Lesson 59


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The phone is ringing

Doctor: Dental surgery. How can I help you?

Patient: Good morning. I would like to make an appointment. My tooth has been hurting for two days, and last night I had to even wake up at night to take some painkiller.

Doctor: I see. I can see you today, but only at the very end, after all the patients. Please come about 8 p.m.

Patient: Thank you. I will come for sure.

In the office

Patient: Good evening, I have an appointment at 8 o’clock.

Doctor: Hello, come into the office please. You have mentioned over the phone that your tooth have been hurting for two days.

Patient: Yes, Sir. But at the beginning I would like you to know that I am HIV positive. I hope that you will help me.

Doctor: Of course. Treating a patient infected with HIV is the ethical duty of every dentist and I can not imagine that I could refuse you. Is your condition monitored by a doctor?

Patient: Yes, it is. The situation is stable. I receive medications and besides the results of blood tests which indicate that I am a carrier, I do not have any symptoms.

Doctor: I see. Well I’m glad that you told me about your disease, although this doesn’t matter anyway. As you see, I use gloves and protective visors, so I feel safe. I do not fear also for the health of my patients, because all the tools that I use are sterilized. I also sterilize handpiece and a 3 way syringe. And now let’s get down to business. Can you tell me exactly which tooth hurts?

Patient: I have a toothache on the left, probably it’s the upper tooth, but I am not sure.

Doctor: Well, please rinse your mouth with this solution. It is water with antiseptic, and now please open your mouth. Well, the case is clear. There is a profound loss in the upper molar. Has the tooth hurt in reaction to cold and heat?

Patient: At first it reacted just to cold, but now it hurts when something is hot, and the last night was terrible.

Doctor: I have to make sure that this is really the tooth. Unfortunately, it may hurt.

Patient: Ouch! It hurts. It was hurting just like that. Oh, and it doesn’t want to stop, and it is even spreading to the temple.

Doctor: I do not want to expose you to more pain. I’ll provide anesthesia. But before I do it, I ask you to fill in the information card. There are questions about your health, including reaction to the anesthesia and other drugs. Once you do it, I’ll take care of your.


Look at the points below. Complete the sentences with words formed by rearranging the letters in brackets

  1. Oral healthcare 1)__________ (IDERSRVPO) can ask about drug 2)_________ (RIMGENSE) and note this on the medical record if patients disclose their HIV status confidentially.

  2. The dental team can reinforce the message to take drugs as 3)_________ (BEDCRIPESR), consistently and correctly, and to attend to doctor’s visits on regular 4)__________ (BASSI).

  3. Some oral 5)__________ (ISLIONSE) have been used as identifiers for HIV/AIDS, including oral candidiasis, oral hairy leukoplakia or severe herpetic 6)_______ (CUERLS).

  4. Treating HIV positive patients who have painful oral lesions with appropriate 7)__________ (LAGESNICSA) or medicines for oral lesions is especially important because it’s crucial to keep them comfortable while eating, as many drugs that control AIDS must be 8)______________ (TENAK) with food.

  5. This particular group of patients frequently developes dry mouth as an 9)_________ (AVERSED) reaction to highly active antiretroviral therapy and therefore some 10)_________ (AALSIV) enhancements must be considered.

  6. Cross-contamination from patient to dental specialist occasionally 11)________ (RESCCUO) mainly through direct contact with patient’s saliva, blood, open lesions or 12)_________ (PAQLUE) if proper safety measures are not taken.

Match terms with proper definitions

Kaposi’s sarcoma (    )

oral fluid test (    )

hairy leukoplakia (    )

antiretroviral therapy (    )

CD4 count (    )

  1. Frequently abbreviated as ART is the combination of several antiretroviral medicines used to slow the rate of HIV multiplication in the body. This combination of three or more medicines is more effective than using just one medicine (monotherapy) to treat HIV.
  2. This condition may occur intraorally, either alone or in association with skin lesions. Lesions inside the mouth have been reported at other sites and may be the first manifestation of late-stage HIV disease (AIDS).
  3. One of the indicator for AIDS or that the treatment of this condition is ineffective. It results from infection with the Epstein-Barr virus (EBV). It is manifested by fuzzy, white patches  on both sides of tounge.
  4. One of the testing measures that uses bodily fluids to screen for HIV antibodies. This particular one uses oral fluid (not saliva).
  5. It measures the number of white blood cell that fights infection in a sample of patient’s blood. Along with other tests, it helps tell how strong the immune system is, indicates the stage of HIV disease, guides treatment, and predicts how the disease may progress.

Look at the information concerning preventing transmission of bloodborne infectious diseases. Complete the text with words provided below













Personal protection

Wear gloves:

  • If you have open or 1)__________ wounds, or skin infections.
  • When in contact with saliva, mucous 2)__________or blood.
  • When in contact with blood-soiled items, body fluids or surfaces 3)__________ by them.

Replace torn or 4)_________ gloves immediately.

Use new gloves for every patient.

Wear gowns:

  • When blood or body fluids are likely to 5)_______ clothing.

Wear masks, face/eye protection or chin-length plastic face 6)________  (with safety glasses or 7)________ ).

Wash hands:

  • Between patients.
  • After completing procedure and before leaving work area.
  • With 8)________ soap before and immediately after removing gloves.
  • Use 9)_____________ materials. Dispose in plastic bags.
  • Routinely sterilize instruments used in all dental procedures.
  • 10)_________ after each use other dental instruments that come in contact with oral tissues.
  • 11) _____________ with clear plastic wrap equipment and surfaces that may become contaminated and are not easy to clean. Remove and 12)________ for each patient.

Lesson 59 - answers Lesson 59 - answers