Lesson 41


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(In the surgery: phone’s ringing)

Patient: Good morning. I would like to make an appointment as soon as possible. I think I have a serious problem with my teeth.

Doctor: Are you in pain?

Patient: No, but my teeth are loose and they slightly move.

Doctor: I see. If it’s not hurting you, I will not be able to see you today. Could you come to my surgery tomorrow? Would you prefer to come in the morning or afternoon?

Patient: I prefer in the morning.

Doctor: Then please come by 9 o’clock. About 10 o’clock I have another patient.

Patient: Very well. I’ll be there for sure.


(Next day)

Patient: Hello, I was to come today at 9 o’clock.

Doctor: Good morning. Because you are in my surgery for the first time, I must ask you to fill out a questionnaire. In this questionnaire, among other things, there are questions about your health, diseases you have suffered from and you are currently suffering from, and all the details necessary for further contact. Please complete it right now.

Patient: All done.

Doctor: Thank you, and please sit down on the chair. You told me yesterday that your teeth move, didn’t you?

Patient: Yes, that’s right. I must admit that I haven’t been to dentist for at least ten years. I’ve noticed, maybe half a year ago, that my front bottom teeth move slightly. But they were moving just a little. But the last few days they started moving much. I can elevate them with my tongue.

Doctor: Please rinse your mouth with this solution in the cup. Now please open your mouthwide.

Doctor: Well, yes, actually there is a large mobility. I do not know what the condition of the bones is, but it looks bad. Two central incisors have very high mobility. To be able to say something more I need to take X-rays. I have to tell you bluntly that the chances of saving these teeth are low.

Patient: Oh, does that mean I’ll lose them for good?

Doctor: I’ll take the photo and then I’ll tell you what I think. In the picture I’ll see how the adjacent bone looks like. I also recommend to take a panoramic radiograph as you haven’t seen a dentist for ten years. The fact that these teeth move, and you probably lose them, is because of the enormous amount of tartar, which you probably have never had removed and because of poor oral hygiene.

Patient: I see. I have never had the tartar removed, and I must say that nobody has ever showed me how to brush my teeth properly.

Doctor: I understand, but it does excuse you of not taking care of your oral hygiene and the health of your teeth. You have to visit the dentist and check the condition of your teeth regularly not once in 10 years.

Patient: I know, Doctor. I am aware of that, and I will do the check-ups regularly now.


(After X-rays and comprehensive oral examination)

Doctor: Well, unfortunately the image shows a significant deterioration of the bone at the central incisors. Actually, they do not lie at all in the alveolar crest and the only treatment involves removal of these teeth. Fortunately, lateral incisors lie partly in the bone and we can save them.

Patient: Does this mean that I will lose those teeth?

Doctor: Yes. The teeth are eligible for extraction.

Patient: But in three days I’m leaving abroad for six months.

Doctor: I have a solution. After removing the teeth I’ll cut off the crowns and stick them on a dental splint to the other teeth. I’ll place in the splint two teeth on each side. This will be a temporary stabilization, but for a long period of time. With this split your lateral incisors, whose periodontium is also not in good condition, will be immobilized, too. Before I do it I need to improve the condition of your teeth and periodontium. First of all, we have to remove the tartar deposits and improve the state of your oral health, that is, you must learn how to clean your teeth well. I recommend you to complete two procedures: we need to do curettage in two places. I’ve also found two cavities which require treatment and one filling needs to be replaced. It could be worse if we consider your ten-year break.

Patient: Well, I agree to all of these. Are you going to extract these two teeth today?

Doctor: No, I’ll do it tomorrow. Today I will only remove tartar, because I have the next patient in half an hour and I would not have enough time for the procedure. Anyway, I still have to teach you how to clean the teeth properly.

Patient: Ok, I give myself up to you.



Read the text below and complete it with the words from the table



night guard




























Question:What to do if you get a loose front tooth?

Answer: A loose front tooth is very normally seen in children. This is a normal 1)………….. when the permanent teeth are about to 2)…………... This however is not normal in adults, unless slowly happening with 3)…………. age. If you are an adult with such a problem, you should definitely set up an appointment with a dentist.


Question:Can a loose tooth be saved? Or will it need to be removed?

Answer: Prognosis depends on the cause of the condition and on the 4)……………. of the problem. Whether or not treatment is possible will depend on how much gum tissue is left to hold the teeth in place. Grinding your teeth, often done at night, puts undue forces on the teeth. This in turn can make them lose. The prognosis is typically good as the grinding stops when one wears a 5)…………….. to reduce the biting forces. A 6)………….. to the mouth area can obviously damage the teeth – the trauma. The amount of damage 7)……………, but can lead to loss of teeth. And if a tooth is extremely loose, it is most likely that you lose it. The reason is that there is probably very little 8)……………… left to hold it in place. It is pretty much impossible to replace lost gum and bone. An exception to this is when a tooth is knocked and made loose. In this case tooth may be 9)……………. if replaced and splinted for some time.

Question: What causes loose teeth?

Answer: One of the main factors in 10)……………. people is gum disease, which is an infection that influences the 11)………….., or gums. Bruxism is also frequently related to this particular symptom because jaw 12)………… and tooth clenching can contribute to dental mobility. Mouth injuries (particularly in sports) can also lead to the consequences of loose teeth and can be 13)…………… enough to cause 14)…………. tooth loss.


Look at the terms below and try to match them with their definitions

flap surgery






bone grafting




root planing


____________: a process that connects teeth together hence creating a support system that will stop further loosening.

_________: this common surgery involves lifting back the gums and removing the tartar. The gums are then pushed back in place so that the tissue fits tightly around the tooth again

____________: scraping off the tartar from above and below the gum line.

____________: are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist.

____________: gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the periodontal disease.

___________: natural or synthetic bone is placed in the area of bone loss which can help promote bone growth

Lesson 41 answers Lesson 41 answers