口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003

口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003
口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003

Chapter 1 At the reception desk (在接待處) 1. Making an appointment (約診)

重要單語 Check-up 檢查 Fully booked 預約排滿了 Cancel an appointment 取消預約

1.Making an appointment 約診
Miss Suzuki (鈴木): Hello, this is Dr. Sato (佐藤) and Dr. Richard’s Dental Clinic. How can I help you? Mr. Abe: Good morning. I am ringing (calling or phoning) to ask if I could make an appointment for a check-up? Miss Suzuki: Unfortunately Dr. Sato (佐藤) and Dr. Richard are both busy all this week. Is next Monday OK? We have some spaces in the morning. Mr. Abe: Next Monday morning is fine for me. Could it be early in the morning?

1.Making an appointment 約診
Miss Suzuki：The first available space is 8:30. Is 8:30 am alright for you? Mr. Abe：8:30 am is perfect, thank you. Miss Suzuki：Could I have your name again, please? Mr. Abe：Yes of course. My name is Kenji Abe (阿部健二).

Chapter 1 At the reception desk (在接待處) 2
Chapter 1 At the reception desk (在接待處) 2. Cancelling an appointment (取消預約)

2.Cancelling an appointment 取消預約
Miss Suzuki: Good afternoon, Dr. Sato and Dr. Richard’s Dental Clinic. Can I help you? Mr. Otake: Hello this is Kenichi Otake (大竹健一). I would like to cancel an appointment if possible. Miss Suzuki: Could you tell me when is your appoint Mr. Otake? Mr. Otake: It’s this Friday at 4 pm. Miss Suzuki: That’s no problem. I will cancel it for you. Would you like to make another one?

2.Cancelling an appointment 取消預約
Mr. Otake: Yes please. Dr. Richard was going to do a filling so I need to come again. Could I come in next week? Miss Suzuki: I am sorry. Dr. Richard is fully booked (預約排滿; no more spaces were available) next week. Because you need a filling, a longer appointment is necessary. The next time Dr. Richard can see you will be a week on Tuesday. Will that be alright? Mr. Otake: Yes, that’s fine thank you.

Chapter 1 At the reception desk (在接待處) 3 .Changing an appointment (改約)

3.Changing an appointment 預約的變更
Miss Suzuki: Dr. Sato and Dr. Richard’s Dental Clinic, how can I help you? Mrs. Sayama: My name is Mrs. Sayama (佐山) and I have an appointment this afternoon with Dr. Sato but I have to change it because I don’t feel well. Miss Suzuki: Oh dear, I’m sorry to hear that you are not feeling well. Would you like to make another appointment?

3.Changing an appointment 預約的變更
Mrs. Sayama: Can I call you back because I’m going away for a few days? Miss Suzuki: That’s fine. We look forward to seeing you again, Mrs. Sayama.

Chapter 2 Emergency (牙科急診) 1. Broken tooth (牙齒斷裂)
牙醫學系:周肇茂教授分機:7003

重要單語 Composite filling, composite resin: 複合樹脂充填, 複合樹脂
Metal crown: 金屬牙冠 White crown: 白色金屬牙冠 Ceramic materials: 陶瓷材料 Zirconium oxide: 氧化鋯 Prepare the tooth: 修磨牙齒; 預備牙齒 Emergency: 急診 Chew: 咀嚼

1.Broken tooth 牙齒斷裂 Dr. Sato: You’re back again, Mr. Ishida. Is it the same tooth? Mr. Ishida: I’m not sure. I bit (past tense of bite) on a yakitori (燒鳥: 把雞肉或鳥、豬等的內臟切成小塊用籤子穿起來烤的食品。烤雞肉串。烤雞雜(豬雜)串.) last night, then I heard a crack and felt something sharp in my mouth. I think it is either the tooth you worked on or the one next to it. I can’t say.

1.Broken tooth 牙齒斷裂 Dr. Sato: Well, luckily the tooth I rebuilt last time is OK. It is the tooth behind. You had a composite filling in that tooth but now the remaining bit of enamel has broken off. Mr. Ishida: Is it serious? Dr. Sato: Yes and no. (used to show that there is not one clear answer to a question 既是又不是﹝表示難以明確答覆﹞)

1.Broken tooth 牙齒斷裂 Mr. Ishida: What do you mean?
Dr. Sato: Well , yes in the sense that if we do what we did last time and repair the broken enamel with composite resin, your entire tooth will consist of composite resin. Mr. Ishida: That’s good, isn’t it?

1.Broken tooth 牙齒斷裂 Dr.Sato: Not really. If the entire tooth consists of composite resin, it can easily break again and all the filling may break off. We will need to place a crown on the tooth. Mr.Ishida: I don’t want a metal crown. Some of my friends have metal crowns and they don’t look very nice. Can I have a white crown?

1.Broken tooth 牙齒斷裂 Dr. Sato: Yes, that’s no problem. There are some new ceramic materials available, which can be used to make the crown. Because you have a tendency to break your teeth we will need to use a strong ceramic. Something like a Procera high strength alumina coping or one made of zirconia.

1.Broken tooth 牙齒斷裂 What we’ll do today is put some composite resin on as a temporary measure and give you another appointment. Mr. Ishida: Can’t you prepare the tooth today? Dr. Sato: Unfortunately you were seen as an emergency and I have another patient waiting. Sorry.

1.Broken tooth 牙齒斷裂 Mr. Ishida: It’s just that I have to go Italy for a business trip. I’ll be out of the country for a month. So I‘m worried that the composite resin won’t last. Dr. Sato: If you are careful not to eat anything very hard on that tooth, you should be fine.

1.Broken tooth 牙齒斷裂 Mr. Ishida: I’ll make sure I chew on the other side. Thanks for what you have done today .I’m sorry for all the trouble I have caused you. Dr. Sato: It’s my pleasure Mr. Ishida (石田).

Chapter 2 Emergency (牙科急診) 2
Chapter 2 Emergency (牙科急診) 2.A denture tooth has broken off (活動假牙的人工牙齒斷裂)

重要單字 She has broken a tooth off her upper denture: 她上顎的活動人工假牙斷裂.
What can I do for you?: 我能為你做些什麼? A front tooth has broken off my upper denture.: 我上顎活動假牙的一顆人工前齒斷裂了.

2.A denture tooth has broken off 活動假牙的人工牙齒斷裂
Miss Suzuki: Sorry to trouble you Dr. Richard, a lady called Mrs. Kawajima (川島女士) has come in and would like to know if someone could see her. She is very distressed. She says she has broken a tooth off her upper denture. Dr. Richard: Could you see if Dr. Sato is free?

Miss Suzuki: Yes certainly. Dr. Richard: I have just finished so I can see Mrs. Kawajima. Could you call her in please, Miss Kato (加藤)? Miss Kato: Would you like to come through please, Mrs. Kawajima (川島)？

Dr. Sato: What can I do for you Mrs. Kawajima？ Mrs. Kawajima: A front tooth has broken off my upper denture and now I can’t smile. It’s terrible. I must give a presentation this afternoon in front of 200 people. If this tooth can’t be fixed everyone will laugh at me!

Dr. Sato: Let me have a look. Ah, no problem. The tooth just needs to be stuck back on. It will take me just a few minutes. Mrs. Kawajima: Thank you so much.

Chapter 2 Emergency (牙科急診) 3. Pericoronitis (牙冠周圍發炎)

重要單字 Patient’s file 病歷資料 Wisdom tooth 智齒; 第三大臼齒 Bite 咬 Gum 牙齦
Lower third molar 下顎第三大臼齒 Swollen / Swell 腫脹 Crown 牙冠 Pericoronitis 牙冠周圍發炎 Flap of gum 牙齦瓣 Infection 感染 Erupt 萌發 Radiograph 放射線照片 Impacted tooth 埋伏齒

重要單字 Mesially 近心側 Refer 轉診 Oral surgeon 口腔外科 Second opinion 第二意見
Extract 拔牙 Sterile water 滅菌水 Antibiotics 抗生素 Allergic to Penicillin 盤尼西尼過敏 White spot 白斑 Have a sweet tooth 喜好吃甜食 Hygienist 口腔衛生師

3. Pericoronitis 牙冠周圍發炎 Miss Suzuki: Your first patient has just cancelled so you have a bit more time. However, there is an emergency patient on the way. I will call you when I have made the patient’s file. Miss Tanaka (田中): Dr. Richard, we will be working in Dr. Sato’s surgery today. We are lucky. He is not in today.

3. Pericoronitis 牙冠周圍發炎 Dr. Richard: That’s good. Has someone been called to come and check the autoclave (高壓蒸氣消毒鍋)? Miss Tanaka: Yes. Your first patient cancelled. But there is an emergency patient on the way. Miss Suzuki: The emergency patient has come. The patient’s name is Miss Komata (小俁ㄩˇ). Here is her file. Miss Tanaka: Dr. Richard, are you ready for the emergency patient? Her name is Miss Komata. Dr. Richard: Yes. Can you call her in please? .

3. Pericoronitis 牙冠周圍發炎 Miss Tanaka: Good morning Miss Komata (小俁ㄩˇ). Could you come this way please. Dr. Richard: Good morning Miss Komata, please come in and have a seat. What can we do for you? Miss Komata: Thank you for seeing me at such short notice. I think it’s the wisdom tooth. The back of my mouth hurts when I try to bite together. The pain has been getting worse and I couldn’t sleep last night. I am also having difficulty opening my mouth.

3. Pericoronitis 牙冠周圍發炎 Dr. Richard: Ok. Let’s have a look. Yes, the gum around your lower third molar is swollen. Part of the crown is visible. You have pericoronitis. Miss Komata: Pericoronitis? What’s that? Dr. Richard: There is a flap of gum overlying the wisdom tooth. Food has been trapped underneath the flap of tissue and an infection has started. It looks like your third molar is having trouble erupting. We need to take a radiograph to check its position.

3. Pericoronitis 冠周圍發炎 Dr. Richard: Your tooth is impacted mesially. Let me show you. Miss Komata: Will it come through later on? Dr. Richard: I don’t think so. It is tilted against the molar in front. I will refer you to an oral surgeon for a second opinion. He may recommend you have it extracted. I will wash under the gum with sterile water and give you some antibiotics. They will reduce the infection. Are you allergic to penicillin?

3. Pericoronitis 牙冠周圍發炎 Miss Komata : No. I have had Penicillin before. Dr. Richard :I have noticed a couple of other things. You have several white spots on your teeth and there is some calculus behind your lower incisors. Do you like to eat a lot of sweet thing. Miss Komata : Yes I do. My friends have told me I have a “sweet tooth”. Dr. Richard: I will give you another appointment so we can talk about your diet and give you some advice and also I will book(預約) you in with our oral hygienist. Miss Komata : Thanks very much.

Chapter 2 Emergency (牙科急診) 4 . An allergic reaction (過敏反應)

重要單字 Allergic reaction 過敏反應 Wisdom tooth 智齒 Swelling 腫脹 Rash 濕疹
Go and see a doctor 看醫生 Alternative antibiotics 替代抗生劑 oral surgeon 口腔外科醫生 Have one’s wisdom tooth removed 拔掉某人的智齒 Indication 適應症

4 . An allergic reaction 過敏反應
Miss Suzuki: Miss Tanaka, do you think Dr. Richard can see an emergency patient? Miss Tanaka: Yes I’m sure he can. What’s the problem? Miss Suzuki: Mrs. Komata has returned. She thinks that she’s had an allergic reaction to the antibiotics Dr. Richard gave her for her wisdom tooth trouble. Miss Tanaka: I remember Mrs. Komata. She came in yesterday as an emergency. I’ll let Dr. Richard know that she’s in the waiting room. .

Miss Tanaka: Dr. Richard. We have an emergency patient. Do you remember Mrs. Komata who came in yesterday with the wisdom tooth swelling? Well she thinks she’s had an allergic reaction to the antibiotics you gave her. Dr. Richard: that doesn’t sound good. We had better bring her in right away. Miss Tanaka: Please come this way, Mrs. Komata. Dr. Richard: I hear things aren’t going well for you, Mrs. Komata.

Mrs. Komata: Unfortunately no they aren’t. I have developed a rash on my arm and I think it’s an allergic reaction to the antibiotics you gave me. Dr. Richard: Yes, I can see the rash. I gave you penicillin. When I asked you if you had any allergies you said you hadn’t. Mrs. Komata: That’s right I don’t. Dr. Richard: Have you had penicillin before? Mrs. Komata: Yes, once a long time ago.

Dr. Richard: Well it looks like you have had an allergic reaction. You must go and see your medical doctor for further tests. In the meantime, please stop the penicillin and I will give you an alternative antibiotic. You have a review (follow-up) appointment next week don’t you? Mrs. Komata : Yes, I do. Dr. Richard: I will see you then and decide if we need to refer you to the oral surgeon to have your wisdom tooth removed. If you have an infection that requires antibiotics then that is an indication to have the tooth removed.

Mrs. Komata: Thanks for seeing me so quickly. I’ll go straight to my doctor. Dr. Richard: Before you leave, I will write a letter for you to give to your doctor explaining what has happened. Please take a seat in the waiting room for a few minutes.

Chapter 2 Emergency (牙科急診) 5. An avulsed tooth (脫落齒)

重要單字 Upper central incisor 上顎正中切齒 Come through 長出(牙齒)
Surgery (British dental clinical or手術) Splint the tooth (靠相鄰牙齒的連結)固定牙齒 Periodontal membrane 牙周膜

5. An avulsed tooth 脫落齒 Miss Suzuki: Miss Kato, could you see if Dr. Sato can come to the phone please? Mrs. Ogata (緒方) would like to speak to Dr. Sato urgently. Apparently her daughter’s front tooth was knocked out. Miss Kato: I’ll get him at once. Miss Suzuki: Dr. Sato, Mrs. Ogata’s daughter had an accident at school and her front tooth was knocked out. She wants to know what to do. Dr. Sato: Hello, Mrs. Ogata. This is Dr. Sato speaking. I hear your daughter had an accident.

5. An avulsed tooth 脫落齒 Mrs. Ogata: Yes. I remember you telling me her upper central incisors have come through. It is one of those. Dr. Sato: The best thing to do is put the tooth back if you can. Is there some milk near by? If so, put the tooth in milk and gently move it around. Try not to touch or clean the root. Mrs. Ogata: Ok. Yes, there is some milk available and I shall do that now. Dr. Sato: Good.

5. An avulsed tooth 脫落齒 Dr. Sato : Now, the next step is difficult. You need to put the tooth back in the socket. But please be careful to put the tooth back correctly. The flat part of the tooth faces to the front of her mouth. Push the tooth in as quickly as you can then ask her to bite gently on something soft like a piece of cotton. Dr. Sato : Then bring her straight to the surgery (British dental clinical) and I shall have a look at her when she is here. I’ll splint the tooth for a few days just to keep it in position while hopefully a new periodontal membrane will grow.

5. An avulsed tooth 脫落齒 Mrs. Ogata: I have cleaned her face and wiped the blood away so I am ready to try to put the tooth back. Once I have done that I’ll bring her straight to you. Thank you so much for your advice.

Chapter 3 Treatment (牙科治療) 1. Composite filling (複合樹脂充填)

重要單字 Premolar 小臼齒 Palatal cusp 顎側咬頭
Light-cured composite resin 光聚合型複合樹脂 Glass particle 玻璃顆粒 Polymerize 聚合 Restoration 補綴物 (贋復物或修復物) Set 聚合 Adhesion 接黏劑 Indirect onlay 間接法製作的冠蓋體 Metal-ceramic crown 金屬-陶瓷牙冠 Calculus 牙結石

1. Composite filling 複合樹脂充填
Miss Kato: Good morning Dr. Sato. Ready for this morning？ Dr. Sato: Absolutely. How many patients do we have? Miss Kato: Five this morning. The first patient is Mr. Ishida. He has broken a tooth. Are you ready? Dr. Sato: Yes. Can you call him in? Mr. Ishida: Thanks for seeing me, Dr. Sato. I was eating some Yakitori when I heard a crack and then noticed a piece of tooth in my mouth. I think it is one of my premolars.

Dr. Sato: I’ll have a look. Ah yes, you have broken the palatal cusp of your second premolar. We can rebuild it with light-cured composite resin. Mr. Ishida: What is light-cured composite resin? Will it last for a long time? Dr. Sato: Light-cured composite resin is a resin, which contains glass particles of different sizes. We use a blue light to polymerize (聚合) it. The material has a long working time so that we can create the correct shape. When we are happy with the shape of the restoration, then we set it with the light. It relies on adhesion to stay in place.

Dr. Sato: How long will it last？ Dr. Sato: Well that is difficult to say. It depends on many things. If it breaks again, we could either place an indirect onlay or prepare the tooth for a metal-ceramic crown. These are more expensive and time-consuming long-term options. I noticed that you also have some calculus on your teeth. I will arrange for you to see our dental hygienist, Miss Yoshida (吉田).

Chapter 3 Treatment (牙科治療) 2
Chapter 3 Treatment (牙科治療) 2. A painful tooth, endodontic treatment (牙痛, 根管治療)

重要單字 Amalgam filling 汞齊充填 Pulp 牙髓 Radiograph X光照片
Endodontic treatment 根管治療 Secondary caries 二次齲齒 Bacteria 細菌 Toxins 毒素 Drop out 脫離 Inflamed 發炎的 Non-vital 非活性的 Dental abscess 牙(齒)膿瘍

重要單字 Pulp extirpation 牙髓摘除術 Local anesthetic 局部麻醉 Numb 使…麻醉 Clamp夾
Rubber dam 橡皮障 Root canal(s) 根管 Antibiotic paste 抗生素糊劑 Temporary filling 暫時性充填 Topical anesthetic 表面麻醉

2. A painful tooth, endodontic treatment 牙痛,根管治療
Miss Yoshida: Good morning Mr. Santana, how are you today? Mr. Santana: Not too good actually. Miss Yoshida: Why? What’s happening? Mr. Santana: Well, one of the teeth which you were going to clean is hurting me. It’s the first upper big tooth on the left. Miss Yoshida: Oh dear. How long has it been hurting you?

2. A painful tooth, endodontic treatment 牙痛, 根管治療
Mr. Santana: Since last week. Now it’s starting to keep me awake at night. I also can’t chew on it. Something broke last week. I think it was the filling. Miss Yoshida: I’ll have a look. Yes, you have broken an amalgam filling in the upper first molar. I will call Dr. Sato in to have a look…

Dr. Sato: Miss Yoshida is right. The amalgam filling has broken. The supporting structure of the tooth became soft and was no longer able to support the filling. It looks like the soft tooth has reached the pulp and now the pulp is dying, which is why you have pain. We need to take a radiograph to see how deep the soft tooth is.

Dr. Sato: Unfortunately the soft tooth has affected the pulp and the tooth needs endodontic treatment. Mr. Santana: Sorry, could you explain that again? Dr. Sato: Yes, certainly. I’ll go slowly and show you some pictures. Sometimes fillings can become decayed. This is called secondary caries because it is the second time the tooth has become decayed. Dental caries is caused by bacteria releasing toxins, which dissolve the mineral part of the tooth, causing the tooth to become soft.

Dr. Sato: This can cause the filling to drop out because it has no firm support. The bacterial toxins eventually reach the pulp, which is in the middle of the tooth. The pulp becomes inflamed, which is why you feel pain. Unfortunately in your case it is impossible to keep your pulp alive. We need to remove the inflamed pulp to stop your pain.

Dr. Sato: If we don’t do it, the infection will go further and all the pulp will die. In other words, it will become non-vital. This will give rise to infection in the bone around the tooth. This is called a dental abscess. Mr. Santana: Can you get rid of the pain? Dr. Sato: Yes, we can initiate endodontic treatment. In other words we can remove the pulp and clean the inside of the tooth so there is nothing left to cause pain. This procedure is called pulp extirpation.

. Mr. Santana: Is it painful when you clean out the tooth? Dr. Sato: No, I will give you a local anesthetic, which will numb the tooth. Dr. Sato: It will be numb for a few hours so you must be careful with hot drinks and eating. You may bite your lip or burn yourself if you are not careful.

Mr. Santana: How do you clean out the tooth? Dr. Sato: After your tooth become numb, we clamp a piece of rubber over the tooth. This is called a rubber dam. It prevents you from swallowing anything. Then we remove all of the old filling and decayed tooth. The upper first molar has 3 roots and at least 3 root canals, which are channels inside the roots. Dr. Sato: We use small, very narrow files to remove the contents of the root canals. After we have cleaned the root canals we put in some antibiotic paste and a temporary filling. You will need to come back so we can complete the treatment.

Mr. Santana: I am sorry for asking so many questions. I feel less nervous now that I know what is going to happen. Dr. Sato: First, I’ll put some cream on the gum to numb the surface. Can I have the topical anesthetic, please, Miss Kato…

Chapter 3 Treatment 3. porcelain laminate veneer ( 陶瓷片狀鑲面 ): (1) preliminary discussion with the dental technician

Porcelain laminate veneer 陶瓷片狀鑲面 Prepare Upper incisor上顎切齒
重要單字 Surgery 診療室 Appointment 來院的預約 Wax-up 築蠟 Porcelain laminate veneer 陶瓷片狀鑲面 Prepare Upper incisor上顎切齒 Silicone index 矽化物指標 Transparent acrylic template 透明壓克力模板

3. porcelain veneer: (1) preliminary discussion with the dental technician
Dr. Richard: Good morning Miss Suzuki. How are you? Miss Suzuki: I’m fine thanks. Kaz Yoshida of Hi-Ceramics asked you to call him.。 Dr. Richard: I will call him right away. Have you seen Dr. Sato? Miss Suzuki: Yes, he is in his surgery. By the way, your first patient Mr. Jones rang to say that unfortunately he has been called to an urgent meeting and cannot come this morning. He apologized and asked if he could make another appointment.

3. porcelain veneer: (1) preliminary discussion with the dental technician
Dr. Richard: I’ll call Kaz and see what he wants…Is that Mr. Yoshida? Kaz Yoshida: Hi, Dr. Richard. Thanks for calling back. I rang regarding the wax-up for Miss Ito (伊藤). You plan to make four Porcelain Laminate Veneers for her. Dr. Richard: That’s right. We are going to prepare the upper incisors for Porcelain Laminate Veneers. I will show Miss Ito the Wax-up on Wednesday. Then, if she is happy with it, I will ask you to make a silicone index and transparent acrylic template. Could you come in on Wednesday to talk with Miss Ito? Kaz Yoshida: Wednesday is fine. See you then.

Chapter 3 Treatment 3. porcelain laminate veneer: (2) Wax-up

重要單字 Porcelain veneers: 陶瓷貼片 Dental Technician: 牙科技工師
Labial surface: 唇側面 Enamel: 牙釉質 Anterior teeth: 前牙 Treatment: 治療 Wear: 裝著

重要單字 Mold:模型 Silicone putty:矽化物油灰 Set:硬化 Trim:修整
Clear acrylic mask:透明的丙烯酸面罩 Prepare the teeth:支台齒形成

3. porcelain veneer: (2) Wax-up
Dr. Richard: Did you have any trouble with the trains this morning, Miss Tanaka? Miss. Tanaka: No, but I heard there were delays on the Yamanote line (山手線). Your first patient, Miss Ito, is here. Dr. Richard: Ah yes. We are going to show her the wax-up for her new porcelain veneers. Could you see if Kaz has also arrived? I asked him to come when Miss Ito was due in.

Miss Tanaka: I'll go and have a look...Yes, he is here. He is talking to Miss Suzuki at the reception desk. Dr. Richard: Good. I'll ask him in...How's it going Kaz? Kaz Yoshida: Very well, thanks. Dr. Richard: Could you ask Miss Ito to come please, Miss Tanaka? Miss Tanaka: Please have a seat, Miss Ito. Dr. Richard: Good morning, Miss Ito. I have asked our dental technician, Kazuo Yoshida (吉田和夫), to join us to discuss the wax-up of your teeth.

Miss Ito (伊藤): Nice to meet you. Dr. Richard: Well this is the wax-up. SInce you have lost some of your enamel, we have been able to build out the teeth a little. This will make them more like they were before you began losing the surface enamel. Miss Ito: Yes, unfortunately too many soft drinks and fruit juices. Well I have followed your advice and stopped drinking soft drinks and cut down on the fruit juice.

The teeth look a little bigger now and also slightly longer. But they seem to appear more like they used to look. Kaz Yoshida: I looked at the photograph which you gave me of your teeth a few years ago and compared it with the photo, which Dr. Richard took last time. I added wax where you lost some of the enamel and also lengthened the teeth slightly so that you show a little more tooth when you smile. Miss Ito: Yes, they look much nicer now.

Dr. Richer: Do you want us to proceed with the treatment? The next stage would be for you to wear a clear acrylic mask, which will be lightly attached to your teeth. You will wear the mask for a couple of weeks to get used to your new smile. After that, if you are happy with your new smile, we can go head and prepare the teeth. If you do not like your new appearance, then we will not proceed with the preparations.

Miss Ito: What is an acrylic mask? Dr. Richard: First, we copy the wax up in dental stone. Then we make a mold of the labial surfaces of the anterior teeth using silicone putty. When you come back we fill this silicone putty mold with clear acrylic and hold it against the teeth while it sets. It does not stick to the teeth. It is carefully trimmed so that it clips onto the teeth. It allows you to check your new smile at home. Of course, the color will not be perfect but it will allow you to evaluate what the final shape of the teeth will be…

3.Porcelain Veneer: ③Tooth preparation
Dr. Richard: What do you think of the acrylic mask? Miss Ito: It looked a bit strange at first but I got used to it. I like the new shape of the teeth. Dr. Richard: Would you like me to prepare your teeth for porcelain veneers on your upper central incisors? Miss Ito: Do you have to remove much enamel? Dr. Richard: No. Your teeth incline inwards and you have composite fillings in both teeth so we only have to remove a few fractions of a millimeter. My technician, Kaz, has made me a putty matrix.

Chapter 3 Treatment 3. porcelain veneer: ③Tooth preparation( 支台齒形成 )

重要單字 Porcelain veneer:陶瓷鑲面 Matrix:基質或成形帶 Acrylic mask:丙烯酸面罩
Cast the impression in plaster:注入石膏於印象 Prepare:支台齒成形 Central incisor:中切齒 Adhesive resin cement:黏著樹脂黏著劑

Miss Ito: Sorry, why do you need a putty matrix? Dr. Richard: The putty matrix is very useful. It will make sure I do not remove too much enamel. Kaz made an impression of the wax-up of your central incisors. He then cast the impression in plaster. This gave him a model of how you wish your teeth to look. A putty matrix was made on this model. As we adjust the surfaces of your central incisors, we place the putty matrix against the preparations. We can then see how much space there is for the porcelain veneers. We need about mm of space.

Miss Ito: It all sounds very complicated. I’m not sure I understand but you seem to be taking great care. Dr. Richard: Yes, I am. But this way we can ensure that the veneers will look like the acrylic mask but a better color. Miss Ito: Will they fall off the teeth? Dr. Richard: We use a special adhesive resin cement so it is unlikely they will fall off. We shall give you an appointment in a week’s time. Will that be alright for you? Miss Ito: That will be great thank you.

Chapter 3 Treatment 4. Making a new denture: (1)Complaints about old dentures

重要單字 Denture:義齒 False teeth: 假牙 Set: 義齒上下一組 Appearance: 外觀
Preliminary impression: 初次印模 Cast (up):灌模 Model : 模型 Laboratory: 技工室 Technician:牙科技工師(齒模技術員) Special tray( custom or individual tray):個別模托 Fitting: 適合

4.Making a new denture: (1)Complaints about old dentures
Miss Kato: Dr. Sato, Mrs. Kawajima is here. Dr. Sato: Oh no, don’t tell me the tooth on her denture has fallen off again. Miss Kato: No, she wants you to make her a new denture. Shall I call her in? Dr. Sato: Yes, please. Mrs. Kawajima: Thanks for seeing me Dr. Sato. Dr. Sato: How can I help you? Mrs. Kawajima: it’s my false teeth. They are getting quite loose and the top one keeps dropping down.

Dr. Sato: How long have you had them? Mrs. Kawajima: Oh, it’s so long ago I can’t remember. Over 20 years I think. Dr. Sato : Would you like me to make you a new set? Mrs. Kawajima: Yes, please. Dr. Sato : Are you happy with the appearance of the teeth of your current set? Mrs. Kawajima: Not really. I think the teeth are a little small. Also, I would like whiter teeth. Will it take long to make me a set of new teeth.

Mrs. Kawajima: Can you begin today? Dr. Sato: Yes, we can make the preliminary impressions today. After taking the impressions, we will cast them up and then send the models to the laboratory. The technician will then make some special trays. Mrs. Kawajima: May I ask why you need to make special trays? Dr. Sato: Special trays are custom-fitted to your mouth. They will enable me to take some accurate impressions of your mouth. Accurate impressions will help in making better fitting dentures.

Chapter 3 Treatment 4.Making a new denture: ② Making an impression

重要單字 Special tray ( individual or custom tray ): 個別模托 Treatment: 治療
Impression material: 印象材 Zinc oxide-eugenol impression paste: 氧化鋅丁香油酚印模糊劑 Vinyl polysiloxane (addition silicone) (乙烯聚矽氧烷)(加成式矽化物印模材) Acrylic: 丙烯酸的 Alveolar ridge: (齒槽骨脊) Denture flange: (義齒凸緣) Peripheral seal: 周邊封鎖 Insert: 裝入

4.Making a new denture:② Making an impression
Dr. Sato: Have Mrs. Kawajima’s special trays come back? Miss Suzuki: Yes, they have. Mrs. Kawajima: Good morning, Miss Suzuki, good morning Dr. Sato. I think I’m a little early. Dr. Sato: I’ve already finished my previous treatment so it won’t be too long. My assistant, Miss Kato, will call you in a few minutes.

Miss Kato: which impression material will you be using? Dr. Sato: I will use Exadenture. Miss Kato: Don’t you usually use zinc oxide-eugenol impression paste? Dr. Sato: I do, but I will try this new vinyl polysiloxane impression material today. I will use Exadenture Border type first, then Exadenture paste.

Miss Kato: Shall I call her in? Dr. Sato: Yes please. Mrs. Kawajima: I’m really happy you can see me again so soon. Could you tell me what you are going to do today? Dr. Sato: We are going to make the final impressions. We will place the impression material in the upper and lower acrylic special trays that we made. We make each impression in two stages.

Mrs. Kawajima: May I ask why two stages are necessary? Dr. Sato: We must first record the shape of the tissues surrounding the alveolar ridges. If the denture flanges accurately reproduce the shape of the surrounding tissues, a good peripheral seal will be obtained when the denture is inserted. This means it will stay in better.

Mrs. Kawajima: That makes sense (那是合乎情理的). I was just asking because my previous dentist just took one impression. Dr Sato: First I will check the fit of the trays then make any necessary adjustments.

Chapter 3 Treatment 4.Making a new denture: ③ Jaw registration( 咬合採得 )

重要單字 Jaw registration (bite registration): 咬合採得
Fox’s occlusal plane guide: 咬合平面板 Wax rim: 蠟堤 Instrument: 道具,器具 Imaginary line: 假想線 Pupil: 瞳孔 Inter-pupillary line: 瞳孔間線

重要單字 Alar of the nose: 鼻翼 Tragus of the ear: 耳珠 Ala-tragus line: 鼻翼耳珠線
Freeway space (Interocclusal space): 休憩間隙或咬合間隙 Measurement: 計測,測定

4.Making a new denture:③ Jaw registration
Dr. Sato: Are you ready for Mrs. Kawajima? Miss Kato: Is it the jaw registration stage? Dr. Sato: Yes, I will need the Fox’s occlusal plane guide and Willis bite gauge. Miss Kato: Would you like to come through, Mrs. Kawajima? Dr. Sato: Good afternoon, Mrs. Kawajima, how are you today? Mrs. Kawajima: I’m fine, thanks.

Dr. Sato: Today, we are going to measure up two wax rims, which we will be placing in your mouth. First we will put the upper wax rim inside your mouth to determine how much tooth you will show and then trim the wax rim so that the teeth do not appear to be sloping to one side. Mrs. Kawajima: How do you do that? Dr. Sato: We use this plastic instrument, which is called the Fox’s occlusal plane guide. We place it against the wax rim and line it up with two imaginary lines.

Dr. Sato: An imaginary line between the pupils called the inter-pupillary line and a line between the ala of the nose and the tragus of the ear called the ala-tragus line. We then trim the wax rim so that the Fox’s occlusal plane guide is parallel to these lines. Mrs. Kawajima: That sounds difficult. Dr. Sato: I also must trim the lower wax rim so that I can determine the free way space.

4. Making a new denture:③ Jaw registration
Mrs. Kawajima: Could I ask what freeway space is? Dr. Sato: We must make sure that there is a small gap of a couple millimeters between the teeth when you are not eating, otherwise you will get pain beneath the dentures. Next time you come we will make another measurement. Mrs. Kawajima: You certainly seem to be taking a great deal of care.

Chapter 3 治療 4.Making a new denture: ④ Retruded contact position 後縮接觸位置

重要單字 Mandible: 下顎 Retruded contact position: 後縮接觸位置 Measurement: 測定，測量
Gothic arch tracer: ↓哥德氏弧形描繪器 Wax rim: 蠟環 Mold: 型, 形 Artificial teeth: 人工牙齒

重要單字 clicking sound: (擬聲)滴答,滴答的聲音 bite: 咬合
high quality acrylic teeth: 高品質樹脂牙 realistic: 實際 set up: 設置，排列 Processing: ( 重合, 煮聚)

4.Making a new denture:④ retruded contact position
Mrs. Kawajima: What’s happening today, Dr Sato? Dr. Sato: We are going to record the relationship of the mandible to the maxilla. It is called the retruded contact position.

4.Making a new denture:④ retruded contac position
Mrs. Kawajima: Didn’t you do that last time? Dr. Sato: No. We made some different measurements at your last appointment. Today, I am going to use a device called a Gothic arch tracer (哥德式弓), which has been fitted to the upper and lower wax rims. I will put the wax rims in your mouth and then ask you to move your mandible forwards and backwards and side to side. Also, we need to select the correct mold and shade of artificial teeth.

Mrs. Kawajima: I would like white teeth. My existing teeth are starting to look yellow. Also, is it possible to have porcelain teeth? Dr. Sato: You can definitely have whiter teeth, however, I wouldn’t recommend porcelain teeth. They are difficult to adjust and can make a ‘clicking sound’ when you bite together. I suggest high quality acrylic teeth. They look quite realistic.

Mrs. Kawajima: That sounds fine. Dr. Sato: Next time you come the teeth will have been set up in wax. While the teeth are in wax, it is possible to change them if you are not happy. Once you are happy with them we will process the wax trial dentures into acrylic.

Mrs. Kawajima: How long do I have to wait until my next appointment? Dr. Sato: We can have the wax trial dentures ready in one week. However, they may need some adjustments so they may not be ready for processing next time. Mrs. Kawajima: I appreciate all the trouble you are going to. Thank you.

Chapter 3 治療 4.Making a new denture: ⑤ Try-in試戴

重要單字 set-up: 排列 prominent: 突出 process: 重合,煮聚 acrylic: 丙烯酸的，壓克力的

4.Making a new denture:⑤ Try-in
Dr. Sato: How do you like the set-up of your new teeth? Mrs. Kawajima: I like the color and shape of the teeth. It’s just the two front teeth… they look a little prominent. Dr. Sato: Yes, I agree. I will alter the positions of the upper incisors. Mrs. Kawajima: Do you think they will be ready next time?

4.Making a new denture:⑤ Try-in
Dr. Sato: Yes. The technician has done a good job. The bite is correct and you are happy with the shape and color of your teeth. So, if you are happy with the position of the teeth once I have altered them, the dentures can be processed into acrylic.

Chapter 3 治療 4.Making a new denture: ⑥ Insertion

重要單字 Laboratory　實驗室(技工所) Set 一對 Insert 裝入 Hurt 痛 Gum 牙齦 Fitting surface 黏膜面 Pressure indicating paste ( 壓力顯示膏) Follow-up appointment 追蹤約診 Wear 戴 Ulcer 潰瘍

4.Making a new denture:⑥ Insertion
Dr.Sato: Good news Mrs. Kawajima, your new dentures have come back from the laboratory Mrs. Kawajima: I hope they fit better than my current set. They have been giving me a lot of trouble recently. Dr. Sato: I will insert the upper denture first and make sure it doesn’t hurt you before I insert the lower denture. Do you feel any pain when I press on the top denture ? Mrs. Kawajima: No, it feels fine.

Dr. Sato: Ok. I will insert the lower denture and then you can tell me if it hurts. Mrs. Kawajima: It feels as if it’s digging in the gum on the right-hand side. Drs. Sato: Before I adjust the denture I am going to paint a white paste on the fitting surface of the denture. Mrs. Kawajima: What’s the white paste for? Dr. Sato: It’s called Pressure Indicating Paste and can help identify which area of the denture is causing the pain. Then, I can carefully adjust the denture, otherwise I might cut away too much.

Dr. Sato: How do they feel now? Mrs. Kawajima: Much better. The dentures are not rubbing now. Dr. Sato: This hand mirror will let you see how the dentures look. Mrs. Kawajima: They look nice. I like their color and appearance. Thank you.

Dr. Sato: I am pleased that you like them. There are some instructions, which you need to follow for the next few days. You may find eating difficult at first. Please cut your food into small pieces and eat soft things first. If you start having any discomfort, please take them out. I will give you a follow-up appointment in a few days. If you keep wearing them when they are hurting, you may get an ulcer. Mrs. Kawajima: I understand. Thank you.

Chapter 3 治療 4.Making a new denture:⑦ Denture adjustment

重要單字 hurt 痛 dig 插入 post-dam (posterior palatal seal) 後障 (後顎封) seal 封鎖
Ridge 齒槽脊 Acrylic 樹脂 posterior border後緣 soft-tissue軟組織 hard and soft palate硬、軟顎 plaster model石膏模型 reduce減少

4.Making a new denture:⑦ Denture adjustment
Dr. Sato: So, how have your dentures been? Mrs. Kawajima: Quite good. All my friends said how much younger I look, which is very nice. I am slowly beginning to eat better with them. However, you did say to be careful while eating because it might be a little difficult at first. Dr. Sato: Do they hurt anywhere? Mrs. Kawajima: Just the top one. It seems to be digging in a little at the back.

Dr. Sato: I’ll have a look. Ah, yes. It’s the post-dam we made. It’s a little deep. Mrs. Kawajima: Sorry did you say post-dam? Dr. Sato: Yes. In order to get a good seal at the back, we added a thin ridge of acrylic to the back of the denture. The back of the upper denture is called the posterior border. A couple of visits previously, I took some soft-tissue measurements at the junction of your hard and soft palates. These measurements told me how deep to make the ridge of acrylic. I then altered the plaster model according to the measurements.

Mrs. Kawajima: Ah, I think I understand. Dr. Sato: It appears the ridge is a little too deep, so I will reduce it slightly. Mrs. Kawajima: Thank you.

Chapter 3 治療 5. Metal-ceramic crown replacement: ① Black margin

重要單字 Certainly 當然 How can we help you? 我們如何幫你 Cap(crown) 帽冠
Front teeth 前齒 What’s wrong with them? 他們出了什麼問題 Metal-ceramic crown 金屬陶瓷冠 Ceramic 陶瓷 Metal 金屬 Ceramic material 陶瓷材料 Porcelain 瓷器 Fracture 斷裂

重要單字 Fitted密合 Prepare the teeth 牙齒的形成 Margins of preparation牙齒形成的邊緣 Gum margins牙齦邊緣 Cemented 黏合劑的 Gingivae 牙齦 Recede 退縮 Collar of metal 金屬領 Replace 代替 Periapical radiograph 根尖X光片

5.Metal-ceramic crown replacement:① Black margin
Dr. Richard: Who is our next patient, Miss Tanaka? Miss Tanaka: It’s Mrs. Shioda (鹽田) Dr. Richard: Could you ask her in please? Miss Tanaka: Certainly. Dr. Richard: How can we help you, Mrs. Shioda? Mrs. Shioda: It’s the caps on my two front teeth. Dr. Richard: What’s wrong with them? Mrs. Shioda: I think they are going bad. They are going black around the edges. Do you know what’s happening with them?

Dr. Richard: Your caps are what we called metal-ceramic crowns. They have an outer covering of ceramic on top of a thin layer of metal. Mrs. Shioda: May I ask why it is necessary to use metal in the crown? Dr. Richard: The outer ceramic material is porcelain, which is brittle and can easily fracture. The metal strengthens the porcelain so that it doesn’t fracture as easily. The black line, which you can see is metal.

Mrs. Shioda: Why is the metal showing? I couldn’t see it when the crowns were first fitted. Dr. Richard: We prepare the teeth so that the margins of the preparation lie just below the gum margins so when the crowns are cemented you can’t see their margins. However, over a period of years the gums or gingivae may recede slightly. If the gingivae recede, then the crown margins will be exposed. If the crown is a metal ceramic crown and has been designed such that there is a collar of metal all the way around, then the metal may be visible.

Mrs. Shioda: I would like you to replace these two old crowns with new crowns. Dr. Richard: First, we must take some periapical radiographs of the teeth to see what is beneath the crowns.

Chapter 3 治療 5. Metal-ceramic crown replacement (2) Getting a nice appearance

重要單字 Central incisors 中央門齒 Root treated 根管治療完畢 Cast metal posts 鑄造金屬柱子
Apical infection 根尖感染 Cut off 切斷 Root fracture 牙根斷裂 All ceramic material 全瓷材料 High strength alumina 高強度氧化鋁

重要單字 Zirconium oxide 氧化鋯 All ceramic 全瓷 Metal post 金屬柱 Recede (動詞)退縮
Recession (名詞)退縮 Electric toothbrush 電動牙刷 Collarless metal ceramic crown 無金屬領烤瓷冠

Shade:色調 Technician: 齒模技術員 Face-bow: 面弓 Ear tube (external auditory meatus): 外聽道 Inter-condylar axis: 髁間軸 Palatal surface: 顎側面 Articulator: 咬合器 Informed consent: 充分了解情況後的同意

5.Metal-ceramic crown replacement(2) Getting a nice appearance
Mrs. Shioda: Can you see anything on the radio-graphs? Dr. Richard: Yes, a few things. Your two central incisors have been root treated and fitted with cast metal posts. These cast posts are quite long. The good news is that there is no apical infection around the roots of the teeth. If we are to replace the two crowns we would need to cut them off but leave the cast posts in the roots. If we try to remove the posts there is a risk of root fracture.

Mrs. Shioda: Can you replace the old crowns with ones without metal? Dr. Richard: There are all ceramic materials available such as high strength alumina and zirconium oxide, which are very strong. However, because we must leave the metal post in the roots, an all ceramic crown may not possess good esthetics because the metal may show through. Therefore, we would need to make two metal ceramic crowns.

Mrs. Shioda: I understand that it would not be a good idea to replace the metal-ceramic with all ceramic crowns because the metal posts might be visible through the ceramic. You said the reason why I can see the metal is that my gums have receded. Will this happen if I have new crowns made?

Dr. Richard: Yes, it is possible that you may get some more recession. The amount the gums recede depends on several factors. For instance, if you brush your teeth vigorously in a sideways motion, the brushing action may accelerate gum recession. Could I ask how you brush your teeth, Mrs. Shioda?

Mrs. Shioda: I use an electric toothbrush. I hold it lightly against the teeth and let the bristles do the work. You also said that you would make new metal-ceramic crowns. Does that means the metal will be visible? Dr. Richard: What I propose is that we make collarless metal ceramic crowns. The underlying metal will not extend to the crown margin. The crown margin will be all in porcelain.

Mrs. Shioda: How will you get the color of the new crowns to match my natural teeth? Dr. Richard: We use a machine, which takes a digital reading of the color of your natural teeth. The reading is then matched with a shade of porcelain. If the color of your natural teeth is difficult to match then I will ask my technician to come in and look at your teeth. While you are here today I will take some digital photographs of your teeth and also some impressions of your upper and lower teeth. I will also take a face-bow recording.

Mrs. Shioda: Sorry, did you say face-bow recording? What is that? Dr. Richard: I will put some wax on your upper teeth and then use a device, which consists of a metal fork and an arm, which rests in your ear tubes. This is a face bow. Its purpose is to capture the relationship of the maxilla with the inter-condylar axis. The face bow is then attached to an articulator, which enables us to study the relationship of the upper and lower teeth. When we make new upper anterior crowns, it is very important to get the slope of the palatal surface correct.

Mrs. Shioda: It sounds very complicated. I am sorry, I will stop asking so many questions. Dr. Richard: That’s not a problem. It is important that you understand the treatment we are proposing so you can give informed consent.

Chapter 3 治療 5.Metal-ceramic crown replacement: (3) Crown removal

Administer a local anesthetic 使用局部麻醉 Anaesthetize (麻醉)
重要單字 Numbed up 麻痺 Administer a local anesthetic 使用局部麻醉 Anaesthetize (麻醉) Lidocaine (商品名, 指麻醉藥) Adrenaline 腎上腺素 Alginate impression (藻膠印模) Temporary crown 臨時牙冠 Gingival retraction cord 牙齦排開線 Preparations 支臺齒形成 Addition silicone 加成式矽化物 Glaze 瓷釉

5.Metal-ceramic crown replacement:(3) Crown removal
Dr. Richard: Would you like to come through, Mrs. Shioda? Mrs. Shioda: Thanks for seeing me early. Dr. Richard: How are you today, Mrs. Shioda? Mrs. Shioda: Not very well unfortunately. Dr. Richard: What’s wrong? Mrs. Shioda: It’s my ankle. I twisted it a few days ago and now it is all bandaged up.

Dr. Richard: What happened? Mrs. Shioda: I was playing tennis last Saturday and during the match I slipped while trying to reach a ball. Dr. Richard: Oh dear, I’m sorry to hear that. Mrs. Shioda: What’s happening today? Dr. Richard: We are going to remove your old crowns and take some impressions for your new crowns. Mrs. Shioda: Will I need to be numbed up?

Dr. Richard: Yes, unfortunately we need to administer a local anesthetic. We need to anaesthetize your two upper incisors. The local anesthetic agent is a mixture of lidocaine and adrenaline. Your lip will feel numb for about two to three hours so please avoid hot drinks. Mrs. Shioda: Why’s that? Dr. Richard: You will not have any feeling in your upper lip so you might burn it. Also you must be careful you don’t bite it if you are going to try to eat.

Mrs. Shioda: I prefer you to my last dentist. He never told me anything. I was always worried about what he was going to do. Could you tell me what you are going to do today so I know what to expect? Dr. Richard: Certainly. While the teeth are going numb, I will take an alginate impression. We will use this to make the temporary crowns. After that I will cut the old crowns so they can be carefully removed from the teeth. Mrs. Shioda: Sorry to interrupt you, but is that a piece of string you are cutting off?

Dr. Richard: It is like string but a bit thicker. It’s called gingival retraction cord. We have removed both crowns and tidied up the preparations. Before I take the impressions, I am going to place this gingival retraction cord around the preparations. Mrs. Shioda: May I ask why? Dr. Richard: The retraction cord keeps the edge of the gum away from the tooth. It is soaked in a solution, which stops any bleeding. This way we can make a good impression. Mrs. Shioda: Which impression material are you going to use?

Dr. Richard: I think I will use the addition silicone sample, that the sales representative gave me last week. It’s in the drawer on your right. Dr. Richard: You are doing well Mrs. Shioda. We are on the last stage now. I just need to make some nice temporary crowns for you. Mrs. Shioda: I hope they are better than the ones my last Dentist made for me. They went yellow. Dr. Richard: Don’t worry that shouldn’t happen with these. I will put a special glaze on them so that food won’t stain them…

Chapter 3治療 5.Metal-ceramic crown replacement (4) Characterization

重要單字 metal-ceramic crown 金屬瓷冠 Porcelain butt margin 陶瓷方形邊緣 Shade 色調 Characterization 特徵 Staining 染色 Natural teeth 自然牙 Ultrasonic scaler 超音波結石刮 Internal characterization 內部特徵 Surface texture 表面組織構造 Mimic 模仿 I am looking forward to ~ing 我正期待著…

5.Metal-ceramic crown replacement (4) Characterization
Dr. Richard: How are things, Kaz? Kaz Yoshioda: Fine thanks, I stopped by to talk to you about Mrs. Shioda’s new crowns. Dr. Richard: Yes, we are making two new metal-ceramic crown with porcelain butt margins for her upper central incisors. Kaz Yoshida: I wanted to discuss the shade and shape of these crowns with you. You requested some special characterization.

Dr. Richard: Yes. Her adjacent lateral incisors exhibit some staining. Mrs. Shoida would like the new crowns to also have some staining. Her existing crowns are all one color and do not blend in with her natural teeth. Kaz Yoshioda: I have printed out the digital photos that you ed me. They clearly show that the existing crowns appear to stand out from the surrounding natural teeth. The lower anterior teeth also have some staining. Is the staining permanent or can it be removed with an ultrasonic scaler (超音波結石刮)?

Dr. Richard: It’s permanent. It would not come off with an ultrasonic scaler. Mrs. Shioda says they have been stained for many years. Kaz Yoshioda: I will need to add some internal characterization using different shades of porcelains. It is important that I also create some surface texture. It appears from the photos that the adjacent lateral incisors have some vertical dark lines so these will need to be mimicked in the crowns. I will put a faint brown stain in the porcelain to mimic the brown lines in the lateral incisors.

Dr. Richard: That sounds very good. I took several photographs at different exposures to try to give you a good idea of the different colors. I am looking forward to seeing the finished crowns.

Chapter 3 Treatment 5.Metal-ceramic crown replacement (5)Cementation

重要單字 Temporary crown: 暫時性牙冠 Cement: 黏合劑 Cementation: 黏合
Zinc phosphate cement: 磷酸鋅黏合劑 Glass ionomer cement: 玻璃離子黏合劑 Resin cement: 樹脂黏合劑 Consistency: 稠度 Film thickness: 膜厚度 Restoration: 補綴物 (贋復物或修復物) Adjacent natural teeth: 鄰接天然齒

5.Metal-ceramic crown replacement (5)Cementation
Dr. Richard: We have your new crowns, Mrs. Shioda . Mrs. Shioda: Very good. I’m looking forward to seeing how they look. Dr. Richard: The plan today is to remove the temporary crowns and then let you see the new crowns in place before cementation. So, what do you think of them ?

Mrs. Shioda: I’m really pleased with them. The color is very good. They don’t stand out anymore. They blend in with the other teeth. Dr. Richard: I am pleased to hear that. Would you like me to go ahead and cement them in place? Once they have been cemented, the only way to change them would be to cut them off.

Mrs. Shioda: Yes, please go ahead. May I ask a question? Dr. Richard: Of course. Mrs. Shioda: What kind of cement do you use to cement the crowns? Dr. Richard: There are basically three types of cements : Zinc phosphate, glass ionomer, and resin cement. Each one has advantages and disadvantages.

Mrs. Shioda: Which one will you use today? Dr. Richard: I think I will use a resin cement. Resin cements stick well to both tooth and metal. Their main disadvantage is that they are a little thick in consistency and have a high film thickness. Mrs. Shioda: Is that a problem? Dr. Richard: It can be sometimes.

Dr. Richard: SInce resin cements are quite thick in consistency and have a high film thickness, sometimes it can be a difficult to cement the restoration exactly in place. Mrs. Shioda: Well, I’m sure you know what you are doing. I am attending a party tonight so I wonder if anyone will notice my new crowns. Dr. Richard: Hopefully, no one will. If the crowns blend in with the adjacent natural teeth then they will not be conspicuous.

Chapter 3 Treatment 6. New technology (1)Microscope

重要單字 Loupes 放大鏡 Microscope 顯微鏡 Openings of the root canals 根管口
Eye doctor 眼科醫生 Radiograph X光照片 Anesthetize 麻醉 Extirpate the pulp 拔牙髓 Prepare and dress the root canals 根管形成 Symptomless 無症狀 Root fill 根管充填

6. New technology (1)Microscope
Dr. Richard: How are you doing, Mrs. Watanabe? Mrs. Watanabe: To tell the truth, I’m feeling a bit nervous about today. Dr. Richard: I’ll try to explain what’s going to be happened so you’ll feel more relaxed. Today I’m going to begin cleaning the roots of your lower right first molar, then you’ll experience no more pain from the tooth.

Mrs. Watanabe: How can you see what you are doing because the tooth is so small? Dr. Richard: I have a pair of loupes, which can magnify the tooth approximately 2 times. The practice also has an operating microscope . The microscope is excellent for locating the openings of the root canals. The microscope is over there. It is just like the operating microscopes eye doctors use.

Mrs. Watanabe: It’s big isn’t it? How powerful is it? Dr. Richard: It can magnify the tooth about 12 times. It is on wheels so it can be easily moved around the dental unit. I will be using it today. Before we do any work on your tooth we must first take a radiograph and then anesthetize the tooth. Dr. Richard: Miss Suzuki, can you start getting the microscope ready while I am taking the radiograph?

Miss Suzuki: I’ll ask Miss Kato to come and help me move it across the dental unit. Will you be filling the roots today? Dr. Richard: No, I’ll just extirpate the pulp, and try to prepare and dress the root canals today. If the tooth remains symptomless, I’ll fill the roots next time.

Chapter 3 Treatment 6. New technology (2)Ni-Ti file

重要單字 The anesthetic wore (wear) off: 麻醉作用逐漸消失 Channel: 根管
Root canal: 根管 Rotary instrument: 迴轉器具 File: 銼 Nickel-titanium alloy: 鎳鈦合金 Handpiece: 牙科用手機 Endodontic treatment: 齒內療法 Microscope: 顯微鏡 Fiber optic illumination: 光纖照明

6. New technology (2)Ni-Ti file
Dr. Richard: How has your tooth been, Mrs. Watanabe? Mrs. Watanabe: It was a bit sore the first few days. After the effects of the anesthetic wore off, it was a bit tender when I chewed on it. It’s better now. Dr. Richard: your tooth is quite difficult. It has three roots and the channels inside the roots are very narrow. One was blocked and it took some time to clear the blockage. We didn’t have time to finish cleaning and shaping the root canals. Today we are going to use some special rotary instruments in the root canals.

Mrs. Watanabe: They look like miniature files. Dr. Richard: They are miniature files. They are made of Nickel-titanium, which makes them flexible. This allows them to negotiate curved root canals. We use them in a special handpiece, that rotates at a constant speed of a few hundred revolutions per minute. Mrs. Watanabe: Do you think you will finish preparing the tooth this morning?

Dr. Richard: Yes, I will. The most difficult part of endodontic treatment is trying to find and negotiate the root canals. We managed to do this at the last appointment so we just have to carefully enlarge the canals. Mrs. Watanabe: Are you going to use your microscope again? Dr. Richard: Dr. Sato is using it at the moment, so I’ll use my loupes. They are quite helpful. My loupes provide 3 times magnification and fiber optic illumination of the tooth.

Mrs. Watanabe: Are they the same as surgeons use? Dr. Richard: Yes, indeed.

Chapter 3 Treatment 6. New technology (3) Periodontal surgery

BEFORE AFTER

重要單字 Periodontal surgery 牙周手術 Calculus 結石 Put stitches in 縫合
Suture (s) 縫合線 Heal up 痊癒 Local anesthetic 局部麻醉 Resorbable sutures 可吸收縫合線 Gingival papilla 牙齦乳頭 Periodontal pack 牙周敷料 Remove the sutures 去除縫合線 Painkillers 止痛藥

6. New technology (3) Periodontal surgery
Dr. Sato: Are you OK, Mr. Okuda (奧田)? We are almost finished. I removed all the calculus from around the roots of the teeth and we just need to put the gum tissue back in place. Mr. Okuda: Are you going to put stitches in? Dr. Sato: Yes, I need to put some sutures in to hold the gum tissue in the correct position so it will heal up nicely. Mr. Okuda: I can’t feel any pain.

Dr. Sato: That’s good. I administered plenty of local anesthetic. The microscope helps things a lot, Miss Kato. It makes things so much easier. I can see the root surfaces much more clearly and it is easy to see any remaining calculus. I wish we had bought this microscope sooner! Miss Kato: Which suture material are you going to use? Dr. Sato: I will use silk rather than resorbable sutures, because we need to positioning the gingival papillae very precisely.

The patient had a midline diastema prior to the loss of the left central incisor.
A nonsubmerged implant was placed using an exaggerated curvilinear flap design with beveled incisions. Meticulous alignment of wound margins was accomplished during closure.

Miss Kato: I’ll get the periodontal pack out as well. Dr. Sato: Yes, that will be good. Dr. Sato: That’s it. We’ve finished, Mr. Okuda. We’ll need to see you again in a week’s time to remove the sutures and check how the gum tissue is healing. I will also give you a list of instructions. You won’t be able to brush your teeth near the surgical site, so you will need to use a mouthwash. It might be a good idea to take some painkillers before the local anesthetic wears off. Mr. Okuda: Thank you for all your hard work.

Chapter 3 Treatment 6. New technology (4)CAD/CAM (Computer-Assisted Design/Computer-Assisted Manufacture)

Cheap 3Treatment 3. porcelain veneer: ③Tooth preparation ( 支台齒形成 )

重要單字 Filling: 填補物 Fall out: 脫落 Cavity: 窩洞 Anesthetizing: 麻醉
Take (make) an impression:印模 Ceramic: 陶瓷 Optical impression: 光學印模

重要單字 Milling machine: 軋研機器 Glazed: 上瓷釉 Tried in: 試戴
Adhesive resin cement: 黏著樹脂黏著劑 Ceramic restoration: 陶瓷修復 Re- cemented: 再黏著

6. New technology (4)CAD/CAM
Dr. Sato: What’s happened, Mr. Yamada? Mr. Yamada: A filling has come out from one of my back teeth. Dr. Sato: I’ll have a look. Ah, yes. Quite a large filling has fallen out of your upper first molar. Mr. Yamada: Can I have a white filling this time please? Dr. Sato: You have three choices of white fillings, Mr. Yamada. First, we can use composite resin. We can either pack the resin directly into the cavity after anesthetizing and cleaning the cavity.

Dr. Sato: Or, we can take an impression and make a resin filling in the laboratory. The third choice is to fabricate a filling made of ceramic . Mr. Yamada: I would like a ceramic filling, please. Will it take a long time to make? Dr. Sato: Actually, no. We have purchased a new machine for making ceramic fillings. It is called Cerec 4D. It’s quite clever and uses CAD/CAM technology. You can watch your filling being made in the other room.

Mr. Yamada: Could you tell me a bit more about Cerec 4D. I have heard about CAD-CAM before, but did not know it was used in Dentistry. Dr. Sato: Certainly. After we remove the cavity, we take an optical impression of the tooth preparation. We design the shape of the filling using special software. A ceramic block is placed in a separate milling machine and cut to the required dimensions. It takes about an hour in total. After the filling has been made, it is glazed. It is then ready to be tried in the prepared area of the tooth.

Mr. Yamada: That sound’s really good. Do the fillings fall out? Dr. Sato: We use a special adhesive resin cement, which cements the ceramic restoration in place. But, yes, occasionally fillings do fall out. However, they can be easily re-cemented.

Chapter 3 Treatment 7.Bleaching: (1)A consultation

重點單字 Whitening (美白) Bleach teeth (美白牙齒) Sensitive (敏感的)
In the dental unit (at the dental clinic) (在診療室) At home (居家) Gel (膠體) Tray (模托、托盤)

7.Bleaching (1)A consultation
Miss Tanaka: Are you ready for the next patient, Dr. Richard? Dr. Richard: Indeed I am. Miss Tanaka: Please have a seat, Mrs. Ono(小野). Mrs. Ono: You’re very kind, thank you. Dr. Richard: Good afternoon, Mrs. Ono. What brings you to see us? Mrs. Ono: I am not happy with my yellow teeth. My daughter is getting married next month and I would like my teeth whitened. I read in a magazine that you can bleach teeth.

Dr. Richard: Yes, I can bleach your teeth. It’s not quite as simple as it seems. I have to warn you regarding a few things. First, it is difficult to lighten the teeth in some patients. In addition, your teeth can become sensitive while we are bleaching the teeth. Finally, bleaching is not permanent. Bleached teeth tend to darken over time and you will need to have them bleached again in the future.

Mrs. Ono: I don’t mind having them bleached again. I heard that there are two ways you can bleach teeth. One way is in the clinic and the other is at home. Is that true? Dr. Richard: Yes. When the teeth are bleached in the clinic, a gel is put on the teeth and a powerful light shone on the teeth. If the teeth are bleached at home, you need to wear a bleaching tray to keep the gel against the teeth.

Mrs. Ono: Which method do you prefer? Dr. Richard: I prefer to make bleaching trays that you can wear at home. Then you can control how white you want your teeth. What I’ll do is give you these leaflets, which explain how bleaching works and Miss Suzuki, our receptionist will tell you how much it will cost. Mrs. Ono: Thank you for your time.

Chapter 3 Treatment 7.Bleaching (2) Home bleaching

重點單字 Bleaching trays (漂白模托、托盤) Bleaching gel (漂白膏)
Home bleaching (居家牙齒美白) Shade (色調) Alginate impressions (藻膠印模)

Yellow discolorations
After completing the first Bleaching session. Before treatment

7.Bleaching (2) Home bleaching
Miss Tanaka: Shall I call Mrs. Ono(小野) in? Dr. Richard: Yes, please. Miss Tanaka: Please have a seat, Mrs. Ono. I’ll take your coat. Mrs. Ono: Thank you. Dr. Richard: So you have decided you would like me to bleach your teeth. Mrs. Ono: Yes, I have been reading the leaflets that your practice manager gave me, and I definitely would like you to try to lighten them if you can.

Dr. Richard: The way I prefer to bleach teeth is to make the bleaching trays first then give you the trays at your next appointment along with the bleaching gel. You can then continue using the gel until you feel your teeth have become lighter. Mrs. Ono: I read that you can bleach teeth in the clinic. Wouldn’t it be better if you did it? Dr. Richard: I prefer home bleaching. You have more control over any color changes. Is this OK for you?

Mrs. Ono: If you think it’s better, I’ll follow your advice. Dr. Richard: What I will do today is to photograph your teeth so we have a record of the shade of your teeth before we start any treatment. Then I will take some alginate impressions of your upper and lower teeth so our technician, Kaz can make the bleaching trays. Mrs. Ono: Do you know when the trays will be ready? Dr. Richard: Yes, they’ll be ready in three days time. Today is Monday so they will be ready on Thursday. When you come back on Thursday, I will give you a couple of boxes of the bleaching gel. Mrs. Ono: That’s great, thank you.

Chapter 3 Treatment 7.Bleaching (3)Bleaching tray and gel

重點單字 Fit (適合) Side-effects (副作用) Sensitivity (敏感)
Carbamide peroxide (過氧化尿素)

7.Bleaching (3)Bleaching tray and gel
Dr. Richard: Have Mrs. Ono’s bleaching trays come back? Miss Tanaka: Yes, Kaz brought them this morning. Shall I call Mrs. Ono in? Dr. Richard: Yes, please. Mrs. Ono: Thanks for seeing me again so soon. Dr. Richard: No problem. These are the trays. I will check if they fit comfortably and I will show you where to put the gel.

7.Bleaching (3)Bleaching tray and gel
Mrs. Ono: How often should I use them? Dr. Richard: As often as possible and certainly at nighttime. I will see you again in a week’s time. Mrs. Ono: Are there any side-effects? Dr. Richard: Yes, it is possible you may get some sensitivity. This will be temporary. Mrs. Ono: What is the gel made of? Dr. Richard: It is carbamide peroxide. If you don’t see much change in the color in a week, you will need to continue using the trays longer.

Chapter 3 Treatment 8. An orthodontic consultation: (1) Dracula’s teeth (小說中之吸血鬼主角)

重要單字 Canines (犬齒) Buccally (頰側) Orthodontist (齒顎矯正專科醫師)
Specialist (專科醫生) Erupt (萌發) First premolars (第一小臼齒) Extract (拔牙) Arch (牙弓)

重要單字 Bracket (托架) Bond to (黏接著) Wire (金屬線) Elastics (彈性圈、橡皮圈)
Living tissues (活組織) Biology of tooth movement (牙齒移動生物學) Study model (研究用模型)

8. An orthodontic consultation:①Dracula’s teeth
Miss Kato: You can come right in, Mrs. Ono. We are ready for Hitohiro(仁弘). Dr. Sato: I hear you’re not happy with your front teeth, Hitohiro. Hitohiro Ono: No, they are horrible. I look like Dracula! Dr. Sato: How old are you, Hitohiro? Hitohiro Ono: Twelve. Dr. Sato: Well, you are at the right age to have them straightened. Let me have a look. I see you keep them nice and clean. Hitohiro Ono: My mum makes me brush them three times a day.

8. An orthodontic consultation:① Dracula’s teeth
Dr. Sato: That’s good. I see your upper canines don’t have much space. They are coming through buccally. Don’t worry Hitohiro. The situation looks worse than it is. Hitohiro Ono: Can you fix them? Dr. Sato: I can’t, but I will refer you to an orthodontist. Hitohiro Ono: What’s an orthodontist? Dr. Sato: An orthodontist is a dentist who is a specialist in straightening teeth. Mrs. Ono, I’ll tell you what is likely to happen. There is not enough space for Hitohiro’s upper canines. As a result, they are erupting buccally. To treat this problem, Hitohiro will need to have a couple of teeth taken out to create some space.

8. An orthodontic consultation:①Dracula’s teeth
Mrs. Ono: Do you know which teeth? Dr. Sato: Usually both upper first premolars are extracted because they are in the middle of the arch, but it will depend on the orthodontist. Mrs. Ono: How does the orthodontist straighten the teeth?

Dr. Sato: Brackets are bonded to the teeth and then a wire is attached to the brackets using elastics. This enables a controlled force to be applied to the teeth, which moves them through the bone. Mrs. Ono: Sorry did you say the teeth are moved through the bone? The bone is solid, how can that happen? Dr. Sato: Bone is a living tissue, which contains many cells. When a controlled force is applied to the tooth, bone is removed from around the tooth allowing the tooth to move to a new position. These movements are done very carefully. Once the tooth is in a new position, new bone is deposited.

Mrs. Ono: It sounds very complicated. Dr. Sato: Yes, the biology of tooth movement is very complex. I will need to send the orthodontist some study models and radiographs of Hitohiro’s teeth. You are coming back on Thursday to collect your bleaching trays aren’t you? Mrs. Ono: Yes, 4pm on Thursday. Dr. Sato: Well, to save you two visits, I will see Hitohiro after Dr. Richard sees you and take the impressions and radiographs. Mrs. Ono: That’s very kind of you.

Chapter 3 Treatment 8. An orthodontic consultation: (2) Cephalometrics( 測顱分析術 )

8. An orthodontic consultation: (2) Cephalometrics
Dr. Sato: Mrs. Ono, today we are going to take some radiographs of Hitohiro’s teeth. One is called a dental pantomogram, known as a DPT, and another called a true cephalometric lateral skull radiograph. Hitohiro, would you like to follow me to the room where we take the radiographs? Hitohiro Ono: Are those the machines (機械)? Dr. Sato: Yes. We will use one machine but we will take different views. We’ll take the DPT first. If you can move into the machine and just gently bite on this bit of plastic. The top of this machine is going to move around your head. You just need to keep still for about 20 seconds. We’ll be watching you outside.

重要單字 Dental Pantomogram (環口斷層放射照片)
Cephalometric lateral skull radiograph (測顱術側方頭部攝影) Erupt (萌出) Mandible (下顎) Maxilla (上顎). Decay (龋齒) Alginate impressions (藻膠印模) Models (模型)

Hitohiro Ono: Ok. Dr. Sato: That’s great. Now we just need to take the lateral skull radiograph. Hitohiro Ono: Can I see the pictures when you have finished? Dr. Sato: Certainly, we can discuss them together. It will be about 15 minutes, so please have a seat in the waiting room in the meantime. Miss Kato: Hitohiro, your radiographs have been developed. Would you and your mum like to follow me? Dr. Sato: These are the radiographs, that we have taken. Hitohiro Ono: What can you see?

Dr. Sato: These radiographs show us which teeth are present and the location of the teeth, which are about to erupt. We can also see the relationship of the mandible to the maxilla. The good news is that I can’t see any decay in your teeth. Before you go I just need to take some alginate impressions of your upper and lower teeth. I will then send the models and radiographs to the orthodontist, who will send you an appointment in a few days.

Miss Kato: Which size of trays would you like? Dr. Sato: Medium for both upper and lower will be fine. Miss Kato: Shall I start mixing? Dr. Sato: Yes please. Hitohiro Ono: Does it have a flavor? Dr. Sato: Peppermint. Ok, I’m going to take the lower impression first, so try to relax and breathe through your nose.

Chapter 3 Treatment 9. Chrome denture (鈷鉻合金義齒) (1)Broken acrylic denture (破裂的丙烯酸的義齒)

重要單字 False teeth 假牙 (一般用語) Partial acrylic denture 局部丙烯酸壓克力的義齒
Missing 缺失 Cobalt-chromium alloy 鈷鉻合金 Bar 桿、槓 Framework 義齒支架

重要單字 Clasp 牙鉤 Replace 補綴取代 Implant 植體 Hygienist 口衛師 Scale 刮結石
Primary impression 首次印模

9. Chrome denture: (1) Broken acrylic denture 鈷鉻合金義齒: (1) 破裂的丙烯酸的義齒
Miss Tanaka: Are you ready for your first patient? Dr. Richard: Just about. It’s Mr. Inoue(井上) and he’s broken his denture. Miss Tanaka: That’s right. Apparently you are the third dentist he will have seen this year! Dr. Richard: That doesn’t sound good. We had better see why he has come to see me. Dr. Richard: Mr. Inoue, good morning. Come in and make yourself comfortable. How can I help you? Mr. Inoue: It’s my lower false teeth. They keep breaking all the time. My friend recommended you. Here is my lower denture.

Dr. Richard: I think I can help you. You have a lower partial acrylic denture, which replaces your missing right and left lower premolars and first molars. There is a thin piece of plastic, which runs behind your lower anterior teeth. What I suggest we do is make a lower partial cobalt-chromium denture. Instead of the bulky plastic behind your lower anterior teeth there will be a thin bar of metal. Since the framework of the denture is metal, it will be much stronger and less likely to break. Mr. Inoue: Will the metal be visible?

Dr. Richard: We usually place a couple of clasps on the canines, one on each canine. The clasps will prevent the denture from lifting up when you are eating. These can be made in gold if you wish. The other option is to see if we can replace the missing teeth with implants but these are much more expensive. Mr. Inoue: A new lower denture in metal sounds fine. My lower teeth are not very visible when I speak, so the metal clasps will not be a problem. When can you begin making them? Dr. Richard: First I need to carefully examine all your teeth and gums and take some radiographs.

Dr. Richard: Your fillings don’t need replacing, but I can see that you have some calculus present, so I will schedule an appointment with our hygienist to have your teeth scaled and polished. After you have seen the hygienist I will give you an appointment so we can make the primary impressions. I will also give you a treatment plan so you can see how much the treatment will cost. Mr. Inoue: That sounds fine. Thank you. I’ll see you next time.

Chapter 3 Treatment 9. Chrome denture (鈷鉻合金義齒): (2) Impressions for denture design (為義齒設計之印模)

lower chrome denture 下顎鉻金屬活動假牙 primary impression 首次印象 Plaster 石膏
重要單字 lower chrome denture 下顎鉻金屬活動假牙 primary impression 首次印象 Plaster 石膏 design 設計 survey the model 測量模型 Undercut 倒凹 metal framework 金屬義齒支架 component 構成要素、元件 clasp 牙鉤 rest seat 鉤座 tray 模托、托盤

9. Chrome denture: (2) Impressions for denture design鈷鉻合金義齒:為義齒設計之印模
Miss Tanaka: The weather’s terrible today. It’s causing all sorts of problems with the transportation. Dr. Richard: Yes, my train was late this morning. Hopefully the rain will ease this afternoon. I guess some other patients may also be a little late. Who is our first patient? Miss Tanaka: It’s Mr. Inoue. He’s just arrived. The dental unit is set up now so I’ll call him in if you want. Dr. Richard: Yes, we’re making him a new lower chrome denture. Today we’ll be making the primary impressions using alginate.

9. Chrome denture: (2) Impressions for denture design 鈷鉻合金義齒:為義齒設計之印模
Mr. Inoue: I almost couldn’t make it today because of the weather. Dr. Richard: Awful, isn’t it? Are you ready for me to make some impressions of your month? These will be the primary impressions. We’ll take some additional impressions next time. Mr. Inoue: My last dentist only took one set of impressions. I didn’t have to come back twice! Dr. Richard: Making a well made, comfortable, good fitting lower chrome denture takes time. We will cast the primary impressions in plaster and then use the models to design the lower denture.

9. Chrome denture: (2) Impressions for denture design 鈷鉻合金義齒:為義齒設計之印模
Mr. Inoue: I didn’t know you have to design a denture. Dr. Richard: Yes, first we survey the model to identify the teeth with undercuts and then we design the metal framework. The framework has various components such as clasps, which go around the teeth and rest seats. There will be small areas where the metal will rest on the teeth. Where this occurs, we adjust the occlusal surface of the tooth slightly so the metal will not interfere when you bite together. I then send the design to my technician.

9. Chrome denture: (2) Impressions for denture design鈷鉻合金義齒:為義齒設計之印模
Dr. Richard: Miss Tanaka, ready when you are for the alginate impressions. I’ll do the upper one first. Dr. Richard: Mr. Inoue, we’re going to make the upper impression first. So, please lean forwards slightly. When I put the tray in your mouth, concentrate on breathing through your nose. Ok. Here we go.

Chapter 3 Treatment 9. Chrome denture (鈷鉻合金義齒): (3) Discussing denture design with the technician (跟齒模技術員討論義齒的設計)

重要單語 special tray (custom or individual tray) 個別模托 buccal surface 頰側面
periodontal condition 牙周狀況 abutment teeth 支柱牙 handle 握柄 stub handle 粗而短之柄

Miss Kato: I’ll ask him to take the call in his clinic.
9. Chrome denture: (3) Discussing denture design with the technician 鈷鉻合金義齒:跟齒模技術員討論義齒的設計 Miss Suzuki: Miss Kato, could you let Dr. Richard know our technician, Kaz, is on the phone? Miss Kato: I’ll ask him to take the call in his clinic. Dr. Richard: Good afternoon Kaz, what can I do for you? Kaz: I’m calling to talk about the design for Mr. Inoue’s lower cobalt-chrome denture and the special tray. I surveyed the model and the lower second molars don’t have very much undercut. What do you think we should do?

9. Chrome denture: (3) Discussing denture design with the technician 鈷鉻合金義齒:跟齒模技術員討論義齒的設計
Dr. Richard: I would like to clasp the lower second molars, so I’ll add some composite to the buccal surfaces to create some undercut. Their periodontal condition is good so they are useful abutment teeth. Kaz: Also, how about the handles on the lower acrylic special tray? Would you like a single handle over the lower incisors or two stub handles in the premolar region? Dr. Richard: Two stub handles will be better, Mr. Inoue has a very active tongue, which will tend to dislodge the tray, so I need good control of the tray in the posterior region.

9. Chrome denture: (3) Discussing denture design with the technician 鈷鉻合金義齒:跟齒模技術員討論義齒的設計
Kaz: I think that’s it. The design looks straightforward and we are not replacing any anterior teeth. Does Mr. Inoue know the clasps on the canines may be visible? Dr. Richard: Yes, I have warned him and he is not worried about the clasps. Thanks for calling. Kaz: It’s always better to discuss things if there is any doubt about something.

Chapter 3 Treatment 9. Chrome denture (鈷鉻合金義齒): (4) Final impression for lower chrome denture (下顎鈷鉻合金義齒的最後印模)

重要單語 make the final impression 做出最後的印象 special tray 個別模托
prepare rest seats 做出鉤座 cobalt-chromium framework 鈷鉻義齒支架 gum 牙齦 tooth-supported 牙齒支持的 design (假牙) 設計 cavities 窩洞 occlusal surface 咬合面 sensitivity 感覺、敏感性 silicone 矽化物 metal framework 金屬義齒支架 laboratory 牙科技工所 (實驗室)

Dr. Richard: How are you today Mr. Inoue?
9. Chrome denture: (4) Final impression for lower chrome denture鈷鉻合金義齒:下顎鈷鉻合金義齒的最後印模 Dr. Richard: How are you today Mr. Inoue? Mr. Inoue: I’m fine thank you. May I ask what you plan to do today? Dr. Richard: We are going to make the final impression for your lower chrome denture. This is the special tray Kaz made for us. Before I make the impression, I need to prepare some rest seats in a couple of your teeth. Mr. Inoue: Sorry, did you say rest seats? What are they?

9. Chrome denture: (4) Final impression for lower chrome denture 鈷鉻合金義齒:下顎鈷鉻合金義齒的最後印模
Dr. Richard: The denture we are making for you has a cobalt-chromium framework. This means the denture will be stronger and less bulky. It also rests on your teeth and not the gums. We call this a tooth-supported denture. The advantage of a tooth-supported denture is that it will cause less damage to your gums. The design we have made for your new denture has three rest seats. I will cut some small indentations on the occlusal surface of three of your lower teeth.

9. Chrome denture: (4) Final impression for lower chrome denture鈷鉻合金義齒:下顎鈷鉻合金義齒的最後印模
Mr. Inoue: Will you be cutting a lot of the tooth away? Dr. Richard: No, very little. The rest seats are quite thin so I just have to remove a thin layer of enamel. You won’t have any sensitivity. After I have prepared the rest seats, I’ll make the final impression in silicone. Mr. Inoue: What is the next stage after the impressions? Dr. Richard: Next time you come I’ll hopefully have the metal framework back from the laboratory. I am just going to adjust the tray a little before I put the silicone in your mouth. Miss Tanaka: Can I mix the silicone?

9. Chrome denture: (4) Final impression for lower chrome denture鈷鉻合金義齒:下顎鈷鉻合金義齒的最後印模
Dr. Richard: Yes, please. If you can sit forward a little Mr. Inoue that will be helpful. The tray will be in your mouth for about five to six minutes so if you can concentrate on breathing through your nose, that will be beneficial. Ok, here we go. (used when you are starting to do something or when something is starting to happen <我們>開始了)

Chapter 3 Treatment 9. Chrome denture (鈷鉻合金義齒): (5) Chrome denture try-in (鈷鉻義齒之試戴)

重要單字 Lower incisors: 下顎門牙 Acrylic denture: 丙烯酸義齒 Arm: 金屬製假牙掛鉤
Try in: 試戴 Occlusion: 咬合 Process: 煮聚 Shade guide: 比色板

9. Chrome denture: (5) Chrome denture try-in
Dr. Richard: This is the metal framework we have made for you, Mr. Inoue. Mr. Inoue: It looks very different from my denture. Will it fit? Dr. Richard: Yes, it’s thinner behind the upper incisors so it should feel less bulky. It shouldn’t break like your acrylic denture. Mr. Inoue: Are those little metal arms, the clasps? Dr. Richard: Yes, I’m just going to adjust them slightly before I try the framework in. Dr. Richard: That’s good. It goes in fine. Now we have to send it back to the laboratory to put the teeth on. How does it feel?

Mr. Inoue: Quite good actually. It’s not hurting me and it feels better near my tongue. Dr. Richard: I’m pleased with this framework. Kaz has done a good job. So let’s make another appointment for you. Mr. Inoue: I’m not trying to rush you, but do you know how many more visits will be needed? Dr. Richard: Hopefully, just two more. The metal work fits. Next time, the teeth will be set in wax. If you are happy with them and the occlusion is good, they will be processed in acrylic. We just need to choose a shade.

Could I have a shade guide please, Miss Tanaka? Are you happy with the color of the teeth on your existing denture? Mr. Inoue: Yes, but if possible, I’d like some lighter looking teeth. Dr. Richard: A1 seems to be a good match. I’ll let you have a look. Next time we’ll check how they bite together and let you check the color. Could you bring someone with you? It’s a good idea for a friend or family member to check the appearance as well. Mr. Inoue: Yes, I’ll bring my wife. Thanks Dr. Richard, I’ll see you again.

Chapter 3 Treatment 9. Chrome denture: (6) Wax chrome try-in

重要單字 Trial denture 試戴義齒 Bracket table 托架桌面上 Alignment 排序 Irregular 不規則

9. Chrome denture: (6) Wax chrome try-in
Dr. Richard: Good morning, Mr. Inoue (井上). Mr. Inoue: Good morning, Dr. Richard, I brought my wife as you suggested. Dr. Richard: Good morning, Mrs. Inoue. Very nice to meet you. Miss Tanaka: I’ll put the trial denture on the bracket table. Dr. Richard: Ok. Let’s see how it looks. What do you think, Mr. Inoue? Mr. Inoue: You can hardly see the clasps. Dr. Richard: Yes, the clasps are hidden by your lower lip. What do you think about the color of the teeth?

9. Chrome denture: (6) Wax chrome try-in
Mr. Inoue: I like them. Dr. Richard: How about the color of the teeth, Mrs. Inoue? Mrs. Inoue: The color’s better than the current ones and I like their appearance. They look quite natural. Dr. Richard: I’m pleased you like them. I asked Kaz to make the alignment of the teeth slightly irregular. Do you want me to change anything? While they’re in wax we can make some alterations, but once they are converted to acrylic it is much more difficult. Mr. Inoue: No, my wife and I are happy with them.

Chapter 3 Treatment 9. Chrome denture: (7) chrome fit

重要單字 Treatment 治療 Rub 假牙摩擦口腔黏膜 Ulcer 潰瘍,口內炎 Wear 裝戴假牙 Put in 裝戴假牙

9. Chrome denture: (7) chrome fit
Dr. Richard: Is Mr. Inoue here, Miss Tanaka? Miss Tanaka: Sorry, I forgot to tell you. He called to say that he’ll be a few minutes late. Dr. Richard: No problem. I can finish entering our previous patient’s treatment into the computer. Miss Tanaka: He’s here now. I’ll bring him in. Mr. Inoue: So sorry I’m late. There was an accident on one of the train lines and the trains are running a bit late. Dr. Richard: No, that’s fine. It gave me a chance to catch up with the paperwork. I have your new denture here so, I’ll put it in and see how it is.

9. Chrome denture: (7) chrome fit
Dr. Richard: Does it hurt anywhere? Mr. Inoue: No. Not at the moment. Dr. Richard: You seem to be contacting both sides at the same time. Mr. Inoue: Yes, they feel very good. Dr. Richard: I have a few instructions for you. You probably know this already but, please eat slowly at first. Try to cut your food into small pieces. Eating may feel a bit strange at first, but that’s normal. If it starts rubbing please take it out, otherwise you’ll develop an ulcer. Please be careful with the clasps and don’t adjust them yourself. We can correct anything. If you find you can’t wear it, please put your old denture in.

Chapter 3 Treatment 10. Implant overdenture: (1) A problem denture

重要單字 Waiting room: 候診室 Emergency patient: 急診病患 Dental implant: 牙科植體
Extensive exam: 精密檢查 Place: 置入植體 CT scan: 電腦斷層掃描 Complete lower denture: 下顎全部義齒 Computerized tomography: 電腦斷層攝影 (CT)

10. Implant overdenture: (1) A problem denture
Dr. Sato: We seem to be doing well today, Miss Kato. Is there anyone in the waiting room? Miss Kato: Yes there is. Mr. Obata (小火田) is waiting to see you. He is an emergency patient. His lower denture has broken. Dr. Sato: Sorry, I forgot that we had an emergency patient. Please bring Mr. Obata in. Miss Kato: Good afternoon, Mr. Obata. Please follow me. Dr. Sato: My receptionist tells me you are not happy with your lower denture, Mr. Obata.

Mr. Obata: Yes, that’s right. Ever since I had my first lower denture ten years ago I have not been happy. It is always loose and moves around. Last week I read about dental implants in a magazine. I have come to ask if I could have a new denture fitted on implants. Dr. Sato: I have a couple of patients who have had implants placed and then I made new dentures on top. We will need to carry out an extensive exam before any implants can be placed. Mr. Obata: That’s fine.

Dr. Sato: As part of the extensive exam we need to arrange for you to have a special radiograph of your mandible. The radiograph is a CT scan of your mandible. We can then examine the bone in detail and plan where the implants will be placed. For a complete lower denture we usually place four implants in the central region. Two will remain buried for future use and two will be use to support the denture. Mr. Obata: Excuse me what’s a CT scan? Also, do you place the implants yourself?

Dr. Sato: CT stands for computerized tomography. I have an experienced dentist who I refer my patients to for placement of the implants. It is important that the implants are placed as carefully as possible otherwise they will not integrate with the bone and may become loose. I will carry out the oral examination today and then arrange for you to have a CT scan. Then I will give you another appointment to discuss the results and the steps involved. In the meantime, please take these leaflets home to read. They will give you an idea about what to expect. Mr. Obata: Very good. Thank you.

Chapter 3 :Treatment 10. Implant overdenture: (2) Implant planning

Wax trial denture: 義齒蠟試驗
Duplicate: 複製 Acrylic stent: 壓克力支架 Titanium: 鈦金屬 Osseointegration: 骨整合 Load: 負荷 Uncover: 植體接出來 Healing cap: 癒合帽 Surrounding soft tissue: 周圍軟組織 Bar: 桿, 槓 Magnetic attachment: 磁性附連體 Clip on: 夾狀固定

10. Implant overdenture: (2) Implant planning
Miss Kato: Shall I call Mr. Obata in? Dr. Sato: Yes please. Miss Kato: How are you today, Mr. Obata? Mr. Obata: My shoulder is a bit sore. I think I hurt it while I was practicing my driving at the Golf center last night. Dr. Sato: Do you have a chance to play a game of golf? Mr. Obata: Sadly, not very often. I am a member of a golf club but usually I am busy on weekends, so it is difficult to go to the club. I make do (聚會、社交活動) with my visits to the driving range (室外高爾夫球練習場).

Dr.Sato: Well, I have received a report on your CT scan and it seems you have enough bone for four implants. To help the surgeon place the implants in the correct position in the mandible, we need to make a wax trial denture. With the denture teeth in their correct position, we can determine where the implants should be placed. We then duplicate the denture to make an acrylic stent. I will show you some pictures of what I mean. Mr. Obata: Ah yes, I see what you mean. How does the acrylic stent work?

Dr.Sato: Once we have made the acrylic stent, which is similar in shape to the final denture, we drill holes in the stent. The surgeon will use these holes as guides for placing the implants. If the surgeon does not use a guide when drilling holes in the mandible then the implants may not be in the correct location. This may cause major complications. Once the implants have been placed, it is necessary to wait a few months. Mr. Obata: Oh, so I won't have the denture fitted on the implants right away?

Dr. Sato: I prefer to wait four to six months. The implants are made of titanium and if the implants are going to be there a long time, bone must grow up against the surface of the implant. If this occurs then it is said that osseointegration has occurred. The published long-term studies show that it is better to wait a few months. If the implant is loaded right away, then there is a greater risk that osseointegration will not happen and the implant will fail. Mr. Obata: Yes, I see what you mean. What happens after we have waited for a few months?

Dr. Sato: The surgeon will uncover the implants and place healing caps to give the surrounding soft tissues the correct shape. Then, we take some impressions to make either a bar or magnetic attachments for the denture. The finished denture will either clip on the bar or rest on the magnets. Mr. Obata: It sound very complicated.

Dr. Sato: There are many steps which are necessary in order to get a successful outcome. That‘s why implant treatment is expensive. We'll schedule a series of appointments to make the acrylic stent as soon as possible. Mr. Obata: Thanks very much.

Chapter 3:Treatment 10. Implant overdenture: (3) Implant-supported lower overdenture

重要單字 Lower incisor region Healing cap: 癒合帽 Sleeper: 休息、無作用
Technician, dental technician: 牙科技工師 Take an impression: 取模型 Pick-up impression copings: 細微印模覆蓋冠 Screw : 螺絲 Set: 凝固 Impression coping: 印模覆蓋冠 Implant laboratory replica: 植體技工之複製物 Pouring the impression in stone: 灌模 Abutment: 支台齒

10. Implant overdenture: (3) Implant-supported lower overdenture
Miss Kato: Shall I call our next patient in? Dr. Sato: Yes please. Ah yes, it‘s Mr. Obata. He had four lower implants placed six months ago and he's back for us to make a complete lower overdenture for him. Mr. Obata: Good morning Dr. Sato, nice to see you again. Dr. Sato: I heard the surgery went well. How have you been? Mr. Obata: Very well thank you. I saw the surgeon last month and he is satisfied with the implants and said you can begin making the new overdenture. Am I right in thinking that you are going to make a bar for the denture to clip onto?

Dr. Sato: Yes. You have had four implants placed in the lower incisor region. The surgeon has placed healing caps on two of them and left the other two covered up by gum tissue. These are so-called "sleepers." They will be used only if the uncovered implants fail. Mr. Obata: How is the bar going to be made?

Dr. Sato: It will be made by Kaz, our technician. I am going to remove the healing caps and take an impression of the two implants. In order to get an accurate impression of the implants we use pick-up impression copings. These are screwed into the implant while we make the impression. After the impression has set, I will unscrew the retaining screws that hold the impression copings in place. Then I will remove the impression. Kaz will attach implant laboratory replicas to the impression copings before pouring the impression in stone.

Mr. Obata: I think I understand how you are going to make the impression. I was wondering how is the bar going to be attached to the implants? Dr. Sato: Next time you come, we will screw abutments into the implants and then the bar will be screwed onto these. I will adjust your lower denture so that it fits over the bar The new denture will have some clips, which will clip onto the bar. Mr. Obata: That sounds really good. It’s very complicated isn’t it?

Chapter3 Treatment 10. Implant overdenture : (4) Overdenture try-in

重要單字 wax trial denture: 蠟的試用假牙 model: 模型
fitting side: 黏膜面，又叫fitting surface clip: 夾子 cement: 膠結材料、(牙科用來填補空洞的)黏固粉 adjust: 調整、改變、使…適應 groove: 溝、槽 reline: 換底墊、加襯裡 soft acrylic: 軟性壓克力或樹脂

10. Implant overdenture : (4) Overdenture try-in
Dr. Sato: Is Mr. Obata here, Miss Kato? Miss Kato: Yes, but he hasn’t been waiting long. Shall I get him? Dr. Sato: Yes please. Mr. Obata: Good afternoon Dr. Sato. How are you? Dr. Sato: I’m fine thank you. Mr. Obata: Can you tell me your plans for today?

Dr. Sato: I’ll show you. This is the wax trial denture, that Kaz has made. It’s different from the denture you had before. You can see there is a bar in the mouth which connects the two abutment. If you look on the fitting side of the wax trial denture you can see there is a gold clip. This will clip onto the bar. Mr. Obata: It looks as if it will stay in better than the one I have at the moment.

Dr. Sato: Yes, definitely. Your new denture has a bar to clip onto. Today, I will screw the bar in place then try the wax denture in. After the bar has been screwed in place, I need to adjust your existing denture. So, I’ll cut out a groove in your acrylic denture where the bar is and then reline it with soft acrylic. I will have your new denture back in two days. How does the wax denture feel? I have screwed the bar in place and I need to check how the wax denture bites together. How does the bite feel? Do you bite together evenly, or is one side contacting before the other?

Mr. Obata: No, they feel great. The back teeth on both sides contact at the same time. I’m looking forward to getting the new one. They look great too!

Chapter3 Treatment 10. Implant overdenture : (5) Overdenture fit

重要單字 disinfectant solution: 消毒水 occlusion: 咬合 overload: 使負荷過多、超載
articulating paper: 咬合紙 heavy contact: 強力接觸 premature contact: 早期接觸 grind: 磨 rub: 磨擦、擦痛

10. Implant overdenture : (5) Overdenture fit
Miss Kato: Shall I call Mr. Obata in? Dr. Sato: Is his denture back? Miss Kato: Yes, it’s in the disinfectant solution. Dr. Sato: Good. I was worried Kaz wouldn’t be able to get it back in time. Dr. Sato: Good new, Mr. Obata, we have your new denture! Mr. Obata: Excellent. Dr. Sato: First, I’ll make sure it doesn’t hurt you and that you bite together evenly. It’s very important we get your occlusion correct, otherwise we might overload the implants.

Dr. Sato: Good, it fits well. How about the occlusion? Are you biting together evenly? Mr. Obata: Almost. I seem to be contacting one of the back teeth first though. Dr. Sato: Ok. If you can just bite on this piece of articulating paper. Ah, yes. There is a slightly heavy contact on the lower first molar. Mr. Obata: May I ask how you know that. Dr. Sato: Can you see the blue marks? This tells us that you have a premature contact. You are hitting this tooth slightly before the others.

Mr. Obata: Does that mean you have to adjust the teeth? Dr. Sato: Yes, I will grind the tooth a little… Dr. Sato: How’s that now? Mr. Obata: Much better. Now I’m contacting both sides at the same time and the denture doesn’t rub anywhere. Dr. Sato: Ok. I won’t do any more adjustments. I’ll let you try the denture for a few days then I’ll see you again.

Chapter3 Treatment 10. Implant overdenture : (6)Follow-up

重要單字 fitting surface: 黏膜面 Pressure Indicating Paste: PIP Plaque: 齒垢
inflection: 感染 peri-implantitis: 植體周圍炎 mucosa: 黏膜 inflamed: 發炎的

10. Implant overdenture :(6)Follow-up
Dr. Sato: How’s the denture been Mr. Obata? Mr. Obata: It’s much more secure than my old one. I can eat many more foods than I could before. I’m really pleased with it. There’s just one area where it’s starting to rub a little. Dr. Sato: I’ll brush this white paste onto the fitting surface and see if I can identify the area that is rubbing. Mr. Obata: What’s that paste called? Dr. Sato: It’s called Pressure Indicating Paste. It’s quite useful. Dr. Sato: How’s that now?

10. Implant overdenture : (6)Follow-up
Mr. Obata: Ah, yes. Much better. Dr. Sato: I must stress to you that it’s very important to keep the area around the implants very clean. Please also keep the denture clean. If plaque builds up around the implant, an infection may develop, which could affect the implants. Peri-implantitis is a condition in which the mucosa around the implant becomes inflamed. If this develops, the implant may become loose. Mr. Obata: I’ll take great care. Thank you so much for all your help.

Chapter3 Treatment 11. A Sore Mouth(口內炎)

重要單字 sore mouth: 口內炎 cancer: 癌 lump: 腫塊 hard palate: 硬顎(硬口蓋) ulcer: 潰瘍
aphthous ulcer : 口瘡的潰瘍 medication: 藥療法,用藥 prescribe: 開處方 Benzydamine oral spray: 苄達明口內噴霧, 消炎靈: 止痛消炎藥 numb: 麻痺 general health: 全身健康狀況

11. A Sore Mouth Miss Tanaka: Your next patient, Mrs. Dejima (出島), is here. Shall I call her in? Dr. Richard: Yes please. Do you know what she wants? Miss Tanaka: Apparently she has a sore mouth. Would you come this way Mrs. Dejima? Dr. Richard: Please have a seat Mrs. Dejima. How can I help you? Mrs. Dejima: The floor of my mouth has been quite sore for several days. I am a bit worried that it may be cancer.

11. A Sore Mouth Dr. Richard: When did your mouth begin to feel sore, Mrs. Dejima? Mrs. Dejima: About three days ago. I can also feel a slight lump. Dr. Richard: I’ll have a look. Ah, yes. There is a reddish ulcerated area under your tongue in the floor of your mouth. Mrs. Dejima: Is it serious? Dr. Richard: No. You have a large mouth ulcer known as an aphthous ulcer. Mrs. Dejima: Will it go away?

11. A Sore Mouth Dr. Richard: Yes, it will get better in a few days. The tongue is very sensitive so the ulcer feels larger than it actually is. It is probably at its worse now. Mrs. Dejima: Is there any medication you can give me to stop it hurting when I eat? Dr. Richard: Yes, I can prescribe a spray for you. It is called Benzydamine oral spray. It will make your mouth feel numb. You should spray the ulcer a few minutes before you eat. Unfortunately the spray may affect the taste of the food. Would you mind me asking you a few questions about your general health, Mrs. Dejima?

Mrs. Dejima: No, not at all.
11. A Sore Mouth Mrs. Dejima: No, not at all. Dr. Richard: Do you find your life stressful at the moment? Mrs. Dejima: No more than usual. Dr. Richard: How about your diet? Are you eating a good diet? Mrs. Dejima: I think so. Can my diet be connected to my mouth ulcer? Dr. Richard: It can be. Nobody knows what exactly causes aphthous ulcers. However, people who are stressed and not eating well are more likely to develop mouth ulcers. What I will also do is give you an appointment for two weeks time to see if the ulcer has healed. In the meantime please make sure you eat plenty of fruit and vegetables. Mrs. Dejima: I will, thank you.

Chapter 4 Dental hygienist 1.Scaling, brushing (1) Bad breath

重要單字 appointment: 約診 deposits: 沈澱物 supra and subgingival:上下牙齦
pocket charting: 囊袋記入表內(囊袋記表) halitosis: 口臭 gum: 牙齦 bleeding: 流血 bad breath: 口臭

重要單字 Calculus: 牙結石 inflamed: 發炎的 heal: 癒合 ultrasonic scaler: 超音波刮牙器 hand scalers: 手用刮牙器 periodontal probe: 牙周探針 pocket depths: 牙周囊袋深度 dental floss: 牙線 interproximal brush: 牙間刷 fluoride toothpaste: 含氟牙膏

重要單字 swelling: 腫脹 plaque: 牙菌斑 scale: 刮牙結石 Caries: 齲齒 acid: 酸
dissolve: 溶解 enamel: 琺瑯質( 牙釉質) remineralize: 再礦質化 check-up: 檢查 appointment: 約診 cleaning and polishing: 清潔與磨光

重要單字 Mouthwash, mouthrinse: 漱口劑,洗口藥 Disinfectant: 消毒劑,消毒的
Inflamed gum:牙齦發炎 Fluoride: 氟化物 Electric toothbrush: 電動牙刷 Bristles: 牙刷之毛 Sensitive toothpastes: 去敏感的牙膏 Potassium nitrate: 硝酸鉀 Dentinal tubules: 牙本質的小管

1.Scaling, brushing (1) Bad breath
Miss Suzuki: Miss Yoshita (吉田), Mr. Ishida (石田) has arrived. Shall I send him in? Miss Yoshida: Yes please. How are you Mr. Ishida? Mr. Ishida: Fine, thanks. Dr. Sato (佐藤) said there was some calculus on my teeth and booked an appointment for me with you. Miss Yoshida: Yes his clinical notes say that you have several deposits of both supra and subgingival calculus. Also, a couple of your teeth are getting loose so he would like me to conduct pocket charting of all your teeth.

Mr.Ishida: I’m a little embarrassed to say this, but my wife says I have halitosis. Also my gums have been bleeding. Can you do something about that? Miss Yoshida: Yes, once I have cleaned all your teeth your breath will smell better. Also, your gums will stop bleeding. The reason for the bad breath and bleeding is your gums have become inflamed. Once all the calculus has been removed, the gums can heal. Mr. Ishida: What is supra and subgingival calculus?

1.Scaling, brushing (1) Bad brush
Miss Yoshida: Supragingival calculus is calculus that is found above the gum and subgingival calculus is found below the gum. Mr.Ishida: How are you going to clean the teeth? Miss Yoshida: I will use an ultrasonic scaler and hand scalers. We have a special probe called a periodontal probe to measure the pocket depths around the teeth. Mr.Ishida: Can you give some advice on how to clean my teeth properly?

Miss Yoshida: As well as using a toothbrush, it is important that you clean in between your teeth using dental floss and an interproximal brush. You can buy an interproximal brush at the reception desk if you wish. It is also important to have your teeth checked-up and scaled every 2 to 3 months. Mr.Ishida: I will try harder to keep them clean. I don’t want to lose any more teeth.

Chapter 4 Dental Hygienist 1
Chapter 4 Dental Hygienist 1.Scaling, brushing (2) After scaling and brushing

1.Scaling, brushing (2) After scaling and brushing
Miss Yoshida: Your gums look better, Mr. Ishida. Mr. Ishida: Yes, following your advice, I am now brushing my teeth three times a day using fluoride toothpaste. Miss Yoshida: Your gums are much pinker now. The redness and swelling has diminished. By brushing three times a day you are preventing the build-up of plaque. Are you also using the interproximal brush and dental floss, which you bought last time?

Mr.Ishida: Yes I am. I have also noticed that since you scaled my teeth, the bleeding has stopped. And most importantly, my wife says my breath smells better! Miss Yoshida: That’s very important. Flossing your teeth regularly, removes plaque and food debris from between the teeth and beneath the gum line. It is also important to eat a balanced diet. Try not to eat too many sweet things. Instead, eat plenty of fresh vegetables. Do you smoke? Mr.Ishida: No, I stopped a few months ago. The problem is that I have started eating more sweets.

Miss Yoshida: You have to be careful with your sweet intake. If you have too many sweets, you will develop dental caries. The best time to eat sweets is at meal times. When you eat something sweet, the sugars are broken down to acids, which dissolve the enamel surface. It take 3-4 hours for the enamel surface to remineralize. Mr. Ishida: Thanks for that advice. When should I see you next? Miss Yoshida: Please schedule a check- up appointment with Dr. Sato in about two months time and then he will make a treatment plan, which may include an appointment for cleaning and polishing. Mr. Ishida: I’ll do that.

Chapter 4 Dental Hygienist 2. How to use dental floss

-How to use dental floss-
2. -How to use dental floss- 怎麼使用牙線 Miss Yoshida: Please have a seat, Mr. Obata (小火田). Mr. Obata: Thank you. Miss Yoshida: Do you floss your teeth? Mr. Obata: Sometimes, but I usually forget. It makes my gums sore. I prefer to use wood sticks.

2. -How to use dental floss- 怎麼使用牙線 Miss Yoshida : I’ll show you an easy way. First take about 30cm and wrap it around one finger of each hand.　Then carefully slide it down between the teeth.　Don’t saw it from side to side otherwise you will wear away your teeth. After sliding it down between the teeth, gently pull it out. Why don’t you try, Mr. Obata. There’s a mirror over here.

2. -How to use dental floss- 怎麼使用牙線 Mr. Obata: This way seems much better. How often should I floss? Miss Yoshida: At least once a day. Mr. Obata: Yes, I’ll do that. Thank you.

Chapter 4 Dental Hygienist 3. How to choose mouthwash

-How to choose mouthwash-
3. -How to choose mouthwash- 怎麼選擇漱口水 Miss Yoshida: Do you have any questions, Miss Jones? Miss Jones: I would like to know which mouthwash you recommend. There are several for sale in my local supermarket where I live, but because my Japanese is not very good I get confused. Miss Yoshida: We sell mouthwashes here. I’ll show you which one to buy.

3. -How to choose mouthwash- 怎麼選擇漱口水 Miss Jones: That will be great. Miss Yoshida: There are basically two types. One group is disinfectants. They are helpful if you have inflamed gums. The other group contains fluoride. Miss Jones: What’s the difference?

3. -How to choose mouthwash- 怎麼選擇漱口水 Miss Yoshida: If you use a disinfectant type, your gums will be healthy but you will find your teeth will stain after a while. I prefer to use a mouthwash that contains fluoride. Fluoride makes the surface of the teeth stronger. Fluoride is incorporated into the mineral structure of enamel. You rinse your mouth with the mouthwash for one minute then spit out.

3. -How to choose mouthwash- 怎麼選擇漱口水 Miss Jones: Do you sell fluoride mouthwashes at reception? Miss Yoshida: Yes, we do. They cost around 600 yen. We have a special offer at the moment. If you buy two you get one free.

Chapter 4 Dental Hygienist 4. How to choose a toothbrush

-How to choose a toothbrush-
4. -How to choose a toothbrush- 怎麼選擇牙刷 Mrs. Kasahara(笠原) : I’m thinking of buying an electric toothbrush, Miss Yoshida. What do you think? Are they better than manual toothbrushes?

4. -How to choose a toothbrush- 怎麼選擇牙刷 If you had difficulty moving your hand it may be hard to use a manual toothbrush effectively. Miss Yoshida: That’s a difficult question to answer. Certainly an electric toothbrush would be better if you had difficulty moving your hand. If you have difficulty moving your hand it may be hard to use a manual toothbrush effectively. The aim is to make sure the bristles clean all the surfaces of the teeth. If you use dental floss once a day and brush all the surfaces of the teeth then that will be good. Mrs. Kasahara: What about the size of the toothbrush head and the bristles?

4. -How to choose a toothbrush- 怎麼選擇牙刷 Miss Yoshida: Don’t buy a brush with a big head. Buy one that has a medium sized head and medium to soft bristles. If the bristles are too hard you may abrade the surfaces of the teeth. Mrs. Kasahara: Do sensitive toothpastes work, Miss Yoshida?

4. -How to choose a toothbrush- 怎麼選擇牙刷 Miss Yoshida: They do actually. They contain chemical substances such as potassium nitrate. These chemicals can block exposed dentinal tubules and stop sensitivity. Mrs. Kasahara: Thank you so much for your advice.

Chapter5 Equipment woes 1.Autoclave trouble

重要單字 Autoclave: 高壓蒸氣鍋,高壓蒸氣. sterilization: 滅菌、消毒 attend meeting: 出席會議 dental unit: 牙科治療臺 waterline: 水線 handpiece: 手機、牙科用手機 cancel the appointment: 取消預約 rebook: 重新預約

1. -Autoclave trouble- 高壓蒸氣鍋故障
Miss Tanaka: Today is not starting well. The autoclave in Dr. Richard’s dental unit is not working properly. I think we need to call someone to come and look at it. Miss Suzuki: What is happening with it? Miss Tanaka: It will not complete the sterilization cycle. I have looked through the hand-book, which was sent with the autoclave. However, it is indicating a fault, which is not listed.

Miss Suzuki: Have you checked the door seal? Miss Tanaka: Yes, I have cleaned the door seal and dried it twice. I have talked to Dr. Richard and he agrees that we will have to contact someone.

Miss Suzuki: OK. I will call the company with whom we have a service contract. We are lucky today, Dr. Sato is away today. He had to attend some meetings so you can use his dental unit. Miss Tanaka: That’s good. I will let Dr. Richard know we will be working in Dr. Sato’s dental unit.

Chapter5 Equipment woes 2. Unit trouble

2. -Unit trouble- 治療臺故障 Miss Kato: I think we’ll have to delay our next patient, Dr. Sato. Dr. Sato: Why’s that ? Miss Kato: Have you looked on the floor ? There’s a big puddle. I can see water coming out of the dental unit (牙科治療臺) .

2. -Unit trouble- 治療臺故障 Dr. Sato: Oh dear. You’re right. It's getting bigger. I’ll get some towels. First, I’ll have a look at the waterlines to the handpieces. Miss Kato: I’ll get a mop. Dr. Sato: It’s looks like a valve has broken. Can you switch off the unit and that will stop the water coming out. I’ll have to call an engineer. I’ll go to reception and apologize to our next patient.

2. -Unit trouble- 治療臺故障 Dr. Sato: Miss Suzuki, we have an emergency in my dental unit. It is flooded. Miss Kato is mopping up water! Miss Suzuki: Your next patient is sitting in the waiting room, Dr. Sato. '

2. -Unit trouble- 治療臺故障 Dr. Sato: Oh dear, It’s Miss Sato. She's not going to be happy when I tell her I am going to cancel her appointment today. Miss Sato, I'm afraid we have had an emergency in my dental unit and it is flooded. I can't do anymore treatment until the engineer comes. I'm sorry but I'll have to cancel your appointment today and reschedule you. I'm very sorry for wasting your time.

2. -Unit trouble- 治療臺故障 Miss Sato: That's ok. I wasn't feeling well anyway and was thinking of telling you that I didn't want much treatment done today. So actually, I'm quite relieved that I am not having treatment today. Thank you for telling me.

口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003

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口腔醫學英文 牙科英文會話 牙醫學系:周肇茂 教授 分機:7003

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口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003

Presentation on theme: "口腔醫學英文牙科英文會話牙醫學系:周肇茂教授分機:7003"— Presentation transcript: