The 1-st year,
Module 2
№ 2. Subject: Dental examination. Dental care.
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.
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.
Literature:
Principle: a) Ісаєва О.С., Кучумова Н.В., Шумило М.Ю. English for Dentists. – Львів: Кварт, 2008.
Additional: a) Демченко О. Й., Костяк Н.В. Англійська мова для студентів-медиків. Тернопіль: Укрмедкнига, 2001.
b) Мухіна В.В. Англійська мова для студентів-стоматологів. – М., 2003.
c) Шиленко Р.В., Мухина В.В., Скрипникова Т.П. Англійська мова. /Практичний курс для студентів стоматологічного факультету/. – Полтава, 1998.
d) Верба Г.В. Граматика сучасної англійської мови. – К., Логос, 2000.
e) Матеріали кафедри.
