Patient: Good afternoon Doctor.

Dentist: Good afternoon. What seems to be a problem?

Patient: I have been experiencing some problems with my teeth for the last 2-3 weeks. I can not brush the teeth, because it’s painful just near the gums. What is even worse is the fact that I feel pain on both the left and right side of my gums.

Dentist: Open your mouth, please. I’ll check it out. I can see that the necks of your teeth are exposed. Have you recently changed your diet?

Patient: Yes. I started to eat more vegetables and fruits. Now, because of the season, I eat strawberries two times a day. I like them very much.

Dentist: Well, I think I know what is causing your problems. Could you tell me one more thing; besides the pain during brushing are there still some other problems?

Patient: Pain also appears while eating ice cream, but I do not eat them now because of the diet, and, when I drink cold drinks straight from the refrigerator.

Dentist: The case is clear. Your dentin sensitivity has occurred due to eating acidic fruit. By the way, your necks of the teeth is exposed, too, which predisposes you to hypersensitivity. And how do you brush your teeth?

Patient: Well normally, I do not know how to explain it.

Dentist: Therefore, I give you now the model of teeth and toothbrush and you’ll show me how you brush your teeth. Well, I thought so. You clean your teeth with bad technique and hence you may have the exposed teeth necks. It is especially visible on the left side. Are you right-handed ?

Patient: Yes, I am.

Dentist: That’s it . You should brush your teeth differently. Please have a look. I place my toothbrush partly on gums and partly on teeth and by sweeping I clean this area, and then I change the position of the brush and sweep again. While brushing lower teeth I clean by sweeping upwards and while cleaning teeth on the top I make a downward sweep.

Patient: How do I clean the outer surfaces?

Dentist: Chewing surfaces of the teeth should be cleaned by scrubbing, but from the inside teeth are also cleaned by sweeping.

Patient: I use a hard toothbrush. Should I use a soft one?

Dentist: Soft wouldn’t be proper, but you should buy a brush with medium hardness. And when are the bristles worn out?

Patient: Well in 2-3 weeks. Actually, I change the toothbrush every month.

Dentist: This is wrong and proves that you press your brush to your teeth to hard while cleaning. The toothbrush should last you for about 3 months. Please pay attention to this. What is important is the brushing technique, not how hard you press. You should also pay attention to your diet. If you eat strawberries, please eat them once a day in a bigger portion right away.

Patient: It’s good that you told me that. I keep snacking on them all day long, one, two strawberries at a time, but as soon as I eat them, I brush my teeth.

Dentist: No, do not do that. Like I said, the best is to eat a larger portion at once and do not clean your teeth right away, but after 20-30 minutes. The same applies to fruit juices such as apple juice or orange juice – please drink a whole glass at once, and do not sip on juice for half a day.

Patient: Oh! I keep sipping on juices all day long.

Dentist: Maybe for now, please change the food habits and change the brushing technique. I’ll prescribe you a remedy with high fluorine content. Please apply it for 10 consecutive nights. It is a gel that should be placed on your toothbrush. Do not apply too much, just half a centimeter strap and please brush your teeth. After brushing spit out toothpaste but do not rinse your teeth and the best would be to go to sleep immediately. Please have nothing to eat or drink. I think it will help you if you change the way of brushing and your food habits. If that does not help, we will use other treatments. Please schedule your next check up within 2 weeks.

Patient: Thank you.

VOCABULARY PRACTICE

Complete the sentences with words from a table

Dentine hypersensitivity is a condition felt when the nerves inside the dentin of the teeth are _____________ to the environment.
Dentine hypersensitivity affects the canines and premolars of both the.__________.

Hot or cold food or drinks, and physical pressure are typical ___________ in those individuals with teeth sensitivity.
Tooth grinding and aggressive tooth brushing may ___________ to this problem. 
Majority of ___________ report that cold is the major stimulus for pain.

One recommendation for patients is to avoid tooth brushing for at least two to three hours after consuming __________ foods or drinks.
Use of desensitising toothpaste is considered by many as the ___________ treatment.

In-office treatments of dentine hypersensitivity might be much more _____________ and they may include the application of dental sealants.

Studies have found that mouthwashes containing potassium salts and fluorides can ____________ dentine hypersensitivity.

Match terms words with their definitions

 1. __________ – that point where a tooth’s root and crown meet.
2. __________ – microscopic canals that run from the outside of the dentin to the nerve inside the tooth.
3. __________ – 
is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth.
4. __________ – 
toothpaste that eliminates or subdues the painful response of exposed, vital dentin to irritating agents or thermal changes.

Lesson 37 answers