Побічна дія лікарських засобів.

Ускладнення лікарської терапії називають по-різному: побічною дією лікарських засобів, лікарською алергією, непереносністю лікарського препарату, медикаментозною патологією тощо. Небажані реакції, які викликаються деякими лікарськими засобами, можна об'єднати поняттям «побічна дія», або «ускладнення фармакотерапії».

Профілактика побічної дії лікарських засобів є одним із засобів підвищення ефективності лікарської терапії.

Щоб запобігти ускладненням фармакотерапії, потрібно дотримуватись таких правил:
1. Обов'язково з'ясовувати у кожного хворого медикаментозний анамнез (переносність лікарських засобів), а в разі потреби проводити спеціальні дослідження для встановлення можливої підвищеної чутливості до призначеного препарату чи його непереносності.

2. Лікарські засоби слід призначати тільки за показаннями, в оптимальних дозах, краще всередину, якщо можливо уникати ін'єкцій.

3. Не слід застосовувати одночасно кілька лікарських засобів з однаковим механізмом дії

4. Складати обгрунтовану схему - план медикаментозного лікування для кожного хворого.

5. Слід враховувати стан тканинних мішеней, з якими буде взаємодіяти лікарська речовина, а також зміни функцій життєво важливих органів і систем.

6. Необхідно враховувати стадію захворювання і клінічний стан хворого.

7. У разі неадекватної реакції на лікарський засіб слід замінити його іншим.

8. Антибіотики і сульфаніламідні препарати, які найширше застосовують і які часто викликають побічні ефекти, слід призначати з урахуванням етіології захворювання, виду і властивостей збудника, а також його чутливості до призначуваного препарату.

9. Широко застосовувати метод прикриття щодо побічної дії лікарських засобів іншими препаратами.

10. Проводити роз'яснювальну роботу, спрямовану на запобігання безконтрольному застосуванню лікарських засобів, самолікуванню, щодо суворого дотримання строків зберігання лікарських засобів.

TEST

1. Cardiovascular medications are used as a means to control or to prevent certain forms of … .

a) pulmonary disease b) heart disease c) digestive disease

d) nervous disease e) kidney disease

2. Drug treatment may change if the disease… .

a) advance or improve b) to advance or improve c) advanced or improved

d) advances or improving e) advances or improves

3. Types of cardiovascular drugs may be broken into groups depending … their action or what they treat.

a) on b) in c) from d) upon e) to

4. Statins may be better known to people as … .

a) cholesterol-lowering drugs b) protein-lowering drugs

c) insulin-lowering drugs d) calcium-lowering drugs e) lipid-lowering drugs

5. Digitalis is a good contrast to… .

a) statins b) diuretics c) digitalis d) beta-blockers

e) Calcium Channel Blockers

6. Doctors may use a combination of drugs, or may try some, only to switch to other types that … more effectively for an individual patient.

a). appears to work b). appearing to work c). appear work

d). appear works e). appear to work

7. … are cardiovascular drugs that help to reduce fluid retention.

a). Vasodilators b). Angiotensin-converting-enzyme inhibitor

c). Diuretics d). Vasodilators e). Anti-platelet drugs

8. People who … a stroke, or who are at risk for one may need an anticoagulant like warfarin to minimize future risk.

a). Have b). to have had c).has to have d). have had e).having

9. An ACE inhibitor decreases some blood supply to the heart which reduces … work.

a).his b).it is c).this d).it’s e). its

10. Some drugs may have very significant interactions with others or a combination of medications may … more difficult side effects.

a). Resulting b). result from c). result to d). result in e). result out

CENTRAL NERVOUS SYSTEM DRUGS – ЦНС препарати

Exercise 1. Learn the following words:

Exercise 2. Read and then translate the following word combinations into the Ukrainian language:

Gastrointestinal disorders, central nervous system, spinal cord, to speed up the vital processes, in case of shock and collapse, to oppose the depressant effect, temporary feeling of euphoria, to relive lethargy, side effects, to suppress the central nervous system, to be addictive (habit-forming), to be used for control, severe disturbances of behaviour of psychoses, electrical discharges, to result in abnormal muscular movements, loss of consciousness, sensory and cognitive parts of brain, to control movement and motor activity, to affect in several ways, to account for talkativeness, consumption of alcohol, to be used as a dilator of vessels, to produce loss of sensation.

Exercise 3. Skim through the table and revise the forms of modal verbs:

Exercise 4. Translate the following sentences paying attention to the use of modal verbs:

1. The environment must be provided with the proper amount of oxygen for the growth of aerobic microorganisms.

2. I’m sure the doctor ought not to have told him that the disease is incurable. He should have encouraged him.

3. The doctor had to examine the patient’s pulse and to take his temperature to exclude the possible diagnosis of influenza.

4. A neuropsychologist is to treat people with brain damage (cerebral lesions, hemorrhages, tumors)

5. During the experiment the scientist was to investigate the process of inhibition in the cortex of the experimental animal.

6. Convulsions in this patient must have resulted from mental overstrain.

7. Everyone should remember that most viruses are destroyed at the temperature 50⁰-60⁰ within 30-60 minutes.

8. Any woman who is pregnant should get enough folic acid.

9. Oil-soluble vitamins can be stored for long periods of time in the body’s fatty tissue and the liver.

10. High doses of certain vitamins can cause vitamin poisoning.

Exercise 5. Read and translate the text:

Central nervous system drugs

The drugs which affect the central nervous system are of two main types: those which stimulate the nerves in the brain and spinal cord, stimulants, and those which depress the nerves in the brain and spinal cord, depressants.

The central nervous system stimulants are used to speed up vital processes in cases of shock and collapse, and also to oppose the depressant effect of other drugs. Stimulants produce a temporary feeling of euphoria (well-being) and help to relieve lethargy. Examples of drug stimulants are caffeine and amphetamine (Benzedine). Amphetamines are much more powerful than caffeine and can produce restlessness, insomnia and nervousness as well as hypertension (high blood pressure) and gastrointestinal disorders when given in high doses. Used in excessive doses, these drugs can produce convulsions.

There are several types of central nervous system depressants. These include analgesics, hypnotics, sedatives and barbiturates, tranquilizers, anticonvulsants, alcohol and anesthetics.

Analgesics are agents which act to relieve pain. Examples of narcotic analgesics are opium, morphine, heroine, codeine, and meperidine. Narcotics are drugs which in moderate doses can suppress the central nervous system and relieve pain but in excessive doses produce unconsciousness, stupor, coma and possibly death. Most of narcotic analgesics are additive and habit-forming.

Sedatives are used to quiet and relax the patient without necessarily producing sleep. Some drugs act as sedatives in small doses and as hypnotics in large doses. Chloral hydrate (хлоралгидрат) is an example of another type of sedative. Depending on the dose and how it is administered, the response to a barbiturate may range from mild sedation to hypnosis and finally to general anesthesia.

Tranquilizers are drugs which alter behaviour, allowing for control of nervous symptoms such as anxiety, depression, fear or anger.

Anticonvulsant agents are used to treat epilepsy, a central nervous system disorder caused by abnormal electrical discharges within the brain which result in abnormal muscular movements, loss of consciousness and other symptoms.

Alcohol is another central nervous system depressant. It affects the cerebral cortex of the brain in several ways. One way is to block the processes which control or inhibit behaviour. This effect accounts for the talkativeness and lack of inhibition which accompany consumption of even small amounts of alcohol in some people. Alcohol is also used as a dilator of blood vessels in vascular disease and as a hypnotic.

Anesthetics are drugs which produce loss of sensation and particularly loss of appreciation of pain. General anesthetics produce loss of sensation throughout the entire body by depressing the central nervous system, producing sleep, unconsciousness and muscle relaxation.

Exercise 6. Answer the following questions:

1. What are the two main types of drugs which affect the central nervous system?

2. What are the central nervous system stimulants used to?

3. What do stimulants produce and help?

4. What are the side effects of amphetamines?

5. What are the main types of central nervous system depressants?

6. What can narcotics produce?

7. What are the hypnotic drugs?

8. What are the anticonvulsant agents used to?

9. How does alcohol affect the cerebral cortex?

10. What are anesthetics used for?

Exercise 7. Match the words with their definitions::

Exercise 8. Give the English equivalents of the following words and word-combinations:

Спинний мозок, центральна нервова система, тимчасове відчуття ейфорії, тахікардія, безсоння, страх, серцево-судинні захворювання, навіть мала кількість, затьмарення свідомості, кров’яні судини, втрата свідомості, відчуття болю, вживання алкоголю, електричні розряди, стимулятори, прискорювати життєві процеси, надмірна доза, болезаспокійливі, кров’яний тиск, шлунково-кишкові розлади, кора головного мозку, що викликає звикання, злість, змінювати поведінку, депресанти, побічні дії, снодійне, відповідати за мову, м’язова релаксація, протисудомне.

Exercise 9. Complete the following sentences according to the text:

1. There are two main types of the drugs which affect the central nervous system: those which…

2. Central nervous system stimulants are used to speed up…

3. Examples of drug stimulants are…

4. Amphetamines are much more powerful than caffeine and can produce…

5. The examples of central nervous system depressants are…

6. Narcotics are drugs which in moderate doses can produce…

7. Tranquilizers are drugs which alter…

8. Anticonvulsant agents are used to treat…

9. Alcohol as another central nervous system depressant effects the…

10. Anesthetics are drugs which produce loss…

Exercise 10. Complete the sentences using must (not), could (not), have (not), should.

1. I’m afraid I can’t come tomorrow. I … work.

2. I … eat too much. I’m supposed to be on a diet.

3. The girl fell into the river but fortunately we … rescue her.

4. She … to wear glasses as she is short-sighted.

5. Don’t make so much noise. We … to wake the baby.

6. I looked everywhere for the book but I … find it.

7. Whatever you do, you … touch matches. It’s dangerous.

8. Sometimes doctors do not like their job as they … to work at weekends.

9. You … work hard to pass an exam in Chemistry and Biology.

10. Last night the child had a sudden attack of severe cough so we … to call in a doctor.

Exercise 11. Join two parts of the sentences:

Exercise 12. Insert the missing prepositions:

1. Examples … drug stimulants are caffeine and amphetamine.

2. Central nervous system stimulants are used to speed up vital processes … cases of shock and collapse.

3. Used … excessive doses, theses drugs can produce convulsions.

4. Analgesics are agents … act to relieve pain.

5. Narcotics are drugs which … moderate doses, can suppress the central nervous system.

6. Sedatives are used to quiet and relax the patient … necessarily producing sleep.

7. Tranquilizers are drugs which alter behaviour, allowing … control of nervous symptoms such as anxiety, fear or anger.

8. Alcohol affects the cerebral cortex of the brain … several ways.

Exercise 13. Open the brackets using the verbs in a correct form:

1. Acute gastritis (to occur) due to a great variety of causes.

2. By the end of the day both the X-ray examination and ECG (to show) the changes in the size of the heart and its functions.

3. Much progress (to achieve) in treating bronchial asthma for the last few years.

4. If a common bile obstruction (to develop), jaundice (to occur).

5. The patient (not to develop) severe anemia, if he (not to suffer) from profuse abdominal bleeding because of a bad injury.

6. The surgeon said that the patient (to operate) on next week.

7. I (to talk) with your doctor for half an hour before you came in.

8. The problem of cerebral vascular diseases (to become) increasingly serious nowadays because of severe nervous tension.

Exercise 14. Make up questions to the underlined words:

1. This hypothesis has attracted many followers.

2. They were known to be the patients with duodenal ulcer.

3. We have learnt the functions of skeletal muscles this month.

4. We were observing how these salts were dissolving in water.

5. After the sutures are removed, the surgeon has to examine the wound.

6. The bite of a dog leads to rabies.

7. AIDS is known to be an incurable disease affecting the internal vital organs of the body.

8. Despite technical advances the number of patients with hepatic metastasis remains high.

9. Recurrence of the disease means of a disease means return of symptoms after a temporary absence.

10. Due to suddenly occurred diarrhea the patient was directed to the hospital for examination and treatment.

Exercise 15. Describe the following words in 5 sentences:

Stimulants, depressants

TEST

1. The drugs which affect the … system are of two main types: stimulants and depressants.

a) central nervous b) respiratory c) urinary d) digestive

2. The central nervous system stimulants are used to … vital processes in cases of shock and collapse.

a) slow b) stop c) keep d) speed up

3. Stimulants produce a temporary feeling of … and help to relieve lethargy.

a) fear b) happiness c) euphoria d) anxiety

4. Amphetamines are much more powerful than caffeine and can produce restlessness, insomnia and nervousness as well as hypertension (high blood pressure) and gastrointestinal disorders when given in … doses.

a) high b) low c) moderate d) proper

5. … are drugs which in moderate doses can suppress the central nervous system and relieve pain.

a) opium b) coffee c) amphetamines d) narcotics

6. Tranquilizers are drugs which … behaviour, allowing for control of nervous symptoms such as anxiety, depression, fear or anger.

a) inhibit b) alter c) control d) quiet

7. Anticonvulsant agents are used to treat epilepsy, a central nervous system disorder caused by abnormal electrical discharges within the … .

a) brain b) spinal cord c) bone marrow d) heart

8. Alcohol is also used as a … of blood vessels in vascular disease and as a hypnotic.

a) controller b) constrictor c) inhibitor d) dilator

9. Anesthetics are drugs which produce loss of sensation and particularly loss of appreciation of … .

a) fear b) pain c) reality d) anxiety

10. General anesthetics produce loss of sensation throughout the entire body by … the central nervous system, producing sleep, unconsciousness and muscle relaxation.

a) depressing b) controlling c) inhibiting d) altering

DENTAL CARIES – Зубний карієс

Exercise 1. Learn the active vocabulary:

To compromise [‘komprəmaiz] порушувати

Hygiene [‘haidʒi:n] гігієна

Technique [tək’ni:k] техніка

Susceptibility [səspti’biliti] сприйнятність

To be predisposed [pridis’pouzd] бути схильним

Consumption [kən’sʌmp∫n] споживання

Impaction [im’pæk∫n] застряття

Intervention [,intə’ven∫n] процедура, втручання

To remove [ri’mu:v] видаляти

Enamel [i’næməl] емаль

Exercise 2. Translate the word combinations:

Tooth structure, proper oral hygiene, fluoridated water, a person’s susceptibility, sticky sugary foods, local demineralization, loss of the entire tooth, annoying impaction of small food pieces, extent of dental caries, fluoride treatments, root canal treatment.

Exercise 3. Read and translate the text.

DENTAL CARIES

Dental caries is a disease that can lead to cavities (small holes) in the tooth structure that compromises both the structure and the health of the tooth.

Statistics on Dental Caries

Dental caries is the second most common disease in our community after the common cold. However, it can be prevented with proper oral hygiene. The rate of dental caries has declined due to fluoridated water and improved oral hygiene techniques.

Risk Factors for Dental Caries

There are several risk factors associated with dental caries. The 3 main factors that lead to dental caries are sugars, oral bacteria and the time these are combined in the presence of the tooth. These factors increase a person’s susceptibility to developing caries and play varying roles in the development of caries, depending on its nature.

For example, sticky sugary foods are much more likely to cause dental caries than non sticky sugary foods. It is important to recognize that people with teeth defects are predisposed to dental caries.

Progression of Dental Caries

Dental caries is caused by bacteria producing acids from the consumption of sugars. The acid can cause local demineralization of the tooth surface. If damage to the tooth is not significant, the protective qualities of saliva may stop further demineralization of the tooth and remineralization will occur. Also, proper oral hygiene e.g. brushing teeth 3 times a day reduces the development and progression of caries.

If caries is allowed to continue to progress, much more of the tooth structure will be lost and there is an increased risk of loss of the entire tooth and infection such as a tooth abscess.

Symptoms of Dental Caries

The patient usually complains of a painful tooth that is made worse when eating hot, cold or sugary drinks. There may be discoloration or holes present on affected tooth, which may cause annoying impaction of small food pieces. If the tooth has become infected, the patient's face may appear swollen on the affected side.

Clinical Examination of Dental Caries

The early sign of dental caries is a chalky white appearance of the enamel surface. If the caries progresses the damaged enamel surface becomes dark brown or black. A late sign of dental caries is holes or cavities in the affected tooth. The affected tooth is probed to check the depth of the hole. If the tooth is painful when probed, the tooth is still alive. If not, the tooth is not vital any more.

How is Dental Caries Diagnosed?

An x-ray confirms diagnosis of dental caries.

Prognosis of Dental Caries

The prognosis of dental caries depends on the health of the patient, oral health practices and the extent of dental caries. Early signs of dental caries may be reversed with minor dental intervention and improved oral hygiene. If dental caries has lead to holes in the tooth, the lost tooth structure must be filled and rebuilt with dental materials. If there is significant damage to the tooth and signs of infection, the tooth should be removed and the infection treated.

How is Dental Caries Treated?

The main goal is to keep as much tooth structure as well as preventing further complications. Caries that are superficial may require only fluoride treatments to help with remineralization.

If caries have lead to cavities, the caries must be removed and the repaired with dental materials such as composite and amalgam. If a significant amount of tooth structure is lost, the tooth may have a crown placed over it. If much of the tooth structure is lost and the tooth is vulnerable to infection, the tooth may need root canal treatment.

The final stage will be to remove the tooth if it is untreatable. The patient may then choose to have an implant (a false tooth put into the jaw) or partial denture, depending on oral health and financial status.

Exercise 4. Answer the questions to the text:

1. What is dental caries?

2. What has the rate of dental caries declined due to?

3. What 3 main factors lead to caries?

4. How does caries progress?

5. What does the patient with caries usually complain of?

6. How does enamel of the tooth change in caries?

7. What does the prognosis of dental caries depend on?

8. How can we treat dental caries?

9. When may the tooth require a crown?

Exercise 5. Make the corresponding equivalents:

Exercise 6. Translate the following word-combinations into your native language:

To compromise the structure and the health of the tooth, the most common disease, a common cold, to improve oral hygiene techniques, to increase a person’s susceptibility to developing caries, sticky sugary foods, to be predisposed to dental caries, consumption of sugars, significant damage to the tooth, protective qualities of saliva, loss of the entire tooth, discoloration, annoying impaction of small food pieces, chalky white appearance on the enamel surface, to check the depth of the hole, vital tooth, to confirm the diagnosis, improved oral hygiene, to fill, to rebuild, and to remove the tooth, to prevent further complications, superficial caries, to be vulnerable to infection, a false tooth or partial denture in the jaw.

Exercise 7. Find the missing letters from the active vocabulary of the topic and translate them:

1. _ y _ _ e _ e

2. E _ _ _ _ l

3. d _ _ i _ _ r _ _ _ _ a _ _ _ _

4. _ u _ _ e _ _ i _ i _ i _ _

5. _ _ _ i _ a

6. d _ _ _ o _ o _ _ _ _ o _

7. a _ p _ _ _ _ _ _ e

8. _ _ n _ _r _

9. _ i _ _ _ _ _ i s

10. t _ _ _ _ _ q _ e

Exercise 8. Adverbs can help to describe how things happened and help to make a diagnosis. Look at the statements and underline the most appropriate adverb in these sentences.

1. The fainting? It just happened abruptly / gradually / slowly. The next thing I knew she was lying completely flat on the pavement.

2. The patient suddenly became pale and started to sweat, but not profusely / rapidly / enormously.

3. After the attack, Mr Jones came to rapidly / slowly / leisurely, and questioned whether it was a seizure.

4. Embarrassingly / Gradually / Clearly, I soiled myself and wet myself. It wasn’t very pleasant.

5. She was lying flat, but bystanders were trying to keep her upright, so she was twitching slowly / convulsively / suddenly.

6. As he couldn’t see good / clearly / visually, he got quiet frightened.

7. In a seizure, there is typically / rarely / seldom no prodrome (признак, предшествующий началу заболевания; продром), but this not always a case.

8. After collapsing, he didn’t get better spontaneously / slowly / gradually. The patient was a bit drowsy for quiet a while afterwards.

9. He recovered completely / partially / poorly from the accident. Now he’s perfectly OK.

10. Fainting and vomiting don’t reliably / partially / clearly discriminate (от-, различать) seizures from faints.

Exercise 9. Medical terminology for surgery. Match the prefixes with their meanings:

Exercise 10. Complete the sentences by combining one of the prefixes above with one of the suffixes below. You may use some of the suffixes more than once.

-ectomy -lithotomy -pexy -plasty

-r(h)aphy -ostomy -otomy

1. We’re going to do something called a ________________ to have a look inside your tummy.

2. I’m afraid we’re going to have to do an operation called a ___________ to remove your right kidney.

3. The only option left to us is a ________________, where we remove part of your large bowel and then make an opening in your tummy wall.

4. So how do you feel about having your womb removed by laparoscopic _______________ ?

5. We’re going to do a procedure which will involve a ____________, where we remove several ribs.

6. We can do bilateral _____________, where we lift both breasts.

7. We can do a __________, where we stitch the bladder.

8. We’re going to have to remove the gall bladder. The technical name for this operation is ________________.

9. What we’re going to do is to destroy some stones in the kidney in a procedure called ___________.

10. We’re going to do a procedure called a _____________ to fix the large part of your gut (кишка).

Exercise 11. Rapid tense change. Understanding the sequence of events and hence the tenses is important for correct diagnosis. What are the tenses of highlighted phrases?

We were shopping in Cambridge Street in town, when suddenly Barbara, my wife, just fainted. We tried to get her upright and she started twitching quiet violently. It was very scary. She came round very rapidly. But we dialed 999 and a paramedic appeared almost instantly and then the ambulance almost immediately afterwards. She had been complaining of feeling a bit unwell, and had almost fainted and she felt a bit woozy. She was a bit dizzy and she was yawning repeatedly and then all of a sudden, there she was, lying on the ground. When I come to think of it, she passed out once before about a month ago. She hasn’t been feeling well on and off over the summer. We thought it was the heat.

a. Present Perfect (Pres Perf)

b. Past Continuous (PC)

c. Past Perfect (Past Perf)

d. Past Perfect Continuous (Past Perf Cont)

e. Present Perfect Continuous (Pres Perf Cont)

f. Simple Past (SP)

Exercise 12. Complete the sentences using the verbs in brackets in the correct past tense:

1. We _______ (walk) along the street when she _________ (pass) out suddenly.

2. She ________ (have never) the pain before till now, but she ________ (experience) some bleeding the first time.

3. After he _________ (admit), he _________ (become) suddenly worse, but he has started responding the treatment.

4. He __________ (never suffer) a fit судороги before, but he _________ (feel) unwell since this morning.

5. He __________ (yawn) repeatedly, which he __________ (not do) before, and then he just _________ (faint).

6. After he _________ (fall), he _________ (start) twitching violently when we __________ (try) to get him up.

7. When she ________ (lie) on the ground, she __________ (not shake) at all. Then she just stood up.

8. What actually __________ (happen) when she _________ (fall)?

9. He _________ (bite) his tongue and he _________ (mess) himself and he ________ (feel) a bit groggy помутнение рассудка since.

TEST

1. … is a disease that can lead to cavities (small holes) in the tooth structure.

a) pulpitis b) dental caries c) gingivitis d) abscess

2. Dental caries is the … most common disease in our community after the common cold.

a) first b) fifth c) third d) second

3. The 3 main factors that lead to dental caries are sugars, oral bacteria and the.

a) time b) sweets c) sugars d) chocolate

4. Proper oral hygiene e.g. brushing teeth 3 times a day … the development and progression of caries.

a) increases b) controls c) inhibits d) reduces

5. If caries is allowed to continue to progress, much more of the tooth structure will be … .

a) lost b) found c) hidden d) looked for

6. If the tooth has become infected, the patient's face may appear … on the affected side.

a) redenned b) lost c) swollen d) irritated

7. The … sign of dental caries is a chalky white appearance of the enamel surface.

a) late b) early c) average d) first

8. If dental caries has lead to holes in the tooth, the lost tooth structure must be … and rebuilt with dental materials.

a) extracted b) cleaned c) treated d) filled

9. The main goal is to … as much tooth structure as well as preventing further complications.

a) keep b) save c) treat d) damage

10. If much of the tooth structure is lost and the tooth is … to infection, the tooth may need root canal treatment.

a) untreatable b) vulnerable c) susceptible d) viable

PULPITIS - Пульпіт

Exercise 1. Topic Vocabulary

Pulp - пульпа

Dentine - дентин

Cracked teeth - тріснуті зуби

Filling - пломба

To be sealed off - бути ізольованим, відділеним

Dissipate - розсіюватися, поширюватися

Hallmark - характерна ознака

Transient pain - скороминучий біль

Restoration - пломба

Lingering pain - затяжний біль

Referred pain - біль, що іррадіює

Gutta percha - гутаперча

Coronal tissue - тканина коронки зуба

Root canal therapy - лікування кореневого каналу

Exercise 2. Translate into Ukrainian

Increased sensitivity to stimuli, a prolonged throbbing pain, to penetrate through the enamel and dentin to reach the pulp, to depend upon the severity of the inflammation and the body's response, the pulp chamber, to dissipate through the surrounding soft tissues, a hallmark of inflammation, to respond to an irritant, to be irreversibly damaged, include dull aching pain from hot or cold, a lingering pain after removal of a stimulus, extraction of the tooth, insufficient coronal tissue

Exercise 3. Read the definition of one of the dental specialties and try to define the terms given below

Endodontics (from the Greek endo "inside"; and odons "tooth") is one of the dental specialties recognized by the American Dental Association. It deals with the tooth pulp and the tissues surrounding the root of a tooth. Endodontic treatment includes a variety of procedures endodontic therapy (commonly known as "root canal therapy"), endodontic retreatment, surgery, treating cracked teeth, and treating dental trauma. Root canal therapy is one of the most common procedures. If the pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) becomes diseased or injured, endodontic treatment is required to save the tooth.

Endodontist is …

Dentistry is …

Exercise 4. Read the text

PULPITIS

Pulpitis is inflammation of dental pulp tissue. Usually it is associated with toothache.

Increased sensitivity to stimuli, specifically hot and cold, is a common symptom of pulpitis. A prolonged throbbing pain may be associated with the disease. However, pulpitis can also occur without any pain.

Pulpitis may be caused by a dental caries that penetrates through the enamel and dentin to reach the pulp, or it may be a result of trauma and lots of treatments such as dental tooth fillings or dental crowns.

Inflammation is commonly associated with a bacterial infection but can also be due to other causes such as repetitive trauma or in rare cases periodontitis. In the case of penetrating decay, the pulp chamber is no longer sealed off from the environment of the oral cavity.

When the pulp becomes inflamed pressure from inflammation affects the nerve and can cause mild to extreme pain, depending upon the severity of the inflammation and the body's response. Unlike other parts of the body where pressure can dissipate through the surrounding soft tissues, the pulp cavity is very different. It is surrounded by dentin, a hard tissue that does not allow for pressure dissipation, so increased blood flow, a hallmark of inflammation, will cause pain.

Diagnosis is based on clinical findings and confirmed by x-ray.

Pulpitis can be diagnostically divided into two categories: reversible pulpitis and irreversible pulpitis.

Reversible pulpitis is the condition where the pulp is inflamed and is actively responding to an irritant. This may include a carious lesion that has not reached the pulp. Symptoms include transient pain or sensitivity resulting from many stimuli, notably hot, cold, sweets, water and touch. The pulp is still considered to be vital. This means that once the irritant is eliminated, usually by the removal of decay and the placement of a restoration, the pulp will return to its normal, healthy state.

Irreversible pulpitis is the condition where the pulp is irreversibly damaged and cannot recover. For example, decay that has reached the pulp of the tooth introduces bacteria into the pulp. The pulp is still alive, but the introduction of bacteria into the pulp will not allow the pulp to heal and it will ultimately result in necrosis, or death, of the pulp tissue.

Symptoms associated with irreversible pulpitis may include dull aching pain from hot or cold (though cold may actually provide relief), lingering pain after removal of a stimulus, spontaneous pain, or referred pain.

The pulp of a tooth with irreversible pulpitis may not be left alone to heal.

The tooth may be treated by root canal therapy when the pulp is removed and replaced by gutta percha. An alternative is extraction of the tooth. This may be required if there is insufficient coronal tissue remaining for restoration once the root canal therapy has been completed.

Exercise 5. Answer the questions

1) What kind of disease is pulpitis?

2) What are the common symptoms of pulpitis?

3) What are the causes of pulpitis?

4) Why does pain occur in pupitis?

5) What is the diagnosis of pulpitis based on?

6) How can pulpitis be classified?

7) What are the features of reversible pulpitis?

8) How can reversible pulpitis be treated?

9) What are the features of irreversible pulpitis?

10) How is irreversible pulpitis treated?

Exercise 6. Translate into English the words describing pain and related to pain. Then use the appropriate words in sentences.

I. 1)Pain (the character): острая, тупая, ноющая, пульсирующая, иррадиирующая, спонтанная, жгучая, колющая, давящая, сжимающая, невыносимая, стреляющая, кратковременная, затяжная, длительная, рецидивирующая

2)вызывать боль, чувствовать боль, переносить боль, страдать от боли, снимать (облегчать) боль, усиливать боль, предотвращать боль

II. 1) In reversible pulpitis the pain (subsides, prevents) when the stimulus is removed).

2) A (pressing, throbbing) pain may be associated with pulpitis.

3) Pain killers can (exacerbate, relieve) pain only for a short period.

4) A (lingering, transient) pain after removal of a stimulus is a symptom of irreversible pulpitis.

5) In angina pectoris patients (experience, cause) a (recurrent, sharp) pain behind the breastbone.

6) In irreversible pulpitis the pain is (spontaneous, burning), which may wake the patient at night and may (suffer, become worse) when lying down.

7) The symptoms of gastric ulcer may include a (gnawing, squeezing) or burning pain in the middle or upper stomach between meals or at night.

8) The pain may (feel, persist) for several days.

Exercise 7. Choose pairs of words with the similar meaning

Restoration, transient, tooth decay, findings, trauma, throbbing, persist, extraction, convalesce, response, caries, pain, data, filling, reaction, diffuse, temporal, tenderness, removal, injury, continue, recover, dissipate, pulsating

Exercise 8. Read the patient’s question and the dentist’s answer and tell what kind of pulpitis it can be and what treatment can be required in this case. Explain your conclusion.

Question:

I presently have mouth pain (dull, not acute) what has previously been described to me as pulpitis. I`ve had it several times before; it`s often triggered by biting or chewing something hard, like crusty bread. Sometimes the pain has gradually gone away by itself, and sometimes I`ve had to see an endodontist for a root canal.

This time the pain is receding slowly. Of course I would like to avoid going back to the endodontist. So other than not eating crunchy food, and patience, are there things I can do at home to facilitate recovery? If you have ideas, I`m very motivated to follow them! Thanks.

Answer:

There is no home care to heal or prevent the breakdown of the blood vessels or nerves inside your tooth. A visit to the dentist/endododontist could determine if there are any dental problems that can be fixed to prevent needing a root canal.

I would recommend an evaluation. It is important to note that tooth pain will eventually disappear regardless but if there is a problem it will eventually appear again.

Exercise 9. Transform the sentences with direct speech by those with reported speech

1) The patient said, ‘I have mouth pain (dull, not acute) what has previously been described to me as pulpitis’.

2) ‘It is important to note that tooth pain will eventually disappear regardless but if there is a problem it will eventually appear again’ said the dentist to the patient.

3) ‘Can I facilitate recovery at home?’ asked the patient.

4) ‘How do whitening toothpastes work and how effective are they?’ asked Peter his dentist.

5) The dentist said ‘Whitening toothpastes can lighten your tooth's color by about one shade’.

6) ‘Fluoride-containing toothpastes have been shown to prevent cavities,’ explained the dentist.

7) ‘Visit your dentist to determine if there are any dental problems that can be fixed to prevent needing a root canal,’ said the family doctor to Ben.

8) "We are encouraging dentists to select radiographic examinations for their patients on an individual basis," said Dr. Sharon Brooks.

Exercise 10. Open the bracket and translate

1) If the infection (to be) severe, the child will need to be treated in the hospital and receive antibiotics through an intravenous (IV) catheter.

2) Different types of bacteria (to involve) in this process that can lead to an infection in the inside of the tooth.

3) The pain (to reduce) significantly by physiotherapeutic procedures before the patient (to examine) by the endodontist.

4) Avoid medications such as ibuprofen or aspirin to manage toothache as these generally (not to consider) safe during pregnancy.

5) A 9-year-old boy having caries (to refer) to a paediatric dental clinic after two previous extractions in a general practice.

6) The endodontic treatment (to complete) by the end of the next week.

7) Recent studies (to show) a positive relationship between caries and dental erosion and the consumption of soft drinks.

8) To manage dental pain, acetaminophen (Tylenol) (to recommend) for pain relief.

Exercise 11. Have you ever experienced toothache? Was it pulpitis? Tell about you visiting a dentist.

TEST

1. Pulpitis may be characterized by … pain.

a) permanent burning; b) prolonged throbbing; c) transient squeezing

2. Pulpitis can be diagnostically divided into … categories.

a) two; b) three; c) many

3. Irreversible pulpitis may be treated by … .

a) elimination of the irritant; b) the placement of a restoration;

c) root canal therapy

4. Pain in pulpitis is caused by … .

a) bacteria; b) increased pressure; c) necrosis

5. … does not allow for pressure dissipation.

a) enamel; b) dentine; c) pulp

6. The doctor asked …in the morning.

a) if the patient feels pain; b) if the patient has felt pain;

c) if the patient felt pain

7. Tooth pain will eventually disappear but if there … a problem it will eventually appear again.

a) is; b) are; c) will be

8. Due to many factors the pulp becomes … .

a) inflaming; b) inflame; c) inflamed

9. Endodontics deals … the tooth pulp and the tissues surrounding the root of a tooth.

a) with; b) about; c) to

10. The endodontic treatment will have been completed … the end of the next week.

a) in; b) at; c) by