PART FOUR: GINGIVITIS
Patient: Good morning, Doctor. I’ve come to you today with my younger son, because his gums have been bleeding recently and he even started refusing food because it is painful while eating.

Dentist: Hi, buddy sit in the chair, please. Tell me, how old are you ?

Patient: Five.

Dentist: And do you go to kindergarten.

Patient: Yes, I do.

Dentist: Okay, now open your mouth wide, please. I have to take a look at your teeth and gums.
Well, I was expecting that. There is gums inflammation. Madam, would you like to take a look? The gums are bright red, swollen, about and now when I’m touching it with a probe it’s bleeding profusely. Please also notice, how much plaque I was able to collected with the help of the tool. It is a thick, white coating with visible debris. This is how I know that the child does not clean his teeth.

Patient: But he has a toothbrush and toothpaste.

Dentist: Well, yes, but does he use them? (referring to the boy) Please tell me, do you brush your teeth?

Patient: I used to clean them, but my gums began to bleed, so I stopped.

Dentist: That’s it. The gums begin to bleed slightly, the patient is afraid that the bleeding will get worse after brushing, so he/she stops brushing and we have a vicious circle. You have to brush your teeth at least two times a day, in the morning after breakfast and in the evening after dinner, and if possible also during the day after meals. Has anyone ever showed you how to brush your teeth?
No? So I’ll show you now how to do it on the model of artificial teeth. These surfaces from the top can be cleaned by scrubbing the teeth with a toothbrush, and those from the outside and from the inside by making small circles. Keep in mind that you should clean the teeth for so long, how long is one song on the radio.

Patient: And should I use any special toothbrush and toothpaste?

Dentist: Generally, no, but in fact there are special toothbrushes and toothpastes for children. They contain less fluoride and can be safely used for five-year-olds. However, I would suggest that you Madam will check whether your son cleaned the teeth actually and if he cleaned them long enough. And please check if he brushes teeth in the same way as I’ve showed him today. Anyway, you will visit me in two days again. Please come with your son and take his toothbrush. Then I’ll check whether he brushes his teeth correctly.

Patient: OK, I’ll come with him. Will this bleeding stop if he does a better job with cleaning his teeth?

Dentist: Yes. It should go away, if only he improves his oral hygiene. When patients begin to clean teeth correctly, all symptoms disappear, if there is no other underlying reason. Your son’s gingivitis is clearly related to not brushing his teeth. If the bleeding and the pain persists I will look for another reason.

Patient: Thank you. I will come back in two days.

Dentist: Thank you. See you on Thursday.

VOCABULARY PRACTICE

Complete the text about GINGIVITIS IN CHILDREN AND TEENS with words from the table

Chronic gingivitis is common in children. It usually causes gum tissue to swell, 1)_________ and bleed easily. Gingivitis is both preventable and 2)____________ with help of a regular routine of brushing, flossing and professional dental care. Aggressive periodontitis may begin around 3)___________ and affect the entire mouth. It is manifested by inflammation of the gums and heavy 4)______________of plaque and calculus. Eventually it can cause the teeth to become loose. Hormonal changes related to puberty can put teens at greater 5)_________ for getting periodontal disease. During puberty, an increased level of hormones cause increased blood circulation to the gums. This may cause gum’s 6)____________ and lead to a greater reaction to any irritation. During this time, the gums may become swollen, turn red and feel tender.
Early diagnosis is important for successful and effective treatment of periodontal diseases. That’s why, it is crucial that children have regular periodontal examination. The most important preventive 7)___________ against periodontal disease is to follow good oral health habits with your child. There are basic preventive methods to help children 8)____________ good oral health:
1) 9)___________ good dental hygiene habits as early as possible. Teaching children about the importance of brushing and flossing may start as early as 12 months of life. 
2) Serve as a good role model by practicing good dental hygiene 10)___________ yourself.
3) 11)___________ regular dental visits for family .
4) Check your child’s mouth for the signs of periodontal disease, including bleeding gums, swollen and bright red gums, and bad 12)______________.

Below you’ll find definitions of terms associated with gum inflammation. Guess what terms is being described. One dash stands for one letter.

1. _ _ B _ _ _ - small particles of food that may be stuck between ones teeth. 
2. P _ _ _ _ E- sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth.
3. B _ _ _ _ I _ _ G _ _ _ - blood on toothbrush even with gentle brushing of the teeth.
4. _ _ _ L _ M _ _ _ _ _ N- a condition in which a part of your body becomes red, swollen, and painful.
5. _ E _ _ _ D _ _ _ _ L P _ _ _ E - it is an instrument in dentistry commonly used in assessment. It is usually long, thin, and blunted at the end.
6. S _ _ _ T _ _ _ _ _- it refers to tissues that connect, support, or surround other structures and organs of the body, not being bone. 
7. H _ _ _ T _ _ _ S- bad breath. 
8. P _ _ _ _ D _ _ _ I _ _ - a specialist in diseases of the gingiva and bone around teeth and dental implants. 
9. _ _ M R _ _ _ S _ _ _ _ - one of the symptoms of gum inflammation, this occurs when the gums pull away from the tooth. 
10. T _ _ _ _ _ - another name for calculus. It’s formed when plaque is not removed at regular basis and which is the breeding ground for the germs which cause gum disease.
11. _ _ _ G _ _ A- A word from Latin meaning the same as ‘gum’.
12. P _ R _ _ D _ _ _ _ T _ _ - the next stage of untreated gingivitis involving inflammation and infection of the ligaments and bones that support the teeth
Lesson 38 answers