Lesson 27

DENTAL TRAUMA

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

Trauma to the face or teeth can be caused by auto accidents, falls, and injury from sports. Patients suffering significant head, neck, or facial trauma should be evaluated and treated in hospital emergency rooms. Such trauma may involve bleeding from the nose or ears, concussion, dizziness, lapse of memory, severe headache and earache, or breaking of the skull or jaws. Dental injury withoutassociated head and neck trauma can be evaluated and treated in a dental office. Such dental injuries include broken (fractured) teeth, teeth totally knocked out of the mouth, or teeth displaced by unexpected external forces.

TOOTH FRACTURE can range from minor (involving chipping of the outer tooth layers called enamel and dentin) to severe (involving fractures of the root). Dental X-rays are necessary in most cases to diagnose, locate, and measure the extent of tooth fracture. A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. The tooth may be displaced and loose, and the gums may bleed. The most serious injuries involve verticaldiagonal, orhorizontal fractures of the tooth roots. In such situations, fracture of the tooth root leaves the injured tooth very loose, therefore tooth extraction must be completed.

CHIPPED TOOTH. A minor tooth fracture involves chipping of the enamel only. The tooth is not displaced, and there is no bleeding from the gums. The only symptom of such minor chipping may be sharp or rough tooth edges irritating the cheek and tongue. The injured tooth itself may not even be painful or sensitive to food or temperature. The risk of pulp injury is small, and treatment is not urgent. A small amount of orthodontic wax or sugarless gum can be placed over the rough edge until the dentist can be reached.

FRUCTURE OF ENAMEL AND DENTIN. A deeper fracture can involve both the enamel and the dentin of a tooth. The tooth is still not displaced and the gums are not bleeding. These deeper fractures may be sensitive to cold temperature or food.Prolonged exposure of dentin to oral bacteria can cause the death of the inner pulp tissue. Death of pulp tissue can lead to serious tooth infection and abscess. If the fracture has already significantly injured the pulp, then treatment involves either extracting the dying tooth or performing a root canal procedure to prevent serious tooth infection.

KNOCKED OUT TEETH. The upper front permanent teeth are the most common teeth to be completely knocked out. Knocked out baby or primary teeth are usually not reimplanted in the mouth, since they will be naturally replaced by permanent teeth later. However, knocked out permanent teeth should be retrieved, kept moist, and reimplanted as soon as possible. The most important factor affecting the success of reimplantation is the amount of time that the tooth is out of its socket. Teeth reimplanted within one hour of the accident frequently reattach to their teeth sockets. The knocked out tooth should be rinsed in clean water or milk until it’s reimplanted.

DISPLACED TOOTH. A displaced tooth may be pulled out and look elongated, or bepushed in and appear shorter. A displaced tooth can also be pushed forward, backward, sideways, or rotated.

GLOSSARY
abscess – ropień 
accident – wypadek 
affect – wpływać 
associated – związany z czymś, powiązany 
as soon as possible – tak szybko jak to możliwe 
backward – w tył 
chipping – wyszczerbienie 
concussion – wstrząs mózgu 
diagonal – ukośny 
displace – przemieścić 
dizziness – zawroty głowy 
edge – brzeg 
elongated – wydłużony 
expose – odsłaniać 
extent – rozmiar 
external – zewnętrzny 
factor – czynnik 
forward – w przód 
horizontal – poziomy 
lapse of memory – zaniki pamięci
moist – wilgotny
prolonged – długotrwały
promptly – bezzwłocznie
pulled out – wyciągnięty, wysunięty
pushed in – wciśnięty
reattach – ponownie połączy/dołączyć
retrieve – odzyskać
rinse – wypłukać
rotated – obrócony
rough – szorstki, ostry, nierówny
sideways – bokiem
significantly – znacząco
skull – czaszka
urgent – pilny, naglący
vertical – pionowy
wax – wosk

Mark the sentences True (T) or False (F)

1. Patients with some alarming symptoms such as dizziness or bleeding must be taken to hospital.
2. Patients with slight head trauma and additional dental injury can be evaluated just in a dental office. 
3. Severe tooth fracture involves serious fracture of dentine and enamel.
4. X-rays help in evaluating the extent of enamel chipping.
5. Chipped tooth is hypersensitive to temperature.
6. Untreated dentin fracture may lead to the death of inner pulp.
7. Knocked out baby teeth must be reinplanted.
8. Knocked out tooth should be kept in a cold and dry place.

Match words from the GLOSSARY section with the definitions

1. inability to remember something - ……………….
2. revive or restore something- ………………
3. slightly damp or wet - …………………
4. parallel to or in the plane of the horizon- ………………..
5. when something is pressing and should be immediate- ……………….
6. brain injury caused by a sudden blow- …………………
7. made longer or extended- ………………
8. a feeling that you are about to fall- ………………….
9. a localized collection of pus surrounded by inflamed tissue- ………………..
10. facing rear- ………………

Complete the text with words from the table

interfere reduce well-fitting
 
 joints impression pressure
 
mold participating

custom made

Prevention of dental injuries involves aligning protruding front teeth by dental braces and using face masks and mouthguards while 1)……………. in sports. Mouthguards have been shown to 2)…………… trauma not only to teeth, gums, and the surrounding jaw bone but also to reduce injury to the temporomandibular 3)………… and to reduce the intensity and number of head concussions. Mouthguards also reduce 4)………….. and bone deformation of the skull when a force is directed to the chin.

Mouthguards can be purchased in pharmacies and sports supply stores. They can also be 5)……………. by the dentist. Store-bought mouthguards are less expensive. However, the store-bought ones may not fit the athlete's mouth, may become loose and may 6)………….with speech or breathing. The ideal mouthguards are custom made by a dentist. A/An 7)……………. is made of the athlete's upper dental arch to make a 8)………….of his/her teeth and gums. A 9)…………… custom mouthguard is comfortable and will not interfere with breathing and speech.


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