lesions. Periodontal disease is caused by bacterial plaque, genetic susceptibility, diet or poor oral hygiene. Dental caries is a disease that causes demineralization and dissolution of the dental tissues. This process occurs not only in the crown of the tooth, but also on the root surface. The disease is characterized by the formation of carious lesions and cavities. Gingivitis is a periodontal disease caused by bacterial plaque formation at the gingival margins. The inflammatory process causes swelling and colour change of the gingiva. Pulpitis is the inflammation of the pulp tissue. Acute pulpitis is frequently infective and purulent, chronic pulpitis is non-infective and non-purulent. Localized periodontitis is characterized by severe and rapid bone loss. Treatment is rendered to minimize tooth loss as a result of the rapid bone loss. Proper nutrition, dental hygiene, and regular dental examinations are important in preventing caries, periodontal disease and other common disorders.

Public Health Measures.

Dental Health Education

The practitioner can explain the causes and prevention of dental disease to individual patients in his surgery. But there still remains an urgent need for a much greater effort by the public health services. Expectant and nursing mothers, parents of schoolchildren, and young teenagers are the groups most in need of advice on dental care. Much more publicity is necessary to warn these groups of the damage done by dummies used with sweetened fruit juices; of acquiring the habit of unrestricted snacks between meals; and evading dental inspection until toothache develops. Doctors, midwives, health visitors, clinic staff and school teachers all have a part to play in helping the dental profession to educate the public.

Nursing mothers should be encourage to bring their babies when they have their own dental inspections. Toddlers will thereby accept the dental surgery as a place of interest and soon become regular and cooperative patients themselves, long before any treatment is necessary. The discipline of confining sweets to mealtimes and brushing after meals can be developed at an early age, and will establish good dental habits of lifelong value.

Parents should be warned of the danger of sticky carbohydrates causing caries and encouraged to restrict consumption of sweets between meals. In school, steps should be taken to ensure that school dinners do not leave a film of carbohydrate debris on the teeth.

Young teenagers soon realize the importance of good appearance and this can be utilized in dental health education. Regular visits to the dentist for scaling and polishing, filling cavities in front teeth, orthodontics for straightening teeth, and the value of dietary discipline and oral hygiene: all these ways of improving appearance are freely available to them, but too little is being done at national level to make it known.

Many excellent films, posters and pamphlets are already available for display in clinics and schools but these forms of dental health education are only reaching a small section of the population. To help reduce the vast amount of dental disease, the entire populatioeeds to be shown how to maintain good dental health by dietary discipline, strict oral hygiene and regular dental inspection.

Dental Services in Our Country

All kinds of dental aids in our country are rendered mainly at state owned medical institutions — dental clinics, dental departments at district polyclinics, at schools. Private practice also exists. One can speak about a basic preventive outlook.

In the preventive field careful studies are being done by our dentists. They regard good hygiene, rational feeding and healthy diet, the prevention of infections and chronic diseases as the most important general preventive measures against dental infection.

We have various experiments in fluoridation of water supplies. It is necessary to know more regarding control of individual dosages and effects in various age groups.

The general dental services cover the ordinary routine reparative and restorative requirements. The work of dentists is good in oral surgery, especially in the reconstructive surgery of the face.

The country has set up state dental service for children. In the towns the pediatric surgery is the basic unit. There the number of dentists is proportional to the number of children under care and is laid down by law.

The variety and range of research work is also impressive in our country.

The organization of dental services in the United Kingdom

There are currently over 20 000 dentists registered in the United Kingdom. The majority work within National Health Service. Some 80% of dentists work as independent contractors in the general service, around 10 percent work in the salaried community service and only 7% are employed in hospitals. The number of dentists per head of population in Britain is around 1 to 3 500.

Dentists in general practice work on a fee for item of Service basis and paid for courses of treatment completed. The service is oriented to curative and rehabilitative treatment rather than prevention^.

In. contrast to the general medical service, there are no restrictions on where dentists may practice and their lists are not closed. Patients do not register with a particular practitioner but may seek a course of dental treatment wherever they can obtain it. While the NHS guarantees everyone a doctor no one is guaranteed a dentist. Adult patients are obliged to pay a contribution towards the cost of routine dental treatment with higher charges for dentures and some of the more costly items of restorative treatment. Some items such as examination and report, arrest of bleeding are free under the NHS.

General practitioners contracts are held by Family Practitioner Committees of Area Health Authorities.

Dentists working in the community service are remunerated by salary. The service is organized on an area basis in clinics and .health centers and is devoted to dental care of defined priority. Priority group patients can obtain dental treatment free of charge. These groups include children of all ages, expectant and nursing mothers and handicapped adults. Because community dental officers are not subjected to the same demanding economic pressures as their collegues in general practice, they have more time to devote to children and to balance the curative treatment they provide with appropriate prevention.

The hospital dental service provides specialist consultant advice and treatment in oral and maxillofacial surgery, orthodontics and restorative dentistry. In addition it has responsibility for routine dental care for long stay hospital patients and the emergency treatments of short stay patients.

Oral health education

While Dental Aid is an oral health care provider our focus is larger than simply cleaning and restoring teeth. Dental Aid hopes to positively impact the oral health of the populations most at risk of oral disease through prevention and early intervention.  Our dream is a generation of children who grow into adulthood without ever experiencing oral disease – no cavities and no gum disease!  We work to achieve this dream through community outreach, oral health screenings, and patient education.

Oral Health Education and Screenings

Dental Aid’s education program includes showing age appropriate videos, distributing toothbrushes and toothpaste, and instructing children and caregivers on preventive maintenance, including brushing, flossing, fluoride, and healthful nutrition habits.

During Dental Aid non-invasive screenings, a dental hygienist or assistant looks at each child’s mouth and rates oral health needs according to five categories: urgent dental needs, problems found, orthodontic consult recommended, better brushing recommended, or no problems found. A complete examination, x-rays, and cleaning are recommended for all children. The purpose of the screenings is to assess overall oral health and identify dental problems, such as severe dental caries or infection, which require immediate treatment. Parents are notified of the screening results by the school/center staff and encouraged to access dental care services.

Individual Patient Education

All Dental Aid patients receive individualized oral health education during each visit.  Patients (and when the patient is a child, their parents) receive information on the benefits of brushing, flossing, fluoride, good nutrition, and regular dental visits. Patients and parents are also asked to commit to positive oral health behavior changes for themselves and their children. The result is an increase in awareness of good oral health care, not only for the patient, but for the entire family.   

Oral Health

Mission

The mission of the Oral Health Unit is to prevent oral disease among Georgia’s children through education, prevention and early treatment.

The Oral Health Unit plays a vital role in improving the quality of life for all the children of Georgia, and in eliminating health disparities. Oral Health Unit programs focus on preventing, controlling and reducing oral diseases and conditions as well as promoting healthy behaviors. Dental Public Health staff coordinate local, state, and federal resources to address the burden of oral disease and promote cooperative working relationships among state agencies and community organizations to, prevent and control oral diseases.

Prevention

Oral diseases are a major health concern affecting almost every person in Georgia. Dental caries and periodontal diseases have a huge economic and social cost and can result in serious systemic problems, pain, and suffering. Most oral diseases are preventable, and Oral Health Unit makes every effort to promote and implement preventive measures for all of Georgia’s citizens.

·                    Community Water Fluoridation

o        As of December 2006, 95.8% of Georgia’s population using public water systems received fluoridated water. Water fluoridation has been shown to reduce dental decay by 20-40% in fluoridated communities, and results in a savings of $38 in future dental expenditures for each $1 invested in fluoridation.

·                    School-linked Fluoride Supplement Programs for high-risk children

o        Fluoride mouth rinse or fluoride varnish treatments are provided to children lacking an adequate source of fluoride. Approximately 13,474 school age children received fluoride treatments in fiscal year 2008.

·                    Dental Sealants

o        A plastic coating is placed on the chewing surfaces of permanent molar teeth to seal out food and bacteria that cause tooth decay. In FY 2008, dental public health personnel placed 27,455 sealants on the permanent molars of Georgia children.

Education

·                    Dental Health Education

o        Public Health dental hygienists teach school children the importance of proper brushing, flossing, and good nutrition for good dental health. More than 66,378 school children were reached in fiscal year 2008.

Screening and Referral

·                    Dental screenings

o        Dental inspections of the mouth are performed to see if there are any dental or oral problems. The most common dental problems that children have are dental decay, gum disease, and malocclusion. Most of these problems are preventable. Early diagnosis and prompt treatment can eliminate pain, infection, and progressive oral diseases.

·                    Dental referrals

o        If a child is found to have oral health problems, a referral note is sent to the parent/guardian regarding the child’s condition and detailing available resources. More than 60,678 school children were screened and referred for treatment in fiscal year 2008 through public health dental programs. The 2005 Georgia Third Grade Oral Health Survey documents results of a statewide screening assessment.

Treatment

·                    More than 210,606 dental treatments were provided for 64,512 children in fiscal year 2008

.

o        First priority for treatment is given to children who need emergency dental services because of pain or infection, and who are eligible for the Free and Reduced Meal Program (185% Federal Poverty Level).

o        Basic dental treatment services include:

§     Exams

§     Cleanings

§     Dental sealants

§     Silver (amalgam) and tooth colored (composite) fillings

§     Stainless steel crowns

§     Minor nerve treatments

§     Extractions

o        Clinic locations and hours depend on local and state resources available. Information about specific dental services, hours, and location of services can be obtained by calling the local health department or the Health District Dental Contact.

o        Payment for dental treatment services are based on a sliding fee scale based upon ability to pay. Many health departments have a minimal administrative fee.

o        o Public health dental services are provided to children who are enrolled in Medicaid and PeachCare programs,as well as to low-income patients on a sliding-fee scale (based on the patient’s ability to pay).

Oral Hygiene and the Prevention of Dental Disease

Most dental disorders arise directly or indirectly from two basic diseases of the teeth and their supporting tissues — caries and periodontal disease. Prevention of dental disease therefore entails elimination of food stagnation, as this is the primary cause of caries and periodontal disease. Food stagnation causes plaque formation; which in turn¹ leads to acid production, in the case of caries; and to bacterial irritation and calculus in periodontal disease. The methods of prevention are oral hygiene, which is the patients’ responsibility; preventive dentistry which is the dental surgeon’s contribution; dental health education and increasing the resistance of teeth to disease, which are public health measures. If everyone realized it, a lot of tooth problems would be avoided.

Oral Hygiene

Oral hygiene consists simply of keeping the teeth free of food debris, thus preventing plaque formation which leads to dental disease. It can be achieved by cleaning the teeth regularly after meals and not eating between meals. Cleaning is best performed by brushing as this is the only way of removing plaque. If brushing is not possible, food debris can be removed by finishing the meal with a detergent food. Such foods are raw, firm, fibrous fruits or vegetables, e.g. apples, pears, carrots, celery, etc. By virtue of their tough fibrous consistency they require much chewing and thereby scour the teeth clean of food remnants.

 Although it is easy enough to brush the teeth or eat an apple after meals at home, it may often be inconvenient elsewhere. On such occasions a plain water mouth rinse, which can be swallowed afterwards, is better thaothing.

Of all these methods of cleaning teeth, toothbrushing is the most effective. When properly done⁴ it removes plaque, whereas detergent foods can only clean away loose food particles. Thus the role of detergent foods or mouth rinsing is not that of a satisfactory alternative to brushing; but an additional measure at the end of a meal, or a substitute when brushing is not possible.

Toothbrushing

Brushing after meals can only be effective if it removes plaque. The object is to clean every accessible tooth surface, thus removing food debris and plaque and massaging the gum margin.

Toothbrushes with a small head and medium bristles are probably the most effective. The brush is rinsed and toothpaste added. Several strokes are used on each section of the mouth. Buccal, lingual, mesial and distal surfaces are cleaned by a rotary motion from gum to tooth. Occlusal surfaces are cleaned by a scrubbing action. Finally the gingival margins are cleaned by a backwards and forwards motion which must be done gently to avoid abrasion of the necks of the teeth.

 

Each jaw is done in turn and the mouth is then thoroughly rinsed with warm water to expel food debris dislodged by the toothbrush. Brushes should be washed afterwards and allowed to dry.

Correct and effective toothbrushing in the way described requires time, knowledge and skill. Many people lack these requirements and brushing is ineffective as a preventive measure. The whole process can be made simpler for such people by using an electric toothbrush. Teeth are cleaned rapidly and effectively as most of the movements are done automatically. It is particularly valuable for children and the physically handicapped. Although it is no better than a properly used ordinary toothbrush, it is probably preferable.

Bacteria Cause Gum Disease

The research isn’t conclusive, but red, swollen, and bleeding gums may point to health problems from heart disease to diabetes. Sometimes, bacteria from your mouth can travel to your bloodstream, setting off an inflammatory reaction elsewhere in your body. Left untreated, gum disease can increase your risk for a host of diseases linked to inflammation. Certain diseases and medications also may cause mouth problems.

Gum Disease and Diabetes

Diabetes can reduce the body’s resistance to infection. Elevated blood sugars increase the risk of developing gum disease. What’s more, gum disease can make it harder to keep blood sugar levels in check. Protect your gums by keeping blood sugar levels as close to normal as possible. Brush after each meal and floss daily. See your dentist at least once a year.

Dry Mouth and Tongue Cause Tooth Decay

The 4 million Americans who have Sjögren’s syndrome are more prone to have oral health problems, too. With Sjögren’s, the body’s immune system mistakenly attacks tear ducts and saliva glands, leading to chronically dry eyes and dry mouth (called xerostomia). Saliva helps protect teeth and gums from bacteria that cause cavities and gingivitis. So a perpetually dry mouth is more susceptible to tooth decay and gum disease.

Medications That Cause Dry Mouth

Given that a chronically dry mouth raises risk of cavities and gum disease, you may want to check your medicine cabinet. Antihistamines, decongestants, painkillers, and antidepressants are among the drugs that can cause dry mouth. Talk to your doctor or dentist to find out if your medication regimen is affecting your oral health, and what you can do about it.

Stress and Teeth Grinding

If you are stressed, anxious, or depressed, you may be at higher risk for oral health problems. People under stress produce high levels of the hormone cortisol, which wreaks havoc on the gums and body. Stress also leads to poor oral care; more than 50% of people don’t brush or floss regularly when stressed. Other stress-related habits include smoking, drinking alcohol, and clenching and grinding teeth (called bruxism).

Osteoporosis and Tooth Loss

The brittle bone disease osteoporosis affects all the bones in your body — including your jaw bone — and can cause tooth loss. Bacteria from periodontitis, which is severe gum disease, can also break down the jaw bone. One kind of osteoporosis medication — bisphosphonates — may slightly increase the risk of a rare condition called osteonecrosis, which causes bone death of the jaw. Tell your dentist if you take bisphosphonates.

Pale Gums and Anemia

Your mouth may be sore and pale if you’re anemic, and your tongue can become swollen and smooth (glossitis). When you have anemia, your body doesn’t have enough red blood cells, or your red blood cells don’t contain enough hemoglobin. As a result, your body doesn’t get enough oxygen. There are a many types of anemia, and treatment varies. Talk to your doctor to find out what type you have and how to treat it.

Eating Disorders Erode Tooth Enamel

A dentist may be the first to notice signs of an eating disorder such as bulimia. The stomach acid from repeated vomiting can severely erode tooth enamel. Purging can also trigger swelling in the mouth, throat, and salivary glands as well as bad breath. Anorexia, bulimia, and other eating disorders can also cause serious nutritional shortfalls that can affect the health of your teeth.

Thrush and HIV

People with HIV or AIDS may develop oral thrush, oral warts, fever blisters, canker sores, and hairy leukoplakia, which are white or gray patches on the tongue or the inside of the cheek. The body’s weakened immune system and its inability to stave off infections are to blame. People with HIV/AIDS may also experience dry mouth, which increases the risk of tooth decay and can make chewing, eating, swallowing, or talking difficult.

Treating Gum Disease May Help RA

People with rheumatoid arthritis (RA) are eight times more likely to have gum disease than people without this autoimmune disease. Inflammation may be the common denominator between the two. Making matters worse: people with RA can have trouble brushing and flossing because of damage to finger joints. The good news is that treating existing gum inflammation and infection can also reduce joint pain and inflammation.

Tooth Loss and Kidney Disease

Adults without teeth may be more likely to have chronic kidney disease than those who still have teeth. Exactly how kidney disease and periodontal disease are linked is not 100% clear yet. But researchers suggest that chronic inflammation may be the common thread. So taking care of your teeth and gums may reduce your risk of developing chronic kidney problems.

Gum Disease and Premature Birth

If you’re pregnant and have gum disease, you could be more likely to have a baby that is born too early and too small. Exactly how the two conditions are linked remains poorly understood. Underlying inflammation or infections may be to blame. Pregnancy and its related hormonal changes also appear to worsen gum disease. Talk to your obstetrician or dentist to find out how to protect yourself and your baby.

What Healthy Gums Look Like

Healthy gums should look pink and firm, not red and swollen. To keep gums healthy, practice good oral hygiene. Brush your teeth at least twice a day, floss at least once a day, see your dentist regularly, and avoid smoking or chewing tobacco.

Bacteria Cause Gum Disease

The research isn’t conclusive, but red, swollen, and bleeding gums may point to health problems from heart disease to diabetes. Sometimes, bacteria from your mouth can travel to your bloodstream, setting off an inflammatory reaction elsewhere in your body. Left untreated, gum disease can increase your risk for a host of diseases linked to inflammation. Certain diseases and medications also may cause mouth problems.

Preventive Dentistry

Preventive dentistry includes instruction in oral hygiene, regular inspection, and any necessary treatment for prevention and removal of stagnation areas. Instruction in oral hygiene is best given at the chair-side, whilst posters and pamphlets in the waiting room serve as an extra reminder. Patients are hold how dental disease arises and how it can be prevented. This entails an explanation of the all important role of plaque and the effects it produces. The most impressive way of demonstrating plaque on their own teeth is to give patients a disclosing tablet to suck. This contains a dye which stains it bright red. Patients can then see for themselves in a mirror whether they are cleaning their teeth properly. They are then shown how to use a toothbrush correctly, advised to clean their teeth after every meal, and warned against snacks between meals.

However, they are not likely to heed such advice unless is practicable. Patients must therefore be told how to clean their teeth when a tooth-brush is not available. The best substitute in such cases is a detergent food or plain water mouth rinse.

It must be emphasized that the principle of cleaning after every meal has little effect unless it is combined with dietary discipline to stop eating between meals. The beneficial effect of cleaning teeth after meals is cancelled out if food debris is continually replaced by frequent snacks between meals. They should either be stopped altogether or some fruit taken instead.

Prevention is better than cure. Patients should be encouraged to have a regular inspection twice a year. Oral hygiene can then be checked with disclosing tablets and any deficiencies shown to the patient. Further instruction can then be given if necessary. Bite-wing X-rays are taken at the same time for early diagnosis of caries.

These visits will detect incipient dental disease which can be treated far more easily in its earliest stages than later_. Such treatment may involve all branches of dentistry. Periodic scaling to remove small deposits of calculus will prevent the onset of periodontal disease before it ever reaches the stage of gingivitis. Early treatment of caries enables affected teeth to be conserved rather than extracted.

Dental aid

         Dentistry became a medical profession a little over a hundred years ago. In previous century a dental abscess still sometimes led to death. Now dental disease and practice of dentistry are not usually associated with mortality. As doctors dentists must recognize their obligations to preserve the health and lives of their patients. Responsibility does not end with the teeth for any dentists – he must remember for the mouth he is the doctor.

         For most people it is the pain and inconvenience of dental disease and the associated sepsis, disfunction and disfigurement which cause it to be a troublesome health problem.

            In our country it is the generative and chronic disease of long standing, of which caries and periodontal disease are examples that are receiving increasing attention. It is important to stress that both can be prevented or contained by removing their cause. As expectation rise and value of a healthy, natural dentition is appreciated, people are becoming more interested in the possibility of avoiding dental disease and retaining their teeth for life.

 

Diet, nutrition and the prevention of dental diseases

Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association betweeutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks.

Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride.

It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is < 15–20 kg/yr (6–10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

 Protective elements

Several food components have been tested on their ability to reduce the caries-inducing effects of carbohydrates. Some positive results have been found in animal experiments but evidence for a significant effect on human caries is lacking, except for fluorides.

Phosphates are found naturally in different cereals. In tests, sodiumphosphates or calcium sucrose phosphates have been added to different food products resulting in an increased cariesreduction. The cariostatic actions of phosphates is primarily, if not entirely, a local topical one. “The presence of phosphates in the oral environment prevents the loss of phosphorus from the tooth enamel because of the common ion effect. Phosphates, along with calcium and fluoride ions, contribute to the remineralization of incipient demineralized areas of enamel. The phosphates seem to improve the structural nature of the enamel surface by making it harder and smoother. By virtue of their detergent properties, phosphates can probably interfere with the adherence of pellicle and plaque bacteria to the enamel surface. Phosphates can also inhibit bacterial growth.” (Nizel, AE, Nutrition in preventive dentistry, 1981)

Fats seem to reduce the cariogenicity of different foods but it is not clear how or to what extent. Some possible explanations may be that the fat would form a protective barrier on the tooth surface or maybe just surround the carbohydrates, making them less available and making the removal from the oral cavity a little faster. Some fatty acids have an antimicrobial effect which could have an impact on plaque formation.

Cheese may reduce the levels of cariogenic bacteria according to some studies. The high calcium and phosphorus content also seems to be a factor in the cariostatic mechanisms of cheese as well as the casein and cheese proteins. (Herod EL. The effect of cheese on dental caries:

Family physicians can have a positive impact on their patients’ dental health. We may be the primary source of dental advice for infants and toddlers, and even some older children. This fact permits us to initiate preventive measures, recognize problems, address parental concerns and make appropriate referrals.This article reviews aspects of developmental and preventive dentistry that are of relevance to family physicians.

Dental Disease

Dental disease is almost entirely preventable, yet it is common in the United States among persons of all ages. The average 17-year-old has had eight decayed permanent teeth, and 60 percent of adolescents have periodontal disease.[9] Almost 98 percent of adults over age 65 are missing at least one tooth, and nearly one-half have no teeth at all. Over two-thirds of older adults who still have teeth have moderate to severe periodontal disease.

Dental caries is the predominant form of dental disease in children. Caries develops when the tooth’s protective enamel covering is breached, permitting progressive destruction of the underlying structure. Cariogenic bacteria form colonies (dental plaque) and metabolize food substrate into organic acids that demineralize tooth enamel. If this damage is mild and occurs infrequently, direct remineralization will occur from the action of inorganic ions present in saliva, but this restorative mechanism is easily. overwhelmed.

In adults, most dental pathology is the result of periodontal disease – gingivitis and periodontitis – which affects the tissues that surround and support the teeth. Gingivitis is an inflammatory condition of the gums, while periodontitis involves inflammation and destruction of the bone and supporting structures . Like dental caries, periodontal disease is caused by plaque microorganisms that remain in contact with the tooth and surrounding tissue. Treatment of established periodontal disease is difficult, because the plaque has become mineralized calculus and is located in the deeper, less accessible areas of the tooth root and supporting tissues.

Hygiene

Parents can begin to teach their children good dental hygiene from an early age. Even before teeth erupt, parents can wipe the infant’s gums with a soft cloth after feedings, thus helping to condition the child to oral cleaning. As soon as teeth appear, use of a soft toothbrush should begin. Parents should initiate flossing when the child’s molars come into contact – usually before school age. Children may develop the dexterity to floss their own teeth by age 10. It is recommended that children and adults brush twice and floss at least once daily.

Oral Surgery

Oral surgery is the branch of dentistry concerned with the study of dental diseases, traumatic injuries and diseases of the teeth, jaws, oral tissues where surgical methods are used. Oral surgery is closely connected with therapeutic dentistry, oral orthopedics, pediatric dentistry and a number of medical disciplines — therapy, surgery, radiology and others. Surgical operations on teeth and the oral cavity have been known since ancient times. Tooth extraction is the most commonly used dental operation. It is usually performed in the cases where conservative treatment is unsuccessful. It helps to stop the spread of the inflammatory process on the surrounding tissues and to avoid complications. Sometimes the tooth is extracted, it being the source of the infection as in acute osteomyelitis. In this case drainage should be established as soon as possible. The patient should have good general care. In some cases when the tooth is far gone and can’t be restored it is necessary to extract it as well. It is better to replace it by denture in order to have good esthetic results and function. Teeth maybe traumatized, the trauma maybe so severe that teeth become luxated, fractured, or even comminuted. In this case the prognosis maybe unfavourable. A totally displaced tooth may be replanted but generally should be removed. The interior teeth are more often fractured than the posterior ones. Extraction of a tooth is the last alternative in its treatment. One should always remember that the loss of a single tooth can give rise to caries and periodontal disease in at least three other teeth.

Endodontics

     Endodontics is the term used for all forms of root canal therapy. It includes root filling, pulpotomy, pulp capping and apicectomy. Everyone considers them to be very unpleasant procedures. Pulpitis always leads to pulp death. This in turn eventually leads to an acute alveolar abscess, which is a very painful condition. To prevent this chain of events, endodontic treatment or extraction is required whenever the pulp is inflamed or dead, or when an alveolar abscess is already present. The basic object of endodontic treatment is to remove the inflamed or dead pulp and replace it with a root filling. This removes the source of irritation which causes alveolar abscess. It will also allow drainage and complete cure of an existing abscess. The root-filled tooth will then function just as well as¹ one with a normal pulp. There are many causes of pulpitis and pulp death but the treatment is similar in each case; either extraction or endodontics. The commonest cause of pulpitis is exposure of the pulp. This allows mouth bacteria to enter the pulp chamber and infect the pulp. Exposure of the pulp may be due to:

1. Caries;

2. Accidental exposure during cavity preparation;

3. Fracture of the crown.

     Even when the pulp is not exposed, pulpitis can still occur. The causes are:

1. Irritant filling; e.g. unlined silicate or acrylic.

2.  Excessive heat during cavity preparation; e.g. use of air turbine handpiece without water spray.

3. Impact injury.

     Impact injuries are noticed to be common in children with prominent front teeth. The crown may fracture and expose the pulp. Alternatively the crown remains intact but the blow damages the apical blood vessels and the dentist sees pulp death ensue.

     The dentist’s decision on whether to treat a decayed tooth by an ordinary filling, endodontics or extraction, depends on the state of the pulp. If it is dead, endodontics or extraction is necessary. If it is alive and unexposed, an ordinary filling will suffice.

     The state of the pulp is not always apparent and vitality tests are often required to determine whether it is alive or dead. These tests depend on the painful response of the pulp to certain stimuli. If there is a response the pulp is vital; if not, it is probably dead.

Orthodontics

     Orthodontics is the branch of dentistry concerned with correction of irregularities of the teeth. When the permanent teeth erupt, parents may notice that the front teeth are crooked or protruding. The condition is known as a malocclusion and treatment is sought to improve the child’s appearance.

 

     The aims of orthodontic treatment are to reposition the teeth so that appearance is improved and a good functional occlusion obtained. By correcting badly positioned teeth it may also eliminate some stagnation areas and help prevent caries and periodontal disease developing.

     The basic types of malocclusion are crowding, protruding upper in­cisors and a prominent lower jaw.

     Crowding is due to insufficient room for all the teeth. It usually arises from inheritance of jaws which are too small to accommodate thirty-two permanent teeth. The teeth become crooked and overlapping, whilst those which normally erupt late cannot take up their proper position as there is insufficient room left.

     Thus the canines are usually displaced buccally, second premolars lingually and the lower third molars are impacted.

     Early extraction of carious deciduous molars may also contribute to the crowding in these cases. The gap left by the extraction soon closes, as the back tooth drifts forward and takes up the space required for the permanent successor.

     Many children attend for orthodontic treatment because their up­per front teeth protrude between their lips. This condition usually arises from inheriting a jaw relationship in which the upper teeth are too far forward relative to the lowers. It is commonly associated with an open lip posture.

     Prominent lower jaw is the condition, in which the chin is unduly prominent, is due to inheritance of a jaw relationship in which the lower teeth are too far forward relative to the uppers. It usually results in the lower incisors biting in front of the uppers, instead of behind them.

A number of conditions may require oral surgery, including:

Impacted Teeth

Wisdom teeth, otherwise known as third molars, are the last set of teeth to develop. Sometimes these teeth emerge from the gum line and the jaw is large enough to allow room for them, but most of the time, this is not the case. More often, one or more of these third molars fails to emerge in proper alignment or fails to fully emerge through the gum line and becomes entrapped or “impacted” between the jawbone and the gum tissue. Impacted wisdom teeth can result in swelling, pain, and infection of the gum tissue surrounding the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage to nearby teeth, gums, and bone and can sometimes lead to the formation of cysts or tumors that can destroy sections of the jaw. Therefore, dentists recommend people with impacted wisdom teeth have them surgically removed.

It’s not just wisdom teeth that sometimes become impacted and need to be removed. Other teeth, such as the cuspids and the bicuspids can become impacted and can cause the same types of problems described with impacted wisdom teeth.

Tooth Loss

Dental implants are an option for tooth loss due to an accident or infection or as an alternative to dentures. The implants are tooth root substitutes that are surgically anchored in place in the jawbone and act to stabilize the artificial teeth to which they are attached. Suitable candidates for dental implants need to have an adequate bone level and density, must not be prone to infection, and must be willing to maintain good oral hygiene practices.

Jaw-Related Problems

• Unequal jaw growth. In some individuals, the upper and lower jaw fail to grow properly. This can cause difficulty in speaking, eating, swallowing, and breathing. While some of these problems — like improper teeth alignment — can be corrected with braces and other orthodontic appliances, more serious problems require oral surgery to move all or part of the upper jaw, lower jaw, or both into a new position that is more balanced, functional, and healthy.

• Improve fit of dentures. For first-time denture wearers, oral surgery can be done to correct any irregularities of the jaws prior to creating the dentures to ensure a better fit. Oral surgery can also help long-term denture wearers. Supporting bone often deteriorates over time resulting in dentures that no longer fit properly. In severe cases, an oral surgeon can add a bone graft to areas where little bone remains.

• Temporomandibular joint (TMJ) disorders. Dysfunction of the TMJ, the small joint in front of the ear where the skull and lower jaw meet, is a common source of headache and facial pain. Most patients with TMJ disorders can be successfully treated with a combination of oral medications, physical therapy, and splints. However, joint surgery is an option for advanced cases and when the diagnosis indicates a specific problem in the joint.

Other Conditions Treated By Oral Surgery

• Facial injury repair. Oral surgery is often used to repair fractured jaws and broken facial bones.

• Lesion removal and biopsy. Oral surgeons can take a small sample of abnormal growth or tissue and then send it for laboratory testing for identification. Some lesions can be managed medically or can be removed by the oral surgeon.

• Cleft lip and cleft palate repair. Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip and/or a split in the opening in the roof of the mouth. Oral surgeons work as part of a team of health care specialists to correct these problems through a series of treatments and surgical procedures over many years.

• Facial infections. Pain and swelling in the face, neck, or jaws may indicate an infection. Infections in this area of the body can sometimes develop into life-threatening emergencies if not treated promptly and effectively. An oral surgeon can assist in diagnosing and treating this problem. Surgical treatment, if needed, may include cutting into and draining the infected area as well as extracting any teeth that might be involved.

• Snoring/sleep apnea. When conservative methods fail to alleviate this problem, surgery can be tried. Surgical procedures involve removing the soft tissues of the oropharynx (an area in the back portion of the mouth) or the lower jaw. Laser surgery is a newer treatment option. Depending on the surgical technique used, the laser is used to either slowly scar the palate, which tightens it, or to remove palate tissue.

Dental Instruments

While examining and treating a patient the dentist needs a set of instruments for fillings. For each patient the instruments required are:

·         1. Mirror, probe, tweezers, napkins, waste receiver.

·         2. Aspirator, saliva ejector, cotton wool rolls and cotton wool for keeping the cavity dry.

·         3. Enamel chisels for removing undermined enamel and smoothing the cavity margins.

·         4. Excavators for removing caries.

·         5. Handpiece and burs for drilling away hard tissue.

·         6. Plastic instruments. These double-ended blunt instruments have flator round ends for manipulating, packing and trimming the filling or lining.

·         7. Special instruments and drugs. Some fillings require the use of certain instruments or drugs which are not used for other fillings. These special requirements are dealt with under the appropriate filling mate­rials.

Handpieces

Cavities are cut with burs fitted in a handpiece. Speed of cutting depends on the type of handpiece used.

Conventional handpieces run at slow speedy — up to 4,000 revolutions a minute. They are usually driven by a cord running from the electric motor on a unit. Alternatively they are driven by a miniature motor at the base of the handpiece. A contra-angle handpiece is used most often as it provides access to every tooth. For easily accessible teeth, and trimming dentures, a straight handpiece is used.

Air turbine handpieces run at very high speeds — up to 400,000 revo­lutions a minute. There is a tiny air turbine motor in the head of the handpiece which is driven by compressed air. They are contraangled and are used with a built-in water spray to counteract the heat generated by high-speed cutting. The advantages of air turbine handpieces are the ease and speed of cutting, and absence of vibration. Disadvantages are the difficulties caused by water spray, and the high, pitched whistling noise.

Burs

Burs used in conventional low speed handpieces are made of steel. For air turbine handpieces they are made of tungsten carbide or diamond. Straight handpiece burs have a long plain shank. Burs for con­ventional contraangle handpieces are short and have a notch in the shank which fits by a latch grip. Short burs are also used for the air turbine handpieces but they have a plain shank which gives a friction grip.

Contra-angled conventional handpieces with smaller heads, and using even shorter burs, are used on children. They are called miniature handpieces and burs. The cutting ends of burs are made in many different shapes but those most commonly used are as follows:

·         1. Rounds — used for gaining access to cavities and removing caries.

·         2. Cone — used for undercutting cavities.

·         3. Fissure — used for extending cavity to remove stagnation areas.

The Perfect Tenses

The Present Perfect Tense

The present perfect tense is used to describe action that began in the past and continues into the present or has just been completed at the moment of utterance. The present perfect is often used to suggest that a past action still has an effect upon something happening in the present.

Each of the highlighted compound verbs in the following sentences is in the present perfect tense.

They have not delivered the documents we need.

This sentence suggest that the documents were not delivered in the past and that they are still undelivered.

The health department has decided that all high school students should be immunised against meningitis.

The writer of this sentence uses the present perfect in order to suggest that the decision made in the past is still of importance in the present.

The government has cut university budgets; consequently, the dean has increased the size of most classes.

Here both actions took place sometime in the past and continue to influence the present.

The heat wave has lasted three weeks.

In this sentence, the writer uses the present perfect to indicate that a condition (the heat wave) began in past and continues to affect the present.

Donna has dreamt about frogs sitting in trees every night this week.

Here the action of dreaming has begun in the past and continues into the present.

The Past Perfect Tense

The past perfect tense is used to refer to actions that took place and were completed in the past. The past perfect is often used to emphasis that one action, event or condition ended before another past action, event, or condition began.

Each of the highlighted verbs in the following sentences is in the past perfect.

Miriam arrived at 5:00 p.m. but Mr. Whitaker had closed the store.

All the events in this sentence took place in the past, but the act of closing the store takes place before Miriam arrives at the store.

After we located the restaurant that Christian had raved about, we ate supper there every Friday.

Here the praise (“had raved”) precedes the finding (“located”) of the restaurant. Both actions took place sometime before the moment of speaking or writing.

The elephant had eaten all the hay so we fed it oats for a week.

In this sentence, both actions take place in the past, but the eating of the hay (“had eaten”) preceded the eating of the oats (“fed”).

The heat wave had lasted three weeks.

While the sentence “The heat wave has lasted three weeks” suggests that a condition began in the past and continues into the present, this sentence describes an action that began and ended sometime in the past (“had lasted”). By using the past perfect the writer indicates that the heat wave has no connection to any events occurring in the present.

After she had learned to drive, Alice felt more independent.

Here the learning took place and was completed at a specific time in the past. By using the past perfect rather than the simple past (“learned”), the writer emphasises that the learning preceded the feeling of independence.

The Future Perfect Tense

The future perfect is used to refer to an action that will be completed sometime in the future before another action takes place.

Each of the highlighted verbs in the following sentences is in the future perfect tense.

The surgeon will have operated on 6 patients before she attends a luncheon meeting.

In this sentence, the act of operating (“will have operated”) takes place in the future sometime before the act of attending (“attends”).

The plumber and his assistant will have soldered all the new joins in pipes before they leave for the next job.

Here, the plumbers’ act of soldering (“will have soldered”) will precede the act of leaving (“leave”).

By the time you get back from the corner store, we will have finished writing the thank you letters.

In this sentence, the act of returning from the store (“get back”) takes place after the act of writing (“will have written”).

If this year is like last year, I will have finished my holiday shopping long before my brother starts his.

In this example, the act of finishing (“will have finished”) occurs well before the act of starting (“starts”).

They will have written their first exam by the time we get out of bed.

Here, the act of getting out of bed occurs sometime after the writing of the exam.

 

 Table of Irregular Verbs

be  [bJ]	was [wOz], were [wW]	been [bJn]	Бути
become [bi’kAm]	became [bi’keim]	become [bi’kAm]	Ставати
Begin [bi’gin]	began [bi’gxn]	Begun [bi’gAn]	Починати
Bring [brIN]	brought [brLt]	brought [brLt]	Приносити
Build [bild]	built [blt]	built [blt]	Будувати
buy [bai]	bought [bLt]	bought [bLt]	Купувати
Come [kAm]	came [keim]	Come [kAm]	Приходити
cut [kAt]	cut [kAt]	cut [kAt]	Різати
deal [dJl]	dealt [delt]	Dealt [delt]]	мати справу
do [dH]	did [did]	done [dAn]	Робити
Drink [driNk]	drank [drxNk]	drunk [dANk]	Пити
eat [Jt]	ate [et] [eit]	eaten [‘Jt(q)n]	Їсти
fall [fLl]	fell [fel]	Fallen [‘fLlqn]	Падати
feel [fJl]	felt [felt]	felt [felt]	Відчувати
Fight [fait]	fought [fLt]	fought [fLt]	Змагатися
find [faind]	found [faund]	found [faund]	Знаходити
fly [flai]	flew [flu:]	Flown [flqun]	Літати
forget [fq’get]	forgot [fq’gOt]	forgotten [fq’gOtn]	Забувати
get [get]	got [gOt]	got [gOt]	Одержувати
give [giv]	gave [geiv]	Given [‘giv(q)n]	Давати
go [gqu]	went [went]	gone  [gOn]	Ходити
Have [hxv]	had [hxd]	had [hxd]	Мати
hear [hiq]	heard [hWd]	heard [hWd]	Чути
Keep [kJp]	kept [kept]	kept [kept]	Зберігати
Know [nqu]	knew [nju:]	known [nqun]	Знати
Learn [lWn]	learnt [lWnt]	learnt [lWnt]	Учити
Leave [lJv]	left [left]	left [left]	Залишати
lie [lai]	lay [lei]	lain [lein]	Лежати
Make [meik]	made [meid]	Made [meid]	Робити
Meet [mJt]	met [met]	met [met]	Зустрічати
pay [pei]	paid [peid]	paid [peid]	Платити
put [put]	put [put]	put [put]	Класти
read [rJd]	read [red]	read [red]	Читати
ring [riN]	rang [rxN]	Rung [rAN]	Дзвонити
rise [raiz]	rose [rquz]	Risen [‘riz(q)n]	Піднімати
run [rAn]	ran [rxn]	run [rAn]	Бігати
say [sei]	said [sed]	said [sed]	Сказати
see [sJ]	saw [sL]	seen [sJn]	Бачити
sell [sel]	sold [squld]	sold [squld]	Продавати
Send [send]	sent [sent]	sent [sent]	Посилати
Show [Squ]	showed [Squd]	showed [Squd]	Показувати
sing [siN]	sang [sxN]	Sung [sAN]	Співати
sit [sit]	sat [sxt]	sat [sxt]	Сидіти
speak [spJk]	spoke [spquk]	spoken [‘spquk(q)n]	Говорити
spend [spend]	spent [spent]	spent [spent	Витрачати
Stand [stxnd]	stood [stu:d]	stood [stu:d]	Стояти
take [teik]	took [tuk]	Taken [‘teik(q)n]	Брати
Teach [tJC]	taught [tLt]	taught [tLt]	Учити
tell [tel]	told [tquld]	told [tquld]	Розказувати
Think [TiNk]	thought [TLt]	thought [TLt]	Думати
understand [“Andq’stxnd]	understood [“Andq’stud]	understood [“Andq’stud]	Розуміти
Wake [weik]	woke [wquk]	woken [‘wquk(q)n]	Прокидатися
Write [rait]	wrote [rqut]	written [‘rit(q)n]	Писати

 

 

The Uses of One

As a determiner, the word one is sometimes used before a proper noun to designate, particularly, this person: “He delivered the package to one Ronald Pepin of Colchester.” The article “a” will also function in that position for the same purpose.

Sometimes we use the word one as an adjective, as in “I’ll have just one scoop of ice-cream,” and we seldom have trouble with that usage. But we also use one as a pronoun, and this is where one becomes surprisingly complex.

Sometimes the pronoun one functions as a numerical expression:

·                    Those are lovely scarves. I think I’ll buy one.

·                    One is hardly enough.

·                    One is purple, the other green.

·                    The three brothers get along quite well; in fact they adore one another.

·                    One of the senators will lead the group to the front of the capitol.

·                    The yellow car is fast, but I think the blue one will win.

As a pronoun, one can also function in an impersonal, objective manner, standing for the writer or for all people who are like the writer or for the average person or for all people who belong to a class. In the United States, one sometimes has a literary or highfalutin feel to it; the more it is used, the more pretentious it feels. In British English, the use of the impersonal or generic one is more commonplace and has no such stigma. In the U.S., one is often replaced by you.

·                    One would think the airlines would have to close down.

·                    One would [You’d] think the inner dome of heaven had fallen.

·                    The young comedian was awful; one felt embarrased for him.

·                    If one fails, then one must try harder next time.

When the pronoun one is used in the numerical sense, a different pronoun can be used in a subsequent reference.

·                    We watched as one [of the ospreys] dried its feathers in the sun.

·                    One [driver] pulled her car over to the side.

However, it is generally regarded as a bad idea to mix the impersonal or generic pronoun one with another pronoun, especially in the same sentence, as in “If one fails, then he/you must simply try harder.”

One‘s Reflexive and Possessive Forms

In the United States, the possessive and reflexive forms of one — one’s and oneself — are often replaced by other pronoun forms. In British English, they are commonplace:

·                    One must be conscientious about one’s dental hygiene.

In the U.S. that one’s is apt to be replaced by a third-person “his” or (more informally) a second-person “your”:

·                    One must learn from one’s [or his] mistakes.

·                    One must be conscientious about one’s [or his] dental hygiene.

·                    One must be conscientious about your dental hygiene.

In formal writing, the use of your in that last sentence — in either American or British English — would be regarded as too casual or even sub-standard. On the other hand, the problem with using “his” is obvious: it runs counter to the tendency to remove gender bias from one’s language as much as possible. Thus, even in American English, this mixture of “one” with “he/his/him” is slowly disappearing.*

Oneself is used in formal writing and speech as the proper reflexive form of one:

·                    If one slipped on this icy walk, one could hurt oneself badly.

Notice there is usually no apostrophe used in the spelling of oneself. The construction one’s self is used to refer to the concept of self (in psychology, for instance): “One’s self, according to Freud, is defined by the interactions of the id, the ego, and the super-ego.”

The Plural of One

As a singular numerical pronoun, we don’t have trouble with one: “Those donuts look delicious; I think I’ll pick this one.” But what if I want two donuts? It is possible, sometimes, to pluralize one:

·                    I really like the chocolate ones.

·                    The ones with chocolate frosting have cream fillings.

·                    Are these the ones you want?

·                    Do you want these ones?

When the word ones is preceded by a plural determiner (like these), we usually drop the ones and the determiner turns into a demonstrative pronoun: “Do you want these?”

The phrases “one in [plural number]” and “more than one” always take a singular verb:

·                    One in four dentists recommends this toothpaste.

·                    One out of every five instructors gets this question wrong.

·                    There is more than one reason for this.

·                    More than one lad has lost his heart to this lass.

The “one” in the phrase “more than one” apparently controls the number of the verb. It is probably wise not to attempt to divine some of the mysteries of the English language.

One of those [plural noun] that is/are …

“One is one and all alone and ever more shall be so,” goes the old Christmas song, but the fact that the singular one needs a singular verb can lead to confusion. In a recently published collection of language columns by William Safire, No Uncertain Terms, he wrote the following sentence (page 336):

“Conduct unbecoming an officer and a gentleman” is one of those phrases that sounds as if it comes out of Kipling.

The sentence caused considerable stir (as such things go), for the verb “sounds” should really relate to the plural “phrases,” not the singular “one.” The sentence should probably read (underlining things for our purpose):

“Conduct unbecoming an officer and a gentleman” is one of those phrases that sound as if they came out of Kipling.

The rare device for figuring out which verb to use in this construction is as follows: turn the sentence inside out:

Of those phrases that sound as if they came out of Kipling, “conduct unbecoming an officer and a gentleman” is one.

In this situation, the subject of the subordinate clause — usually a who or a that — will refer to the plural noun in the preceding prepositional phrase (not the one before it) and require a plural verb to follow.

There is a possible exception, however. In Burchfield’s New Fowlers*, we find this example:

“Don’t you think,” said Bernard, “that Hawaii is one of those places that was always better in the past.” (from David Lodge, 1991; my underline)

Burchfield adds, “A plural verb in the subordinate clause is recommended unless particular attention is being drawn to the uniqueness, individuality, etc., of the one in the opening clause.” In an earlier note, Burchfield writes: “Exceptions [to the rule that we use the plural verb] occur when the writer or speaker presumably regards one as governing the verb in the subordinate clause,” and he gives another two or three examples, including “I am one of those people who wants others to do what I think they should.”

 

Glossary of Dental Health Terms

abscess: an infection of a tooth, soft tissue, or bone.

abutment: tooth or teeth on either side of a missing tooth that support a fixed or removable bridge.

acrylic resin: the plastic widely used in dentistry.

ADA Seal of Acceptance: a designation awarded to products that have met American Dental Association’s criteria for safety and effectiveness and whose packaging and advertising claims are scientifically supported.

adjustment: a modification made upon a dental prosthesis after it has been completed and inserted into the mouth.

air abrasion/micro abrasion: a drill-free technique that blasts the tooth surface with air and an abrasive. This is a relatively new technology that may avoid the need for an anesthetic and can be used to remove tooth decay, old composite restorations and superficial stains and discolorations, and prepare a tooth surface for bonding or sealants.

alveolar bone: the bone surrounding the root of the tooth, anchoring it in place; loss of this bone is typically associated with severe periodontal (gum) disease.

amalgam: a common filling material used to repair cavities. The material, also known as “silver fillings,” contains mercury in combination with silver, tin, copper, and sometimes zinc.

anaerobic bacteria: bacteria that do not need oxygen to grow; they are generally associated with periodontal disease (see below).

analgesia: a state of pain relief; an agent for lessening pain.

anesthesia: a type of medication that results in partial or complete elimination of pain sensation; numbing a tooth is an example of local anesthesia; general anesthesia produces partial or complete unconsciousness.

antibiotic: a drug that stops or slows the growth of bacteria.

antiseptic: a chemical agent that can be applied to living tissues to destroy germs.

apex: the tip of the root of a tooth.

appliance: any removable dental restoration or orthodontic device.

arch: a description of the alignment of the upper or lower teeth.

baby bottle tooth decay: decay in infants and children, most often affecting the upper front teeth, caused by sweetened liquids given and left clinging to the teeth for long periods (for example, in feeding bottles or pacifiers). Also called early childhood carries.

bicuspid: the fourth and fifth teeth from the center of the mouth to the back of the mouth. These are the back teeth that are used for chewing; they only have two points (cusps). Adults have eight bicuspids (also called premolars), two in front of each group of molars.

biofeedback: a relaxation technique that involves learning how to better cope with pain and stress by altering behavior, thoughts, and feelings.

biopsy: removal of a small piece of tissue for diagnostic examination.

bite: relationship of the upper and lower teeth upon closure (occlusion).

bite-wing: a single X-ray that shows upper and lower teeth teeth (from crown to about the level of the supporting bone) in a select area on the same film.

bleaching: chemical or laser treatment of natural teeth that uses peroxide to produce the whitening effect.

bonding: the covering of a tooth surface with a tooth-colored composite to repair and/or change the color or shape of a tooth, for instance, due to stain or damage.

bone resorption: decrease in the amount of bone supporting the roots of teeth; a common result of periodontal (gum) disease.

braces: devices (bands, wires, ceramic appliances) put in place by orthodontists to gradually reposition teeth to a more favorable alignment.

bridge: stationary dental prosthesis (appliance) fixed to teeth adjacent to a space; replaces one or more missing teeth, cemented or bonded to supporting teeth or implants adjacent to the space. Also called a fixed partial denture.

bruxism: grinding or gnashing of the teeth, most commonly during sleep.

calcium: an element needed for the development of healthy teeth, bones, and nerves.

calculus: hard, calcium-like deposits that form on teeth due to inadequate plaque control, often stained yellow or brown. Also called “tartar.”

canker sore: sores or small shallow ulcers that appear in the mouth and often make eating and talking uncomfortable; they typically appear in people between the ages of 10 and 20 and last about a week in duration before disappearing.

cap: common term for a dental crown.

caries: tooth decay or “cavities.” A dental infection caused by toxins produced by bacteria.

cementum: hard tissue that covers the roots of teeth.

clasp: device that holds a removable partial denture to stationary teeth.

cleaning: removal of plaque and calculus (tarter) from teeth, generally above the gum line.

cleft lip: a physical split or separation of the two sides of the upper lip that appears as a narrow opening or gap in the skin of the upper lip. This separation often extends beyond the base of the nose and includes the bones of the upper jaw and/or upper gum.

cleft palate: a split or opening in the roof of the mouth.

composite resin filling: tooth-colored restorative material composed of plastic with small glass or ceramic particles; usually “cured” or hardened with filtered light or chemical catalyst. An alternative to silver amalgam fillings.

conventional denture: a denture that is ready for placement in the mouth about eight to 12 weeks after the teeth have been removed.

cosmetic (aesthetic) dentistry: a branch of dentistry under which treatments are performed to enhance the color and shape of teeth.

crown: (1) the portion of a tooth above the gum line that is covered by enamel; (2) dental restoration covering all or most of the natural tooth; the artificial cap can be made of porcelain, composite, or metal and is cemented on top of the damaged tooth.

cuspids: the third tooth from the center of the mouth to the back of the mouth. These are the front teeth that have one rounded or pointed edge used for biting. Also known as canines.

cusps: the high points on the chewing surfaces of the back teeth.

cyst: an abnormal sac containing gas, fluid, or a semisolid material.

DDS: Doctor of Dental Surgery — equivalent to DMD, Doctor of Dental Medicine.

decay: destruction of tooth structure caused by toxins produced by bacteria.

deciduous teeth: commonly called “baby teeth” or primary teeth; the first set of (usually) 20 teeth.

demineralization: loss of mineral from tooth enamel just below the surface in a carious lesion; usually appears as a white area on the tooth surface.

dentin: inner layer of tooth structure, immediately under the surface enamel.

denture: a removable replacement of artificial teeth for missing natural teeth and surrounding tissues. Two types of dentures are available — complete and partial. Complete dentures are used when all the teeth are missing, while partial dentures are used when some natural teeth remain.

DMD: Doctor of Medical Dentistry; equivalent to DDS, Doctor of Dental Surgery.

dry mouth: a condition in which the flow of saliva is reduced and there is not enough saliva to keep the mouth moist. Dry mouth can be the result of certain medications (such as antihistamines and decongestants), certain diseases (such as Sjögren’s syndrome, HIV/AIDS, Alzheimer’s disease, diabetes), certain medical treatments (such as head and neck radiation), as well as nerve damage, dehydration, tobacco use, and surgical removal of the salivary glands. Also called xerostomia.

dry socket: a common complication that occurs when either a blood clot has failed to form in an extracted tooth socket or else the blood clot that did form has been dislodged.

edentulous: having no teeth.

enamel: the hard, mineralized material that covers the outside portion of the tooth that lies above the gum line (the crown).

endodontics: a field of dentistry concerned with the biology and pathology of the dental pulp and root tissues of the tooth and with the prevention, diagnosis, and treatment of diseases and injuries of these tissues. A root canal is a commonly performed endodontic procedure.

endodontist: a dental specialist concerned with the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth.

eruption: the emergence of the tooth from its position in the jaw.

extraction: removal of a tooth.

filling: restoration of lost tooth structure with metal, porcelain, or resin materials.

fistula: channel emanating pus from an infection site; a gum boil.

flap surgery: lifting of gum tissue to expose and clean underlying tooth and bone structures.

flossing: a thread-like material used to clean between the contact areas of teeth; part of a good daily oral hygiene plan.

fluoride: a mineral that helps strengthen teeth enamel making teeth less susceptible to decay. Fluoride is ingested through food or water, is available in most toothpastes, or can be applied as a gel or liquid to the surface of teeth by a dentist.

fluorosis: discoloration of the enamel due to too much fluoride ingestion (greater than one part per million) into the bloodstream, also called enamel mottling.

general dentist: the primary care dental provider. This dentist diagnoses, treats, and manages overall oral health care needs, including gum care, root canals, fillings, crowns, veneers, bridges, and preventive education.

gingiva: the soft tissue that surrounds the base of the teeth; the pink tissue around the teeth.

gingivectomy: surgical removal of gum tissue.

gingivitis: inflamed, swollen, and reddish gum tissue that may bleed easily when touched or brushed. It is the first step in a series of events that begins with plaque build up in the mouth and may end — if not properly treated — with periodontitis and tooth loss due to destruction of the tissue that surrounds and supports the teeth.

gingivoplasty: a procedure performed by periodontists to reshape the gum tissue.

gold fillings: an alternative to silver amalgam fillings.

gum recession: exposure of dental roots due to shrinkage of the gums as a result of abrasion, periodontal disease, or surgery.

gutta percha: material used in the filling of root canals.

halitosis: bad breath of oral or gastrointestinal origin.

handpiece: the instrument used to hold and revolve burs in dental operations.

hard palate: the bony front portion of the roof of the mouth.

hygienist: a licensed, auxiliary dental professional who is both an oral health educator and clinician who uses preventive, therapeutic, and educational methods to control oral disease.

hypersensitivity: a sharp, sudden painful reaction in teeth when exposed to hot, cold, sweet, sour, salty, chemical, or mechanical stimuli.

immediate denture: a complete or partial denture that is made in advance and can be positioned as soon as the natural teeth are removed.

impacted tooth: a tooth that is partially or completely blocked from erupting through the surface of the gum. An impacted tooth may push other teeth together or damage the bony structures supporting the adjacent tooth. Often times, impacted teeth must be surgically removed.

implant: a metal rod (usually made of titanium) that is surgically placed into the upper or lower jawbone where a tooth is missing; it serves as the tooth root and anchor for the crown, bridge, or denture that is placed over it.

impression: mold made of the teeth and soft tissues.

incision and drainage: surgical incision of an abscess to drain pus.

incisors: four upper and four lower front teeth, excluding the cuspids (canine teeth). These teeth are used primarily for biting and cutting.

inlay: similar to a filling but the entire work lies within the cusps (bumps) on the chewing surface of the tooth.

jawbone: The hard bone that supports the face and includes alveolar bone, which anchors the teeth.

leukoplakia: a white or gray patch that develops on the tongue or the inside of the cheek. It is the mouth’s reaction to chronic irritation of the mucous membranes of the mouth.

malocclusion: “bad bite” or misalignment of the teeth or jaws.

mandible: the lower jaw.

maxilla: the upper jaw.

mercury: a metal component of amalgam fillings.

molars: three back teeth in each dental quadrant used for grinding food.

mouth guard: a soft-fitted device that is inserted into the mouth and worn over the teeth to protect them against impact or injury.

muscle relaxant: a type of medication often prescribed to reduce stress.

nerve: tissue that conveys sensation, temperature, and position information to the brain.

nerve (root) canal: dental pulp; the internal chamber of a tooth where the nerves and blood vessels pass.

night guard: a removable acrylic appliance that fits over the upper and lower teeth used to prevent wear and temporomandibular damage caused by grinding or gnashing of the teeth during sleep.

nitrous oxide: a gas (also called laughing gas) used to reduce patient anxiety.

NSAID: a nonsteroidal anti-inflammatory drug, often used as a dental analgesic.

occlusal X-rays: an X-ray showing full tooth development and placement. Each X-ray reveals the entire arch of teeth in either the upper or lower jaw.

occlusion: the relationship of the upper and lower teeth when the mouth is closed.

onlay: a type of restoration (filling) made of metal, porcelain, or acrylic that is more extensive than an inlay in that it covers one or more cusps. Onlays are sometimes called partial crowns.

oral cavity: the mouth.

oral and maxillofacial radiologist: the oral health care provider who specializes in the production and interpretation of all types of X-ray images and data that are used in the diagnosis and management of diseases, disorders, and conditions of the oral and maxillofacial region.

oral and maxillofacial surgery: surgical procedures on the mouth including extractions, removal of cysts or tumors, and repair of fractured jaws.

oral hygiene: process of maintaining cleanliness of the teeth and related structures.

oral medicine: the specialty of dentistry that provides for the care of the medically complex patient through the integration of medicine and oral health care.

oral pathologist: the oral health care provider who studies the causes of diseases that alter or affect the oral structures (teeth, lips, cheeks, jaws) as well as parts of the face and neck.

oral surgeon: the oral health care provider who performs many types of surgical procedures in and around the entire face, mouth, and jaw area.

orthodontics: dental specialty that using braces, retainers, and other dental devices to treat misalignment of teeth, restoring them to proper functioning.

orthodontist: the oral health provider who specializes in diagnosis, prevention, interception, and treatment of malocclusions, or “bad bites,” of the teeth and surrounding structures. This is the specialist whose responsibility it is to straighten teeth by movement of the teeth through bone by the use of bands, wires, braces, and other fixed or removable corrective appliances or retainers.

overbite: an excessive protrusion of the upper jaw resulting in a vertical overlap of the front teeth.

overjet: an excessive protrusion of the upper jaw resulting in a horizontal overlap of the front teeth.

overdenture: denture that fits over residual roots or dental implants.

palate: hard and soft tissue forming the roof of the mouth.

panoramic X-ray: a type of X-ray that shows a complete two dimensional representation of all the teeth in the mouth. This X-ray also shows the relationship of the teeth to the jaws and the jaws to the head.

partial denture: a removable appliance that replaces some of the teeth in either the upper or lower jaw.

pathology: study of disease.

pedodontics or pediatric dentistry: dental specialty focusing on treatment of infants, children, and young adults.

pedodontist/pediatric dentist: the oral health care provider who specializes in the diagnosis and treatment of the dental problems of children from infancy to young adulthood. This provider also usually cares for special needs patients.

periapical: region at the end of the roots of teeth.

periapical X-rays: X-rays providing complete side views from the roots to the crowns of the teeth.

periodontal ligament: The connective tissue that surrounds the tooth (specifically covering the cementum) and connects the tooth to the jawbone, holding it in place.

periodontist: the dental specialist who specializes in diagnosing, treating, and preventing diseases of the soft tissues of the mouth (the gums) and the supporting structures (bones) of the teeth (both natural and man-made teeth).

periodontitis: a more advanced stage of periodontal disease in which the inner layer of the gum and bone pull away from the teeth and form pockets and alveolar bone is destroyed.

periodontium: The tissue that lines the socket into which the root of the tooth fits.

permanent teeth: the teeth that replace the deciduous or primary teeth — also called baby teeth. There are (usually) 32 adult teeth in a complete dentition.

plaque: a colorless, sticky film composed of undigested food particles mixed with saliva and bacteria that constantly forms on the teeth. Plaque left alone eventually turns in to tartar or calculus and is the main factor in causing dental caries and periodontal disease.

pontic: a replacement tooth mounted on a fixed or removal appliance.

porcelain: a tooth-colored, sand-like material; much like enamel in appearance.

porcelain crown: all porcelain restoration covering the coronal portion of tooth (above the gum line).

porcelain fused to metal (PFM) crown: restoration with metal caping (for strength) covered by porcelain (for appearance).

porcelain inlay or onlay: tooth-colored restoration made of porcelain, cemented or bonded in place.

post: thin metal rod inserted into the root of a tooth after root canal therapy; provides retention for a capping that replaces lost tooth structure.

pregnancy gingivitis: gingivitis that develops during pregnancy. The hormonal changes that occur during pregnancy — especially the increased level of progesterone — may make it easier for certain gingivitis-causing bacteria to grow as well as make gum tissue more sensitive to plaque and exaggerate the body’s response to the toxins (poisons) that result from plaque.

pregnancy tumors: an extreme inflammatory reaction to a local irritation (such as food particles or plaque) that occurs in up to 10% of pregnant women and often in women who also have pregnancy gingivitis. Pregnancy tumors appear on inflamed gum tissue as large lumps with deep red pinpoint markings on it, usually near the upper gum line. The red lump glistens, may bleed and crust over, and can make eating and speaking difficult and cause discomfort.

primary teeth: the first set of 20 temporary teeth. Also called baby teeth, the primary dentition, or deciduous teeth, normally fall out one by one between 6 and 12 years of age.

prophylaxis: the cleaning of the teeth for the prevention of periodontal disease and tooth decay.

prosthetics: a fixed or removable appliance used to replace missing teeth (for example, bridges, partials, and dentures).

prosthodontist: a dental specialist who is skilled in restoring or replacing teeth with fixed or removable prostheses (appliances), maintaining proper occlusion; treats facial deformities with artificial prostheses such as eyes, ears, and noses.

pulp: the living part of the tooth, located inside the dentin. Pulp contains the nerve tissue and blood vessels that supply nutrients to the tooth.

radiographic: refers to X-rays.

radio wave therapy: a therapy involving the use of low level electrical stimulation to increase blood flow and provide pain relief. In dentistry, this is one type of therapy that can be applied to the joint of individuals with temporomandibular disorder.

recontouring: a procedure in which small amounts of tooth enamel are removed to change a tooth’s length, shape, or surface. Also called odontoplasty, enameloplasty, stripping, or slenderizing.

remineralization: redeposition or replacement of the tooth’s minerals into a demineralized (previously decayed) lesion. This reverses the decay process, and is enhanced by the presence of topical fluoride.

restorations: any replacement for lost tooth structure or teeth; for example, bridges, dentures, fillings, crowns, and implants.

retainer: a removable appliance used to maintain teeth in a given position (usually worn at night).

root: tooth structure that connects the tooth to the jaw.

root canal therapy: procedure used to save an abscessed tooth in which the pulp chamber is cleaned out, disinfected, and filled with a permanent filling.

rubber dam: soft latex or vinyl sheet used to establish isolation of one or more teeth from contamination by oral fluids and to keep materials from falling to the back of the throat.

saliva: clear lubricating fluid in the mouth containing water, enzymes, bacteria, mucus, viruses, blood cells and undigested food particles.

salivary glands: glands located under tongue and in cheeks that produce saliva.

scaling and root planing: a deep-cleaning, nonsurgical procedure whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing).

sealants: a thin, clear or white resin substance that is applied to the biting surfaces of teeth to prevent decay.

sedative: a type of medication used to reduce pain and anxiety, and create a state of relaxation.

soft palate: the back one-third of the roof of the mouth composed of soft tissue.

space maintainer: dental device that holds the space lost through premature loss of baby teeth.

stains: can be either extrinsic or intrinsic. Extrinsic stain is located on the outside of the tooth surface originating from external substances such as tobacco, coffee, tea, or food; usually removed by polishing the teeth with an abrasive prophylaxis paste. Intrinsic stain originates from the ingestion of certain materials or chemical substances during tooth development, or from the presence of caries. This stain is permanent and cannot be removed.

stomatitis: an inflammation of the tissue underlying a denture. Ill-fitting dentures, poor dental hygiene, or a buildup of the fungus Candida albicans can cause the condition.

supernumerary tooth: an extra tooth.

tartar: common term for dental calculus, a hard deposit that adheres to teeth; produces rough surface that attracts plaque.

teething: baby teeth pushing through the gums.

temporomandibular disorder (TMD)/temporomandibular joint (TMJ): the term given to a problem that concerns the muscles and joint that connect the lower jaw with the skull. The condition is characterized by facial pain and restricted ability to open or move the jaw. It is often accompanied by a clicking or popping sound when the jaw is opened or closed.

thrush: an infection in the mouth caused by the fungus Candida.

tooth whitening: a chemical or laser process to lighten the color of teeth.

topical anesthetic: ointment that produces mild anesthesia when applied to a soft tissue surface.

transcutaneous electrical nerve stimulation (TENS): a therapy that uses low-level electrical currents to provide pain relief. In dentistry, TENS is one type of therapy that can be used to relax the jaw joint and facial muscles.

transplant: placing a natural tooth in the empty socket of another tooth.

trauma: injury caused by external force, chemical, temperature extremes, or poor tooth alignment.

trigger-point injections: a method of relieving pain whereby pain medication or anesthesia is injected into tender muscles called “trigger points.” In dentistry, this can be used in individuals with temporomandibular disorders.

ultrasound: a treatment in which deep heat is applied to an affected area to relieve soreness or improve mobility. In dentistry, ultrasound can be used to treat temporomandibular disorders.

underbite: when the lower jaw protrudes forward causing the lower jaw and teeth to extend out beyond the upper teeth.

unerupted tooth: a tooth that has not pushed through the gum and assumed its correct position in the dental arch.

veneer: a thin, custom-made shell of tooth-colored plastic or porcelain that is bonded directly to the front side of natural teeth to improve their appearance — for example, to replace lost tooth structure, close spaces, straighten teeth, or change color and/or shape.

wisdom teeth: third (last) molars that usually erupt at age 18-25.

xerostomia: dry mouth or decrease in the production of saliva.

X-rays: high frequency light (or radiation) that penetrates different substances with different rates and absorption. In dentistry, there are typically four types of X-rays: periapical, bite-wing, occlusal, and panoramic.