Tuesday, 15 April 2014

Breaking bad news: MOUTH SCREENING CHECKS

 Read the article on Free checks in Edinburgh to raise awareness of mouth cancer.


Then do the following:


1. Supposing you were one of the dentists, what questions would you ask to find out the factors likely to have triggered mouth cancer?


2. How exactly would you  break the news to the patient who presented such signs? Imagine you have in front of you such a patient, address him/her directly!


3. What one major initiative would you take in our country to promote oral health?

79 comments:

  1. First of all I would like to say that I was a little bit shocked when I read in the article about the frequency of this disease, I thought it was a less freguent one.
    The questions I would ask to find out the factors likely to have triggered mouth cancer would be: Are you smoking?, How often do you drink alcohol?. In my opinion these two questions would be relevant. I think that telling someone that he/she presents the signs of the mouth cancer is one of the most difficult things in the world. I would start by telling that he/she presents signs of mouth cancer and even if it is difficult to hear these facts I thought it was important to tell. Also, I would mention that it is important to consult a specialist as soon as possible, in order to start the treatment. When telling these information to the pacient I would try to be as kind and understanding as I could, but I would not lie to him/her, in order to hide the facts, as some people do in such situation.
    I think that doing a research about the frequency of mouth cancer in our country, and making the results public would be a good way to promote oral health, because this research would show people what are the consequences of a bad oral hygiene.

    ReplyDelete
  2. Hi Evelyn, thank you for your good answer. Could you now just imagine I was the patient, how exactly would you tell me that I have this disease? So, if you know what I mean, don't just say: " I would tell her...."... address Me (the virtual patient) directly with YOU. Did you get my point?

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  3. If I were one of the dentists involved in the free check-ups for mouth cancer,I would probably ask questions regarding to the factors that may cause mouth cancer ,mentioned in the article,such as :Do you smoke?How many cigarettes per day do you smoke?How regular do you drink alchool? Do you know if you had contact with HPV-virus?
    If the patient that came for my check-up had any signs of mouth cancer I would be very careful in how I would break the news,because a disease like this could be a shock.So,I would probably tell him/her like this: "Miss/Mister...what I'm about to say it's not a final diagnostic,but the truth is you have some signs of mouth disease.Please,let's not worry until it's time.We will take some samples and send it to a specialist and we will go from there.I will constantly keep you posted and we'll find a way to solve this out!"
    I think a good way to promote oral health is by TV,because all type of human have acces to this kind of information.It's important to let people know that poor oral hygiene can lead to this kind of mouth diseases,such as cancer,so in order to promote oral hygiene we let patients know what may happen to them if they don't give the appropriate importance.

    ReplyDelete
    Replies
    1. Again, I liked the comforting and indirect way of telling the patient about his/her condition.

      Why do you think some doctors use straightforward language when it's about serious problems such as this?

      New challenge: spot some more mistakes/typos, please.

      Delete
    2. I think some doctors would rather use a straightforward language not because they aren't trained for this kind of situations,but because maybe they want to get rid of such a burden,because of course it's hard the a doctor too.Finding out that your patient is having a severe disease and you have to give your best to help the patient it's not easy ,so some doctors,in my opinion,are using this kind of language to let the patient know that what's next is going to be as hard as the words he just said.
      As far as my mistakes are concerned,I find some..."How many cigarettes per day do you smoke?How regular do you drink alchool?",the correct form would be:""How many cigarettes do you smoke per day? Do you drink alchool regulary?".In the sentence:"If the patient that came...." ,I have some mistakes and the correct form would be:"If the patient who came for a check-up would have any signs of mouth cancer I would be very careful when telling him the news,because news like this could be shocking."
      Also,in my last paragraph,I have a spelling mistake:"acces" because the correct form is:"access" and I would replace "kind" with "type".

      Delete
    3. Wow, this is a very long message and it's difficult for me to put it in an educational way; so thank you for trying to do your best to hunt for your own mistakes but I hope you won't mind if I correct them myself so as you learn from them, ok?, so here is the correct version:
      ALCOHOL
      DRINK REGULARLY (yes!)
      The If-clause : If the patient that/who came for a check-up ... is correct: in if-clauses we use the PAST TENSE (not would!) - so again please revise your "if clauses" type II (this time)
      TYPE/KIND - is ok, but in the plural: all TYPES/KINDS
      What I am going to say IS not a final DIAGNOSIS

      I also strongly suggest that you use the short forms (don't, it's) only in speech and in letters to close friends. In writing we usually use the long forms (do not, it is).

      Hope this helps you in the future.

      Delete
  4. If I were one of the dentists, I would first ask if they are aware of the factors that are contributing to mouth cancer, and after that I would ask questions regarding the quantity of cigarettes they smoke each day, and if they drink large amounts of alcohol every day. Then I would ask them about their oral hygiene (how often they brush their teeth, their technique of brushing, if they use floss, mouthwash or other ways to clean their teeth/mouth) and finally I would ask them if they have ever been infected with HPV.
    If the patient in front of me has signs of mouth cancer I would tell him/her: "Miss/Mister, I need to tell you something very important and I want you to stay calm because what I am about to tell you is not as tragic as it seems. After I checked your mouth I found a few signs that need to be analyzed in detail. With your permission we will take some samples and send them to the lab to find out the exact diagnosis. We will notify you as soon as we get the result and make sure that you will receive the most effective treatment. Early detection is in your favor, and this is yet a preliminary state, so please don't take it as a tragedy. Perhaps you could get your family tested to screen for any genetic relevance."
    In order to promote oral health in Romania, I would gather a group of dentists in each city and especially in remote and poor villages to give free check-ups and explain to them how to brush correctly and how to floss. I would also give free toothbrushes and tooth pastes. As far as the children are concerned, the dentists could utilize cartoons or dummies to convey the importance of dental hygiene. We could also give a "pro-bono" twice a year for check-ups and if the patient doesn't show up every six months, he/she will not get a free consultation (this way the patients will go to the dentist, so they won't loose the opportunity).

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  5. ‘Sir, I have some questions for you, regarding your daily routine. Please don’t hesitate to mention any detail you remember because even if something may appear insignificant it could be very helpful to me. So, to start with, I would like to know where do you live. Is there, in your town, a high level of pollution?’

    ‘Well, I actually live in a small countryside village and there are no factories nearby or any other sources of pollution, but I spend the entire day working here, in the city, where, as you already know the environment is not very pure. Perhaps, you must also know that I work at the cigarettes factory.’

    ‘Oh, and how many cigarettes do you smoke a day?’

    ‘I don’t smoke actually, but my friends do. And the only time I come across cigarettes smoke is when I go out with them or when we go clubbing.’

    ‘And how frequently does it happen?’

    ‘I don’t know exactly, maybe twice or three times a week. It usually happens in weekends.’

    ‘Ok. Tell me please, have you ever lived in the village you are living now?’

    ‘Oh, no. I was born and I grew up in W by the age of 7 . My father had been working at the ironworks before it failed and we moved here. But, I don’t understand how this things can be useful to you.’

    ‘Well, I believe that the lesions on your oral mucosa are the result of the industrial waste of that plant. As you were only a child, your fragile body couldn’t fight the harmful substances of the polluted air which proved to have a slow but permanent degenerative action.’

    ‘Wait, what does it mean? Is this cancer? Please tell me the truth, doctor.’

    ‘Please don’t panic. It is not necessary to be cancer. It is very possible to be a lesion with no malignant potential. We will do a histopathological exam for a sure diagnostic.’

    ‘Ok. I’ll try to keep calm, but it will be very hard until a final result. Let’s start the procedures as quickly as it is possible please.’

    ‘Ok. You have to go to a histopathology laboratory […].’

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  6. D: Hi, darling. How are you feeling today?
    P: A bit better.
    D: That's good to hear. Are you still feeling nauseous?
    P: No, I haven't felt sick since you switched my medication.
    D: Great. Your test results came in this morning. But first I have to put you some additional questions.
    P: Oh, go on, doctor.
    D: Do you now or have you ever used tobacco?
    P: Yes, to relive tension, especially after arguments or during stressful times, or when I feel angry, depressed, or upset.
    D: I understand and do you drink alcohol?
    P: I don't like the feeling of not being in control of myself, so I avoid alcohol and other drugs
    D: One more question, have you ever received radiation therapy to your head or neck area?
    P: Me not, but my mother had oral cancer, she survived this procedure and now she is healthy.
    D: Oh, I see! Are you the sort of person who likes to find out everything?
    P: For sure, please tell me the entire truth, doctor!
    D: It's difficult for me to tell you this, you do have oral cancer and it is a serious illness but it is not necessarily a death sentence, especially these days. This must be a shock to you. You probably didn't expect this at a routine appointment. You will need a major operation followed by some treatment that will make you feel very unwell but you can get through it. You are in good hands and you have lots of people around who care about you. You have a fight on and we can win. One of the most important features is your attitude. Remember that if you have any problems or want to discuss anything we are here for you.
    P: Oh my God, I’ll try to keep calm, I have to fight to win this battle, like my mother.

    ReplyDelete
  7. 1. To find out what factors were likely to have triggered mouth cancer I would ask the following questions :
    Do you have any relatives that suffered from mouth disease ?
    Do you live next to a factory / industrial place?
    Do you smoke? If yes ,how many cigarettes per day ? Since when do you smoke ?
    Are you usually drinking large amounts of alcohol ?
    Do you have HPV infection ? Do you know what that is ?
    How many times do you brush your teeth , per day ? What complementary methods of oral hygiene do you use?
    What type of diet to you have ?

    ReplyDelete
    Replies
    1. Cristina, please do not forget questions 2 and 3 of the post!

      Delete
  8. 2. Your test results came and the bad news is that you have an oral disease that might be cancer. Don't panic and let me explain you . This illness might have been triggered by an insufficient oral hygiene or smoking and large quantities of alcohol. The good news is that we have discovered your problem in a very incipient stage due to this rutinely control and there are various ways of treatment. There is also a high probability that you will heal if you listen to me and if you desire. I am sure that your friends and familly will support you and if you don't wish to tell them this news by your own , I will help you with that. I will write you a note so you can go to a specialist and run more tests. If you have any problems or if you need more information I will be here .

    ReplyDelete
    Replies
    1. OK, now I see your answer here, but it should have belonged to the previous comment.

      Delete
  9. 3. In my country I belive that the only oral hygiene promotion that will be succesfull is to offer free consults to the people and maybe even offer them something for coming to the dentist. I believe that this is the only approach because here in Romania , few people understand the true value of the teeth , oral hygiene and brushing correctly. Most of the people do not respect the biannual check ups and go to the dentist only when the pain becomes unbearable.
    This is why it is very important to promote oral hygiene in a country in which people aren't informed properly . Even if after this campaign the only thing found is how badly are romanians affected by decay and bacterian plaque it will be a succes because there are no such studies in our country .

    ReplyDelete
  10. What about toothpaste?I have red that toothpaste contains many harmful ingredients,a lot of chemicals which can bring out mouth cancer.

    ReplyDelete
    Replies
    1. Debora, please read my comment for you below.

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    2. Debora, can you tell us what's wrong about "red" in your sentence?

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    3. I missed a letter.The correct form is" I have read". Thank you!

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    4. Yes, one letter which changes the whole meaning! That is why spelling is so important!

      Delete
  11. 1. The questions I would ask : Do you smoke? Do you drink regularly alcohol? What profession do you have? How often do you brush your teeth?
    2. I would explain what signs do he/she have, the risks that he/she expose on, he/she should come regularly for investigations and to start a treatment for prevention.
    3. To promote oral health it is necessary to explain people how important it is to have a healthy mouth, the risks that they have if they don’t take care of it’s health. We should do more meetings, advertisements and free consultations.

    ReplyDelete
    Replies
    1. Natalia, you have to pay attention to agreement: what signs he/she HAS, the risks that she exposeS to; take care of THEIR health.

      Delete
    2. I agree with you, Natalia! I think you will be a great doctor! ;)

      Delete
  12. If I were one of the dentists who discover mouth cancer in a pacient's mouth, I would ask him: "Are you smoking ? Are you drinking alcohol ?"Because this are the factors that promote cancer .Before telling him the horrifying news , I would ask him : "What would you do if you would find out you have mouth cancer ? Would you give up your smoking and alcohol habit ?" And then I'll tell him : "Mr/Mrs I'm sorry to give you this news , but after the examination , you have the signs of the disease . Don't panic , because as sooner the cancer is detected , we can do more for your health."
    Is important that patients should be trained regarding the importance of oral hygiene. Promoting the oral hygiene can be made trough the TV or different things that patients can come in contact with : leaflets , newspapers , magazines .

    ReplyDelete
    Replies
    1. Hi Andrea, I suppose that in the phrase: " this are the factors" , " this" is a typo. Could you let us know the right version, please?
      Also, this term we revised the " if clauses". Can you correct your sentence: What would you do if you would find out....
      Could you also try correcting the mistakes in the sentences: 1. as sooner the cancer is detected.....; 2. Is important....

      Delete
    2. The right version is: If I were one of the dentists who discover mouth cancer in a pacient's mouth, I would ask him: "Are you smoking ? Are you drinking alcohol ?"Because these are the factors that promote cancer.Before telling him the horrifying news,I would ask him:"What would you do if you found out you had mouth cancer?Would you give up your smoking and alcohol habit?And then I'd tell him:"Mr/Mrs I'm sorry to give you this news , but after the examination , you have the signs of the disease . Don't panic , because the sooner the cancer is detected, the more we can do for your health.It is important that patients are trained regarding the importance of oral hygiene.Promoting oral hygiene can be made via TV or different ways that patients can get in contact with:magazines,newspapers,leaflets.

      Delete
  13. As I read this article I was also shocked by the pure facts about mouth cancer. It is a very hard thing to tell for someone that they have signs of mouth cancer. If I were a dentist I would be as kind as I could. I would ask questions about the patient smoking, drinking, eating and oral hygiene habits. It is also very important that as a dentist I have to do a carefully and accurate examination to get a valuable result. I would tell him/her: "I am a man of my word and I have to tell you something very important and urgent. I was checked your mouth very carefully and I found some signs which were not ordinary at your age. I have to send you to a specialist for a more accurate examination. But you do not have to worry because it is not as bad as it sounds. When we get the results I will tel you what to do." After that I would recommend a preventive treatment and follow the way of the developments.

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  14. 1. I would make a quick questionnaire, including the next question:
    a) Do you smoke ? How much ?
    b) Do you consume alcohol ? How much ?
    c) When was your last dentist control ?
    d) Are your gums bleeding ?
    e) Do you think you are at risk ?

    2. "Your results just came and there were some simptoms that appeared positive. Unfortunately these cand be bad news if not treated immediately.

    3. I would demand by law periodically consultation at dentists.

    ReplyDelete
    Replies
    1. There are some typos in your comment. Can you find and correct them?

      Delete
    2. "Can" instead of "cand" and at the first line, "questions" instead of "question". My mistake :)

      Delete
    3. Also: SYMPTOMS, PERIODICAL (it's an adjective, not adverb), AT THE DENTIST'S.

      Delete

  15. Supposing I am one of the dentists, the questions I would ask to find out the factors likely to have triggered mouth cancer are the ones that I believe all dentists should ask at any given time.I would ask if the person is a smoker and how many cigarettes they smoke in a day, I would ask if they drink periodically and what they eat on a daily basis .
    If one of my patients would present the signs I would say to him that I need him to make some tests that would provide us enough information about what I believe he could have , about how severe the condition is and I would tell him that it is something that if we take care of as soon as possible he should have 100% chance of recovery .
    Oral hygiene should be introduced from primary schools so the children would see it as something fun and show them movies that would describe in a funny way what the consequences of a bad hygiene and life style would be.

    ReplyDelete
    Replies
    1. Mihai, can you correct your "if clause": If one of my patients....

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  16. If I were one of these dentists maybe I would start like this:
    ‘How long do you have that scab on your lip?’
    ‘A couple of weeks, I think it’s a herpes.’
    ‘Do you smoke?’
    ‘yes’
    ‘And how much a day?’
    ‘It depends, when I’m stressed up to a pack.’
    ‘Do you consume alcool frequently?’
    ‘One or two glasses of whiskey at evenings’
    ‘Ok. I would like to take a biopsy from that scab and after we will have more information’
    ‘Why? What other can be than a herpes?’
    ‘Well, I don’t want to scare you but it can be other than herpes, maybe a rudimentary cancer.’
    ‘Oh my God!’
    ‘ Please keep calm, it’s just a theory but I have to review all possibilities. It can be a herpes too and if it’s not then we recognized in time.’

    ReplyDelete
    Replies
    1. We don't say "what other" but......?

      Delete
  17. If I were one of the dentists who discover mouth cancer to a pacient first of all I`ll try to master my emotions and then I would ask him: if he`s a smoker, if he regulary drinks large amounts of alcohol or if he feels lumps in the mouth that grow.

    I honestly don`t know how I would react and how I could give such news, I hope not to be put in such a position!
    I couldn`t be the one to break the news and most likely I will send him to consult a specialist as soon as possible.

    I found on the Internet that On 20th March 2014, it was celebrate the World
    Oral Health Day, I think that is a good ideea to celebrate something like this.
    Me, for example I would organize special events or activities to raise awareness and encourage individuals, families, health associations, communities and institutions to take action to reduce all forms of oral diseases.

    ReplyDelete
    Replies
    1. Maria, in point 2 you have to address the patient directly as if he/she were in front of you!

      Delete
    2. I think that somehow I have tried to avoid this point because I couldn't imagine myself in this situation. But I thought better and ...here is my answer for point 2.:)

      I'm sorry but I have to give you some bad news...Your test results came and the diagnosis is mouth cancer. Do not panic! In my career of doctor I have encountered such cases and now patients feel better.
      Even the lady who just left, has suffered from such thing. It's good that we have discovered your problem in a very incipient stage, when you can begin a very good and strictly treatment.
      You must have faith, follow the treatment and everything's gonna be alright!

      Delete
    3. Maria, can you tell me what is wrong with your phrase:
      - strictly treatment

      Delete
  18. As dentist's we should always be aware of any type of irregularities in the patients oral cavity. If we do notice anything unusual we should ask about smoking habits, alcohol consume, and any known infections. And if necessary send our patients to further consultations.
    I do not know if I would have the heart to scare anybody in that manner. I would just strongly advise them to go and see a specialist.

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    Replies
    1. The same for you as for Maria, in point 2 you have to break the news to the patient as if he/she was in front of you.

      Delete
    2. Understood.
      "small talk""
      D: Sir, if I may ask, how long do you have those white spots all over your oral cavity?
      P: Hm.. For quite a while now. But they don't hurt, so I thought it cannot be serious.
      D: I have tried rubbing them off, hoping it was a yeast infection, easily curable with medication, but those spot do not seam to disappear.
      P: My Lord, than what is it?
      D: It is a disease which in time could develop cancer, if it did not until now.. let me feel your lymph nodes. They are a bit swollen, as a matter of fact..
      P: Oh My.. please doctor, tell what should I do?
      D: First of try to keep calm, I will recommend you a specialist.

      Delete
    3. OK, Julia.
      How about:
      "those spot do not seam" - 2 errors in this phrase
      "first of try to....

      Delete
  19. If I was one of the dentists involved in that program my questions woud be:
    Do you smoke? How many cicarettes a day? Do you drink alcohol regulary? How often do you brush you teeth?
    I wish to announce that test results have come and have a predisposition to cancer is very high, but if you will not stop smoking, not drink alcohol and you have a better care of your oral hygiene there will be no problem.
    In my country the only way to promote oral hygiene is to make preventive courses to schools and kindergartens as small childrens need to know how to brush their teeth and take care of their teeth.

    ReplyDelete
  20. If I were one of the dentists , I would ask the patient about triggering factors like smoking, alcohol consumption, oral hygiene, but the local irritating factors( mechanical, electrical, chemical) and the mouthwashes which contains alcohol can cause precancerous diseases in the oral cavity. I would break the news to the patient with solidarity: I don’t want to scare you, but you have a suspicious lesion and it has to be examined by a specialist. It is not sure that you have cancer, but the possibility exists.
    In my opinion the doctors should attract people’s attention of mouth cancer, because people doesn’t care it sufficiently.

    ReplyDelete
    Replies
    1. Orsolya,
      please correct: "doctors should attract people's attention of mouth cancer, because people doesn't care it sufficiently" - it has too many mistakes!

      Delete
    2. I tried to correct my mistakes: doctors should draw people's attention to mouth cancer, because people don't care about it sufficiently.

      Delete
    3. Great! That sounds differently!

      Delete
  21. In our country there is a total lack of personal interest and of information regarding the risks of such diseases. How many of us have beneficiated from a free consult or from campaigns that promote cancer awareness. It is our duty, as future doctors, to inform our patients regularly, that their bad habits lead to cancer (smoking, alcoholism, bad dental hygiene). If I could change something, I would start with hygiene promovation, even in kindergarden. Though images, interactive movies and games so das the children will understand easier and better. Then I would offer free consultations to children, adolescents and adults, at least once a year.
    I believe that there are ideas for such approaches but not enough will.

    ReplyDelete
    Replies
    1. Andreea, there are some mistakes in your comment:
      1. many of us have beneficiated from a free consult
      2. promovation
      3. Though images... so das the children

      I agree with your last idea.

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    2. 1.Many of us had benefited of a free examination
      2.promotion
      3,through images...so children

      Delete
    3. - the right preposition after "benefit" is............

      Delete
  22. 1. If I were one of the dentists I would ask about the factors that cause cancer: "Do you used to smoke regularly? / Do you consume alcohol frequently? / How many times a day? Are you regularly exposed to UV rays? Have you ever come in contact with HPV? "
    2. “Mister / Miss ... Do you know that spot that you have since some time in the mouth? ... Now it does not look good, I really think it looks worse than before ... (if he/she want to know: what it seems? Do I have cancer?) If he/she does not want to know, the question would be: What can be done? I prefer this approach because not all patients are ready to face with such a situation. I've heard of cases where such a diagnosis communication, even at young people, led to immediate suicide and then I consider that it is wrong to tell the bad news to some patients which are not psychologically prepared.”
    3.I believe that the best way to promote oral hygiene in our country would be organizing of lectures on oral hygiene that everyone can participate, and they are financed by the Ministry of Health.

    ReplyDelete
  23. 1. Firstly I'd look out for the telltale signs of mouth cancer such as bleeding gums, a history of alcooholism , smoking or the like.
    2. Assuming the signs are there and there is a growth or something else abnormal I'd probably say something allong the lines of "Mr/Mrs please don't be alarmed but you show signs -asociated- with mouth cancer (I'd enphasise on the word "asociated") , I'd recomend that you'd undergo a biopsy of what I -perceive- (again emphasise the word perceive) to be the affected tissue imediately)
    3. A great way to ensure that oral hygene takes up it's rightful place within the public's awareness is reintroducing the dentist offices in schools, children would rutinely go to check-ups and the in-house dentist could very well hold lectures or maybe even a weekly class on the importance of good oral hygene.

    ReplyDelete
    Replies
    1. Stefan,
      will you correct the following in your comment:
      - allong, asociated, imediately
      - oral hygiene takes up its rightful place....

      Delete
  24. If I were that dentist, I would start by asking about the most common factors that can lead to mouth cancer, such as heavy drinking, smoking, unhealthy diet and bad oral hygiene.
    I would probably be more calm and collected and try to break the news as positive as possible given the circumstances. I would advise that he/she should immediately turn to a specialist and if it is treated in time there is still a possibility of regress.
    As shown in the article, the best and direct approach should be giving the people a chance to a free screening check and encourage them to take on a more preventive approach than that of a reactive one.

    ReplyDelete
    Replies
    1. Zsuzsi,
      what do you mean by "collected"?
      Also, you were supposed to address a patient directly as if he/she was in front of you (rather than telling "how yo would do it")

      Delete
  25. 1.If I were the dentist I would probably make questionnaires for each patient to complete, questionnaires with short and direct questions that can provide me with decisive information regarding the risk factors at which the patient is exposed such as smoking, alcohol, radiation exposure, infections, oral hygiene and so forth. In my opinion it would be much easier this way, because many patients tend to lie the doctor when asked directly, for certain reasons.
    2.If I found myself in a situation like this I would try to give him the news in such a manner so he could keep his head cool. I would explain to him the situation so he can understand with what he is dealing with and how it can be treated in time. I would also try to encourage him as much as I can so he would not feel demoralized.
    3.I think it would be a good idea to have seminaries in schools, hospitals, institutions, in order to promote oral health and to emphasize the importance of it for our well-being not only for having "good looking teeth".

    ReplyDelete
    Replies
    1. Andrei, please read again what you have to do in point 2. You are not supposed to tell us how you would do it, but do address the patient as if he/she were in front of you, i.e. directly. Please see what your colleagues wrote before.

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    2. 2."Mrs. Smith, we'd just received the results from the morphopathology laboratory and I am sorry to inform you that the tests came positive. It seems that you were diagnosed with oral cancer. However I also have some good news. The cancer seems to be in it's incipient form so I am very positive about the way it will respond to treatment. Don't worry Mrs. Smith I will tell you everything there is to know about it and everything will be okay and any time you need consultation you just need to call me or come over and I'll be here to help."

      Delete
    3. Now the task is correctly addressed. One question: do you think "it’s" in "it’s incipient form" is correct? Can you explain the difference between its/it’s?

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    4. No it is not correct. The correct form is "in its incipient form". The difference is that "it's" is the short form of "it is" while "its" is the possessive form of "it".

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    5. Good, so from now on I hope you will use them correctly.

      Delete
  26. 1.what I would ask:Do you smoke?how much?
    Do you consume alcohol ?How much?
    Do you have any relatives that suffered from mouth disease ?

    2."Sir,what I'm about to say it's not a final diagnostic,but the truth is you have some signs of mouth disease.Please,let's not worry until it's time."
    And finally i will have to tell him,so:"Since cancer cells were confirmed by histological examination, you have a cancer. You should be admitted as soon as possible or your condition will become serious. If you would like to talk about it, I’m here!"

    3.I think a good way to promote oral health is by periodically free consultations.It's important to let people know that poor oral hygiene can lead to this kind of mouth diseases,such as cancer

    ReplyDelete
  27. If I would be the doctor, I would ask my patient about how adequate his oral hyigiene is, how often he smokes, consumes alcool if he does. I would try to communicate the bad news calmly and confidently so he doesn't freak out: "Sir, unfortunetely the results ot the tests show that the lesion we found in your oral cavity is malignant, so I would advice to find a specialist as soon as possible, consult with them and your problem should be solved without any complications." I think dentists should lecture on the importance of oral hygiene and the correct way of tooth brushing, for kids in preschool and elementary schools, this way kids from early age could learn how to prevent decays and diseases.

    ReplyDelete
    Replies
    1. Abigel,
      my first impulse was to reject your comment because the first sentence, an If-clause which we learnt this term is WRONG!
      But then I thought that maybe if I ask you to correct it now, at least from now on you will be able to use it correctly - so please show me that you have understood the if-clause type II.

      Delete
    2. If I were the doctor, I would ask my patient about how adequate his oral hygiene is, how often he/she smokes, consumes alcohol if it’s the case.

      Delete
  28. 1: Do you smoke? How often?
    Do you consume alcohol? How often? What kind of drinks?
    Do you know about any family members who suffered from this affection?
    How would you describe your oral health?
    How often do you check your oral heath?

    2: " It is not easy for me to say but unfortunately we found something wrong in the results of your lab tests. I strongly recommend starting a treatment in order to save what still can be saved."

    3: I think prevention is the best way to avoid this kind of oral health issue, the best solution would be to screen, aware, inform and offer special consultations to all patients.

    ReplyDelete
    Replies
    1. Andrea, you included "aware" in a list of verbs: screen, inform, offer. Is there such a verb as "aware"?

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    2. The right form of the verb is : to aware

      Delete
    3. Where did you find such a verb?

      Delete
  29. Reading this article I've realised that it would be very important as a dentist to inform every patient about the risks of the mouth cancer, because as I see it, it's very common and high prevalented.
    1.) If i were one of the dentists,I would you ask to find out the factors likely to have triggered mouth cancer:
    - Do you smoke, and if you do, how many times a day?
    -How often do you consume alcohol?
    -Do you have any relatives that suffered from any mouth disease?
    - When was your last dentist control ?

    2.) Unfortunatelly,your results just came back and there were some simptoms that appeared positive. We should immediately begin your treatment to reduce the risk of spreading your disease, but don't worry I will do anything to make you feel better or heal you as soon as it's possible.

    3.) I think it would be useful informing people not just in our cabinets when they come to consultations, but in schools, and other instituitons too, at every ages, starting from kids, to older people- neglections can cause severe problems to anyone.

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    Replies
    1. Dear PinkRibbon,
      I do not know who you are!!! Please let me know at least your family name!!!
      - prevalented
      - I would you ask
      - simptoms
      - every ages
      Please correct the following language mistakes in your post:
      -

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    2. it's wide-spreaded
      I would ask you
      symptoms
      every age-group

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    3. wide- spread or prevalent
      OK! Seems I am talking to two different students :-)

      Delete
  30. I think if I were one of those dentists I would have had asked about the lifestyle of the patient to detect possible causes because most people tend to lie when asked questions like "do you drink large
    quantities of alcohol" and such. Patients are delicate when it comes to subjects like oral cancer therefore I believe that the information given to them by the dentist should be well understood. I would tell a patient who shows oral cancer symptoms exactly what I know because first of all it's part of the job,and then if I would be in the patient's situation I would want to know the truth because it can be fatal. I think a major initiative,one that would have practical improvements is to give not only good information about the risks of developing oral cancer but free oral hygiene 'instruments' such as professional toothbrush and toothpaste,dental floss,etc. There will always be people who neglect things like hygiene and later on from this reason develop diseases; Information equals power,nowadays information is available to everyone, especially medical information,so I think that competent authorities are doing what they can to inform people,but then it is up to each individual to fight for their own health.

    ReplyDelete
    Replies
    1. Ruxandra,
      1. I appreciate the way in which you deal with breaking bad news to patients who show signs of oral cancer. But, you were asked not to tell us HOW to do it, but DO IT, directly, as if you were talking to a real patient: e.g. Mr. X, .... - can you do this point?

      2. Your first "if clause": If I were.... is ok, but the following is not:

      - If I would be in the patient’s situation - can you correct it?

      Delete
  31. 1.If I were one of the dentists I would ask about the factors that cause cancer:
    „Do you used to smoke regularly? „
    „Do you consume alcohol frequently?„ „ How many times a day?”
    „Are you regularly exposed to UV rays? „
    „Have you ever come in contact with HPV? "
    2. Your test results are bad … you have an oral disease that might be cancer. Don't panic and let me explain you . This illness might have been caused by insufficient oral hygiene or smoking and large quantities of alcohol. The good news is that we have discovered your problem in a very incipient stage due to this rutinely control and there are various ways of treatment. There is also a high probability that you will heal if you listen to me and if you desire. If you have any problems or if you need more information I will be here .
    3. On 20th March is the Day of Oral Health, I think that is a good ideea to celebrate it in our country too! We should organize conferences about oral hygiene that everyone can participate, and they should be financed by the Ministry of Health.

    ReplyDelete
    Replies
    1. Nora,
      your sentence: " Do you used to smoke?" needs correction. Also, " routinely control" " I think that is a good idea" .

      Delete