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

Toothache or tooth pain is caused when the nerve root of a tooth is irritated. Dental (tooth) infection, decay, injury, or loss of a tooth are the most common causes ofdental pain. Pain may also occur after an extraction. Bacteria growing inside your mouth can contribute to gum disease, plaque, and dental decay. These problems also can become painful.

A toothache needs to be differentiated from other sources of pain in the face.Sinusitis, ear or throat pain, or an injury to the temporomandibular joint (TMJ) may be confused with toothache.

The most common symptoms of toothache include severe pain to pressure, or to hot or cold stimuli. The pain may persist for longer than 15 seconds after the stimulus is removed. As the area of inflammation increases, the pain becomes more severe. It may radiate to the cheek, the ear, or the jaw. Additional signs and symptoms that may lead you to seek advice include the following: pain with chewing, hot or cold sensitivity, bleeding or discharge from around a tooth or gums, swelling around a tooth or swelling of your jaw, injury or trauma to the area.

To ease the toothache, over-the-counter pain medications such as acetaminophen or ibuprofen may be used. For jaw and joint pain, Aspirin may be in adults. Acetaminophen (not aspirin) should be used for children and teenagers.

If pain occurs every time mouth is opened widely, the temporomandibular joint (TMJ) may be the source of the pain. Yawning or taking a large bite of food may intensify the pain. An appointment with dentist will help to determine the cause.

In most cases, dental or jaw pain can be managed with pain medications and antibiotics. A referral to a dentist for follow-up will usually be recommended. In some cases, the doctor may try an injection around the tooth for pain control. If there is swelling in the gums or face, or fever is present, antibiotics may be prescribed.

At the dentist's office, fillings, extractions, or other procedures may be recommended. A tooth extraction will be the most likely procedure with a baby tooth. On permanent teeth if the problem is severe, root canal treatment and crownprocedures are generally performed.

GLOSSARY
additional – dodatkowy 
bite – kęs 
cheek – policzek 
confuse – mylić 
differentiate – odróżnić, rozróżnić 
discharge – wydzielina 
dental – (adj.) zębowy, zębny 
extraction – wyrwanie, usunięcie 
fever – gorączka 
filling – plomba 
follow-up – kontynuacja leczenia 
injection – zastrzyk 
injury – uszkodzenie 
manage – radzić sobie 
over-the-counter – (o lekach) sprzedawane bez recepty
persist – nie ustępować, utrzymywać się
reccomend – zalecać
referral – skierowanie
remove – usuwać
root canal treatment – leczenie kanałowe
seek advice – szukać porady, radzić się
sinusitis – zapalenie zatok
source – źródło
stimuli – l.m. bodźce
teenager – nastolatek
temporomandibular joint – staw skroniowo-żuchwowy
trauma – uraz
yawning – ziewanie

Look at these typical causes of toothache. Match definitions with proper terms.

A. another name for a broken tooth without cavity or advanced gum disease. Biting on the area of tooth fracture can cause severe sharp pains. These fractures are usually due to chewing or biting hard objects such as hard candies, pencils, nuts, etc. 

B. it refers to inflammation of the soft tissue (gingiva) and abnormal loss of bone that surrounds the teeth and holds them in place. It is caused by toxins produced by bacteria in "plaque" that accumulate over time along the gum line. This plaque is a mixture of food, saliva, and bacteria.

C. these are teeth pressing together

D. called also carries, are caused by a process in which holes in the two outer layers of a tooth are formed. When they are small and shallow they may not cause pain and may be unnoticed by the patient. The larger deeper ones can collect food debris. The inner living pulp of the affected tooth can become irritated by bacterial toxins or by foods that are cold, hot, sour, or sweet-causing toothache.

E. this condition affects the lower 2/3 of the teeth that are normally buried in bone. The bacterial toxins dissolve the bone around the roots and cause the gum and the bone to expose the roots. The exposed roots can become sensitive to cold, hot, and sour foods because they are no longer protected by healthy gum and bone.

F. these are the large teeth in the back of the jaw that are cutting through the gums

G. it is characterized by pain, usually in front of one or both ears which frequently is a result of trauma or inflammatory or degenerative arthritis. Sometimes, muscles in this area can go into spasm, causing head and neck pain and difficulty opening mouth normally.

Put the following dialog in order

1. The Barrow’s Dentistry… How can I help you?
2. Yes, my name is Lisa Brown. I would like to schedule the appointment with dr. Barrow.
___. I see, in that case, let me ask dr. Barrow if he can see you today in the afternoon around 5p.m. I’ll call and confirm your appointment as soon as I talk to him. 
___. No, I have no idea. The pain started today and it’s been intensifying throughout the day. 
___. No, it’s still very painful. 
___. No, unfortunately not, I can’t come on Monday. Would it be possible to see him today or early tomorrow morning? I have a terrible toothache. 
___. Has it eased your pain? 
___. Of course Ms. Brown. Let Me check dr. Barrow’s availability. …. Dr. Barrow can see you on Monday at 11:30a.m. Does it fit your schedule?
___. Have you used any pain killers? 
___. Oh, I see. Do you suspect what the problem might be?
___. Yes, I‘ve taken Ibuprofen. 
___. Thank you very much. I’m waiting for your call.

Complete the sentences using proper words

1. If you notice the swelling is increasing and discharge is present you must _ _ E _ doctor’s advice immediately.
2. When one suffers from TMJ Syndrome he or she may experience severe pain while 
_ _ _ N _ _ _ or opening mouth widely. 
3. F _ _ _ _ _- _ P with a dentist is necessary when a patient completed antibiotic treatment 
4. I _ _ _ _ _ or _ _ _ _ _ A to a tooth are common causes of toothache. 
5. Other conditions may be easily C _ _ _ _ _ _ _ with a toothache, so make sure you eliminate all other possible culprits.

Lesson 6 answers