The 1-st year,

Module 2

№ 14. Subject: Filling. Fillings. Crowns.

Filling

Conservative treatment of caries, when the pulp is vital and unexposed is by filling. If the pulp is exposed or dead, root canal therapy is usually necessary before the filling is done. Fillings are inserted in teeth to replace the pulp destroyed by caries. The normal function of the tooth is thereby restored, pain is prevented, and the vitality of the pulp is preserved. In front teeth, fillings restore normal appearance; whilst in back

The 1-st year,

Module 2

№ 14. Subject: Filling. Fillings. Crowns.

Filling

Conservative treatment of caries, when the pulp is vital and unexposed is by filling. If the pulp is exposed or dead, root canal therapy is usually necessary before the filling is done. Fillings are inserted in teeth to replace the pulp destroyed by caries. The normal function of the tooth is thereby restored, pain is prevented, and the vitality of the pulp is preserved. In front teeth, fillings restore normal appearance; whilst in back teeth, the stagnation areas are eradicated and further caries prevented.

Temporary fillings are inserted as a temporary measure only. They are too soft to use as permanent fillings. The temporary fillings are:

zinc oxide and eugenol cement,

zinc phosphate cement,

zinc polyacrylate cement,

gutta-percha.

Permanent fillings are also various.

For premolars and molars, amalgam or gold is used. In front teeth, where these fillings would show, silicate cement, acrylic or composite fillings are used instead as their colour matches the tooth. A permanent filling cannot be inserted directly into a carious cavity. Careful preparation of the cavity is required to ensure that all caries is removed; that the filling will be a permanent fixture; and caries will not recur at its margins. The general principles of cavity preparation are as follows:

1. Undermined enamel is chipped away with an enamel chisel.

2. The cavity is extended to remove the entire stagnation area, e.g, occlusal fissures, on the carious surface. This is done with a handpieces and burs.

3. Any remaining caries is removed with an excavator.

4. Burs and chisels are then used to finish off the cavity according to the type of filling necessary.

Permanent fillings are meant to stay put permanently and the cavity must be specially prepared to provide maximum retention. Before explaining how this is done, it is necessary to consider the types of fillings used. There are only two types available: plastic and pre-constructed.

Plastic fillings are soft and plastic on insertion but set hard in the cavity. They include temporary cements, gutta-percha, amalgam, silicate cement, acrylic and composite fillings.

Pre-constructed restorations are gold inlays and crowns. These are made in the laboratory, after the teeth have been prepared, and are then cemented into place.

Retention for plastic fillings is obtained by simply undercutting the cavity to make the entrance smaller than its inside dimensions. Thus a plastic filling can be packed in when soft but cannot possibly come out when hard. For fillings involving occlusal and mesial surfaces, or occlusal and distal, a dovetail is cut in the occlusal surface to prevent the filling coming out mesially or distally. Gold inlays and crowns are hard and rigid when inserted and cannot utilize undercuts for retention. To prevent them coming out occlusally, they rely on parallel cavity walls and adhesive cement. As with plastic fillings an occlusal dovetail is used to prevent dislodgement mesially or distally

Before a permanent filling is inserted the cavity may need to be lined. A lining is an insulating layer of cement which protects the pulp against conduction of heat or cold through metal fillings; or against the irritant effect of certain other fillings, such as silicates and acrylic. Pain, and possibly death of the tooth, may occur through failure to insert an adequate lining. The technique of inserting a filling varies with the type of cavity and filling material used.

Fillings

The temporary filling materials most commonly used are zinc oxide and eugenol cement, zinc phosphate cement, zinc polyacrylate cement and gutta-percha. They are not used as permanent fillings as they are too soft and would not remain intact for long periods.

Temporary Fillings are used:

1. As a first-aid measure to relieve pain.

2. When there is insufficient time to complete the cavity and insert a permanent filling in one visit.

3. For permanent fillings requiring more than one visit, e.g. inlays and crowns, a temporary restoration is necessary between visits.

Zinc oxide and eugenol cement is non-irritant to the pulp and can be safely used in the very deepest cavities.

It is too soft and slow-setting to use as a foundation for a permanent filling in one visit. But this can be overcome by using a quick-setting proprietary brand which hardens rapidly enough to make a satisfactory lining for permanent fillings. It cannot be used as a lining for acrylic fillings.

Preparations containing eugenol may cause a burning sensation if they come in contact with the lips. Amalgam is the most widely used permanent filling in dentistry and is prepared by mixing the alloy with mercury. The alloy contains silver, tin, copper and zinc; well over half consists of silver, whilst tin forms just over a quarter. It is supplied in the form of powder for hand mixing, or as pre-packed capsules or pellets for mechanical mixing.

As amalgam is a plastic filling and a good conductor, cavities are undercut for retention and lined to insulate the pulp.

The colour precludes its use in front teeth where it would show. As it is a good conductor, a lining is necessary in all but the shallowest cavities to prevent pain from sudden temperature changes, such as occur with very hot or cold drinks.

Acrylic is used as a permanent filling for front teeth as it matches them perfectly and equals silicate in this respect. However, it has many other important uses in dentistry. Both silicate cement and acrylic have serious shortcomings as permanent filling materials for front teeth. Silicate fillings are really only semi-permanent and, unless a meticulous technique is used, may discolour and lose their perfect appearance. Similarly, acrylic fillings may undergo marginal staining due to shrinkage. In an attempt to overcome disadvantages, new filling materials have recently been introduced which combine the best properties of both materials and avoid their worst defects. These new materials are known as composite fillings and several types are available.

Basically they consist of an inorganic strengthener in a resin binder. The inorganic strengthener may resemble silicate cement or consist of glass beads or quartz. This is incorporated into the resin binder.

VIDEO

FILLINGS

Dental Health and Tooth Fillings

What Steps Are Involved in Filling a Tooth?

First, the dentist will numb the area around the tooth to be filled with a local anesthetic. Next, a drill, air abrasion instrument, or laser will be used to remove the decayed area. The choice of instrument depends on the individual dentist's comfort level, training, and investment in the particular piece of equipment as well as location and extent of the decay.

Next, your dentist will probe or test the area during the decay removal process to determine if all the decay has been removed. Once the decay has been removed, your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Several additional steps are required for tooth-colored fillings and are as follows. After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that "cures" or hardens each layer is applied. When the multilayering process is completed, your dentist will shape the composite material to the desired result, trim off any excess material, and polish the final restoration.

What Types of Filling Materials Are Available?

Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material, patients' insurance coverage, and your dentist's recommendation assist in determining the type of filling that will best address your needs.

Cast Gold Fillings

Advantages of cast gold fillings:

1. Durability - lasts at least 10 to 15 years, usually longer; doesn't corrode

2. Strength - can withstand chewing forces

3. Aesthetics - some patients find gold more pleasing to the eye than silver, amalgam fillings

Disadvantages of cast gold fillings:

1. Expense - gold cast fillings are more than other materials; up to 10 times higher than cost of amalgam filings

2. Additional office visits - requires at least two office visits to place

3. Galvanic shock - a gold filling placed immediately next to a silver, amalgam filling can cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur - it's a rare occurrence, however

4. Aesthetics - most patients don't like any "colored" fillings

Silver Fillings (Amalgams)

Advantages of silver fillings:

1. Durability - silver fillings last at least 10 to 15 years and usually outlasts composite fillings

2. Strength - can withstand chewing forces

3. Expense - is less expensive than composite fillings

Disadvantages of silver fillings: 

1. Poor aesthetics - silver fillings don't match the color of your natural teeth

2. Destruction of more tooth structure - healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling

3. Discoloration - amalgam fillings can create a grayish hue to the surrounding tooth structure

4. Cracks and fractures - although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack orfracture, amalgam material - in comparison with other filling materials - may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fractures

5. Allergic reactions - a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations

Tooth-colored Composites

Advantages of composites:

1. Aesthetics - the shade/color of the composite fillings can be closely matched to the color of existing teeth; is particularly well suited for use in front teeth or visible parts of teeth

2. Bonding to tooth structure - composite fillings actually chemically bond to tooth structure, providing further support to the tooth

3. Versatility in uses - in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth

4. Tooth-sparing preparation - sometimes less tooth structure needs to be removed compared with amalgams when removing decay and preparing for the filling

Disadvantages of composites:

1. Lack of durability - composite fillings wear out sooner than amalgams (lasting at least 5 years compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgams under the pressure of chewing and particularly if used as the filling material for large cavities

2. Increased chair time - because of the process to apply the composite material, these fillings can take up to 20 minutes longer than amalgams to place

3. Additional visits - if composites are used for inlays or onlays, more than one office visit may be required

4. Chipping - depending on location, composite materials can chip off the tooth

5. Expense - composite fillings can cost up to twice the cost of amalgams

In addition to tooth-colored, composite resin fillings, two other tooth-colored fillings exist - ceramics and glass ionomer.

Other Filling Types

1. Ceramics. These fillings are made most often of porcelain, are more resistant to staining than composite resin material but are also more abrasive. This material generally lasts more than 15 years and can cost as much as gold.

2. Glass ionomer is made of acrylic and a specific type of glass material. This material is most commonly used for fillings below the gum line and for fillings in young children (drilling is still required). Glass ionomers release fluoride, which can help protect the tooth from further decay. However, this material is weaker than composite resin and is more susceptible to wear and prone to fracture. Glass ionomer generally lasts 5 years or less with costs comparable to composite resin.

Does Dental Insurance Cover the Cost of Composites?

Most dental insurance plans cover the cost of the composites up to the price of the silver filling, then the patient must pay the difference.

What Are Indirect Fillings?

Indirect fillings are similar to composite or tooth-colored fillings except that they are made in a dental laboratory and require two visits before being placed. Indirect fillings are considered when not enough tooth structure remains to support a filling but the tooth is not so severely damaged that it needs a crown.

During the first visit, decay or an old filling is removed. An impression is taken to record the shape of the tooth being repaired and the teeth around it. The impression is sent to a dental laboratory that will make the indirect filling. A temporary filling (described below) is placed to protect the tooth while your restoration is being made. During the second visit, the temporary filling is removed, and the dentist will check the fit of the indirect restoration. Provided the fit is acceptable, it will be permanently cemented into place.

There are two types of indirect fillings - inlays and onlays.

• Inlays are similar to fillings but the entire work lies within the cusps (bumps) on the chewing surface of the tooth.
• Onlays are more extensive than inlays, covering one or more cusps. Onlays are sometimes called partial crowns.

Inlays and onlays are more durable and last much longer than traditional fillings - up to 30 years. They can be made of tooth-colored composite resin, porcelain, or gold. Inlays and onlays weaken the tooth structure, but do so to a much lower extent than traditional fillings.

Another type of inlay and onlay - direct inlays and onlays - follow the same processes and procedures as the indirect, the difference is that direct inlays and onlays are made in the dental office and can be placed in one visit. The type of inlay or onlay used depends on how much sound tooth structure remains and consideration of any cosmetic concerns.

What's a Temporary Filling and Why Would I Need One?

Temporary fillings are used under the following circumstances:

1. For fillings that require more than one appointment - for example, before placement of gold fillings and for certain filling procedures (called indirect fillings) that use composite materials

2. Following a root canal

3. To allow a tooth's nerve to "settle down" if the pulp became irritated

4. If emergency dental treatment is needed (such as to address a toothache)

Temporary fillings are just that; they are not meant to last. They usually fall out, fracture, or wear out within 1 month. Be sure to contact your dentist to have your temporary filling replaced with a permanent one. If you don't, your tooth could become infected or you could have other complications.

Are Amalgam-Type Fillings Safe?

Over the past several years, concerns have been raised about silver-colored fillings, otherwise called amalgams. Because amalgams contain the toxic substance mercury, some people think that amalgams are responsible for causing a number of diseases, including autism, Alzheimer's disease, and multiple sclerosis.

The American Dental Association (ADA), the FDA, and numerous public health agencies say there's no proof that dental fillings cause harm to consumers. The causes of autism, Alzheimer's disease, and multiple sclerosis remain unknown. Additionally, there is no solid, scientific evidence to back up the claim that if a person has amalgam fillings removed, he or she will be cured of these or any other diseases.

Although amalgams do contain mercury, when they are mixed with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for more than 100 years to fill and preserve hundreds of millions of decayed teeth.

How Should I Care for My Teeth With Fillings?

To maintain your fillings, you should follow good oral hygiene practices - visiting your dentist regularly for cleanings, brushing with a fluoride toothpaste, and flossing at least once daily. If your dentist suspects that a filling might be cracked or is "leaking" (when the sides of the filling don't fit tightly against the tooth, this allows debris and saliva to seep down between the filling and the tooth, which can lead to decay), he or she will take X-rays to assess the situation. If your tooth is extremely sensitive, if you feel a sharp edge, if you notice a crack in the filling, or if a piece of the filling is missing, call your dentist for an appointment.

Problems With Dental Fillings

Tooth Pain and Sensitivity

Tooth sensitivity following placement of a filling is fairly common. A tooth may be sensitive to pressure, air, sweet foods, or temperature. Usually, the sensitivity resolves on its own within a few weeks. During this time, avoid those things that are causing the sensitivity. Pain relievers are generally not required.

What is a dental crown? Why do teeth require dental crowns?

What are dental crowns?

Crowns are a type of dental restoration which, when cemented into place, fully cup over the portion of a tooth that lies at and above the gum line. In comparison, fillings are dental restorations that fill in or cover over just a portion of a tooth. Since dental crowns encase the entire visible aspect of a tooth, a dental crown in effect becomes the tooth's new outer surface.

Crowns can be made out of porcelain (meaning some sort of dental ceramic), metal (a gold or other metal alloy), or a combination of both. Other terms that are used to refer to dental crowns are "dental caps" and "tooth caps."

Why do teeth need dental crowns?

A dentist might recommend placing a dental crown for a variety of reasons but, in general, most of these reasons will usually fall within one of the following basic categories:

• To restore a tooth to its original shape.
• To strengthen a tooth.
• To improve the cosmetic appearance of a tooth.

Dental crowns be used to restore a tooth's shape and strength.

Since a dental crown that has been cemented into place essentially becomes the new outer surface for the tooth, it is easy to imagine how the placement of a crown can restore a tooth to its original shape. It's also easy to see how a dental crown can help to strengthen a tooth by way of being a hard outer shell that encases the tooth structure that lies within it. For both of these reasons, dental crowns are routinely made for teeth that have broken, worn excessively, or else have had large portions destroyed by tooth decay.

It is conceivable that a dental filling, as an alternative, could be used as a means to restore a tooth's shape. Dental crowns however offer your dentist a big advantage over dental fillings by way of the fact that they are fabricated "away from your mouth." By this we simply mean that dental crowns are fabricated in a dental laboratory (by a dental technician using plaster molds your teeth). Dental fillings, in comparison, are created "in your mouth" by way of your dentist placing the filling material directly upon your tooth.

When a dental crown is made the dental laboratory technician can visualize and examine all aspects of your bite and jaw movements, from a variety of angles, and then sculpt your dental crown so it has the perfect anatomy. In comparison, when a dentist places a dental filling they have far less control over the final outcome of the shape of your tooth because it is often difficult for them to visualize, evaluate, and access to the tooth on which they are working.

From a standpoint of strength considerations, there are some types of filling materials that can bond to tooth structure. For the most part, however, dental fillings are not considered to substantially strengthen a tooth in the same way that a dental crown, with its rigid encapsulation a tooth, can.

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Porcelain dental crowns be used to improve the cosmetic appearance of teeth.

Since a dental crown serves to cup over and encase the visible portion of a tooth, any dental crown that has a porcelain surface can be used as a means to idealize the cosmetic appearance of a tooth. Possibly you have heard it rumored (especially in past decades) that certain movie stars have had their teeth "capped." This simply means that the person has obtained their "Hollywood smile" by way of having dental crowns placed.

Actually, getting your teeth "capped" just to improve their cosmetic appearance can at times be a very poor choice. Dental crowns are best utilized as a way to improve the cosmetic appearance of a tooth when the crown simultaneously serves other purposes also, such as restoring a tooth to its original shape (repairing a broken tooth) or strengthening a tooth (covering over a tooth that has a very large filling).

In general, a dental crown probably should not be used as a means to improve the appearance of a tooth if there is any other alternative dental treatment that could equally satisfactorily achieve the same cosmetic results. This is because a dentist must grind a significant portion of a tooth away when a dental crown is made. If a more conservative dental procedure could equally well improve the tooth's appearance, such as a porcelain veneer, dental bonding, or even just teeth whitening, then it is usually best to consider that treatment option first.

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.

What is a Noun?

A noun is a word used to name a person, animal, place, thing, and abstract idea. Nouns are usually the first words which small children learn. The highlighted words in the following sentences are all nouns:

Late last year our neighbours bought a goat.

Portia White was an opera singer.

The bus inspector looked at all the passengers' passes.

According to Plutarch, the library at Alexandria was destroyed in 48 B.C.

Philosophy is of little comfort to the starving.

A noun can function in a sentence as a subject, a direct object, an indirect object, a subject complement, an object complement, an appositive, an adjective or an adverb.

Noun Gender

Many common nouns, like "engineer" or "teacher," can refer to men or women. Once, many English nouns would change form depending on their gender -- for example, a man was called an "author" while a woman was called an "authoress" -- but this use of gender-specific nouns is very rare today. Those that are still used occasionally tend to refer to occupational categories, as in the following sentences.

David Garrick was a very prominent eighteenth-century actor.

Sarah Siddons was at the height of her career as an actress in the 1780s.

The manager was trying to write a want ad, but he couldn't decide whether he was advertising for a "waiter" or a "waitress"

Noun Plurals

Most nouns change their form to indicate number by adding "-s" or "-es", as illustrated in the following pairs of sentences:

When Matthew was small he rarely told the truth if he thought he was going to be punished.

Many people do not believe that truths are self-evident.

As they walked through the silent house. they were startled by an unexpected echo.

I like to shout into the quarry and listen to the echoes that returned.

He tripped over a box left carelessly in the hallway.

Since we are moving, we will need many boxes.

There are other nouns which form the plural by changing the last letter before adding "s". Some words ending in "f" form the plural by deleting "f" and adding "ves," and words ending in "y" form the plural by deleting the "y" and adding "ies," as in the following pairs of sentences:

The harbour at Marble Mountain has one wharf.

There are several wharves in Halifax Harbour.

Warsaw is their favourite city because it reminds them of their courtship.

The vacation my grandparents won includes trips to twelve European cities.

The children circled around the headmaster and shouted, "Are you a mouse or a man?"

The audience was shocked when all five men admitted that they were afraid of mice.

Other nouns form the plural irregularly. If English is your first language, you probably know most of these already: when in doubt, consult a good dictionary.

Possessive Nouns

In the possessive case, a noun or pronoun changes its form to show that it owns or is closely related to something else. Usually, nouns become possessive by adding a combination of an apostrophe and the letter "s."

You can form the possessive case of a singular noun that does not end in "s" by adding an apostrophe and "s," as in the following sentences:

The red suitcase is Cassandra's.

The only luggage that was lost was the prime minister's.

The exhausted recruits were woken before dawn by the drill sergeant's screams.

The miner's face was covered in coal dust.

You can form the possessive case of a singular noun that ends in "s" by adding an apostrophe alone or by adding an apostrophe and "s," as in the following examples:

The bus's seats are very uncomfortable.

The bus' seats are very uncomfortable.

The film crew accidentally crushed the platypus's eggs.

The film crew accidentally crushed the platypus' eggs.

Felicia Hemans's poetry was once more popular than Lord Byron's.

Felicia Hemans' poetry was once more popular than Lord Byron's.

You can form the possessive case of a plural noun that does not end in "s" by adding an apostrophe and a "s," as in the following examples:

The children's mittens were scattered on the floor of the porch.

The sheep's pen was mucked out every day.

Since we have a complex appeal process, a jury's verdict is not always final.

The men's hockey team will be play as soon as the women's team is finished.

The hunter followed the moose's trail all morning but lost it in the afternoon.

You can form the possessive case of a plural noun that does end in "s" by adding an apostrophe:

The concert was interrupted by the dogs' barking, the ducks' quacking, and the babies' squalling.

The janitors' room is downstairs and to the left.

My uncle spent many hours trying to locate the squirrels' nest.

The archivist quickly finished repairing the diaries' bindings.

Religion is usually the subject of the roommates' many late night debates.

Using Possessive Nouns

When you read the following sentences, you will notice that a noun in the possessive case frequently functions as an adjective modifying another noun:

The miner's face was covered in coal dust.

Here the possessive noun "miner's" is used to modify the noun "face" and together with the article "the," they make up the noun phrase that is the sentence's subject.

The concert was interrupted by the dogs' barking, the ducks' quacking, and the babies' squalling.

In this sentence, each possessive noun modifies a gerund. The possessive noun "dogs"' modifies "barking", "ducks"' modifies "quacking," and "babies"' modifies "squalling."

The film crew accidentally crushed the platypus's eggs.

In this example the possessive noun "platypus's" modifies the noun "eggs" and the noun phrase "the platypus's eggs" is the direct object of the verb "crushed."

My uncle spent many hours trying to locate the squirrels' nest.

In this sentence the possessive noun "squirrels"' is used to modify the noun "nest" and the noun phrase "the squirrels' nest" is the object of the infinitive phrase "to locate."

Types Of Nouns

There are many different types of nouns. As you know, you capitalise some nouns, such as "Canada" or "Louise," and do not capitalise others, such as "badger" or "tree" (unless they appear at the beginning of a sentence). In fact, grammarians have developed a whole series of noun types, including the proper noun, the common noun, the concrete noun, the abstract noun, the countable noun (also called the count noun), the non-countable noun (also called the mass noun), and the collective noun. You should note that a noun will belong to more than one type: it will be proper or common, abstract or concrete, and countable or non-countable or collective.

If you are interested in the details of these different types, you can read about them in the following sections.

Proper Nouns

You always write a proper noun with a capital letter, since the noun represents the name of a specific person, place, or thing. The names of days of the week, months, historical documents, institutions, organisations, religions, their holy texts and their adherents are proper nouns. A proper noun is the opposite of a common noun

In each of the following sentences, the proper nouns are highlighted:

The Marroons were transported from Jamaica and forced to build the fortifications in Halifax.

Many people dread Monday mornings.

Beltane is celebrated on the first of May.

Abraham appears in the Talmud and in the Koran.

Last year, I had a Baptist, a Buddhist, and a Gardnerian Witch as roommates.

Common Nouns

A common noun is a noun referring to a person, place, or thing in a general sense -- usually, you should write it with a capital letter only when it begins a sentence. A common noun is the opposite of a proper noun.

In each of the following sentences, the common nouns are highlighted:

According to the sign, the nearest town is 60 miles away.

All the gardens in the neighbourhood were invaded by beetles this summer.

I don't understand why some people insist on having six different kinds of mustard in their cupboards.

The road crew was startled by the sight of three large moose crossing the road.

Many child-care workers are underpaid.

Sometimes you will make proper nouns out of common nouns, as in the following examples:

The tenants in the Garnet Apartments are appealing the large and sudden increase in their rent.

The meals in the Bouncing Bean Restaurant are less expensive than meals in ordinary restaurants.

Many witches refer to the Renaissance as the Burning Times.

The Diary of Anne Frank is often a child's first introduction to the history of the Holocaust.

Concrete Nouns

A concrete noun is a noun which names anything (or anyone) that you can perceive through your physical senses: touch, sight, taste, hearing, or smell. A concrete noun is the opposite of a abstract noun.

The highlighted words in the following sentences are all concrete nouns:

The judge handed the files to the clerk.

Whenever they take the dog to the beach, it spends hours chasing waves.

The real estate agent urged the couple to buy the second house because it had new shingles.

As the car drove past the park, the thump of a disco tune overwhelmed the string quartet's rendition of a minuet.

The book binder replaced the flimsy paper cover with a sturdy, cloth-covered board.

Abstract Nouns

An abstract noun is a noun which names anything which you can not perceive through your five physical senses, and is the opposite of a concrete noun. The highlighted words in the following sentences are all abstract nouns:

Buying the fire extinguisher was an afterthought.

Tillie is amused by people who are nostalgic about childhood.

Justice often seems to slip out of our grasp.

Some scientists believe that schizophrenia is transmitted genetically.

Countable Nouns

A countable noun (or count noun) is a noun with both a singular and a plural form, and it names anything (or anyone) that you can count. You can make a countable noun can be made plural and attach it to a plural verb in a sentence. Countable nouns are the opposite of non-countable nouns and collective nouns.

In each of the following sentences, the highlighted words are countable nouns:

We painted the table red and the chairs blue.

Since he inherited his aunt's library, Jerome spends every weekend indexing his books.

Miriam found six silver dollars in the toe of a sock.

The oak tree lost three branches in the hurricane.

Over the course of twenty-seven years, Martha Ballad delivered just over eight hundred babies.

Non-Countable Nouns

A non-countable noun (or mass noun) is a noun which does not have a plural form, and which refers to something that you could (or would) not usually count. A non-countable noun always takes a singular verb in a sentence. Non-countable nouns are similar to collective nouns, and are the opposite of countable nouns.

The highlighted words in the following sentences are non-countable nouns:

Joseph Priestly discovered oxygen.

The word "oxygen" cannot normally be made plural.

Oxygen is essential to human life.

Since "oxygen" is a non-countable noun, it takes the singular verb "is" rather than the plural verb "are."

We decided to sell the furniture rather than take it with use when we moved.

You cannot make the noun "furniture" plural.

The furniture is heaped in the middle of the room.

Since "furniture" is a non-countable noun, it takes a singular verb, "is heaped."

The crew spread the gravel over the roadbed.

You cannot make the non-countable noun "gravel" plural.

Gravel is more expensive than I thought.

Since "gravel" is a non-countable noun, it takes the singular verb form "is."

Collective Nouns

A collective noun is a noun naming a group of things, animals, or persons. You could count the individual members of the group, but you usually think of the group as a whole is generally as one unit. You need to be able to recognise collective nouns in order to maintain subject-verb agreement. A collective noun is similar to a non-countable noun, and is roughly the opposite of a countable noun.

In each of the following sentences, the highlighted word is a collective noun:

The flock of geese spends most of its time in the pasture.

The collective noun "geese" takes the singular verb "spends."

The jury is dining on take-out chicken tonight.

In this example the collective noun "jury" is the subject of the singular compound verb "is dining."

The steering committee meets every Wednesday afternoon.

Here the collective noun "committee" takes a singular verb, "meets."

The class was startled by the bursting light bulb.

In this sentence the word "class" is a collective noun and takes the singular compound verb "was startled".

What is a Verb?

The verb is perhaps the most important part of the sentence. A verb or compound verb asserts something about the subject of the sentence and express actions, events, or states of being. The verb or compound verb is the critical element of the predicate of a sentence.

In each of the following sentences, the verb or compound verb is highlighted:

Dracula bites his victims on the neck.

The verb "bites" describes the action Dracula takes.

In early October, Giselle will plant twenty tulip bulbs.

Here the compound verb "will plant" describes an action that will take place in the future.

My first teacher was Miss Crawford, but I remember the janitor Mr. Weatherbee more vividly.

In this sentence, the verb "was" (the simple past tense of "is") identifies a particular person and the verb "remembered" describes a mental action.

Karl Creelman bicycled around the world in 1899, but his diaries and his bicycle were destroyed.

In this sentence, the compound verb "were destroyed" describes an action which took place in the past.

Verbs in the English language are a lexically and morphologically distinct part of speech which describes an action, an event, or a state.

While English has many irregular verbs, for the regular ones the conjugation rules are quite straightforward. Being part of an analytic language, English regular verbs are not very much inflected; all tenses, aspects and moods except the simple present and the simple past are periphrastic, formed with auxiliary verbs and modals.

Principal parts

A regular English verb has only one principal part, the infinitive or dictionary form (which is identical to the simple present tense for all persons and numbers except the third person singular). All other forms of a regular verb can be derived straightforwardly from the infinitive, for a total of four forms (e.g. exist, exists, existed, existing)

English irregular verbs (except to be) have at most three principal parts:

	Part	Example:
1	infinitive	write
2	preterite	Wrote
3	past participle	Written

Strong verbs like write have all three distinct parts, for a total of five forms (e. g. write, writes, wrote, written, writing). The more irregular weak verbs also require up to three forms to be learned.

The highly irregular copular verb to be has eight forms: be, am, is, are, being, was, were, been, of which only one is derivable from a principal part (being is derived from be). On the history of this verb, see Indo-European copula.

Verbs had more forms when the pronoun thou was still in regular use and there was a number distinction in the second person. To be, for instance, had art, wast and wert.

Most of the strong verbs that survive in modern English are considered irregular. Irregular verbs in English come from several historical sources; some are technically strong verbs (i. e. their forms display specific vowel changes of the type known as ablaut in linguistics); others have had various phonetic changes or contractions added to them over the history of English.

Infinitive and basic form

Formation

The infinitive in English is the naked root form of the word. When it is being used as a verbal noun, the particle to is usually prefixed to it. When the infinitive stands as the predicate of an auxiliary verb, to may be omitted, depending on the requirements of the idiom.

Uses

· The infinitive, in English, is one of two verbal nouns: To write is to learn.

· The infinitive, either marked with to or unmarked, is used as the complement of many auxiliary verbs: I will write a novel about talking beavers; I am really going to write it.

· The basic form also forms the English imperative mood: Write these words!

· The basic form makes the English subjunctive mood: If you write it, they will read.

Third person singular

Formation

The third person singular in regular verbs in English is distinguished by the suffix -s. In English spelling, this -s is added to the stem of the infinitive form: run → runs.

If the base ends in a sibilant sound like /s/, /z/, /ʃ/, /tʃ/ (see IPA) that is not followed by a silent E, the suffix is written -es: buzz → buzzes; catch → catches.

If the base ends in a consonant plus y, the y changes to an i and -es is affixed to the end: cry → cries.

Verbs ending in o typically add -es: veto → vetoes.

In Early Modern English, some dialects distinguished the third person singular with the suffix -th; after consonants this was written -eth, and some consonants were doubled when this was added: run → runneth.

Use

· The third person singular is used exclusively in the third person form of the English simple "present tense", which often has other uses besides the simple present: He writes airport novels about anthropomorphic rodents.

Exception

English preserves a number of preterite-present verbs, such as can and may. These verbs lack a separate form for the third person singular: she can, she may. All surviving preterite-present verbs in modern English are auxiliary verbs. The verb will, although historically not a preterite-present verb, has come to be inflected like one when used as an auxiliary; it adds -s in the third person singular only when it is a full verb: Whatever she wills to happen will make life annoying for everyone else.

Present participle

Formation

The present participle is made by the suffix -ing: go → going.

If the base ends in silent e, it is dropped before adding the suffix: believe → believing.

If the e is not silent, it is retained: agree → agreeing.

If the base ends in -ie, change the ie to y and add -ing: lie → lying.

If:

· the base form ends in a single consonant; and

· a single vowel precedes that consonant; and

· the last syllable of the base form is stressed

then the final consonant is doubled before adding the suffix: set → setting; occur → occurring.

In British English, as an exception, the final <l> is subject to doubling even when the last syllable is not stressed: yodel → yodelling, travel → travelling; in American English, these follow the rule: yodeling, traveling. Similarly focus → focussing (AE focusing).

Irregular forms include:

· singeing, where the e is (sometimes) not dropped to avoid confusion with singing;

· ageing, in British English, where the expected form aging is ambiguous as to whether it has a hard or soft g;

· words ending in -c, which add k before the -ing, for example, panicking, frolicking, and bivouacking.

· a number of words that are subject to the doubling rule even though they do not fall squarely within its terms, such as diagramming, kidnapping, programming, and worshipping.

Uses

· The present participle is another English verbal noun: Writing is learning (see gerund for this sense).

· It is used as an adjective: a writing desk; building beavers.

· It is used to form a past, present or future tense with progressive or imperfective force: He is writing another long book about beavers.

· It is used with quasi-auxiliaries to form verb phrases: He tried writing about opossums instead, but his muse deserted him.

Preterite

Formation

In weak verbs, the preterite is formed with the suffix -ed: work → worked.

If the base ends in e, -d is simply added to it: hone → honed; dye > dyed.

Where the base ends in a consonant plus y, the y changes to i before the -ed is added; deny → denied.

Where the base ends in a vowel plus y, the y is retained: alloy → alloyed.

The rule for doubling the final consonant in regular weak verbs for the preterite is the same as the rule for doubling in the present participle; see above.

Many strong verbs and other irregular verbs form the preterite differently, for which see that article.

Use

· The preterite is used for the English simple (non-iterative or progressive) past tense. He wrote two more chapters about the dam at Kashawigamog Lake.

Past participle

Formation

In regular weak verbs, the past participle is always the same as the preterite.

Irregular verbs may have separate preterites and past participles; see Wiktionary appendix: Irregular English verbs.

Uses

· The past participle is used with the auxiliary have for the English perfect tenses: They have written about the slap of tails on water, about the scent of the lodge... (With verbs of motion, an archaic form with be may be found in older texts: he is come.)

· With be, it forms the passive voice: It is written so well, you can feel what it's like to gnaw down trees!

· It is used as an adjective: the written word; a broken dam.

· It is used with quasi-auxiliaries to form verb phrases: 500,000 words got written in record time.

Tenses of the English verb

English verbs, like those in many other western European languages, have more tenses than forms; tenses beyond the ones possible with the five forms listed above are formed with auxiliary verbs, as are the passive voice forms of these verbs. Important auxiliary verbs in English include will, used to form the future tense; shall, formerly used mainly for the future tense, but now used mainly for commands and directives; be, have, and do, which are used to form the supplementary tenses of the English verb, to add aspect to the actions they describe, or for negation.

English verbs display complex forms of negation. While simple negation was used well into the period of early Modern English (Touch not the royal person!) in contemporary English negation almost always requires that the negative particle be attached to an auxiliary verb such as do or be. I go not is archaic; I don't go or I am not going are what the contemporary idiom requires.

English exhibits similar idiomatic complexity with the interrogative mood, which in Indo-European languages is not, strictly speaking, a mood. Like many other Western European languages, English historically allowed questions to be asked by inverting the position of verb and subject: Whither goest thou? Now, in English, questions are trickily idiomatic, and require the use of auxiliary verbs.

Overview of tenses

In English grammar, tense refers to any conjugated form expressing time, aspect or mood. The large number of different composite verb forms means that English has the richest and subtlest system of tense and aspect of any Germanic language. This can be confusing for foreign learners; however, the English verb is in fact very systematic once one understands that in each of the three time spheres - past, present and future - English has a basic tense which can then be made either perfect or progressive (continuous) or both.

	Simple	Progressive	Perfect	Perfect progressive
Future	I will write	I will be writing	I will have written	I will have been writing
Present	I write	I am writing	I have written	I have been writing
Past	I wrote	I was writing	I had written	I had been writing

Because of the neatness of this system, modern textbooks on English generally use the terminology in this table. What was traditionally called the "perfect" is here called "present perfect" and the "pluperfect" becomes "past perfect", in order to show the relationships of the perfect forms to their respective simple forms. Whereas in other Germanic languages, or in Old English, the "perfect" is just a past tense, the English "present perfect" has a present reference; it is both a past tense and a present tense, describing the connection between a past event and a present state.

However, historical linguists sometimes prefer terminology which applies to all Germanic languages and is more helpful for comparative purposes; when describing wrote as a historical form, for example, we would say "preterite" rather than "past simple".

This table, of course, omits a number of forms which can be regarded as additional to the basic system:

· the intensive present I do write

· the intensive past I did write

· the habitual past I used to write

· the "shall future" I shall write

· the "going-to future" I am going to write

· the "future in the past" I was going to write

· the conditional I would write

· the perfect conditional I would have written

· the (increasingly seldom used) subjunctives, if I be, if I were.

Some systems of English grammar eliminate the future tense altogether, treating will/would simply as modal verbs, in the same category as other modal verbs such as can/could and may/might. See Grammatical tense for a more technical discussion of this subject.

A full inventory of verb forms follows.

Present simple

Or simple present.

· Affirmative: I write; He writes

· Negative: He does not (doesn't) write

· Interrogative: Does he write?

· Negative interrogative: Does he not write? (Doesn't he write?)

Note that the "simple present" in idiomatic English often identifies habitual or customary action:

He writes about beavers (understanding that he does so all the time.)

It is used with stative verbs:

She thinks beavers are remarkable

It can also have a future meaning (though much less commonly than in many other languages):

She goes to Milwaukee on Tuesday.

Put Tuesday in the plural, and She goes to Milwaukee on Tuesdays means that she goes to Milwaukee every Tuesday.

The present simple has an intensive or emphatic form with "do": He does write. In the negative and interrogative forms, of course, this is identical to the non-emphatic forms. It is typically used as a response to the question Does he write, whether that question is expressed or implied, and says that indeed, he does write.

The idiomatic use of the negative particles not and -n't in the interrogative form is also worth noting. In formal literary English of the sort in which contractions are avoided, not attaches itself to the main verb: Does he not write? When the colloquial contraction -n't is used, this attaches itself to the auxiliary do: Doesn't he write? This in fact is a contraction of a more archaic word order, still occasionally found in poetry: *Does not he write?

Present progressive

Or present continuous.

· Affirmative: He is writing

· Negative: He is not writing

· Interrogative: Is he writing?

· Negative interrogative: Is he not writing? (Isn't he writing?)

This form describes the simple engagement in a present activity, with the focus on action in progress "at this very moment". It too can indicate a future, particularly when discussing plans already in place: I am flying to Paris tomorrow. Used with "always" it suggests irritation; compare He always does that (neutral) with He's always doing that. Word order differs here in the negative interrogative between the hyperformal is he not writing and the usual isn't he writing?

Present perfect

Traditionally just called the perfect.

· Affirmative: He has written

· Negative: He has not written

· Interrogative: Has he written?

· Negative interrogative: Has he not written? (Hasn't he written?)

This indicates that a past event has one of a range of possible relationships to the present. This may be a focus on present result: He has written a very fine book (and look, here it is, we have it now). Or it may indicate a time-frame which includes the present. I have lived here since my youth (and I still do). Compare: Have you written a letter this morning? (it is still morning) with Did you write a letter this morning? (it is now afternoon). The perfect tenses are frequently used with the adverbs already or recently or with since clauses. Although the label “perfect tense” implies a completed action, the present perfect can identify habitual (I have written letters since I was ten years old.) or continuous (I have lived here for fifteen years.) action:

In addition to these normal uses where the time frame either is the present or includes the present, the “have done” construct is used in temporal clauses to define a future time: When you have written it, show it to me. It also forms a past infinitive, used when infinitive constructions require a past perspective: Mozart is said to have written his first symphony at the age of eight. (Notice that if not for the need of an infinitive, the simple past would have been used here: He wrote it at age eight.) The past infinitive is also used in the conditional perfect.

Present perfect progressive

Or continuous.

· Affirmative: He has been writing

· Negative: He has not been writing

· Interrogative: Has he been writing?

· Negative interrogative: Has he not been writing? (Hasn't he been writing?)

Used for unbroken action in the past which continues right up to the present. I have been writing this paper all morning (and still am).

Past simple

Or preterite.

· Affirmative: He wrote

· Negative: He did not write

· Interrogative: Did he write?

· Negative interrogative: Did he not write? (Didn't he write?)

The same change of word order in the negative interrogative that distinguishes the formal and informal register also applies to the preterite. Note also that the preterite form is also used only in the affirmative. When the sentence is recast as a negative or interrogative, he wrote not and wrote he? are archaic and not used in modern English. They must instead be supplied by periphrastic forms.

This tense is used for a single event in the past, sometimes for past habitual action, and in chronological narration. Like the present simple, it has emphatic forms with "do": he did write.

Although it is sometimes taught that the difference between the present perfect and the simple past is that the perfect denotes a completed action whereas the past denotes an incomplete action, this theory is clearly false. Both forms are normally used for completed actions. (Indeed the English preterite comes from the Proto-Indo-European perfect.) And either can be used for incomplete actions. The real distinction is that the present perfect is used when the time frame either is the present or includes the present, whereas the simple past is used when the time frame is in the absolute past.

The "used to" past tense for habitual actions is probably best included under the bracket of the past simple. Compare:

When I was young I played football every Saturday.

When I was young I used to play football every Saturday.

The difference is slight, but "used to" stresses the regularity, and the fact that the action has been discontinued.

Past continuous

Or imperfect or past progressive.

· Affirmative: He was writing

· Negative: He was not writing

· Interrogative: Was he writing?

· Negative interrogative: Was he not writing? (Wasn't he writing?)

This is typically used for two events in parallel:

While I was washing the dishes my wife was walking the dog.

Or for an interrupted action (the past simple being used for the interruption):

While I was washing the dishes I heard a loud noise.

Or when we are focussing on a point in the middle of a longer action:

At three o'clock yesterday I was working in the garden. (Contrast: I worked in the garden all day yesterday.)

Past perfect

Or the "pluperfect"

· Affirmative: He had written

· Negative: He had not / hadn't written

· Interrogative: Had he written?

· Negative interrogative: Had he not written? (Hadn't he written?)

Past perfect progressive

Or "pluperfect progressive" or "continuous"

· Affirmative: He had been writing

· Negative: He had not been / hadn't been writing

· Interrogative: Had he been writing?

· Negative interrogative: Had he not been writing? (Hadn't he been writing?)

Relates to the past perfect much as the present perfect progressive relates to the present perfect, but tends to be used with less precision.

Future simple

· Affirmative: He will write

· Negative: He will not / won't write

· Interrogative: Will he write?

· Negative interrogative: Will he not write? (Won't he write?)

See the article Shall and Will for a discussion of the two auxiliary verbs used to form the simple future in English. There is also a future with "go" which is used especially for intended actions, and for the weather, and generally is more common in colloquial speech:

I'm going to write a book some day.

I think it's going to rain.

But the will future is preferred for spontaneous decisions:

Jack: "I think we should have a barbeque!"

Jill: "Good idea! I'll go get the coal."

Future progressive

· Affirmative: He will be writing

· Negative: He will not / won't be writing

· Interrogative: Will he be writing?

· Negative interrogative: Will he not be writing? (Won't he be writing?)

Used especially to indicate that an event will be in progress at a particular point in the future: This time tomorrow I will be taking my driving test.

Future perfect

· Affirmative: He will have written

· Negative: He will not / won't have written

· Interrogative: Will he have written?

· Negative interrogative: Will he not have written? (Won't he have written?)

Used for something which will be completed by a certain time (perfect in the literal sense) or which leads up to a point in the future which is being focused on.

I will have finished my essay by Thursday.

By then she will have been there for three weeks.

Future perfect progressive

Or future perfect continuous.

· Affirmative: He will have been writing

· Negative: He will not / won't have been writing

· Interrogative: Will he have been writing?

· Negative interrogative: Will he not have been writing? (Won't he have been writing?)

Conditional

Or past subjunctive.

· Affirmative: He would write

· Negative: He would not / wouldn't write

· Interrogative: Would he write?

· Negative interrogative: Would he not write?

Used principally in a main clause accompanied by an implicit or explicit doubt or "if-clause"; may refer to conditional statements in present or future time:

I would like to pay now if it's not too much trouble. (in present time; doubt of possibility is explicit)

I would like to pay now. (in present time; doubt is implicit)

I would do it if she asked me to. (in future time; doubt is explicit)

I would do it. (in future time; doubt is implicit)

(A very common error by foreign learners is to put the would into the if-clause itself. A humorous formulation of the rule for the EFL classroom runs: "If and would you never should, if and will makes teacher ill!" But of course, both will and would CAN occur in an if-clause when expressing volition. A student of English may rarely encounter the incorrect construction as it can occur as an archaic form.)

Conditional perfect

Or pluperfect subjunctive/past-perfect subjunctive.

· Affirmative: He would have written

· Negative: He would not / wouldn't have written

· Interrogative: Would he have written?

· Negative interrogative: Would he not have written?

Used as the past tense of the conditional form; expresses thoughts which are or may be contrary to present fact:

I would have set an extra place if I had known you were coming. (fact that an extra place was not set is implicit; conditional statement is explicit)

I would have set an extra place, but I didn't because Mother said you weren't coming. (fact that a place was not set is explicit; conditional is implicit)

I would have set an extra place. (fact that a place was not set is implicit, conditional is implicit)

Present subjunctive

The form is always identical to the infinitive. This means that, apart from the verb "to be", it is distinct only in the third person singular and the obsolete second person singular.

· Indicative: I write, thou writest, he writes, I am

· Subjunctive: I write, thou write, he write, I be

Used to refer to situations which are or may be contrary to fact in the present or future; the infactuality is rarely explicit:

I insist that he come at once. (present time; fact that the action is not currently occuring is implicit)

I insist that he come when I call. (future time; fact that the action may or may not occur is implicit)

(The present subjunctive is often interchangeable with the past subjunctive like so: I insist that he must come at once.)

Imperfect subjunctive

The use of the old term "imperfect" shows that this form is so rare that it has not been integrated into the modern system of English tense classification. The imperfect subjunctive is identical to the past simple in every verb except the verb "to be". With this verb, there is an option, but no longer a necessity, of using were throughout ALL forms (i.e., I wish I were an Oscar Meyer weiner, vs. I wish I was a girl).

· Indicative: I was

· Subjunctive: traditionally I were but now more commonly I was.

· If I were rich, I would retire to the South of France.

Auxilliary Verbs

An auxiliary verb is a verb that accompanies a main verb to indicate the tense, voice, mood, number, or person where this is not indicated by inflection:

The concert was enjoyed by all.

You will drown in a sea of homework if you do not work
harder.

The auxiliary verb is also known as the helping verb.

What Is An Adjective?

An adjective modifies a noun or a pronoun by describing, identifying, or quantifying words. An adjective usually precedes the noun or the pronoun which it modifies.

In the following examples, the highlighted words are adjectives:

The truck-shaped balloon floated over the treetops.

Mrs. Morrison papered her kitchen walls with hideous wall paper.

The small boat foundered on the wine dark sea.

The coal mines are dark and dank.

Many stores have already begun to play irritating Christmas music.

A battered music box sat on the mahogany sideboard.

The back room was filled with large, yellow rain boots.

An adjective can be modified by an adverb, or by a phrase or clause functioning as an adverb. In the sentence

My husband knits intricately patterned mittens.

for example, the adverb ``intricately'' modifies the adjective ``patterned.''

Some nouns, many pronouns, and many participle phrases can also act as adjectives. In the sentence

Eleanor listened to the muffled sounds of the radio hidden under her pillow.

for example, both highlighted adjectives are past participles.

Grammarians also consider articles (``the,'' ``a,'' ``an'') to be adjectives.

Possessive Adjectives

A possessive adjective (``my,'' ``your,'' ``his,'' ``her,'' ``its,'' ``our,'' ``their'') is similar or identical to a possessive pronoun; however, it is used as an adjective and modifies a noun or a noun phrase, as in the following sentences:

I can't complete my assignment because I don't have the textbook.

In this sentence, the possessive adjective ``my'' modifies ``assignment'' and the noun phrase ``my assignment'' functions as an object. Note that the possessive pronoun form ``mine'' is not used to modify a noun or noun phrase.

What is your phone number.

Here the possessive adjective ``your'' is used to modify the noun phrase ``phone number''; the entire noun phrase ``your phone number'' is a subject complement. Note that the possessive pronoun form ``yours'' is not used to modify a noun or a noun phrase.

The bakery sold his favourite type of bread.

In this example, the possessive adjective ``his'' modifies the noun phrase ``favourite type of bread'' and the entire noun phrase ``his favourite type of bread'' is the direct object of the verb ``sold.''

After many years, she returned to her homeland.

Here the possessive adjective ``her'' modifies the noun ``homeland'' and the noun phrase ``her homeland'' is the object of the preposition ``to.'' Note also that the form ``hers'' is not used to modify nouns or noun phrases.

We have lost our way in this wood.

In this sentence, the possessive adjective ``our'' modifies ``way'' and the noun phrase ``our way'' is the direct object of the compound verb ``have lost''. Note that the possessive pronoun form ``ours'' is not used to modify nouns or noun phrases.

In many fairy tales, children are neglected by their parents.

Here the possessive adjective ``their'' modifies ``parents'' and the noun phrase ``their parents'' is the object of the preposition ``by.'' Note that the possessive pronoun form ``theirs'' is not used to modify nouns or noun phrases.

The cat chased its ball down the stairs and into the backyard.

In this sentence, the possessive adjective ``its'' modifies ``ball'' and the noun phrase ``its ball'' is the object of the verb ``chased.'' Note that ``its'' is the possessive adjective and ``it's'' is a contraction for ``it is.''

Demonstrative Adjectives

The demonstrative adjectives ``this,'' ``these,'' ``that,'' ``those,'' and ``what'' are identical to the demonstrative pronouns, but are used as adjectives to modify nouns or noun phrases, as in the following sentences:

When the librarian tripped over that cord, she dropped a pile of books.

In this sentence, the demonstrative adjective ``that'' modifies the noun ``cord'' and the noun phrase ``that cord'' is the object of the preposition ``over.''

This apartment needs to be fumigated.

Here ``this'' modifies ``apartment'' and the noun phrase ``this apartment'' is the subject of the sentence.

Even though my friend preferred those plates, I bought these.

In the subordinate clause, ``those'' modifies ``plates'' and the noun phrase ``those plates'' is the object of the verb ``preferred.'' In the independent clause, ``these'' is the direct object of the verb ``bought.''

Note that the relationship between a demonstrative adjective and a demonstrative pronoun is similar to the relationship between a possessive adjective and a possessive pronoun, or to that between a interrogative adjective and an interrogative pronoun.

Interrogative Adjectives

An interrogative adjective (``which'' or ``what'') is like an interrogative pronoun, except that it modifies a noun or noun phrase rather than standing on its own:

Which plants should be watered twice a week?

Like other adjectives, ``which'' can be used to modify a noun or a noun phrase. In this example, ``which'' modifies ``plants'' and the noun phrase ``which paints'' is the subject of the compound verb ``should be watered'':

What book are you reading?

In this sentence, ``what'' modifies ``book'' and the noun phrase ``what book'' is the direct object of the compound verb ``are reading.''

Indefinite Adjectives

An indefinite adjective is similar to an indefinite pronoun, except that it modifies a noun, pronoun, or noun phrasé́́́́, as in the following sentences:

Many people believe that corporations are under-taxed.

The indefinite adjective ``many'' modifies the noun ``people'' and the noun phrase ``many people'' is the subject of the sentence.

I will send you any mail that arrives after you have moved to Sudbury.

The indefinite adjective ``any'' modifies the noun ``mail'' and the noun phrase ``any mail'' is the direct object of the compound verb ``will send.''

They found a few goldfish floating belly up in the swan pound.

In this example the indefinite adjective modifies the noun ``goldfish'' and the noun phrase is the direct object of the verb ``found'':

The title of Kelly's favourite game is ``All dogs go to heaven.''

Here the indefinite pronoun ``all'' modifies ``dogs'' and the full title is a subject complement.

́́́́ THE COMPARISON OF ADJECTIVES

There are three degrees of comparison:
POSITIVE degree, COMPARATIVE degree, SUPERLATIVE degree:

POSITIVE	COMPARATIVE	SUPERLATIVE
cool	cooler	coolest
intelligent	more intelligent	most intelligent

01. COMPARATIVE OF EQUALITY

AS .... AS (for positive comparisons),
(NOT) SO .... AS (for negative comparisons).

Her pronunciation is AS good AS yours.
His pronunciation is NOT SO good AS yours.

Note: We may say NOT AS .... AS, especially after a contracted form: Her pronunciation isn't AS good AS yours.

02. COMPARATIVE OF INFERIORITY

LESS ..... THAN + the adjective.

It is LESS cold today THAN it was yesterday.
Kelly is LESS old THAN Sandra.

03. SUPERLATIVE OF INFERIORITY

THE LEAST ....... OF (or IN) + the adjective.

Sunday was THE LEAST cold day of the week.
Christina is THE LEAST old girl in that class.

04. COMPARATIVE and SUPERLATIVE OF SUPERIORITY

a) Monosyllabic adjectives form their COMPARATIVE and SUPERLATIVE by adding - ER and - EST to the POSITIVE degree.

Tall	tallER THAN	THE tallEST
Warm	warmER THAN	THE warmEST

Exceptions:

Just	MORE just THAN	THE MOST just
Right	MORE right THAN	THE MOST right
Real	MORE real THAN	THE MOST real
Wrong	MORE wrong THAN	THE MOST wrong

b) Adjectives with more than two syllables form their COMPARATIVE and SUPERLATIVE by putting MORE and THE MOST in front of the adjective.

Difficult	MORE difficult THAN	THE MOST difficult
important	MORE important THAN	THE MOST important

c) Disyllabic (two syllables) adjectives form their COMPARATIVE and SUPERLATIVE in two different ways:

1. Adjectives ending in ED, ING, RE, FUL, OUS and those with the stress on the first syllable usually take MORE and THE MOST:

charming	MORE charming THAN	THE MOST charming
famous	MORE famous THAN	THE MOST famous
hopeful	MORE hopeful THAN	THE MOST hopeful
learned	MORE learned THAN	THE MOST learned
obscure	MORE obscure THAN	THE MOST obscure

2. Adjectives ending in ER, Y, LE, OW and those with the stress on the second syllable add ER and EST to the POSITIVE degree.

clever	cleverER THAN	THE cleverEST
narrow	narrowER THAN	THE narrowEST
pretty	prettiER THAN	THE prettiEST
polite	politER THAN	THE politEST
simple	simplER THAN	THE simplEST

Note: Adjectives ending in SOME and the words cheerful, common, cruel, pleasant, quiet, civil may be compared by adding ER and EST or by MORE and MOST.

pleasant

pleasantER THAN

THE pleasantEST

or

pleasant

MORE pleasant THAN

THE MOST pleasant

05. ORTHOGRAPHIC NOTES
a) Add R and ST to adjectives ending in E.

large	largeR THAN	THE largeST
ripe	ripeR THAN	THE ripeST

b) VOWEL SANDWICH (VOWEL + CONSONANT + VOWEL) (THE LAST VOWEL IS DOUBLED)

big	bigGER THAN	THE bigGEST
fat	fatTER THAN	THE fatTEST

NO SANDWICH (JUST THE SUFFIX)

small	smallER THAN	THE smallEST
sweet	sweetER THAN	THE sweetEST

c) Adjectives ending in - y preceded by a consonant, change Y into I before ER and EST.

happY

happIER THAN

THE happIEST

Exceptions:

shY	shYER THAN	THE shYEST
gaY	gaYER THAN	THE gaYEST
greY	greYER THAN	THE greYEST

6. IRREGULAR COMPARISONS

good	better than	the best
bad	worse than	the worst
little	less than	the least
much	more than	the most
many	more than	the most
far	farther than	the farthest
far	further than	the furthest
old	older than	the oldest
old	elder than	the eldest

NOTES:
1. FARTHER and FARTHEST generally refer to distance; FURTHER and FURTHEST also refer to distance but they may have the meaning of "additional".
I live farther from here than you do.
Give me further details.

2. OLDER and OLDEST refer to persons or things; ELDER and ELDEST can only be used for members of the same family:
My elder sister is afraid of mice.
My older friend is afraid of wasps.

but ELDER can not be placed before THAN so OLDER is used:
My sister is two years older than I am.

---

7. CONSTRUCTIONS WITH COMPARATIVES

a) Gradual increase:
Those exercises are getting EASIER AND EASIER. OR
Those exercises are getting MORE AND MORE EASY.

The weather is getting NICER AND NICER. OR
The weather is getting MORE AND MORE NICE.

The rent of our flat is getting MORE AND MORE EXPENSIVE.

---

B) Parallel increase: (THE + comparative ...... THE + comparative).
THE MORE I see you THE MORE I want you.
THE HOTTER, THE BETTER.
THE MORE he studies, THE BETTER he becomes.

COMPARISON OF ADVERBS

1. COMPARATIVE and SUPERLATIVE of SUPERIORITY.

a) Monosyllabic adverbs from their comparative and superlative of superiority in the same way as monosyllabic adjectives.

high	highER THAN	THE highEST
soon	soonER THAN	THE soonEST
fast	fastER THAN	THE fastEST

b) Adverbs of more than one syllable take MORE and MOST.

quickly	MORE quickly THAN	THE MOST quickly
slowly	MORE slowly THAN	THE MOST slowly
seldom	MORE seldom THAN	THE MOST seldom

Exception:

early

earliER THAN

THE earliEST

---

2. IRREGULAR COMPARISONS

well	better than	the best
badly	worse than	the worst
little	less than	the least
much	more than	the most
late	later than	the last

WORD ORDER

Declarative Sentences

Subject	Predicate	Object			Adverbial Modifier of
		indirect	direct	prepo-sitional	manner	place	Time
Our guide	speaks		English		fluently
Наш гід	роз-мовляє		англійською		вільно
My sister	sent	me	a telegram				Yesterday
Моя сестра	на-діслала	мені	телеграму				Вчора
Mother	bought		a dress	for her		in a boutique
Мати	купила		сукню	для неї		в магазині

Negative Sentences

Subject	Auxiliary Verb / Modal Verb + not	Verb	Object and adverbial modifier
My friend	does not	leave for	Spain tonight
Мій товариш	Не	від’їжджає до	Іспанії сьогодні ввечері
He	did not	like	coffee with sugar in it
Він	Не	любив	кави з цукром
You	should not	do	that again
Ти	не повинен	робити	цього більше

General Questions

(General questions require the answer yes or no)

Auxiliary Verb / Modal Verb	Subject	Verb	Object and adverbial modifier
Does	Sugar	dissolve	in water?
	Цукор	розчиняється	у воді?
Could	I	take	your pen?
Можна	мені	взяти	вашу ручку?
Have	the students	coped	with all difficulties?
	Студенти	подолали	всі труднощі?

Special Questions

(Special questions refer to a various parts of the sentence)

Interrogative word	Auxiliary Verb / Modal Verb	Subject	Verb	Object and adverbial modifier
Where	did	she	get	my address?
Де		Вона	дістала	мою адресу?
Who			goes	to the cinema?
Хто			йде	у кіно?
When	was	the castle	built?
Коли		цей замок	збудований?
How long	have	you	known	him?
Як довго		Ви	знаєте	його?

Alternative Questions

(Alternative questions imply choice and consist of two parts connected by the conjunction or)

Interrogative word	Auxiliary Verb / Modal Verb	Subject	Verb	Object and adverbial modifier
	Did	He	start learning	Spanish or French?
		Він	почав вивчати	іспанську чи французьку мову?
Who			invented	the steam engine: James Watt or Thomas Edison?
Хто			винайшов	паровий двигун: Джеймс Ватт чи Томас Едісон?
What time	does	she	have breakfast:	at 7 or 8 in the morning?
О котрій годині		Вона	снідає:	о 7 чи 8 вранці?

Question Tags

(Question tags sconsist of two parts. The first part is a declarative sentence, the second – a short general question. The second part consists of the subject expressed by personal pronoun corresponding to the subject of the first part and of the auxiliary or modal verb. If the first part of the question is positive, the second is negative and vice versa)

Subject	Auxiliary Verb / Modal Verb and not	Verb	Object and adverbial modifiers	Short general question
Your brother		works	there,	does not he?
Ваш брат		працює	там,	чи не так?
Jane	did not	say	that,	did she?
Джейн	не	казала	цього,	чи не так?
Tom and Ted	are	coming	tonight,	are not they?
Том і Тед		приїжджають	сьогодні ввечері,	чи не так?
They	cannot	remember	clearly what happened,	can they?
Вони	не	пригадують	точно, що трапилось,	чи не так?

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

ABBREVIATIONS

Abbreviation or symbol	Meaning	Translation
n	noun	іменник
v	verb	дієслово
adj	adjective	прикметник
adv	adverb	прислівник
prep	preposition	прийменник
pl	plural	множина
e.g.	скорочено від “exempli gratia”	наприклад
i.e.	скорочено від “id est	тобто
Ab	antibody	антитіло
ABc	antibiotic	антибіотик
ad lib	as desired; at one’s pleasure	на свій розсуд; за бажанням
ad us. ext	for external use	для зовнішнього використання
adv	against	всупереч ; проти, навпроти
ag	antigen	антиген
AIDS	acquired immunodeficiency syndrome	синдром набутого імунного дефіциту, СНІД
alt hor	every other hour	через годину
ASAP	as soon as possible	якомога швидше
at wt (AW)	atomic weight	атомна маса
ax	axis	Вісь
b	blood	кров
BC	blood count	аналіз крові
b.i.d	twice a day	двічі на день
BP	blood pressure	кров’яний тиск
Bx	biopsy	біопсія
C	calorie	калорія, мала калорія
cc	cell count	підрахунок кров’яних тілець
c.c.	cubic centimetre	кубічний сантиметр
C.C.	chief complaint	головна скарга
cm	centimetre	сантиметр
CNS	central nervous system	центральна нервова система
c/o	complains of	скарги на
dl	decilitre	децилітр
DU	duodenal ulcer	виразка дванадцятипалої кишки
DM	diabetes mellitus	діабет, цукрова хвороба
DNA	deoxyribonucleic acid	ДНК
Dx	diagnosis	діагноз
dz	disease	хвороба
ED	effective dose	ефективна доза
ECG (EKG)	electrocardiogram	електрокардіограма
ENT	ear, nose and throat	вухо, ніс і горло
ER	endoplasmic reticulum	ендоплазматичний ретикулум
FB	foreign body	чужорідне тіло
Fc	fragment	фрагмент; обривок; уламок; осколок
FH	family history	сімейний анамнез
g	gram	грам
grad.	by steps, gradually	поступово, мало-помалу; послідовно
GU	genitourinary	сечостатевий
Hgb	haemoglobin	гемоглобін
HIV	human immunodeficiency virus	вірус імунодефіциту людини
HR	heart rate	частота серцебиття
HS	heart sounds	Тони серця
Hx	history	історія
Ig	immunoglobulin	імуноглобулін
in d	daily	щодня, щоденно
kg	kilogram	кілограм
l	litre	Літр
mg	milligram	міліграм
min	minute	хвилина
ml	millilitre	мілілітр
mm	millimetre	міліметр
N	nerve	нерв
noc	night	Ніч
N & V	nausea and vomiting	нудота і блювання
O2	oxygen	кисень
OB	occult blood	прихована кров
OH	occupational history	професійний анамнез
OPD	outpatient department	амбулаторне відділення
P	pressure	Тиск
P & A	percussion and auscultation	перкусія (вистукування) і вислухування
pc	after a meal	після прийняття їжі
PH	past history	анамнез
PI	history of present illness	анамнез захворювання, історія теперішнього захворювання
PMH	past medical history	історія хвороби, анамнез
PO	by mouth	перорально
pt	patient	пацієнт
qd	every day	щодня
qh	every hour	щогодини
qid	four times a day	чотири рази на день
qod	every other day	через день
resp	respiratory	респіраторний, дихальний
RNA	ribonucleic acid	РНК
Rx	therapy, treatment	лікування
s & s	signs and symptoms	ознаки і симптоми
t	temperature	температура
TB	tuberculosis	туберкульоз
tid	three times a day	тричі на день
U	unit	одиниця; ціле; відділ
UTI	urinary tract infection	інфекція сечового тракту
VC	vital capacity	життєва ємність
wk	week	тиждень
WNL	within normal limits	у межах норми
wt	weight	вага; маса
x	except	за винятком, крім
Y	year	рік

Literature:

Principle:

1. Ісаєва О.С., Кучумова Н.В., Шумило М.Ю. English for dentists: Англійська мова для студентів-стоматологів: Підручник. – Львів: Кварт, 2008. – 421 с.

2. Аврахова Л.Я., Лавриш Ю.Е. English for dentists: Навчальний посібник для вищих навчальних медичних закладів ІІІ – IV рівнів акредитації. – К.: Видавничий дім «Асканія», 2008. – 366 с.

3. Цебрук І.Ф., Венгренович А.А., Венгренович Н.Ф. Англійська мова для студентів-стоматологів: Підручник. – Івано_Франківськ: ДВНЗ «Івано-Франківський націон. медичний університет», 2012. – 480 с.

4. Матеріали розміщені на сайті Тернопільського державного медичного університету імені І.Я.Горбачевського http://intranet.tdmu.edu.ua/data/kafedra/internal/index.php?path=in_mow/classes_stud/

Additional:

1. Шиленко Р.В., Мухина В.В., Скрипникова Т.П. Англійська мова. / Практичний курс для студентів стоматологічного факультету/. – Полтава, 1998. – 560 с.

2. Демченко О.Й., Костяк Н.В. Англійська мова для студентів-медиків : Посібник для підготовки до іспиту. – Тернопіль: Укрмедкнига, 2001.– 80с

3. Граматика сучасної англійської мови (довідник) [Текст] : довідник / Г. В. Верба, Л. Г. Верба. - К. : Логос, 2000. - 352 с.

4. Матеріали кафедри.

Prepared by H.Y.Pavlyshyn

Adopted at the Chair Sitting

June 10, 2013. Minutes № 11.