What are two factors that lead to Mr. Pignati's death?

When John and Lorraine first meet Mr. Pignati, his wife is dead, but he keeps himself busy by going to the zoo every day to see a baboon named Bobo. He calls Bobo his best friend. As their relationship with Mr. Pignati grows, it seems as if extended life also grows inside of the Pigman. Now the old man has Bobo and John and Lorraine to keep him from suffering complete loneliness.

Mr. Pignati suffers a heart attack in chapter ten as he is playing tag with the kids in his home one night. As a result, he winds up in the hospital to recover for a few days. In chapter 13, while the Pigman is away, John and Lorraine hold a party at his house without his permission. Norton, a mean boy from school, starts stealing things and breaking the pig collection right as Mr. Pignati returns home from the hospital. His heart is broken when he discovers that John and Lorraine did this behind his back. He forgives them, but he is devastated.

The Pigman decides to go to the zoo with John and Lorraine as a token of his forgiveness, but he discovers that Bobo has died. This seems to be the deciding factor behind the Pigman's will to live. First, his two close friends disrespect him and his home by throwing a wild party at his house, then he finds out Bobo is dead. Lorraine screams, "We murdered him," which shows that she feels guilty for the part she played by destroying his trust in the end. Therefore, the two factors that lead to Mr. Pignati's death, besides old age and a heart attack, are the wild party that John and Lorraine throw that breaks his heart and the fact that his best friend Bobo dies.

What is fashion?

The term "fashion" describes the customs or preferences of people in a particular place or time. Fashion can be used to describe styles of cooking, manufacture, arts, and architecture, but we most often use it when talking about clothing and bodily adornment.

In fact, most people think of clothing, accessories, and hairstyles when fashion is mentioned. Many people colloquially use the term to refer to changing tastes and customs in dressing. For example, one might say a particular style of dress has fallen out of fashion, meaning it is no longer in favor with a group of people. 

The "world of fashion" is highly competitive, with many artists and designers competing to innovate while still appeal to public tastes. Sometimes, a single individual is so influential in changing fashions that they become iconic. In the 1960's, model Twiggy's slim figure and short haircut were a departure from the styles of the previous decade but quickly became very fashionable.

What are the differences between how well racism is presented in Harper Lee's novel To Kill a Mockingbird as opposed to in the film?

In the novel To Kill a Mockingbird, author Harper Lee spends a great deal of time developing the theme of racism, whereas in the film of the same title, racism is only briefly mentioned.

In the novel, Lee develops the theme of racism alongside Scout and Jem as they mature. The more they mature, the more they learn about racism. More specifically, they have multiple experiences that tell them about the racist world, aside from learning about racism from Tom Robinson's trial and from slanderous comments about their father given by kids at school and people like Mrs. Dubose. For example, Scout learns about racism as she joins the ladies of her aunt's missionary circle for refreshments and hears them hypocritically speak out for the needs of the African tribe called the
Mrunas while simultaneously saying the African Americans of their community need to stop grumbling about social injustices and be content in their rightful places of subordination. Scout also learns about racism from hypocritical comments made by her third-grade teacher protesting against Hitler's treatment of the Jews while also saying the African Americans of their community need to be put in their rightful places of subordination.

In contrast, many of the above scenes do not take place in the film. Instead, other than the slanderous comments from kids at school, Scout and Jem mostly learn about racism during the trial. In fact, it is during the trial scene that the theme of racism is developed the most. In the film, during Tom Robinson's cross-examination, when asked by Mr. Gilmer why he spent so much time helping Mayella Ewell, Robinson makes a very fatal statement:

I felt sorry for her because ...

He is never allowed to finish his statement because Mr. Gilmer and the spectators of the court are in an uproar that he, a black man, should feel sorry for a white woman. When we feel sympathy for another person, as opposed to empathy, we automatically place ourselves in a position of superiority over that person because it is that person, not us, who is in the terrible circumstance. In the segregated South, the African American should feel inferior at all times. Hence, the film implies that Robinson's statement of sympathy sealed his fate--it is the primary reason why the jury returned with the guilty verdict. It is also through Robinson's expressed feelings of sympathy and the outrage his feelings provoke that the theme of racism is developed the most in the film.

In contrast, while in the novel, Robinson does make a similar statement and Mr. Gilmer does negatively comment on it, it's not evident Robinson's statement of sympathy alone sealed his fate. In the novel, Lee asserts that his fate was sealed the moment "Mayella Ewell opened her mouth and screamed," and nothing Robinson said or could have said would have changed that (Ch. 25).

Hence, as we can see, Lee spends a great deal of time developing the theme of racism along with the children's changing and maturing perception. In contrast, in the film, the theme of racism is developed primarily during the trial scene.

In the poem "A Red, Red Rose" by Robert Burns, what is the relation or tension between the speaker and the world?

The speaker in the first three stanzas of "A Red, Red Rose" declares his love to his bonnie lass. He compares his love to a blooming rose and to a sweet melody, and he voices his commitment with hyperbole, saying he will love his lass until the seas dry up and the rocks melt. The last line of the third stanza is the first that hints at an outside world that might interfere with his ability to remain with his beloved. The phrase "sands o' life" foreshadows the last stanza, where unexpectedly the speaker bids his beloved adieu. Presumably some requirement that life places upon the man forces him to separate physically from the woman he loves. Yet their separation will only last "awhile," he assures her. He will return even if he has to travel ten thousand miles to get back to her side. Thus the tension between the speaker and the world is that some unspecified duty requires him to leave her, which he certainly does not want to do because he loves her so deeply. Whatever commitment calls him away from her, however, will be countered eventually by his undying commitment to his bonnie lass that will bring him back to her as soon as possible.

What are glycogen storage diseases?

Causes and Symptoms

Glycogen storage diseases are caused by inherited defects in the enzymes involved in the synthesis or breakdown
of glycogen
and are characterized by the accumulation of an abnormal type or amount of glycogen. At least twelve such diseases have been identified; they can be diagnosed by enzymatic analysis of a biopsy tissue sample. Prenatal diagnosis of most of these conditions is possible but, because their overall frequency is estimated at 1 in 20,000 to 25,000 live births, is generally not performed unless warranted. Most of these diseases are inherited as autosomal recessive traits, although phosphorylase kinase deficiency is X-linked. In many cases, the causative deoxyribonucleic acid (DNA) mutations have been identified. These diseases primarily affect the liver and muscles, which normally contain most of the glycogen in the body.

Maintaining normal blood glucose levels is essential for the function of various tissues and particularly the brain, which depends on blood glucose as a source of energy. In the fed state, when dietary carbohydrate is digested, blood glucose levels rise and are used to replenish liver glycogen. In the fasting state, when blood glucose levels otherwise fall, liver glycogen is broken down and used to maintain normal blood glucose levels. This cycling in the storage and breakdown of liver glycogen is essential to permit the body to survive periods without meals, especially overnight.

In liver glycogen storage diseases, this cycling is disrupted. Most cases are attributed to defects in four enzymes: glucose-6-phosphatase, glycogen branching enzyme, glycogen debrancher enzyme, and glycogen phosphorylase (or phosphorylase kinase). Because glucose-6-phosphatase is responsible for converting the breakdown product of glycogen (glucose-6-phosphate) to free glucose for release into the blood, its deficiency does not allow stored liver glycogen to restore depleted blood glucose, as during an overnight fast. If untreated, this condition, also known as von Gierke’s disease, results in seizures, coma, and death. Inadequately treated patients may survive but are more likely to experience growth retardation and to develop kidney problems and liver cancer.

Muscle glycogen is also synthesized in the fed state, but it is broken down to provide energy for muscle contraction. Glycogen storage diseases of muscle usually cause intolerance to exercise and susceptibility to fatigue. Most of these cases are attributed to defects in three enzymes: lysosomal glucosidase, glycogen phosphorylase, and phosphofructokinase. The glucosidase found in lysosomes is responsible for breaking down any glycogen that accumulates in these intracellular organelles. When this enzyme is missing, the lysosomes become engorged with glycogen, disrupting their normal function and other cellular metabolism. In the most severe cases, glycogen accumulation in the heart is pronounced, resulting in an enlarged heart and death from heart failure before age two. Glycogen phosphorylase in muscle breaks down glycogen for its use in contraction. When this enzyme is deficient, muscle tissues lack the fuel to provide for extensive exercise, resulting in cramping. Phosphofructokinase is a crucial enzyme in the metabolism of glucose; in the muscle, its deficiency has a consequence much like that of glycogen phosphorylase, namely the inability to engage in strenuous exercise.

When glycogen is synthesized, the branching enzyme inserts branchpoints to give it a treelike structure. A defect in this enzyme leads to an abnormal, long, unbranched glycogen. Because it folds back on itself in a way that makes it difficult for glycogen-breakdown enzymes to act on it, it is not broken down. While this condition generally does not lead to low fasting blood glucose, as alternative pathways are available, the accumulated abnormal glycogen, apparently considered a foreign object, leads to liver cirrhosis and death by age five; no treatment is available other than liver transplantation. A defect in the debranching enzyme that removes the branchpoints during the breakdown of glycogen severely restricts the yield of glucose to those units beyond a branchpoint. Glycogen phosphorylase is the main enzyme that breaks down glycogen to monomeric units, and its deficiency or that of an enzyme controlling its activity (phosphorylase kinase) results in variable manifestation, depending on the severity of the condition. Most patients with the latter diseases usually require no specific treatment.

Treatment and Therapy

A defect in glucose-6-phosphatase can be treated by providing continuous sources of glucose during the day (snacks between meals) and especially overnight (nightly nasogastric infusions of glucose or eating slowly digested carbohydrate, such as uncooked cornstarch, before sleep). If this condition is detected early and treated properly, then normal growth and development are observed. A liver transplant surgery may be necessary in certain cases. Medications such as alglucosidase alfa may help to replace the enzymes needed for proper muscle function.

Perspective and Prospects

The first observation of a defect in glycogen metabolism was made in 1928. In 1929, Edgar von Gierke first noted glucose-6-phosphatase deficiency, and in 1932, J. C. Pompe first reported the lysosomal glucosidase deficiency; their names remain associated with these conditions. As normal glycogen metabolism came to be understood, the enzymatic basis for at least twelve glycogen storage disorders were identified. Each is a candidate for enzyme replacement therapy or gene replacement therapy.

Bibliography:

Badash, Michelle. "Glycogen Storage Diseases." Health Library, September 12, 2012.

Chen, Y.-T. “Glycogen Storage Diseases.” In The Metabolic and Molecular Bases of Inherited Disease, edited by Charles R. Scriver et al. 8th ed. New York: McGraw-Hill, 2001.

Hirschhorn, R., and A. J. J. Reuser. “Glycogen Storage Disease Type II: Acid-Glucosidase (Acid Maltase) Deficiency.” In The Metabolic and Molecular Bases of Inherited Disease, edited by Charles R. Scriver et al. 8th ed. New York: McGraw-Hill, 2001.

Maheshwari, Anurag, et al. "Outcomes of Liver Transplantation for Glycogen Storage Disease: A Matched-Control Study and Review of Literature." Clinical Transplantation 26, no. 3 (2012): 432–436.

Professional Guide to Diseases. 10th ed. Philadelphia: Lippincott Williams & Wilkins, 2012.

What are biochemical tests?

Definition

Biochemical tests play an essential role in infectious disease diagnosis, screening, prognosis, and treatment. Screening may be advisable for
at-risk groups and for checking disease prevalence in a given population.

A physician begins a diagnosis by examining a person’s symptoms. Samples of blood, urine, feces, and tissues may be collected. The samples are sent to various departments in a medical laboratory for examination. These lab departments include bacteriology (culturing), immunology, and pathology.

Biochemistry departments aid in identifying pathogenic species or in distinguishing organisms from other species. Biochemical tests detect distinctive differences in metabolism of a species. These metabolic differences result in the formation of acid, gas, or other chemical products that can be detected by color changes or other means.

Many tests are named according to the enzyme active in the test; the enzyme
names end with the letters ase. An evaluation of test results,
together with a person’s clinical history, can lead to a prognosis, or
a prediction of the course or outcome of the disease. Biochemical tests can also
be important during the treatment phase to monitor changes in body metabolism or
function.

Bacteria can be divided into two physiological groups
depending on whether they retain a Gram’s stain or not. These bacteria are either
gram-positive or gram-negative. Bacteria can assume various shapes,such as
spherical (cocci) or rodlike (bacilli). Biochemical tests can be classified into
three categories according to the characteristics of the bacteria being tested:
gram-negative bacilli, gram-positive cocci, and gram-negative cocci.

Enterobacteriaceae

The Enterobacteriaceae is a large family of gram-negative rods that inhabits the intestinal tract. Most Enterobacteriaceae are harmless normal flora of the intestines, but some can become pathogenic. Important genera in this family include Escherichia, Salmonella, Shigella, Klebsiella, Citrobacter, and Proteus. Many biochemical tests are involved in the identification and differentiation of members of this family.

A series of four tests known collectively by the acronym IMViC is used to differentiate between Escherichia, Enterobacter, and other genera. The indole test is positive for organisms that have tryptophanase. The methyl red and Voges-Proskauer tests examine differences in glucose fermentation among species. The citrate test is positive for species that are able to use citrate as a sole source of carbon.

Other tests are available to differentiate Enterobacteriaceae. The urease, phenylalanine deaminase, and decarboxylase tests detect differences in enzyme activities among species. The Kliger’s iron agar test differentiates Enterobacteriaceae based on how the species ferment lactose and glucose. Hippurate hydrolysis is a positive test for Campylobacter.

Haemophilus is another gram-negative rod. The X and V factors test can differentiate this species (which requires the factors) from other Haemophilus species.

Staphylococci and Streptococci

Staphylococci and streptococci are gram-positive cocci usually grouped in clusters and chains. The
catalase test is valuable for distinguishing between the genera;
Staphylococcus is positive and Streptococcus
is negative. The coagulase test is positive for
Staphylococcusaureus. Lysostaphin is an enzyme that
specifically breaks down Staphylococcus strains. The bile
solubility and optochin disk tests are positive for Streptococcus
pneumonia but negative for other beta hemolytic streptococci. The
litmus milk test differentiates among streptococci based on lactose fermentation.
Finally, the CAMP factor test is positive for group B
Streptococcus.

Neisseria Species

The Neisseria
genus is a gram-negative diplococci with a characteristic doughnut
shape. Neisseria can cause gonorrhea and
meningitis, so several tests have been developed to
differentiate the species. The nitrate reduction test is negative for N.
gonorrhea but positive for closely related species. The DNase test is
also negative for N. gonorrhea. The acid detection test detects
Neisseria species that metabolize carbohydrates by oxidative
pathway rather than by the more common fermentative pathway. The oxidase test is
positive for Neisseria and Moraxella and can
also help to differentiate among many related species in conjunction with other
tests. The carbohydrate utilization test distinguishes between N.
gonorrhea that ferments glucose only and N.
meningitis that ferments both glucose and maltose.

Impact

Clinical biochemistry laboratories are responsible for most of the tests performed on samples sent to diagnostic laboratories by clinicians. The results of biochemical tests are used by medical staff for diagnosis in approximately 70 percent of all cases. Compared with other medical tests, biochemical tests are generally easier to perform but are relatively expensive. They can help prevent misdiagnosis by distinguishing between closely related species.

Bibliography

Forbes, Betty A., Daniel F. Sahm, and Alice S. Weissfeld. Bailey and Scott’s Diagnostic Microbiology. 12th ed. St. Louis, Mo.: Mosby/Elsevier, 2007.

MacFadden, Jean F. Biochemical Tests for Identification of Medical Bacteria. 3d ed. Philadelphia: Lippincott Williams & Wilkins, 2000.

Mandell, Gerald L., John E. Bennett, and Raphael Dolin, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. New York: Churchill Livingstone/Elsevier, 2010.

Murray, Patrick R., Ken S. Rosenthal, and Michael A. Pfaller. Medical Microbiology. 6th ed. Philadelphia: Mosby/Elsevier, 2009.

Murray, Robert K., et al. Harper’s Illustrated Biochemistry. 27th ed. Stamford, Conn.: Appleton & Lange, 2006.

Pagana, Kathleen Deska, and Timothy J. Pagana. Mosby’s Diagnostic and Laboratory Test Reference. 9th ed. St. Louis, Mo.: Mosby/Elsevier, 2009.

Truant, Allan L. Manual of Commercial Methods in Clinical Microbiology. Washington, D.C.: ASM Press, 2002.

Volk, Wesley A., et al. Essentials of Medical Microbiology. Philadelphia: Lippincott Williams & Wilkins, 1995.

Winn, Washington C., Jr., et al. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins, 2006.

What are dental diseases?

Causes and Symptoms

Dental diseases fall into four major categories: dental caries, or tooth decay; periodontal disease, including gingivitis and pyorrhea; Vincent’s infection, or trench mouth; and oral cancer. The first of these diseases was the largest contributor to tooth loss among people under thirty-five in the United States before the widespread fluoridation of drinking water was begun; it remains a major cause of tooth loss in much of the world. Periodontal disease in its two stages, gingivitis and pyorrhea, is the most widespread dental problem for people over thirty-five. Most people who suffer the loss of all of their teeth do so because of this condition. Vincent’s infection, which shares many characteristics with gingivitis, is bacterial. The infection flares up, is treated, and disappears, whereas gingivitis is more often a continuing condition that requires both persistent home treatment and specialized treatment. The most serious but least frequently occurring dental disease is oral cancer. It is the only dental disease commonly considered life threatening, and there is a risk that it may spread to other parts of the body.

Dental caries occur because the food that one eats becomes trapped in the irregularities of the teeth, creating lactic acids that penetrate the enamel through holes (often microscopic) in it. Once lodged between the teeth or below the gum line, carbohydrates and starches combine with saliva to form acids that, over time, can penetrate a tooth’s enamel, enter the dentin directly below it, and progressively destroy the dentin while spreading toward the tooth’s center, the pulp.

This process often is not confined to a single tooth. As decay spreads, adjoining teeth may be affected. Some people have much harder tooth enamel than others. Therefore, some individuals may experience little or no decay, whereas others who follow similar diets and practice similar methods of dental hygiene may develop substantial decay.

Toothache occurs when decay eats through the dentin and enters the nerve-filled dental pulp, causing inflammation, infection, and pain. A dull, continuous ache, either mild or severe and often pulsating, may indicate that the infection has entered the jawbone beneath the tooth. An aching or sensitivity in the back teeth during chewing is sometimes a side effect of sinusitis.

One of dentistry’s nagging problems is periodontal disease, which results from a buildup of calculus, or tartar, formed by hardened plaque. Plaque is formed when food, particularly carbohydrates and starches, interacts with the saliva that coats the teeth, creating a yellowish film. If this film is not removed, it inevitably lodges between the gums and the teeth, where, within twenty-four hours, it hardens into calculus. Dental hygienists can remove most of this calculus mechanically. If it is allowed to build up over extended periods, however, the calculus will irritate the gums, causing the soreness, swelling, and bleeding that signal gum infection. Eventually, this infection becomes entrenched and difficult to treat.

Periodontists can control but not cure most periodontal disease. In its early manifestations, periodontal disease results in gingivitis, marked by inflammation and bleeding. Untreated, it progresses to pyorrhea, which is characterized by gums that recede from the teeth and form pockets in which infections flourish. As pyorrhea advances, the bone that underlies the teeth and holds them in place is compromised and ultimately destroyed, causing looseness and eventual tooth loss.

Vincent’s infection (trench mouth) is communicable through kissing or sharing eating utensils. Although it is sometimes mistaken for gingivitis, Vincent’s infection has one distinguishing characteristic that gingivitis does not have: it is accompanied by a fever stemming from sustained bacterial infection, which also causes extremely foul breath. Vincent’s infection is curable through proper treatment. It is unlikely to recur unless one is again exposed to the infection.

Oral cancer is the most serious of oral diseases. It often spreads quickly, destroying the tissues of the mouth during its ravaging advance. It not only threatens its original site but also can spread to other areas of the body and to vital organs. Fortunately, oral cancer is uncommon. Nevertheless, dentists look vigilantly for signs of it when they perform mouth examinations because early detection is vital to successful treatment, containment, and cure. People who have persistent mouth sores that do not heal may be experiencing the early manifestations of oral cancer and should see their dentists or physicians immediately.

Two other dental conditions afflict many people: malocclusion and toothache. Malocclusion occurs when, for a variety of reasons, the teeth are out of alignment. People with malocclusion are prime candidates for dental caries and periodontal disease, largely because their teeth are difficult to reach and hard to clean. Malocclusion may also cause one or more teeth to strike the teeth above or below them, causing injury to teeth and possibly fracturing them.

Treatment and Therapy

Modern dentistry has succeeded in controlling most dental diseases. In the United States, dental caries have been almost eliminated in the young by the addition of fluoride to most water systems. Used over time, fluoride strengthens the teeth by increasing the hardness of the enamel, making it resistant to the acids that form in the mouth and cause decay. Countries such as the United Kingdom, Canada, Singapore, and Israel have likewise implemented fluoridation programs in an attempt to prevent tooth decay. Fluoride has also been added to toothpaste and mouthwash, which offer considerable protection from dental caries.

Researchers discovered in the mid-1960s that a substance found in the mouth’s streptococcal bacteria creates dextran. Dextran enables bacteria to cling to the surface of the teeth and invade them with the lactic acid that they generate. Researchers ultimately discovered dextranase, an enzyme effective in dissolving dextran. Strides are being made to use dextranase in toothpaste or mouthwash to reduce or eliminate the effects of dextran.

Some people’s teeth seem to be impervious to tooth decay. It has been determined that such people have a common substance in their blood that protects their teeth from dental caries. Attempts are being made to identify and isolate this substance and to make it generally available to the public and to dentists in an applicable form. Some dentists coat the teeth with a durable plastic substance to make them resistant to penetration by the acids that cause dental decay, creating a hard protective coating above the enamel and making it difficult for food to lodge between the teeth or in irregularities in the teeth.

Because malocclusion, or poor spacing, can lead to tooth decay, dentists have become increasingly aware of the need to replace lost teeth so that the alignment of the remaining teeth will not be disturbed. Tooth implantation, a process by which a tooth, either artificial or natural, is anchored directly and permanently in the gum, solves many dental problems that in the past were addressed by attaching artificial teeth to existing ones beside them. In situations where malocclusion is caused by malformations, the use of orthodontic braces results in a more regular alignment.

Nutrition has come to the forefront of recent research in dental health. A lack of calciferol, a form of vitamin D2, may result in dental abnormalities, including malocclusion. Among substantial numbers of hospital patients who suffer from nutritional problems, the earliest symptoms occur in the soft tissue of the mouth.

Brushing the teeth after meals and before bed controls plaque, as does regular flossing. Such daily attention must be supplemented by twice-yearly cleaning, performed by a dentist or dental hygienist, and by annual or biennial whole-mouth x-rays to reveal incipient decay. Various mouthwashes also contain substances that control decay.

People who cannot brush after every meal should use a mouthwash or rinse the mouth out with water after eating, then brush as soon as they can. Special attention must be given to the back surfaces of the lower front teeth because the salivary glands are located there. This area is a breeding ground for the bacteria that cause the formation of lactic acid. Routine home care of this kind, particularly daily flossing, will help prevent both tooth decay and periodontal disease and can also reverse some of the inroads that periodontal disease has made. When gingivitis advances to pyorrhea, however, dental surgery may be necessary.

The major villain in both gingivitis and pyorrhea is tartar, or calculus, which is produced when plaque hardens. When tartar accumulates beneath the gums, it causes an irritation that can lead to infection. Sometimes, this infection moves to other parts of the body, causing joint problems and other difficulties.

People can control plaque by practicing daily dental hygiene at home. They must also have accumulated tartar regularly scraped away or removed by ultrasound in the dentist’s office. Malocclusions and defects in the production of saliva can be corrected by dentists and can greatly reduce the progress of periodontal disease.

When gum surgery is advised for the removal of the deep gum pockets that occur with pyorrhea, further surgery can usually be avoided with regular home care. Meanwhile, researchers are trying to develop a vaccine to immunize its recipients against the bacteria that cause tooth decay. Other decay-inhibiting agents are being studied closely with the expectation that they may in time be added to common foods and beverages.

Vincent’s infection is successfully treated with antibiotics, accompanied by a prescribed course of dental hygiene that is begun in the dentist’s office and continues at home on a daily basis. Some patients have found a peroxide mouthwash helpful in treating this disease.

When dentists find evidence of oral cancer, they usually refer patients to their primary physicians, who coordinate referrals to oncologists. An oncologist will determine if the patient has cancer and will determine the best ways to treat it. Laser treatment and radiation are used in controlling oral cancer, as are chemotherapy and surgery. The most important element in cancer treatment is time. It is essential, therefore, that specialized treatment be initiated as soon as oral cancer is discovered or suspected. In cases of oral cancer, a delay of even days can affect outcomes negatively.

The most immediate treatments for
toothache range from the application of cold compresses to the taking of aspirin or another analgesic every few hours. If the decayed part of the tooth is visible and reachable, sometimes applying a mixture of oil of cloves and benzocaine to the decayed area with a small swab soothes the pain. These treatments, however, offer only temporary relief.

Dentists resist treating toothache by removing the tooth, although removal offers an immediate solution to the problem. In some cases, dentists can drill out the decay and fill the tooth with silver amalgam, gold, or plastic. Quite often, by the time a tooth begins to ache, the pulp and dentin have been ravaged by decay. The best solution is endodontistry, or root canal, which will preserve the tooth but may necessitate the attachment of a crown.

Perspective and Prospects

Great strides have been made in preventing and treating dental disease, as researchers have reached deeper understandings of the root causes of such disease. Dentistry has become increasingly less painful through the use of anesthetics and high-speed, water-cooled drills. The public at large has grown aware of the close relationship between dental health and general health. People are unwilling to accept tooth loss as a natural consequence of aging. They have also begun to realize that orthodontistry is more than a cosmetic procedure. Rather, it is a necessary procedure for correcting misalignments of the teeth that can result in difficulty if uncorrected.

Advances in preventing and treating dental disease are constantly being made. Through genetic engineering, it is almost inevitable that substances will soon be available to increase an individual’s resistance to tooth decay. Nevertheless, controlling the buildup of calculus, the major factor in periodontal disease, will probably remain the responsibility of individuals through daily home care and twice-yearly visits to their dentists.

Bibliography

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Diamond, Richard. Dental First Aid for Families. Ravensdale, Wash.: Idyll Arbor, 2000.

Fairpo, Jenifer E. H., and C. Gavin Fairpo. Heinemann Dental Dictionary. 4th ed. Boston: Butterworth-Heinemann, 1997.

Foster, Malcolm S. Protecting Our Children’s Teeth: A Guide to Quality Dental Care from Infancy Through Age Twelve. New York: Insight Books, 1992.

Gluck, George M., and William M. Morganstein. Jong’s Community Dental Health. 5th ed. St. Louis, Mo.: Mosby, 2003.

Langlais, Robert P., and Craig S. Miller. Color Atlas of Common Oral Diseases. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2009.

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National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health. "Oral Health Resources." Centers for Disease Control and Prevention, April 11 2013.

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