Lesson 40

The phone’s ringing

Doctor: Dental surgery “Dentus”. How can I help you?

Patient: Good morning, Doctor. Here is Iwona Kowalska speaking. I’m your patient. I’m calling because of my son who broke half of his tooth. I really need your help, Doctor.

Doctor: Of course. I am in the office today until 7 p.m. Please come with your son as soon as possible. Do you have the broken-off half of a tooth?

Patient: Yes. I do. I wrapped it in a handkerchief.

Doctor: Good. Please bring it with you. Well, it would be best if you put this half of the tooth into a saline solution. Maybe we’ll be able to bind it with an injured tooth.

Patient: OK, I’ll do so. We are just near the pharmacy, so I’ll ask for the saline solution. I think that we willbe at your office in about half an hour.

Doctor: Perfect, because I’m finishing with one of my patients in 15 minutes, and the next hour I’m off.

***

Patient: Here we are, Doctor.

Doctor: Good morning Madam. Wojtek, sit on the chair, please. Remind me, please, how old you are.

Patient: I’m nine.

Doctor: Tell me when it happened.

Patient: I think about two hours ago.

Doctor: Well, open your mouth wide, please. I have to see how it looks like. It’s not bad. The crown of the tooth is broken in half, but the pulp is not exposed. I need to check if the pulp responds correctly, that is if it’s not dead. Unfortunately, oftentimes after trauma, pulp dies and the root canal treatment is necessary. Listen, I’ll apply to your tooth a cold swab, tell me please, if you feel anything.

Patient: Yes, yes. I feel it. It even hurts a little bit.

Doctor: That’s good, because it means that the pulp is alive. I’ll take an X-ray. I need to check if there is no alveolar fracture.

Patient: But won’t it hurt?

Doctor: Of course not. Taking photo does not hurt.

***

Doctor: Fortunately, all is well. Give me please this broken-off half of a tooth. I’ll see what I can do. Well, unfortunately this is just a small portion of the tooth. I can not stick it. But this is not a big problem. I’ll rebuild the crown of the tooth with composite material.

Patient: Won’t the rebuilt tooth differ from the adjacent teeth?

Doctor: I’ll try to make the way, so the teeth do not differ. But I have to tell you that the death of the pulp may occur some time after the injury, such as a week or a few weeks. Then you need to treat the tooth root canal. That’s why your son should come to me from time to time for a check-up, to see if the pulp is still alive. Today I’ll set him a visit for a week, on Tuesday at 5 p.m.

Patient: All right. And how long will the procedure last today?

Doctor: I think I’ll manage to rebuild the tooth within 45 minutes. My next patient has just called he’ll be 15 minutes late, so I do not have to rush.

Patient: And if in some time it turns out that the tooth requires a root canal treatment,will you have to remove all the filling then?

Doctor: No, it won’t be necessary. In order to get to the chamber to perform a root canal treatment, I’ll just have to remove some material from the bottom.

Patient: Oh, that’s good. You reassured me.

Doctor: I’m very happy that everything is clear. Please sit down in the waiting room. In less than an hour I’ll give you your son back.

VOCABULARY PRACTICE

Match description with a term

LOOSENED TOOTH

DISPLACED TOOTH

CHIPPED TOOTH

FRACTURED TOOTH

AVULSED TOOTH

1. ________________(known also as knocked out tooth) it is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. The treatment for permanent teeth consists of replantation, as soon as possible. Deciduous teeth should not be replanted due to the risk of damaging the permanent tooth germ.

2.
________________it’s a type of a tooth injury in which the tooth may be pulled out and appear elongated, or be pushed in and appear shorter. The tooth can also be pushed forward, backward, sideways, or rotated.

3.
________________this type of tooth injury can range from minor (involving chipping of enamel and dentin) to severe (involving vertical, diagonal, or horizontal fractures of the root). In severe type both the dentin and the pulp tissue can be exposed and it should be treated promptly. The tooth may be displaced and loose, and the gums may bleed.

4.
________________it’s a minor tooth fracture which involves chipping of the enamel only. The tooth is not displaced, and there is no bleeding from the gums. The only symptom of such minor injury may be sharp or rough tooth edges irritating the cheek and tongue.

5.
________________another name given to it is subluxation. It occurs when there is only mild looseness, the tooth usually tightens up on its own. The injured tooth may bleed a little from the gums.

Word formation: complete the following advice with words created from the words in brackets

First Aid Advice for Knocked-Out Permanent Tooth

To save the tooth, it must be (1)__________ (IMPLANT) as soon as possible. Right away is (2)__________ (GOOD). If you are more than 30 minutes away from dental or medical care, replace the tooth in the socket before (3)__________ (COME) in. Use the following tips:

Rinse off the tooth with saliva or water (do not scrub it).

Replace it in the socket facing (4)___________ (CORRECT).

Press down on the tooth with your thumb until the crown is level with the adjacent tooth.

(5)___________ (LAST) bite down on a piece of cloth to stabilize the tooth until you can reach your dentist.

Remember! Baby teeth can’t be re-implanted.

Transporting a Knocked-Out Permanent Tooth

It is very important to keep the tooth (6) __________ (MOISTURE). Do not let it dry out.
Transport the tooth in milk or saliva.
Call 911 (112) if due to (7)___________ (INJURE) the person is (8)_________ (KNOCK) down or if (9)__________ (MAJORITY) (10) __________( BLOOD) can’t be stopped.

Lesson 40 answers