Read the text carefully. Pay attention to words in the bold print

Gingivitis is an inflammation of the gums surrounding the teeth. Gingivitis is one of many periodontal diseases that affect the health of the periodontium. This type of diseases are often classified according to their severity. They range from mildgingivitis, to more severe periodontitis, and finally acute necrotizing ulcerative gingivitis, which can be life threatening.

The most common symptoms of gingivitis include swelling, redness, pain, andbleeding of the gums. The breath begins to take on a foul odor. The gums begin to lose their normal structure and color. They become inflamed and red.

Gingivitis is considered to be a bacterial infection of the gums. Bacteria can cause inflammation of the gums. The mouth is a great place for bacteria to live. The warm,moist environment and constant food supply are everything bacteria need to thrive. An infection begins when the body's immune system is overwhelmed. Gingivitis is an infection that occurs when bacteria invade soft tissues, bone, and other places that bacteria should not be.

The exact reason why gingivitis develops has not been proven, but several theories exist. Accumulation of plaque in the areas between the teeth predisposes one for gingivitis. Another factor may be an underlying illness or a particular medication that may lower the immunity. For example, people with diabetes, HIV, and other immune system diseases lack the ability to fight bacteria invading the gums. Sometimes hormonal changes in the body during pregnancy, puberty, and steroid therapy leave the gums vulnerable to bacterial infection.

Good home dental hygiene and regular dental visits should be all that is required to treat and prevent gingivitis. If gingivitis continues despite the effort to prevent it, contacting a doctor to investigate the possibility of an underlying illness is a key.

Gingivitis can usually be managed at home with good dental hygiene. If gingivitisturns into the most severe periodontal infection, acute necrotizing ulcerative gingivitis (ANUG), treatment at a hospital may be required. ANUG not only affects the gums but may spread to adjacent tissues of the face, neck, and bone. Bleeding, and pain all characterize ANUG. The breath takes on a fetid odor, the teeth becomeloose, and the lymph nodes of the neck are often swollen. People with ANUG often have fever and complain of a generalized weakness.

The best home care for gingivitis is prevention. Regular dental visits to remove plaque build-up are necessary to combat gingivitis. Once a dentist removes plaque, regular brushing and flossing will minimize plaque formation.

Gingivitis is treated simply by removing the source of the infection. Severe gingivitis may require antibiotics and consultation with a physician. 

GLOSSARY
accumulation – nagromadzenie 
acute – ostry 
adjacent – przyległy 
bleeding – krwawienie 
build-up – przyrost 
combat – zwalczyć coś 
constant – ciągły 
despite – pomimo czegoś 
diabetes – cukrzyca 
exact – dokładny 
factor – czynnik 
fetid – cuchnący, przykry zapach 
fever – gorączka 
foul – nieprzyjemny, cuchnący 
gingivitis – zapalenie dziąseł 
include – zawierać 
inflammation – zapalenie 
invade – zaatakować znienacka 
key – klucz 
lack – brak 
life threatening – niebezpieczny/zagrażający życiu 
loose – ruszający się 
lymph node – węzeł limfatyczny
managed – poradzić sobie
mild – łagodny 
minimise – zminimalizować
moist – wilgotny 
odor – zapach 
overwhelmed – przeciążony
periodontal – przyzębny 
periodontium – ozębna
plaque – płytka bakteryjna nazębna
predispose – czynić podatnym na
pregnancy – ciąża
proven – udowodniony
puberty – pokwitanie, okres dojrzewania
range – sięgać, wahać się 
required – wymagany 
severe – poważny 
severity – natężenie 
simply – po prostu 
source – źródło 
spread – rozprzestrzenić się 
surrounding – otaczający
thrive – dobrze się rozwijać 
turn into – zmienić się w 
vulnerable – podatny

Solve the crossword puzzle

1. near or close to but not necessarily touching, nearest in space or position, having a common boundary or edge
2. a film of mucus and bacteria on a tooth surface
3. abbreviation for acute necrotizing ulcerative gingivitis
4. a protective tissue response to destruction of tissues. The classical signs of inflammation are pain, heat, redness , swelling, and loss of function 
5. a scent or smell
6. an agent or element that contributes to the production of a result
7. the tissues investing and supporting the teeth
8. period of human development during which physical growth and sexual maturation occurs

Choose a correct form of the word in bracket

1. (PREGNANT or PREGNANCY) women are at higher risk for developing gingivitis.
2. The treatment of gingivitis depends on how (SEVERE or SEVERITY) the condition really is.
3. (DIABETIC or DIABETES) is one of the underlying diseases which increases the chances of gingivitis.
4. Severe gingivitis may cause you to (LOOSE or LOSE) some of your teeth. 
5. (SWOLLEN or SWELLING) of the gums is one of the signs of gingivitis.
6. ANUG is characterized by bouts of fever and (WEAK or WEAKNESS).

Translate into Polish these useful phrases which may be helpful while deciding on antibiotic treatment:

1. “The major risk of antibiotic therapy is an allergic reaction to the medication. Are you allergic to any antibiotics?”
……………………………………………………………………………………………..
2. “If you use this antibiotic you may experience some adverse reactions such as: rash, hives or stomach upset?”
……………………………………………………………………………………………..
3. “Before we decide to start the treatment with antibiotics we must make sure there is no other underlying disease causing these symptoms.”
……………………………………………………………………………………………..
4. “If you notice any unpleasant side effects, stop taking the drug, and come immediately to me. We’ll switch you to another antibiotic”. 
……………………………………………………………………………………………….
5. “Inappropriate use of antibiotics can lead to the bacteria becoming resistant to the antibiotics' effects”.
……………………………………………………………………………………………….

  Lesson 5 answers