Restricted Cell Phone Areas - 896 Words

In the article From Stone Age To Phone Age , author Barbara Ehrereich argues that all cell phones serve as a status symbol, thus presenting mankind s selfish attempt to showboat their level of importance. By publicly engaging in meaningless conversations individuals are able to obtain admirer s jealously; thus portraying that the on-lookers are lonely because of their absence of a cellular phone or lack of received calls. In fact since primal times it has been a tendency of humans to compete with one another over similar status symbols from shrunken-heads to the best place of residence. Cell phones are both misused and overused instead of serving its original purpose for emergencies it is used to gossip, take pictures and compete†¦show more content†¦Makers have added several features to cell phones over the past year or so; theses features include: radios, mp3 players, video cameras, picture cameras, recorders, internet, pc applications, video games and so on. All this feat ures contribute to users not wanting to ever put their cell phones down. That is, if users aren t talking on their cell phones, their taking pictures, text messaging or downloading music on them. Some people have gotten so attached to their cell phones that can t ever leave home without it. It s ironic how some people will march to their local cell phone provider and purchase the latest phone with the newest features every time an upgrade comes out; spending anywhere from one hundred to six hundred dollars on a phone. There motives, keeping up with the latest phone and features, to fit in and to in time stand out and be the envy of all. They want to be that person that everyone comes up to and says, cool phone, where did you get it? I never seen that one before, it is here that people get the jealously stares that they anticipate on. Those who disagree might argue that people should be free to use their cell phones wherever they please, after all they do pay the monthly bill. To res trict users to the usage of their phones only in certain areas would be depriving them of getting their moneys worth. The problem with thisShow MoreRelatedAdvantages and Disadvantages Between a Cellular Network and Land Line Network1095 Words   |  5 Pages When using a cell phone network you will have a choice between two types of phones, GSM or CDMA. Both are a great choice but each have their uses. When a company choses to go with an all cellular network they should pick one of the above two based on the needs of the company. GSM offers the ability to be completely integrated into other networks around the world. All you would need to do is change out the SIM cards in the phones. You might even get a lower rate on your phone when you changeRead MoreCell Phone Coverage: More Important Than The Gadget Essay1695 Words   |  7 Pagesa rare occasion that you do not see a cell phone when walking down the street. These days everyone has a cell phone and if you do not, then the public looks at you in shock. The cell phone has upgraded communication from the typical party line to the wonders of wireless freedom. Cell phone providers entice people with their hands-free, unlimited text and voice, 4G, mp3, Internet, and video capabilities. Children, as young as kindergarten age, have a cell phone and the older retirement generation isRead MoreTexting in Class to Enhance Learning Essay918 Words   |  4 Pagesand Power Points were even added to give visuals to lessons. Cell phones on the other hand have been given the cold shoulder, and even completely banned by some schools. According to the article, â€Å"Are We Dialing Up Disaster,† by George Engel and Tim Green, eighty-four percent of high school students report to owning a cell phone and that number continues to increase (Engel 39). Because students are distracted by the use of cell phones, schools around the country have made a stand to make sure theyRead MoreCell Phones Essay1621 Words   |  7 PagesCell Phones Cell Phones have changed the way the world operates and people are constantly improving on this revolutionary tool due to it’s large demand and ease of use; While at the same time doing so can cause new hazards for individuals. The walkie-talkie, developed in the late 1930s, was one of the first practical applications of mobile communications. Along with the first mobile telephone, invented in 1941, the walkie-talkie used radio waves to communicate. This was the first wireless communicationRead MoreTelephone Essay1430 Words   |  6 Pagesoccurred when Bell was doing experiments with electrical signals in order to try and improve the telegraph. At this time, the telegraph was the most established means of communication. A telegraph message included dot-and-dash (Morse code) and was restricted to receiving and sending only one message at a time. Initially, Bell wanted to discover a way to send multiple messages at once. Later, Bell recognized the potential of his idea he spoke with his future father-in-law, an attorney, to seek financingRead MoreThe Invention Of The Telephone882 Words   |  4 PagesMobile phones were invented in 1973 the by Martin Cooper (Anjarwalla). With their arrival, communicatio n was no longer restricted to any single place, a call could be made from anywhere (physics.org). At first, mobile phones, or cellphones, could only send and receive calls of short distances, however, with the creation network long distance communication by mobile phones became a reality (physics.org). Land is divided into what scientist call cells (physics.org). These cells are â€Å"hexagonal areas ofRead MoreTechnology Has Made Our Lives1684 Words   |  7 Pages According to Pew Research Center (2015), 91 percent of Americans own cell phones.   For people under the age of 44, the number is closer to 97 percent.   64 percent of those phones are smartphones.   Ã‚  With these phones, we have the world at our fingertips.   We can shop on Amazon and Ebay, get live news updates, and get in touch with our â€Å"friends† from all around the globe on Facebook.   Our cell phones have replaced calculators, cameras, and alarm clocks.   If we want to track our calories, thereRead MorePolice Officer For Driving With Expired License1554 Words   |  7 Pagesof the vehicle. Police proceeded to arrest Riley for the possession of loaded firearms. The arresting officer also found and seized a cell phone in Riley’s possession along with items associated with the â€Å"Bloods† street gang. Photographs and videos accessed on the cell phone connected Riley to the â€Å"Bloods† street gang as well. Upon further investigation of the cell phone’s contents police found photographs of Riley in front of a car that had been involved in a shooting. Based on the evidence foundRead MoreRole Of Commercial Banks On A Part Of Financial Inclusion Programme1598 Words   |  7 PagesKnow Your Customer technique (KYC) for opening financial balance was streamlined requesting that banks look for just a photo of the record holder and self-accreditation of locations (the measure of extraordinary adjust in these records would be restricted to 50000 rupees and aggregate exchanges would be constrained to one lakh rupees in one year. e) KCC/GCC: Banks were made a request to present a general credit card (GCC) plot for issuing GCC to their constituents in rustic and semi-urban regionsRead MoreEssay Adolescents: Leave the Cell Phones At Home1676 Words   |  7 PagesPost inception of the cell phone has fueled a shift in the civility of adolescent social interaction. Gone are the days of seeing teenagers imaginatively playing alongside each other with the only restriction being his or her ability to effectively communicate. Virtual conversations, text messages and online social networks have replaced development of social skills through personal interactions. Some educators insist that cell phones provide a unique opportunity to capitalize on the learning experience

Italian Preposition Da - Preposition Da in Italian

In its simplest form, the Italian preposition da means from in English. It’s used in time expressions, in which case you may translate it as since or for. Here are the most common ways to use â€Å"da† in Italian. Common Ways to Use â€Å"Da† 1) To indicate an an action that began in the past and is still going on in the present. You would use the construction of present tense da time. Da quanto tempo leggi questa rivista? - How long have you been reading this magazine?Leggo questa rivista da molto tempo. - Ive been reading this magazine for a long time. 2) To express the equivalent of the English phrase at the house of: Vado da mio fratello. - Im going to my brothers house.Vado da Filippo. - Im going to Filippos house.Andiamo dai signori Rossi. - Were going to the Rossis house.Arrivo subito da te. - I’ll be right over to your place. 3) To indicate origin or source Vengo da Torino. - I come from Torino.Vengo dalla Francia. - I come from France.È tornato dalle vacanze. - He’s back from vacation.È tornato dagli zii. - He’s back from his aunt and uncles house. This also occurs In surnames: Francesca da Rimini; Leonardo da Vinci In correlation with the prepositions a and : si à ¨ trasferito da Roma a Firenze (movement); cadere dalla padella nella brace (figurative) 4) To indicate the worth or price of something: Voglio un francobollo da cento lire. - I want a 100 lire stamp.È una casa da poco prezzo. - Its a house of little worth.Unautomobile da dieci milioni - A ten thousand million dollar car 5) To indicate a location, place (stato in luogo) Ti aspetto dallavvocato. - I’ll wait for you at the lawyer’s office. 6) To indicate cause, reason (causa) Piangeva dalla gioia - To cry from joy 7) To indicate time Non lo vedo da molti anni. - I haven’t seen him in years. In correlation with the preposition a: lavorare dalla mattina alla sera - to work from the morning until the evening Other Ways to Use â€Å"Da† Here are some other ways to use â€Å"Da† 1) To indicate movement through a particular point (moto per luogo): Sono fuggiti dalluscita di servizio. - They escaped through the service exit. 2) To indicate separation (separazione, allontanamento): I Pirenei dividono la Spagna dalla Francia. - The Pyrenees divide Spain from France.Non riesce a staccarsi da quegli amici. - They can’t get away from those friends. 3) To indicate means, method (mezzo): Giudico le persone dai fatti, non dalle chiacchiere. - I judge people from facts, not from gossip. 4) To indicate purpose, ending (fine): Carte da gioco - Playing cardsSala da pranzo - LunchroomSpazzolino da denti - ToothbrushAbito da sera - Evening dress 5) To indicate an attribute (qualità  ): Una ragazza dagli occhi azzurri - A girl with blue eyesUn uomo dal cuore doro - A man with a heart of gold 6) To indicate a way, matter, mode (modo): Agire da galantuomo - To act like a gentlemanTrattare da amico - To treat as a friend 8) As a predicative (predicativo): Fare da padre - To act as a fatherFungere da presidente - To serve as president â€Å"Da† With Infinitives Followed by a verb in the infinitive, the preposition da introduces the following clauses:  » consecutive clause (proposizione consecutiva): Ho (una) fame da morire. - I’m starving.Fa (un) caldo da impazzire. - It’s so hot!  » final clause (proposizione finale): Dammi un libro da leggere. - Give me a book to read.Che cosa vuoi da bere? - What do you want to drink? Phrases Using â€Å"Da† The Italian preposition da is used to form prepositional and adverbial phrases, such as: Da parte di - A part ofFuori da - Outside ofDi qua da - Further on from/This side ofDi là   da - On the other side of/BeyondDa vicino - Close/CloselyDa lontano - From afar/From far awayDa capo - Start over (from the top)/Start anewDa parte (from somebody) -  Of youDa parte (to save something) - (Put) AsideDa meno - For less...Dappertutto - Everywhere Prepositional Articles With Da When followed by a definite article, da is combined with the article to give the following combined forms known as prepositional articles (preposizioni articolate: Le Preposizioni Articolate Con Da PREPOSIZONE ARTICOLO PREPOSIZIONI DETERMINATIVO ARTICOLATE da il dal da lo dallo da l' dall' da i dai da gli dagli da la dalla da le dalle

The oral effect of fluorides and acids Free Essays

string(113) " the Use of Fluorides The â€Å"Centres for Disease Control† \(CDC\) published the graph shown by figure 4 above\." Introduction Overview Fluorides and acids are synonymous with dental hygiene. They are marketed across the world as being beneficial or detrimental. In this report, I shall explore the many views concerning the effects of fluorides and acids in the mouth. We will write a custom essay sample on The oral effect of fluorides and acids or any similar topic only for you Order Now This includes their effects on teeth and gums as well as other relevant areas that concern human oral anatomy. Below is a brief outline of the topics that shall be discussed within this report: Fluorides: What are fluorides Why are fluorides important for oral hygiene The chemical action of fluorides on teeth. How do fluorides bind with enamel to strengthen and protect it What are the ways in which fluorides can be administered Is â€Å"Fluoridation† good or bad Acids: What are acids Why are acids importantWhy are they bad The chemistry of acids – what makes them acidic The genetic and lifestyle factors that could alter oral acidity. What is the chemical action and effect of acids on teeth What is the effect of acids on gums for tooth support Evaluation: Are the relationships between fluorides and cavities reliable and/or valid What issues of safety concerning the use of fluorides arise as a result of this project Are the sources used in this project reliable and/or valid Fluorides Topics that shall be covered in this section: What are Fluorides Why are fluorides important for oral hygiene The chemical action of fluorides on teeth. How do fluorides bind with enamel to strengthen and protect it What other chemicals are needed to strengthen teeth What are the ways in which fluorides can be administered Is â€Å"Fluoridation† good or bad What are Fluorides? Fluorides are formed from the reduction of the element fluorine – the 17th most abundant element in the earth’s crust.[1][2] Fluorine is highly reactive, and only exists as a combination of other elements in a fluoride compound. Fluoride compounds can be found in rocks and soil. Fluoride ions are generally produced when water passes over rocks that contains the fluoride minerals.[2] Why are Fluorides Important for Oral Hygiene? Fluorides are widely used in toothpaste, mouthwash and supplementary products to help reduce the risk of dental cavities.[6] In the UK, fluorides are mainly administered topically to the teeth through the process of brushing. However, only around five million people in cities across the West Midlands and North East England fluoridate (see fluoridation section) their water, so the fluorides have both topical and systemic administrations.[5] According to the British Dental Health Foundation, â€Å"Children who have fluoride when their teeth are developing tend to have shallower grooves in their teeth, so plaque can be more easily removed†.[3] Moreover, the U.S. Centre for Disease Control lists water fluoridation as one of the â€Å"ten greatest public health achievements of the 20th century†.[4] These methods of exposing the teeth to fluoride also increase the concentration of fluoride in the saliva. The fluoride ions interact with molecules of broken down (demineralised) enamel due to acid erosion.[7] This produces a similar enamel-like compound that can then remineralise the tooth enamel. When the rate of demineralisation is greater than the rate of remineralisation, dental caries begin to form. From this, the administration of fluorides work to increase the rate of remineralisation of tooth enamel, thus offsetting the rate of demineralisation reducing the risk of dental decay.[7][8] It is through the promotion of enamel remineralisation in the remineralisation/demineralisation cycle that fluorides have such an important role in maintaining healthy tooth enamel for good oral hygiene.[8][9] The Chemical Action of Fluorides on Teeth Tooth decay is an infectious disease, involving an increase in the plaque formation of oral bacteria such as Streptococcus mutans and Lactobacillus.[10] These facultative bacteria respire anaerobically. Therefore, organic acids are produced when carbohydrates, such as sugar, are used up.[11] As more acid is produced the pH of the saliva decreases.[14] The pH scale generally ranges from pH 1 (the most acidic) to pH 14 (the most alkaline). The recommended saliva pH is said to around 7.2 to 7.4.[13] Therefore, saliva is just slightly alkaline. According to the ‘Manual of Dietetic Practice’ (2002), at a pH below 5.5, acid reacts with and breaks down the crystalline calcium hydrogen phosphate (hydroxyapatite) – the main component of tooth enamel – in a process known as demineralisation.[12] However, when the food source is depleted, the tooth enamel can be remineralised, where the saliva can provide the mineral ions lost for remineralisation. When the oral pH is greater than 4.5, available fluoride ions in the fluid surrounding teeth react with the dissolved crystalline calcium hydrogen phosphate ions forming a fluorapatite layer. This layer binds itself to the enamel surface. Moreover, the fluoride ions can react with the non-dissolved hydroxyapatite enamel, to substitute the hydroxyl group of the hydroxyapatite compound for fluoride ions. This process eventually forms a fluorapatite coating on the outside layer of the teeth.[8][16] The process to produce this remineralised veneer is much quicker than that to produce the normal hydroxyapatite coating.[8][40] Moreover, it is much harder to demineralise the fluorapatite coating by acid than it is for its hydroxyapatite counterpart.[40] This is because the fluoride group, which was substituted for the hydroxyapatite hydro xyl group, inhibits biological systems in the bacteria, so they cannot produce acids as effectively.[40] All of these factors concerning the formed fluorapatite, make this newly formed tooth enamel less likely to undergo acid erosion.[8] In this way, fluorides can function to reduce the risk of cavities forming in the teeth by its topical effects.[17] However, some fluorides function within the body by interacting with the teeth. In these cases, the fluorides can become incorporated into the blood plasma and impregnated into the developing teeth by its blood supply.[17] This in-built fluoride makes the concerning teeth much more resistant to decay.[19][40] The Chemical Equation for the Production of Fluorapatite: Crystalline calcium hydrogen phosphate (hydroxyapatite) reacts with fluoride sources, such as calcium fluoride – CaF2 to produce a fluorapatite compound (calcium halophosphate).[20] Ca10(PO4)6(OH)2 +CaF2 ? Ca10(PO4)6(F)2+ Ca2+ hydroxyapatite + calcium fluoride ? fluorapatite + calcium Studies Supporting the Use of Fluorides The â€Å"Centres for Disease Control† (CDC) published the graph shown by figure 4 above.[37] From figure 4 above, it can be seen that as the percentage of people drinking fluoridated water increases, the mean number of permanent teeth lost, filled or decayed due to cavities decreases. It has also been shown that the fluoridation of water has reduced the risk of caries by 40-60%.[3] This, therefore, supports the evidence behind the mechanisms of fluorides to reduce the risk of developing cavities. However, it should be noted that these links do not signify a causal relationship between fluoride administration and the risk of developing cavities. This is because many other factors can also reduce the risk of cavities, and so one is not fully certain whether the fluorides are the reason for increased enamel strength. Other Chemicals Needed Naturally Stronger and Whiter Teeth As the surface of the tooth enamel begins to breakdown, the tooth itself begins to discolour. This is mainly due to years of chewing and general use, where staining agents become adsorbed to the teeth and the yellower dentine underneath becomes more exposed. Stains can be caused by smoking, eating, drinking and over grinding of teeth. The stronger one’s teeth, the lesser the likelihood that it would become stained by these methods. When tooth enamel has a strong structure, it is more easy to maintain its naturally white appearance. Strong tooth structure results from eating foods high in certain minerals and vitamins. In this way, stronger tooth enamel is less likely to undergo erosion by acid or undergo tooth decay.[21] The list below states and briefly describes some of the recommended nutritional supplements to take for stronger and whiter teeth:[29] Phosphorus: Phosphorus is involved in strengthening the teeth and the bones in the body. Vitamin C and Vitamin D : Vitamin C and vitamin D aids calcium absorption in the body. Magnesium: Magnesium aids the formation of tooth enamel Calcium: Calcium is needed for the body to develop durable bones and teeth. The more calcium absorbed, the greater the rate of calcification of the bones and teeth to a point. In this way, the teeth are stronger and less susceptible to acid-erosion. As calcium is naturally white, calcified teeth are thus whiter in appearance. Interestingly, the calcium deposited in the bones and teeth can be utilised by the blood to help provide the necessary minerals for the body. These minerals and vitamins have a greater systemic function in the body than fluorides for the prevention of cavities. It is, therefore, through the greater mineralisation of the teeth that these dietary supplements have the greatest effect on increasing tooth density to lower its permeability to acid absorption and breakdown.[22] In this way, both the systemic and topical methods of cavity-prevention are together vital to ensure good oral hygiene.[17] Safe Fluoride Levels Fluoride Dietary Reference Intakes Recommended by the Institute of Medicine:[29] 0.01 mg per day for those aged up to 6 months. 4 mg per day for men aged 19 years upwards. The Tolerable Upper Intake Level: 0.10 mg per day for those aged up to 8 years. 10 mg per day for those aged 8 years and upwards. Background Information: The effects of consuming fluorides depend on the total daily intake of fluoride.[24] According to a publication by Fawell, J.K., et al. (2006), an adult living with unfluoridated water in a temperate climate would have a total daily fluoride intake of 0.6 mg/day, compared to one with fluoridated water, who would intake 2 mg/day of fluoride.[23] However, these intakes are different for different regions in the world, due to differing water compositions, cultures and climates. Requirements: All personnel should report, inspect and monitor all processes involved in fluoridation to help prevent cases of overfeed of fluorides into drinking water. Organisations should also train staff to adhere to safety and good practice regulations. They should also produce audits and reports pertaining to the technical requirements for the safe and efficient usage each major compound used fluoridation.[25] These requirement have been set by the â€Å"The Centres for Disease Control and Prevention†. What are the Ways in which Fluorides can be Administered? Diet Fluorides are naturally found in many of the foods that we eat today. It can be found in fruits, vegetables and even in other organisms. Some of the most common sources containing particularly large fluoride concentrations are listed below:[23 Barley Cassava Rice Yams Potato Raisins Fish Shellfish Taro Fluoride Therapy Fluoride therapy encompasses the use of toothpastes, mouthwashes, fluoridated water, dietary supplements and other means to deliver fluoride ions systemically or topically. Some of these methods shall be discussed below: Fluoridation What is it Water fluoridation is a technique used to administer fluorides via the public water supply. Although fluorides can be naturally occurring in our water, fluoridation specifically concerns the issue of adding more fluorides, so as to be of specific medical benefit to the public. Fluoride compounds are used to fluoridate water supplies. Sodium fluoride is the most common compound to use, due to its greater convenience, lower costs and greater associated safety.[27] Sodium fluoride (NaF): A white crystal or powder with no distinct scent that was the first chemical to be used in fluoridation.[27] Generally, the crystallised form is preferred when the compound is being handled, as there is less potentially toxic dust formed.[28] Because of this, NaF is generally used by smaller water companies. Further Information: Fluoridated drinking water has the greatest contribution to one’s daily fluoride intake.[23] In the United States of America, a census was carried out in 1992. The census found that found that fluorosilicic acid (63%) had the greatest population reach out of all those that received water fluoridation, followed by sodium fluorosilicate (28%) and sodium fluoride (9%) respectively.[31] Some Facts about Water Fluoridation Facts are from the source, â€Å"Fluorides†, produced by the ‘World Health Organisation’.[41] Out of all fluorides ingested, 70% to 90% of it is absorbed. When ingested, it can then form the acid HF (hydrogen fluoride), which makes up 40% of the total absorption. When the carried by the blood, the fluorides can then travel around the body. For those of 0 – 1 years of age, 80% to 90% of the fluorides that are absorbed remain. The rest is then removed by excretion (e.g. urine and faeces) 60% of the fluorides absorbed in adults remain in their body. The large majority (99%) of fluorides that remain are stored in bones and teeth. Excessive amounts of fluoride deposits in these regions can cause fluorosis. Notes: In the United States of America, the optimal level of fluoride range from 0.7ppm to 1.2ppm[32], although the ‘WHO’ states that the absolute upper bound for fluorine in water should be 1ppm.[23] In the UK, the recommended and optimal concentrations of fluoride in water are 1ppm and 1.5ppm respectively.[33] However, the fluoride concentration in water depends on the mean maximum atmospheric temperature in that area. This is because, in hotter regions, inhabitants would consume more of the fluoridated water, and thus less fluorides should be present in it.[32] Toothpaste Method of Administration: Toothpaste is applied topically to teeth through brushing. Notes: On average, toothpaste contains 1000-1500ppm of fluoride, usually in the form of NaF. Further Information: Parents should supervise their children’s tooth brushing to ensure that they do not swallow any toothpaste, which is a major cause of dental fluorosis in children under 7.[3][39] Mouthwash Method of Administration: Mouthwashes are rinsed in the mouth for generally 30-40 seconds before being spat out. Further Information: Typically, mouthwashes contain fluorides by the addition of NaF (sodium fluoride). One can easily buy mouthwashes with 225 ppm of fluoride at local supermarkets without prescription. Notes: Alcohol mouthwashes should not be given to children, due to their increased risk of them swallowing it. This is due to children having greater difficulty in overcoming the swallowing reflex.[3] Moreover, allowing children to swallow fluoride mouthwashes may increase their risk of dental fluorosis.[35] Fluoridation: The Big Debate The issue of fluoridation has always raised big questions regarding its effectiveness, safety and usage. Some of the main pros and cons of fluoridation shall therefore be explored. Pros: Large Reach: All members of the community would have access to regular fluorides doses, regardless of income, education or dental access. It many be particularly beneficial to children, as studies have shown that they do not brush as regularly as they should. Therefore, the omission of this administration fluoride can be compensated through water fluoridation, which all children should and would drink. Advantageous for the Elderly: As you get older, one’s saliva flow would generally decrease. This would mean that the elderly have less salivary fluorides that could access, remineralise and strengthen tooth surfaces. Moreover, the elderly have decreased manual dexterity to brush effectively and reach all surfaces. Therefore, all of these issues increase the risk of root surface decay for the elderly, but fluorides would help prevent this from occurring. Evidence: Many studies have been carried out to show that fluoridation of water does have a positive impact on oral hygiene and helping to prevent dental decay. Support: The fluoridation of water is supported by large health bodies such as: The British Dental Association; The World Health Organisation; The British Medical Association; and the British Fluoridation Society. Cost Effective: The use of fluorides reduces the risk of dental caries, and so potentially saves money for a patient who otherwise would have had to have payed for fillings. Reduces the Risk of Dental Caries: A recent study has concluded that adding fluorides to drinking water supplies can lower the risk of dental caries by 40-60%. Acid Resistance and Speed: The compound formed when the broken down enamel reacts with fluoride is more acid resistant and forms more quickly than the original enamel coating. Natural: Fluorides, derived from the natural element, Fluorine, are non-artificial ions. They are regularly used by the body to carry out many other metabolic processes, so its addition into the body would not be unusual. In this way, we have a better understanding of the systemic interaction of fluorides in the body. Cons: Dental Fluorosis: Dental fluorosis is probably the biggest issue surrounding the fluoridation of water. It is a conditions where an excessive consumption of fluorides can potentially cause white spots or brown stains to appear on the tooth enamel. Poison: An excessive consumption of fluorides is toxic and potentially fatal. However, one would have to regularly consume a volume of water far greater than that recommended for fluorides to have such a harmful effect. Concern: This idea that we are always drinking something potentially toxic could lead to much media attention. For example, the media may frighten the public with just one case regarding a patient with dental fluorosis. In this way, public attention that such stories would attract could lead to exploitation of the water fluoridation topic. Law: A patient contracting a condition where fluoride consumption is a risk factor could sue the water-board/government for unwillingly supplying them with fluorides. Therefore, there could be a vast potential liability in nationalising fluoridated water, and its media coverage may encourage even more to sue. Ethics: Some people may not wish to have further chemicals added to their water, as they cannot choose to drink unfluoridated water in a fluoridated community unless they buy bottled (distilled) water, which may be prohibitive for certain social backgrounds. Necessity: It is not yet completely certain whether fluorides are necessary to ensure that one can live. Fluorides work to reduce the risk of the formation of dental caries by counteracting some of the detrimental effects of acids and the associated oral microbes brought about from the consumption of carbohydrates. Therefore, it could be argued that some people do not need fluorides, since they do not consume much carbohydrates. Resources: Many pieces of equipment and additional resources are needed to carry out the process of water fluoridation. This can be costly, as improper pipework may have to be replaced to avoid health risks regarding overexposure of fluorides, such as fluorosis. All sources for the pros and cons are listed in the bibliography Acids Topics that shall be covered in this section: What are acids What are the different types of dental decay Why are acids harmful The chemistry of acids – what makes them acidic The genetic and lifestyle factors that could alter oral acidity. What is the chemical action and effect of acids on teeth What are the different types of dental decay What is the effect of acids on gums and for tooth support What are Acids? An acid is a substance that has a pH value lower than 7, with the lowest and therefore the most acidic pH value being 1.[14] An acid is conventionally described as a substance that donates protons (hydrogen ions). The greater the ability of an acid to donate these protons, the stronger the acid.[14] Why are Acids Harmful to the Teeth? Just hours after brushing, oral bacteria, such as streptococcus mutans, form a thin coating over your teeth called plaque.[10] When foods or beverages that contain carbohydrates (for sucrose, fructose and glucose) enter the mouth, the bacteria within the plaque rapidly convert these carbohydrates (sugars) into lactic acid through anaerobic respiration. It is the hydrogen ions contained within this produced compound that acts and reacts as the acid.[11] Moreover, the acid can be kept in contact with the tooth for up to 2 hours due to the plaque coating. This time frame allows the acid to breakdown the components of the enamel (hydroxyapatite) to eventually result in cavities.[40] The most common areas that can accumulate plaque are the molars and premolars, due to their deep depressions.[41] The outermost layer of the tooth is called the enamel. The enamel of the tooth is commonly known to be the hardest in the human body, due to its highly dense mineral structure. The main mineral in enamel is known as hydroxyapatite, which is a calcium phosphate lattice.[42][43] As the bacteria produce more acid, the conditions in the mouth become more acidic, reducing the pH. When the pH is lowered to 5.5, the rate at which the tooth is demineralised is greater than the rate for remineralisation. This results in an overall loss of phosphate and calcium ions from the enamel, which over time would lead to dental cavities.[12] The demineralisation reaction in enamel involving the constituent phosphate and calcium ions: Ca10(PO4)6(OH)2(s)+ 8H+(aq) ? 10Ca2+(aq) + 6HPO42-(aq) + 2H2O(l) hydroxyapatite + hydrogen ? calcium+ hydrogen phosphate + water From the equation above, the hydroxyapatite (crystalline calcium phosphate) reacts with the hydrogen ions to dissociate into calcium and hydrogen phosphate ions plus water.[20][42] Therefore, this primary mineral of the enamel has broken down and become absorbed into the saliva. However, once the plaque acid has been diluted and neutralised (mostly due to the saliva) the tooth enamel can then be remineralised, recovering the ions dissolved in the salivary fluid.[44] Throughout the day, your mouth is trying to maintain this continuous balance of demineralisation and remineralisation. Eventually over time, an overall loss of ions from the enamel would lead to tooth decay. Since enamel goes clear in the presence of light, the acids can break it down further to expose the softer and yellower dentine tissue below. The dentine is much more susceptible to acid-erosion, as it is less mineralised – it contains fewer minerals. In this way, fewer reactions need to take place to remove these minerals, so the rate of demineralisation is quicker than that for enamel. Dentine has nerves running through it, whereas enamel does not. Therefore, caries extending to the dentine can cause painful sensations especially when consuming hot or cold substances.[45] 5 things required for remineralisation of tooth enamel[36] The correct minerals (containing Ca2+, PO43- and Fl– ions) must be present in one’s saliva. Carbonic acid must then be produced (naturally produced from carbon dioxide and water) and close to the minerals, so it reacts with and dissociate them into their constituent ions. This process must take place near the tooth area affected. The affected demineralised area of hydroxyapatite must be clean and accessible. Complementary shaped ions formed from the minerals can then attract to oppositely charged ions within the hydroxyapatite lattice. Carbonic acid must then reform carbon dioxide and water, which precipitates the complementary ions that were dissolved in it into the area of demineralised enamel. In this way, remineralisation of the tooth enamel has occurred. What are the Different Types of Dental Decay? Dental decay involves the breakdown and weakening of the tooth structure by oral bacteria. This is normally through acidic conditions in the mouth. However, patients with untreated caries would have a greater risk of cavities continuing to form regardless of acidic conditions. Pit and fissure caries are amongst the most common forms of dental decay.[47] Currently, â€Å"tooth decay is one of the most common disorders† in the world.[46] Pit and Fissure Cari Pits and fissures are typical characteristics of molar and premolar teeth, where the inwardly-folding enamel meet. Fissures are the result of undeveloped grooves, where the two folds of enamel have not fully joined. Therefore, it is in these areas where bacteria can most easily accumulate, increasing the risk of caries forming in these regions. Pits and fissures are also notoriously difficult to clean, so this only propagates the process of dental decay further. The deep grooves, called fissures, occur mainly on teeth at the far back of the mouth. These teeth are known are occlusal teeth, as they are involved in chewing. According to the website, DentalIQ, â€Å"Occlusal surfaces account for 12.5% of all tooth surfaces but will experience over 50% of all decay†.[49] They also state that, â€Å"Pit and fissure caries account for 88% of total caries in children†.[47][49] Pits are different to fissures, as they are only small holes naturally found in the teeth, usually at the points where the fissures themselves meet (in posterior teeth).[48] The reason why there are such a high cases of dental decay associated with these types of tooth surfaces is because the indents in the enamel mean that bacteria can accumulate in the sheltered conditions easily. In this way, if one does not properly clean these surfaces, the bacteria (e.g. streptococcus mutans) can thrive and destroy the nearby enamel. According to a study by the ‘Centres for Disease Control and Prevention’, â€Å"approximately 90% of caries in permanent teeth of children occur in tooth surfaces with pits and fissures†.[50][52] To reduce the risk of dental cavities forming in these pit and fissures regions of the teeth, dentists employ an innovative technique, known as ‘fissure sealing’. This involves filling the pits and fissures with a ‘sealant’, so that they form smooth surfaces that are much easier to remove plaque and food remains. According to the website, DentalIQ, â€Å"Sealants are 100% effective in preventing pit and fissure caries if they are completely retained†.[49] Therefore, acids may not have as harmful effects on the posterior teeth if these preventative measures are taken. Over time, decay breaks down the enamel. The decay typically favours the breakdown of the enamel rods, which are highly ordered and mineralised basic unit of enamel structure. Therefore, x-rays of decayed teeth generally show a very distinct pattern, since the enamel rods are also of a very specific shape. This pattern can be seen by white markings from x-ray to the left.[63] When the enamel rods have fully decayed, the bacteria and acids then begin to break down the much softer dentine underneath, which would require more intensive dental treatment to be carried out, in the form of root canal surgery. Common Tooth Regions where Caries can Form: Definitions from the eNotes nursing encyclopaedia.[38] Facial: Outside surface of anterior tooth, adjacent to the face. The term includes buccal (cheek) and labial (lips) areas. Lingual: Inside surface of tooth, adjacent to the tongue. Occlusal: Biting surface of posterior tooth. Incisal: Biting edge of anterior tooth. Mesial: Proximal surface of tooth closest to the midline. Distal: Proximal surface of tooth farthest from the midline. What are the Genetic and Lifestyle Factors that could Alter Oral Acidity? Foods and Drinks pH Values[53] Gooseberries2.8 – 3.1 Grapes 3.4 – 4.5 Raspberries 3.2 – 3.7 Strawberries3.0 – 3.5 Oysters4.8 – 6.3 Golden Delicious3.6 Lemons2.2 – 2.4 Limes1.8 – 2.0 Sorrel 3.7 Carrots4.9 – 5.2 Rhubarb 3.1 – 3 Pork 5.3 – 6.9 Olives (Green) 3.6 – 3.8 Coca-Cola 2.52 The following risk factors for increased oral acidity have been taken from the website, iloveindia.com.[56] Diseases: Esophagitis or Gastro-Oesophageal Reflux Disease (GERD) can increase oral acidity as the conditions involve acidic juices from the stomach refluxing into the mouth. Salivary Glands: Decreased secretion of saliva, so the rate of acid neutralisation too decreases. Thus, acids are retained in the mouth for longer periods of time. Foods: Excess consumption of foods high in acid (e.g. fizzy drinks and sour sweets) can lead to acid reflux, increasing oral acidity. Diets: Some studies promote following a high carbohydrate diet, which would encourage oral acidity due to its anaerobic breakdown. Eating Intervals: Eating sweet foods over short intervals is far worse than eating the same amount in one sitting. This is because acidic conditions are continually returning to the mouth, due to the anaerobic metabolisation mechanism of bacteria. Eating Disorders: Those suffering from bulimia nervosa reflux consumed food, creating extremely acidic conditions in the mouth What is the Effect of Acids on the Gums and Bone? Gingivitis: â€Å"Gingivitis is an inflammation of the gums surrounding the teeth†.[54] In its early stages, bacteria begins to accumulate in the plaque around the teeth and gums, usually due to a lack of oral hygiene. This causes an excess of acid to be produced, irritating the gums. Over time, the gums become increasingly irritated and broken down, leading to reddening, or inflammation. It is quite common in these circumstances that the gums would also bleed easily when irritated further, such as when brushing. However, in gingivitis, the damage is solely to the gums, and if treated soon enough, is wholly reversible.[54] †¦when gingivitis is left untreated, it can advance to periodontitis: According to the Medical encyclopaedia of the University of Maryland, â€Å"Periodontitis is the inflammation and infection of the ligaments and bones that support the teeth†.[34] Gingivitis is usually a precursor to periodontitis, as the inflammations in the gums, form pockets between the gums and teeth. Plaque, containing the acid-producing bacteria, can then accumulate and become sealed in these formations due to the further swelling of the surrounding damaged gum line. The bacteria is now in closer proximity to the supporting tissues of the teeth. The acids released by these bacteria then begin to breakdown these tissues and ligaments, weakening the attachment of the tooth to the bone. Abscesses (swollen area containing pus) are also very common in patients with periodontitis, since the pockets of plaque contain bacteria that secrete toxic liquids. These abscesses also increase the rate of bone destruction.[34] Over time, the structure holding the tooth in place is broken down, and loss of the affected tooth is much more likely. In fact, periodontitis is the leading cause of tooth loss in adults.[18] Evaluation of Project There have been various strengths and weaknesses of some of the conclusions made within this project. Like many scientific analyses, it is very difficult to try and state a causal relationship between certain variables. For example, from figure 4, which demonstrates a link between fluorides and cavities, it is only suggested that there may be a link between them. However, there are many other factors that could also lead to a reduced risk of cavities, so stating that these effects are solely due to fluorides would be considered an invalid conclusion. However, there are many studies that support these links between fluoride exposure and cavity development, so the inclusion of this relationship is not just a means of convenience. Moreover, fluorides have been used in many countries across the globe for many years, and their theoretical effects have been validated and corroborated, increasing the reliability of the administration methods. In turn, many large companies have utilised fluorides within their oral care products, such as toothpastes and mouthwashes. There are also various social and ethical issues surrounding the use of fluorides, especially when concerned with the fluoridation of water. Since fluorides are a derivative of the highly reactive and potentially toxic element, fluorine, there may be quandaries as to whether fluorides are safe for use. This public anxiety has extended to the point of anti-fluoridation societies being created to outlaw the addition of fluorides to the public water supply. This dilemma has been seen particularly in America, where a majority of the population receive fluoridated water. In turn, by producing this report that supports the use of fluorides, some people may protest against it. All these issues are weaknesses of the report that should be considered. However, fluorides have been extensively studied prior to their use in the water supply. When used correctly, they have been found to be of such beneficial to oral health that the BDA (British Dental Association) and the ADA (American Dental Association) both highly recommend them. Many high-powered governments have considered fluorides to be beneficial for oral health, and they even save their citizens money, as they typically have to pay for less dental work, as a result of a reduced risk of developing cavities. The sources used in this investigation can be considered sufficiently reliable and valid. The source, â€Å"Dental caries: a dynamic disease process†, can be considered reliable, as it has been cited by 17 other independent studies.[8] In this way, the information used in this source has been reviewed and accepted by professional scientists. Since, dental caries are relevant to my studies, the information regarding them can also be considered valid for inclusion within this report concerning the effects of fluorides on the risks of developing cavities. Moreover, ‘dentalhealth.org’ states that â€Å"Fluoride can greatly help dental health by strengthening the tooth enamel. The reliability of this information is increased, as it is supported by the source, ‘tips4dentalcare.com’, which states that, The main positive effect of fluoride is increasing durability of tooth enamel. However, some may consider that certain sources are biased, since they are published by organisations that have certain interests in favour of a particular conclusion. For example, the source detailing the advantages of fluorides on oral health by the â€Å"British Dental Health Foundation†, could be biased towards supporting council fluoridation initiatives. However, these organisations are highly respected, and work on behalf of the public, not private, sector. Therefore, issues of outside interests could be considered invalid, and so the information provided and used within this report can be considered valid for use. Bibliography Greenwood, Norman N.; Earnshaw, A. (1997) Chemistry of the Elements, 2nd ed. Oxford: Butterworth-Heinemann, p. 804. Just Think It. (2008). Fluoride. Available: http://www.just-think-it.com/f008.htm. Last accessed 10th Oct 2010. British Dental Health Foundation. (2005). Fluoride. Available: http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=17. Last accessed 10th Oct 2010. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. (1999) Achievements in public health, 1900–1999: Fluoridation of drinking water to prevent dental caries. MMWR Morb Mortal Wkly Rep. 1999;48(41):933–40. The Times Online. (2008). Minister orders fluoride to be added to water. Available: http://www.timesonline.co.uk/tol/news/uk/health/article3295310.ece. Last accessed 10th Oct 2010. National Fluoride Information Centre. (2008). Toothpaste. Available: http://www.fluorideinformation.com/guide_to_fluoride/toothpaste. Last accessed 10th Oct 2010. Pizzo, G; Piscopo, MR; Pizzo, I; Giuliana, G. (2007). Community water fluoridation and caries prevention: a critical review. Clin Oral Investig. 2007;11(3):189–93. Featherstone, J. (2008) Dental caries: a dynamic disease process. Aust Dent J. 2008;53(3):286–91. Aoba, T; Fejerskov, O. (2008) Dental fluorosis: Chemistry and biology. Crit. Rev Oral Biol Med. 2002;13(2):155–70. Ryan, KJ; Ray, CG. (2004). Sherris Medical Microbiology, 4th ed. New York: McGraw-Hill. Loesche, WJ (1996). Baron’s Medical Microbiology (Baron S et al., eds.): Microbiology of Dental Decay and Periodontal Disease, 4th ed. Univ of Texas Medical Branch. British Dietetic Association; Thomas, B. and Bishop, J (editors). (2002). Manual of Dietetic Practice, 4th ed. Blackwell Publishing, Oxford. Venturi, S.; Venturi, M. (2009). Iodine in evolution of salivary glands and in oral health. Nutrition and Health 20 (2): 119–134. Covington, AK; Bates, RG; Durst, RA. (1985). Definitions of pH scales, standard reference values, measurement of pH, and related terminology. Pure Appl. Chem. 57: 531–542. Wood’s Periodic Table. (2010). Home. Available: http://woodsperiodictable.wikispaces.com/. Last accessed 10th Oct 2010. Cury, JA; Tenuta, LM. How to maintain a cariostatic fluoride concentration in the oral environment. Adv Dent Res. 2008;20(1):13–6. Hellwig, E; Lennon, AM. (2004) Systemic versus topical fluoride. Caries Res. 2004;38(3):258–62. Merk Manuals. (2008). Periodontitis. Available at: http://www.merckmanuals.com/home/sec08/ch115/ch115c.html. Last accessed 10th Oct 2010. Ross, Michael H.; Kaye, Gordon I.; Pawlina (2003). Histology: a text and atlas: with cell and molecular biology, 4th ed. Hagerstown, MD: Lippincott Williams Wilkins. p. 453. Holleman, AF; Wiberg, E. (2001). Inorganic Chemistry. San Diego: Academic Press. Associated Content: Beckham, FD. (2008). White Smile, Weak Teeth. Available: http://www.associatedcontent.com/article/1266495/white_smile_weak_teeth.html?cat=69. Last accessed 10th Oct 2010. Information Portal about Teeth and Dental Disease. (2009) What is the Remineralisation of Tooth EnamelAvailable: http://www.bleaching-dental.com/articles/what_does_the_remineralization_of_enamel_teeth.html. Last accessed 10th Oct 2010. Fawell, J; Bailey, K; Chilton, J; Dahi, E; Fewtrell, L; Magara, Y. (2006) World Health Organization: Environmental occurrence, geochemistry and exposure: Fluoride in Drinking-water. p. 5–27. Institute of Medicine. (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride: Fluoride. Washington: National Academy Press; 1997. p. 288–313. Centers for Disease Control and Prevention. (1995) Engineering and administrative recommendations for water fluoridation. MMWR Recomm Rep. 1995;44(RR-13):1–40. Cure Tooth Decay. (2008). Are germs really the cause of dental decayAvailable: http://www.yourreturn.org/Treatments/Teeth/index.htm. Last accessed 10th Oct 2010. Reeves, TG. Centers for Disease Control. (1986) Water fluoridation: a manual for engineers and technicians. p. 11-14. US Department of Health and Human Services. Lauer, WC. (2004). â€Å"History, theory, and chemicals†. Water Fluoridation Principles and Practices. Manual of Water Supply Practices. M4 (5th ed.). American Water Works Association. p. 1–14 Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academy Press; 1997 The Minerology of Nova Scotia. (1999). Fluorapatite. Available: http://nsminerals.atspace.com/EastKemp.html. Last Accessed: Last accessed 10th Oct 2010. Division of Oral Health, National Center for Prevention Services, Centers for Disease Control and Prevention. (1993) Fluoridation Census 1992. Georgia: U.S. Department of Health and Human Services. Bailey, W; Barker, L; Duchon, K; Maas, W. Populations receiving optimally fluoridated public drinking water 1992–2006. MMWR Morb Mortal Wkly Rep. 2008;57(27):737–41.http://www.defra.gov.uk/evidence/statistics/environment/inlwater/iwfluoride.htm Department for Environment Food and Rural Affairs. (2007). Fluoridation of water supplies. Available: http://www.defra.gov.uk/evidence/statistics/environment/inlwater/iwfluoride.htm. Last accessed 10th Oct 2010. University of Maryland Medical Research Center. (2010). Periodontitis. Available at: http://www.umm.edu/ency/article/001059.htm. Last accessed 10th Oct 2010. Ismail AI, Hasson H (2008). Fluoride supplements, dental caries and fluorosis: a systematic review. J Am Dent Assoc 139 (11): 1457–68. Ora Media. What is the Natural Remineralisation Mechanism. Available at: http://mizar5.com/demin.htm. Last accessed 10th Oct 2010. http://www.fluoridealert.org/health/teeth/caries/who-dmft.html eNotes. (2010). Dental and Periodontal Charting. Available at: http://www.enotes.com/nursing-encyclopedia/dental-periodontal-charting. Last accessed 10th Oct 2010. Sheiham, A. (2001) Dietary effects on dental diseases. UCL: Public Health Nutr. 2001 Apr;4(2B):569–91. British Fluoridation Society. (2010). How fluoride works to control tooth decay. Available: http://www.bfsweb.org/facts/dental_benefits/howfworks.htm. Last accessed 10th Oct 2010. libdoc.who.int – WHO publication website. (2002). Fluorides. Available at: http://whqlibdoc.who.int/ehc/WHO_EHC_227.pdf. Last accessed 10th Oct 2010. Dawes, C. (2003). What is the critical pH and why does a tooth dissolve in acid?. J Can Dent Assoc 69 (11): 722–4. Eastoe, JE. (1965). The chemical composition of bone and tooth. Adv Fluorine Res Dent Caries Prev 3:5-17. Silverstone, LM. (1983). Remineralization and enamel caries: new concepts. Dent Update 10 (4): 261–73. University of Illinois at Chicago: Johnson, C. (1998). Biology of the Human Dentition. Available: http://www.uic.edu/classes/orla/orla312/BHDTwo.html. Last accessed 10th Oct 2010. Brigham and Women’s Hospital. (2010). Tooth Decay in Children. Available: http://healthlibrary.brighamandwomens.org/Library/Encyclopedia/90,P01848. Last accessed 10th Oct 2010. Summit, James B., J. William Robbins, and Richard S. Schwartz. Fundamentals of Operative Dentistry: A Contemporary Approach. 2nd edition. Carol Stream, Illinois, Quintessence Publishing Co, Inc, 2001, p. 30-31. Ash Nelson. (2003). Wheeler’s Dental Anatomy, Physiology, and Occlusion. 8th edition. Saunders, 2003, p. 13. Dentistry IQ. (2003). Sealed. Available: http://www.dentistryiq.com/index/display/article-display/187325/articles/rdh/volume-23/issue-9/feature/sealed.html. Last accessed 10th Oct 2010. Centers for Disease Control and Prevention. (2001). Promoting oral health: interventions for preventing dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. A report on recommendations of the task force on community preventive services. Recomm Rep. 2001 Nov 30;50(RR-21):1-13. Tooth IQ. (2010). Layers of the teeth. Available: http://www.toothiq.com/dental-glossary/dental-definition-layers-of-the-teeth.html. Last accessed 10th Oct 2010. Banting, D.W. (2001) The Diagnosis of Root Caries. Presentation to the National Institute of Health Consensus Development Conference on Diagnosis and Management of Dental Caries Throughout Life, in pdf format; hosted on the National Institute of Dental and Craniofacial Research, p. 19. Food-Info. (2010). What is the pH of FoodsAvailable: http://www.food-info.net/uk/qa/qa-fp65.htm. Last accessed 10th Oct 2010. Emedicine Health. (2010). Gingivitis. Available: http://www.emedicinehealth.com/gingivitis/article_em.htm. Last accessed 10th Oct 2010. Irish Health. (2001) Fluoridation of water. Available: http://www.irishhealth.com/article.html?id=3071. Last accessed 10th Oct 2010. iloveindia.com. (2010). Acid Taste in Mouth. Available at: http://lifestyle.iloveindia.com/lounge/acid-taste-in-mouth-11335.html. Last accessed 10th Oct 2010. IMAGES Tips for Dental Care. (2008). The role of fluoride products in effective dental care. Available: http://tips4dentalcare.com/2008/06/24/role-fluoride-products-effective-dental-care/. Last accessed 10th Oct 2010. Planet Green.com. (2008). Make your own mouthwash. Available: http://planetgreen.discovery.com/food-health/makeown-mouthwash.html. Last accessed 10th Oct 2010. Flex your Smile. (2010). Periodontal disease. Available: http://www.flexyoursmile.net/perio.php. Last accessed 10th Oct 2010. OC Dental Center. (2010). Teeth Whitening Orange County. Available at: http://www.ocdentalcenter.com/teeth-whitening-orange-county.htm. Last accessed 10th Oct 2010. Indolent Indio. (2009). A traumatic annual activity from the late ‘80s. Available: http://www.indolentindio.com/2009/03/a-traumatic-annual-activity-from-the-late-80s/. Last accessed 10th Oct 2010. Picsicio. (2010). Tooth decaying. Available: http://picsicio.us/image/a82d4a63/. Last accessed 10th Oct 2010. ToothIQ. (2010). Dental Image #12. 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Communication Skills Training For Oncology -Myassignmenthelp.Com

Question: Discuss About The Communication Skills Training For Oncology? Answer: Introduction Social work consists of many processes, which pay attention to the relationship among individuals and the improvement in the quality of life of people. Individuals have various social roles and how effectively they perform those determine the social relationships. Social work intervenes in this junction of performing the duties and improving lives of people. Helping process is one of the many functioning of the social works. Social functioning comprises of the activities, which are necessary to satisfy the relationships in the experiences of the social living (Fox, 2013). The basic functions of the helping process are restoration of social functioning, provision of resources for development and prevention of social dysfunction. In simple words, helping process in social work is the set of activities to assist the people to identify and cope up with their problems through relationship building, assessment of the problem, setting of the goals, interventions and termination (Miller Rol lnick, 2012). The stages of helping processes will be discussed in the following essay. Discussion Helping process is sometimes defined as the counseling process. Communication skills are extremely important for effective helping process. There are five stages of helping process, namely, Rapport and relationship building, Assessment or problem defining, goal setting, initiating the interventions, and termination of the problem. In each of the stages, Communication plays an important role, as relationships are always determined through effective communication (Egan, 2013). Relationship building Relationships are always based on trust. Thus, laying the foundations for trust by designing a structure and form, voluntary or involuntary, and the roles of articulating is the primary factor for building relationships. Firstly, rapport needs to be developed between the counselor and the client, through introduction, clear description of individuals roles, purpose and active listening to the client. Thus, through effective communication, a relationship is built. Empathy, unconditional positive regard, and congruence are essential in this stage (Shulman, 2012). In this stage, drilling down to the problem is important. The counselor must ask simple and detailed questions to the client to know the exact problem and its source. There should be some basic questions and detailed inquiry on life functions and stress factors. After that, the focus should be on getting more detailed information about the problems through trust (Crowe et al., 2012). Goal Setting In a helping process, once the problems are identified, goals should be specific and clear. Its the duty of the counselor to talk to the client tactfully and find out his or her objective or goal (Brandler Roman, 2015). It has to be mutually agreed upon. In this process, the trust and relationship between the counselor and the client becomes more strong and the client confides into the counselor about his or her perspectives. Thus, effective communication by the counselor is very important not only for conversing with the client, but also to find out the goals for the process (Shulman, 2012). Initiating Intervention Interventions are the perspectives to find out new ways to approach the issue. How to accomplish the goals and solve the problem is addressed through intervention. Communication again plays a crucial role to define the achievable goals and motivate the client to follow the process. The intervention plans are usually positive and action oriented, and can be adapted with time. Termination This is the last stage in the helping process. In this stage, the dependency of the client on the counselor is tactfully reduced, the client is made prepared for the ending of the sessions, and plans are made for possible needs in the future. Termination is also considered earlier if the counselor feels that the process is not helpful for the client. This is done through a systematic process, so that the client can mentally prepare himself or herself. For example, the counselor sets an advance date for the last session, then gradually reviews the progress and makes future plans accordingly. This process empowers the client to think independently (Arnold Boggs, 2015). Thus, it can be said that, communication is extremely powerful tool in helping process. It is a sensitive issue for all the clients and only through supportive attitude, active and attentive listening and comforting words, the helping process can be successful. Barriers to communication Communication is a process of transferring of information through speaking, listening, writing, reading and observing. Thus, during the helping process, communication takes many forms, such as, speaking, listening, observing etc. (Austin Pinkleton, 2015). There can be many barriers to effective communication in the helping process. Those are as follows: Emotional barriers or taboos: Sometimes people feel shy to express their emotions. Again sometimes, due to social taboos, they do not open up. Cultural and language differences: Social norms often determine the way of expression and these vary across different cultures. For example, the definition of personal space varies among different cultures. Along with that, language difference also impede communication. Sometimes, unfamiliar accents create barriers in understanding. Use of jargons: Sometimes the counselor use jargons, which becomes difficult to understand for the client. Prejudices and expectations: Due to cultural differences, people often have preconceived notions and prejudices. They do not make the effort to think beyond that. Hence, they keep the same expectation from the counselor. However, these prejudices seldom meet the expectation and people cannot accept the helping (Kissane et al., 2012). Non-verbal communication and physical barriers: If the counselor cannot understand the body language, facial expressions, gestures, postures and other non-verbal cues, then the communication becomes less effective. Lack of attention: If any one of the counselor or client is not attentive to the sessions, and gets distracted easily, then the helping process would not be effective. Apart from all these, the differences in the view points and perception, physical disabilities, such as speech problems or hearing problems, lack of flexible attitude of the client also create barriers to communication in the helping process (Berge, 2013). Recommendation for overcoming the barriers in communication In the helping process, the barriers to communication, especially interpersonal barriers, are a common issue. It is a challenge for the counselor to build a trusting relationship with the client and find out the precise problems and solve them. Hence, effective communication is extremely important. As there are barriers to communication, there are also ways to overcome those challenges. Those are as follows: Use of simple language: The counselor must not use jargons and use simple language while communicating to make the client comfortable. The client can understand the process if it is communicated in a simple language with easy accent. Even if the perceptions are different, still it has to be conveyed through easy understandable language (Gratis, 2017). Active listening: The counselor must have high level of patience and the practice of active listening. He must listen to everything attentively that the client has to say. Similarly, the client must also listen to what the counselor is instructing respond accordingly. Clarity in the thoughts: It is very important to know about the topic or subject to be discussed with the client and clear thoughts about that. The Counselor must be very clear about the objectives of the helping process and must design his way of dealing accordingly. After the client expresses his thoughts, the counselor must be able to understand that and find out a solution to help the client (Egan, 2013). Staying calm and patient: Both the parties involved in the helping process must be very patient and must control own emotions and frustrations while communicating through the process. If the conversation needs more time, it should be given and must not be hurried. Avoid too much information in one session: People would feel overloaded if they are asked to process too much information in one session. Hence, the counselor must understand the receiving capacity of each client and plan accordingly as per the needs. Providing feedback: Feedbacks should always be given by both the parties to make the process effective. It helps in personal development as well as contributes in effectiveness of the session. Understanding the body language: Counselors must be able to read the gestures, expressions, general body language and non-verbal cues of the client during the helping process. It helps to get many aspects of the clients nature, which he is not being able to say verbally (Ray, 2014). Conclusion Helping process is an integral part of the social work. Many people need help in many ways and counseling is one of the ways to help them. Through counseling people can overcome many challenges and can live a better life. Helping process is heavily dependent on effective communication. In all the five stages of helping process, communication plays the major role, which lays the foundation of trust and relationship. Although there are many barriers to communication in the helping process, there are ways to overcome them also. Both the counselor and the client must put effort for easy communication, understanding, keeping patience and cooperating with each other for making the process successful. With effective communication, helping process can yield the best results. References Arnold, E. C., Boggs, K. U. (2015).Interpersonal Relationships-E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences. Austin, E. W., Pinkleton, B. E. (2015).Strategic public relations management: Planning and managing effective communication campaigns(Vol. 10). Routledge. Berge, Z. L. (2013). Barriers to Communication in Distance Education.Turkish Online Journal of Distance Education,14(1), 374-388. Brandler, S., Roman, C. P. (2015).Group work: Skills and strategies for effective interventions. Routledge. Crowe, M., Whitehead, L., Carlyle, D., McIntosh, V., Jordan, J., Joyce, P., Carter, J. (2012). The process of change in psychotherapy for depression: helping clients to reformulate the problem.Journal of psychiatric and mental health nursing,19(8), 681-689. Ray, D. (2014). Overcoming cross-cultural barriers to knowledge management using social media.Journal of Enterprise Information Management,27(1), 45-55. Egan, G. (2013).The skilled helper: A problem-management and opportunity-development approach to helping. Cengage Learning. Fox, R. (2013).Elements of the helping process: A guide for clinicians. Routledge. Gratis, B. (2017).Overcoming Interpersonal Barriers to Communication.Nulab. Retrieved 9 October 2017, from https://nulab-inc.com/blog/typetalk/overcoming-interpersonal-barriers-communication/ Kissane, D. W., Bylund, C. L., Banerjee, S. C., Bialer, P. A., Levin, T. T., Maloney, E. K., D'Agostino, T. A. (2012). Communication skills training for oncology professionals.Journal of Clinical Oncology,30(11), 1242-1247. Miller, W. R., Rollnick, S. (2012).Motivational interviewing: Helping people change. Guilford press. Shulman, L. (2012).Brooks/Cole empowerment series: The skills of helping individuals, families, groups, and communities. Cengage Learning.