A Guide to the Problem-Solution
Research Paper
Senior Challenge Committee
These recommendations on the mechanics and format of the research paper reflect
the practices of the Modern Language Association of America (MLA).
Updated by the Hodgson Senior Challenge Committee: August 2007
Specific Requirements for the Research Paper

The final draft of the paper must be produced and saved by the student on an
adequate word processing system. It should be double-spaced and typed in 12point Times New Roman font with 1” margins.

Using a variety of reference materials is encouraged. Sources need to be reliable
and current. Each career area instructor may have different requirements
regarding the sources used in that area’s papers. Students are encouraged, and in
some cases required, to utilize sources of information found outside of the school.

The paper shall be five to eight pages in length. Papers surpassing eight pages in
length will only be graded through the eighth page. The number of pages reflects
the introduction, body, and conclusion of the paper only and does not include the
outline, works cited page, and/or visuals.

Successfully completing requires independent and efficient work as well as the
ability to follow directions and meet deadlines.
1
The Problem-Solution Format
Description
Being able to identify and solve problems in the workplace and in everyday life
are essential skills for all productive citizens. Problem-solution essays inform readers
about problems and propose methods to address the problems. People draft and present
problem-solution essays daily in business, government, education, and other professions.
Problem-solution essays and presentations are an essential component of the world of
work.
In most disciplines and professions, problem solving is a basic way of thinking.
For example, health professionals use problem-solving skills when diagnosing and
addressing patient health concerns; mechanics maintain systems and use sophisticated
tools and problem-solving techniques to perform 60,000 mile checkups on cars, and
optimize performance in turbocharged engines; politicians and community leaders
propose solutions to troubling political and social problems; attorneys find legal
precedents to solve their clients’ problems; teachers make decisions everyday about how
to help students with specific problems; carpenters, plumbers, masons, electricians, and
HVAC technicians are in continuous demand to solve difficulties for home and business
owners; and business owners or managers must themselves be problem-solvers as they
work with the public and plow through bureaucratic red tape.
Problem-solution essays are a form of persuasive writing. In addition to
identifying a problem and exploring its ramifications, the writer proposes a solution or
solutions, recommends a course of action, and explains the reasons the recommended
course of action is the best to pursue. The writer is arguing in favor of following the
recommended course of action. Therefore, the writer must be aware of the reader’s needs
and expectations. Does the reader understand the problem and its seriousness? What
other solutions might the reader think of, and what objections might they have to the
writer’s solution? An awareness of the audience, including their concerns and possible
objections, is a central element of all effective persuasive writing.
2
Basic Features
Each career area will have different expectations regarding information required in the
paper. One career area may require only one solution, but an extremely detailed
discussion of causes and steps in solving the problem; while another may require an indepth discussion of the problem’s history and an explanation why two possible methods
of solving the problem are unacceptable.
Thus, no one outline format will suit every paper. However, the following elements
should be in all papers to some extent. While English teachers and career area teachers
are the primary resources for organization issues, mentors may also offer suggestions.
Introduction: (order of items within paragraph may vary; introduction may be more than
one paragraph in length)
- Identify the problem
- State thesis
- Gain the reader’s interest, perhaps by explaining why he should be concerned or
describing the seriousness of the problem
Present Problem: (more than one paragraph in length)
- Describe the problem thoroughly
- Be sure to address the following questions as they apply to the assigned problem,
giving examples and explanations of each and supporting answers with research:
 What caused the problem?
 Who is affected by the problem?
 What are the effects of the problem?
 Why is it important?
 Where did it begin, or where is it most problematic?
 When did it become a problem?
 What background information would a lay reader (not someone in
your career area) need to know to understand the issue?
- What factors need to be considered when you think about how to “solve” your
problem? What do you need to consider and what are your priorities?
Present Solution(s): (more than one paragraph in length)
- Describe, examine, and evaluate the solution or solutions.
- If you have more than one solution to discuss, place the least acceptable first, then
progress in order to the best solution.
- Each discussion of a solution should
 Identify the solution
 Go through the pro’s and con’s (which can include cost, time,
labor, feasibility, as well as how it meets or surpasses current
industry standards…)
- Some career areas may require papers to include a description of the steps
necessary to implement the solution .
- If more than one solution is required by your career area teacher, your paper
should include a clear explanation of why your chosen solution is the best way to
3
address the problem. Anticipate and address any objections or reservations your
audience may have.
Conclusion:
- Remind the reader of key points, benefits to your solution, or of the problem’s
significance.
- Call to action: What do you want your reader to do now or to better understand?
4
Preparing a Working Bibliography
Once the subject has been chosen and approved, the next step is to search for and collect
a list of POSSIBLE source materials and references. This list is referred to as the
Working Bibliography.
Recommended sources of information include:








The electronic card catalog of a library
Books and other materials within school
UDLib/SEARCH or other sources of current magazine articles
Specialized reference books (dictionaries, encyclopedias, handbooks, manuals,
almanacs)
DELCAT – the computerized catalog of all materials available at the University
of Delaware’s Morris Library
EBSCO database search
INTERNET and CD-ROM
Interviews (inside and outside of the school)
In preparing a Working Bibliography, the first task is to list as many sources as might be
helpful in researching the paper. Even those sources that are questionable should be
included. Later, if some sources seem to be of no help, they can be dropped from the
final list of works cited. The Working Bibliography can be added to at any time as new
materials become available.
Entries in the Working Bibliography must be listed in alphabetical order, and each entry
must follow the prescribed MLA format. Correctly formatting these entries is essential
because they will be used not only in the Working Bibliography, but also on the note
cards and the Works Cited page of the research paper.
All sources listed must be current, authentic, and appropriate to the topic. If the
instructor has any questions concerning the source materials, the student must produce
the actual materials or evidence of their existence within forty-eight (48) hours.
5
Bibliography and Works Cited Page Rules

Italicize (as opposed to underline) the titles of books, magazines, newspapers, and
journals.

When a print source does not indicate the publisher, the place or date of
publication, or the pagination, the following abbreviations should be inserted:
n.p.
n.d.
n. pag.
No place of publication/no publisher given
No date of publication given
No pagination given

When typing bibliography or Works Cited page entries, one space is used after
each punctuation mark.

In listing two or more sources by the same person, the name is given in the first
entry only. Thereafter, three hyphens and a period (---.) are used in place of the
name.

Bibliographies and Works Cited pages are always double-spaced. There are no
extra spaces between entries.

Bibliographies and Works Cited pages are always organized in alphabetical order.

Each entry starts at the margin. Any subsequent line within the entry is indented
five spaces.

Capitalize every important word in a title, regardless of the style used in the
original article.

Months are abbreviated to the first three letters, except May, June, July, and Sept.
6
Bibliography and Works Cited Page Format
MLA Style Guide
Note- All entries on the Bibliography and Works Cited pages must be double-spaced.
The examples on the following pages are single-spaced to save room.
Book with One
Author
Silverstein, Herma. Threads of Evidence; Using Forensic Science to Solve Crimes. New
York: Holt, 1996.
Book with Two or
Three Authors
Biggar, Bill and Joe Myers. Danger Zones; What Parents Should Know about the
Internet. Kansas City: Andrews and McMeel, 1996.
Book with Four or
More Authors
Bisaccio, Dan, et al. Biological Diversity in the El Eden Preserve. Boston: Thomas &
Sons, 2004.
Book with an
Editor (ed.) or
Compiler (comp.)
Mandelbaum, Paul, ed. First Words: Earliest Writing from Favorite Contemporary
Authors. Chapel Hill: Algonquin, 1993.
Gordon, Ruth, comp. Pierced by a Ray of Sun; Poems about the Times We Feel Alone.
New York: HarperCollins, 1995.
Book or Pamphlet
with Corporate
Author
Time-Life, Inc. This Fabulous Century: 1950-1960. New York: Time, 1970.
Centers for Disease Control. Tobacco. Washington: GPO, 1999.
Newspaper article – Knickerbocker, Brad. “Sorting Through a School Tragedy.” Christian Science Monitor 22
print format
April 1999: 1+.
Magazine or
Journal article –
print format
Smith, Jane. “Computers: Where are the Real Bargains?” Consumer Reports Dec. 1999:
54-58.
Ryan, Katy. “Revolutionary Suicide in Toni Morrison’s Fiction.” African American
Review 34 (2000): 389-412.
Article in Print
Collection (e.g.
Opposing
Viewpoints, Current
Controversies)
White, Lawrence. “Campus Speech Codes Do Not Violate Free Speech.” Censorship.
Opposing Viewpoints. San Diego: Greenhaven, 1997: 93-97.
Hepburn, Mary A. “Television Violence May Cause Youth Violence.” Youth Violence.
Current Controversies. San Diego: Greenhaven, 1998: 91-94.
Reference Book —
Conger, Clement Ellis. “White House.” The World Book Encyclopedia. 2004 ed.
7
familiar with
frequent, new
editions
“National Park System.” World Almanac and Book of Facts. 2004 ed.
Weis, Elizabeth, et al. “Motion Pictures.” The New Encyclopaedia Britannica. 15th ed.
1998.
“Ozawa, Seiji.” Current Biography Yearbook. 1998 ed.
Reference Book —
specialized, with
single or infrequent
new editions
“Anne Sexton.” Encyclopedia of World Biography. 2nd ed. Detroit: Gale, 2002.
"Italians." American Immigrant Cultures: Builders of a Nation. Vol. 1. New York:
Simon & Schuster, 1997: 475-483.
Hammond Atlas of the World. 2nd ed. Maplewood, NJ: Hammond, 1999: 188-9.
“A Bell for Adano.” Masterplots. Vol. 1. Englewood Cliffs: Salem, 1976.
Literary Work
in a Collection
(essay, trans. story,
play, poem)
Chaucer, Geoffrey. “The Knight’s Tale.” The Portable Chaucer. Trans. and Ed.
Theodore Morrison. New York: Viking, 1977: 76-123.
Shakespeare, William. “Twelfth Night.” Shakespeare: The Complete Works. Ed. G.B.
Harrison. New York: Harcourt, 1968: 850-879.
Online Database
EBSCOhost Knickerbocker, Brad. “Sorting Through a School Tragedy.” Christian Science Monitor
22 April 1999: 1+. EBSCOhost. Joseph Moore Library, Paul M. Hodgson
Vocational-Technical High School Library, Newark, DE. 10 Nov. 2001 <
http://search.epnet.com>.
History Resource "Mexican Americans." History Resource Center: US. Joseph Moore Library, Paul M.
Center
Hodgson Vocational-Technical High School Library, Newark, DE. 23 Sept. 2002
<http://galenet.galegroup. com/servlet/HistRC/>.
Newsbank Perrin, Marlene J. “Single Book Gets City Reading, Talking.” Cedar Rapids Gazette 25
Nov. 2001: 1B. NewsBank. Joseph Moore Library, Paul M. Hodgson VocationalTechnical High School Library, Newark, DE. 4 Dec. 2001
<http://infoweb.newsbank.com>.
SIRS Wilson, Ted. “How to Feed the World.” Christian Science Monitor 22 Apr. 1999: 3-4.
SIRS. Joseph Moore Library, Paul M. Hodgson Vocational-Technical High School
Library, Newark, DE. 13 Sept. 2002 <http://sks.sirs. com>.
Encyclopedia “Cisneros, Sandra.” Encyclopedia Britannica Online. Joseph Moore Library, Paul M.
Britannica Online
Hodgson Vocational-Technical High School Library, Newark, DE. 25 Oct. 2004
<http://school.eb.com>.
AP Photo Archive “Atomic Bomb Nagasaki.” Photograph. 9 Aug. 1945. AccuNet/AP Multimedia Archive.
Joseph Moore Library, Paul M. Hodgson Vocational-Technical High School
Library, Newark, DE. 5 Dec. 2001 <http://ap.accuweather.com>.
Opposing “A Clone Can Exist with Full Human Dignity.” Opposing Viewpoints. Joseph Moore
Viewpoints
Library, Paul M. Hodgson Vocational-Technical High School Library, Newark, DE.
9 October 2002 <http://www.galenet.com/servlet/OVRC/>.
8
Websites
Peterson, Susan Lynn. The Life of Martin Luther. 1999. 9 Mar. 2001
<http://pweb.netcom.com/~supeters/luther.htm>.
National Rifle Association. A Parent’s Guide to Gun Safety. 12 Sept. 2000. 6 May 2003
<http://www. nrahq.org/>.
The North Atlantic Right Whale. 18 Oct. 2003. Biology Dept., University of New
Hampshire. 3 Apr. 2005 < http://www.unh.edu/projects/right_whale.htm>.
Boshart, Rod. “GOP Candidates Gear Up for Tonight’s Debate in New Hampshire.”
The Union Leader Online. 13 Dec. 1999. 31 Dec. 1999
<http://www.theunionleader. com>.
CD-ROM
Resources
“The Media and Vietnam.” American Decades. CD-ROM. Detroit: Gale, 1998.
Melina, Lois Ruskai. “Adoption.” Encyclopedia Americana 1998. Danbury: Grolier,
1998.
“Bronte, Emily.” DISCovering Authors. CD-ROM. Detroit: Gale, 1999.
Letter to the Editor
/Editorial
Sharma, Ratnesh K. Letter. Discover Feb. 1999: 12.
Love, Robert. “Praise for Clinton.” Editorial. Rolling Stone 5 Aug. 1999: 7.
Interview
Telephone Kennedy, Edward. Telephone interview. 23 Nov. 1999.
Personal
Houlihan, Ted. Personal interview. 15 Feb. 2004.
Email Message
Young, John. “Off-Campus Privileges.” E-mail to the author. 1 Sept. 2005.
(Note: The author is you, the writer of the paper. In this example, John Young sent an
email to you, and you’re using information from that email in your paper.)
Letter or FAX
Slocum, Lee. Letter to the author. 12 Nov. 2005.
(Note: The author is you, the writer of the paper. In this example, Lee Slocum sent a
letter to you, and you’re using information from that letter in your paper.)
Television or Radio
Program
“Deep Jungle: Monsters of the Forest.” Nature. Prod. Gene Gordon. Narr. Paul
Christie. PBS. WGBH, Boston. 19 Sept. 2005.
Lecture, Speech, or
Address
Brockhurst, John. “Slavery and Astronomy.” Hayden Planetarium, Boston. 19 May
2004.
9
Film or Video
Napoleon Dynamite. Dir. Jared Hess. Perf. Jon Heder, Efren Ramirez, Jon Gries, Haylie
Duff, Tina Majorino, and Diedrich Bader. Fox, 2004.
To Kill a Mockingbird. Dir. Robert Mulligan. Perf. Gregory Peck and Robert Duvall.
Twentieth Century Fox, 1962.
Recording
(CD, Audiocassette, LP)
Chapman, Tracy. “Paper and Ink.” Telling Stories. Elektra, 2000.
Dylan, Bob. “Blowin’ in the Wind.” Forrest Gump: The Soundtrack. Perf. Joan Baez.
Sony, 1994.
Musical
Composition
Chopin, Frederic. Waltz in A-flat Major, op. 42.
Work of Art
Cropsey, Jasper Francis. An Indian Summer Morning in the White Mountains. Currier
Museum of Art, Manchester, NH.
Online Images
“Black Bear in Tree.” Bears and You in the North Cascades. National Park Service. 11
Sept. 2002. 28 Sept. 2005 <http://www.nps.gov/noca/bear.htm >.
Online Audio Clips
“Neil Armstrong’s Reactions to 1969 Moon Walk.” NASA Spacelink. NASA. 1 Mar.
1999. 12 Jan. 2003 <http://town.hall.org/radio/IMS/NASA/ 00394_
nasa_01_ITR.au>.
Online Video Clips
“Hurricane Victims on Rooftop.” CNN.com. Cable News Network. 30 Aug. 2005. 15
Sept. 2005 <http://www.cnn.com/video_archives/Katrina_2005/new
_orleans/clip1.html>.
10
Copyright Guidelines
Unless you ask permission of the copyright holder, the following guidelines must be
followed when using other’s material in your multimedia presentation:
Text Material
 Up to 10%, or 1000 words of copyrighted text, whichever is less, may be
reproduced or otherwise used as part of a project or multimedia program created
by a student for educational purposes.
 When copying a poem, you may use up to 250 words, but you are further limited
to: three poems or portions of poems by one poet; or five poems or portions of
poems by different poets from an anthology.
Illustrations and Photographs
 A photograph or illustration may be used in its entirety, but no more than five (5)
images of an artist or photographer may be incorporated into a student project.
When using photographs and illustrations from a published collective work, not
more than 10%, or 15 images, whichever is less, may be used.
Video
 Up to 10% of a motion video, or three (3) minutes, whichever is less, may be
used as part of a project created by a student for educational purposes.
Music
 Up to 10% of a musical sound track, or 30 seconds, whichever is less, may be
used as part of a project created by a student for educational purposes.
Data

Up to 10% of the cells in a database, or a total of 2500 cells, may be used.
Important:
 Even if you follow the guidelines above, you must always cite each source you
use. Please refer to your MLA Style Guide for help.

Include on the opening screen of a multimedia program and any accompanying
print material a notice, i.e., “Certain materials are included under Fair Use
Exemption of the U.S. Copyright Law and have been prepared in accordance
with Multimedia Fair Use Guidelines and are restricted from further use.”
11
Preparing a Preliminary Question Series
Once the subject for research has been selected and a Working Bibliography has been
constructed, it is time to begin a step-by-step plan to complete the paper. The nature of
the problem-solution paper will help the student prepare a series of questions to guide
research and analysis. At this stage the questions may be rough, but often the major
topics will suggest themselves.
The questions that the paper will answer become the basis for the Preliminary Question
Series (PQS). The PQS functions as a general guideline to reading and research. Instead
of wondering where to begin, the student simply finds the answers to questions
The PQS is never carved in stone. As reading progresses and more information is
gained, the questions can be revised and/or extended accordingly. Questions can be
discarded if insufficient research materials exist, and questions can be added as additional
sources become available.
The questions should be listed in an order that makes sense to the continuity and
focus of the paper. A Controlling Purpose or Thesis Statement should emerge as the list
of questions is completed. The length and/or scope of the paper will determine the
number of questions. (A general rule is one question per page, but if the questions are
very broad or require in-depth research, this can vary.)
PQS questions should be “fat.” In other words, because they serve as guides for the
note cards, these questions should generate large amounts of information. It should be
impossible to answer a PQS question in one word or phrase. On the following page is a
sample of an appropriate Preliminary Question Series.
12
Sample Preliminary Question Series
Topic: Impact of Terrorist Attacks on U.S. Immigrants
Controlling Purpose or Thesis Statement:
The calamitous attacks against the United States on September 11 have left immigrants
with not only a less accepting mainstream American society, but also with dramatic
changes to the economic and political aspects of their lives, perhaps for years to come, due
to the government’s stringent changes to immigration policies.
Questions:
1. Why do immigrants come to the United States?
2. What must immigrants do to fit into American society?
3. What impact have the 9-11 terrorist attacks had on American’s perception of
immigrants?
4. What economic impact has 9-11 had on immigrant workers?
5. What solutions have been proposed to address post 9-11 immigration concerns?
6. What impact might implementing proposed solutions have on the nation?
13
How to Take Notes
There are both SOURCE cards and NOTE cards in the research process. Follow the steps
below to create a well-organized note-taking system. Start with any source of
information.

Source Card
Take an index card for the first source. Write in the center of the card all the
bibliography information for that source. (Use underlining to replace italics.)
Label that source card “A” in the upper left-hand corner of the card. The second
source will be labeled “B”, the third source “C”, and so on. DO NOT
automatically write up a source card for every source in the Working
Bibliography. Wait until you actually take notes from that source before you
write a source card for it.
Note Card
1. Take an index card for the first note card. In the upper left-hand corner of the
card write the letter of the source you are using.
2. In the upper right-hand corner of the card write the number of the PQS question
that this note will attempt to answer.
3. In the middle of the card write the FACT, IDEA, QUOTE, or VISUAL that you
are using as a note. If it is a direct quote, it must be put in quotation marks. If it
is paraphrased (in your own words), do not use quotation marks.
4. In the bottom right-hand corner, write the page number from which you got the
note or visual (if appropriate).
Information obtained from interviews, videotapes, other non-print sources, and most
Internet material is written in the exact same way. The only difference will be the
presence or absence of a page number in the bottom right-hand corner. On the following
page is an example of a source card and a note card.
14
Source written in correct
bibliography format
Source Letter
A
Mowar, George. The Ancient Norse in Greenland and
America. New York: Little, Brown and Co.,
1995.
Source Letter
PQS Question Number
A
5
The ancient Norse used the names of their gods
and goddesses to name their ships.
54
One fact that
answers the question
Page Number
15
Your Responsibility as a Researcher
If you are submitting a paper as your own research, then you have a responsibility to
present your own findings. Too often, student researchers piece together the ideas of
other people without adding their own insights, support, and color. How do you make
your research your own?

Gain control over the information. Do not take notes if you do not understand
the information you are writing. If you do not understand it, then either get help
understanding it or do not use it!

Use sound judgment when using direct quotations. Quotations are used to
liven up writing or to prove a point. Choose them carefully. Do not use them as a
thesis statement, to provide background material, or to end the paper. It is your
paper; therefore, your thoughts and commentary must be used to bridge the facts
and opinions supplied by expert sources. Avoid back-to-back quotations. A
string of quotations is not considered your work.

Properly paraphrase a source’s information. Paraphrasing is putting into your
own words something another person has said or written. It is not merely
changing a word or two from the original. Even if you paraphrase, you must still
tell your readers where you got the idea. If you fail to cite your sources or use
words someone else has written as if they were your own, either deliberately or
accidentally, you are guilty of plagiarism, an offense that will damage your
credibility as a researcher and your grade on this paper. “Plagiarism” comes from
the Latin word for “kidnapper”!

Effectively interviewing persons who are knowledgeable about a topic can
make your paper more interesting. Talking with these people can also help
keep you on track and save you valuable time. When you interview someone, do
it in a systematic manner using your PQS questions. Transcribe the answers onto
note cards, following the guidelines. Be courteous, take careful notes, and be
organized when interviewing people inside or outside of the building.
16
General Directions for Taking Notes
Regardless of the short cuts you may think you have devised for taking notes, following
these directions will be the shortest short cut of all!
1. Use ink. It is easier to read than pencil and will not smudge as easily.
2. If it is difficult to decide when to take notes, stop trying. Read a few of your
sources of information and look over your PQS. Revise these preliminary
questions whenever you feel the need. Then return to your sources with a clearer
idea of the facts that you need to find.
3. Write only one item of information, as a complete thought, on a note card.
Write only on one side.
4. Keep your labeling straight. Keep all corners of the cards labeled correctly,
especially page numbers.
5. If you copy information directly from a source, use quotation marks on your
note card. Although you may ultimately paraphrase the material in your paper,
these quotation marks will be a constant reminder to you throughout your study
that the information is a direct quote.
Organizing Notes and Writing the Final Outline
The research paper is longer and more complex than a short paper, and the outline will be
longer, too. Remember, however, much of the work is already done. The PQS numbers
on your note cards and your PQS will provide the divisions and subdivisions of the
outline.
Put each note card into separate piles according to the PQS numbers. Look through the
cards that correspond to each PQS number and see what smaller divisions exist within the
pile. In your outline, the PQS or subheadings will be assigned Roman numerals and the
smaller divisions will be assigned capital letters.
This is the point at which you must decide exactly what you are going to include in the
paper and what you are going to throw away. Make sure that the entire outline is in a
logical order. Look at the sample outline on the following page.
17
Drafting the Paper
Begin with an introduction that establishes the purpose of your research. One or more of
the following elements can be worked into the introduction:




information the reader needs to understand the research
definitions of complex terms or concepts
an opening quotation
an interesting story or anecdote
DO NOT START THE INTRODUCTION WITH THE FOLLOWING:
“My research paper is going to be about…”
FOLLOW THE FORMAT FOR FORMAL COMPOSITIONS!



Do not use contractions.
Write out numbers less than one hundred, other than fractions or
percentages.
Pay close attention to homonyms and frequently confused words.
Present your ideas honestly and clearly. Support the topic sentence of each and every
paragraph with sufficient and documented facts, reasons, statistics, and commentary. As
you incorporate your note cards into the paragraphs, you must connect them cohesively
with your own thoughts. Use a variety of sentence structures and clear, concise
vocabulary. Vary the ways in which direct quotes are introduced.
18
Plan for your visuals. If you are using pictures, diagrams, charts, or photographs, they
must be referred to in the body of the paper, but placed at the end and appropriately
labeled. Visuals do not count towards your minimum number of pages. Visuals work best
when they are easily understood and provide information that would be unclear if only
presented textually. All figures or tables must be labeled (Fig. 1, Fig. 2, Table 1,
Table 2, etc.), titled, and cited. Everything that is not a table (a visual using columns
and rows to organize information) is considered a figure. This includes illustrations and
photographs. Here are two examples.
Figure 1. Dental Implant (“Implant Reconstruction”)
Table 1. Delaware State Test Scores (Baily and Besso A4).
Reading
Grade
3
5
8
10
2002 Score
441
478
519
513
Below Std.
21%
22%
29%
34%
2001 Score
436
471
514
511
19
2000 Score
437
470
513
512
1999 Score
428
463
509
504
1998 Score
421
460
508
509
The final paragraph(s) of the paper should leave the reader with a clear
understanding of the analysis of the solution. This is usually done by reviewing the
important points that have been made and by drawing a final conclusion.
Read the paper out loud to help you find obvious mistakes and problems. MAKE
SURE THAT ALL PARENTHETICAL DOCUMENTATION AND A WORKS CITED
PAGE ARE INCLUDED IN THE DRAFT AND THAT THEY ARE RECONCILED.
Reconciling involves checking to make sure that every source cited parenthetically in the
paper is listed on the Works Cited page and making sure that every source listed on the
Works Cited page is actually parenthetically cited in the paper.
20
Transitional Words and Phrases
To add or show sequence: again, also, and, then, besides, equally important, finally,
first, further, furthermore, in addition, in the first place, last, moreover, next, second, still,
too, to begin with, initially
To compare: also, in the same way, likewise, similarly, in a similar fashion, in a like
manner, as, as though, in the same manner
To contrast: although, and yet, but, but at the same time, despite, even so, even though,
for all that, however, in contrast, in spite of, nevertheless, notwithstanding, on the
contrary, on the other hand, regardless, still, though, yet, either, instead, neither, unless,
whereas
To give examples or intensify: after all, an illustration of, even, for example, for
instance, indeed, in fact, it is true, of course, specifically, that is, to illustrate, truly,
basically, essentially, in essence, certainly, no doubt, doubtless
To indicate place: above, adjacent to, below, elsewhere, farther, here, near, nearby, on
the other side, opposite, there, to the east, to the left, under, beneath, among, amid, behind
To indicate time: after a while, afterward, as long as, as soon as, at last, at length, at that
time, before, earlier, formerly, immediately, in the meanwhile, in the past, lately, later,
meanwhile, now, presently, shortly, simultaneously, since, so far, soon, subsequently,
then, thereafter, until, until now, when
To repeat, summarize, or conclude: all in all, altogether, as has been said, in brief, in
conclusion, in other words, in particular, in short, in simpler terms, in summary, on the
whole, that is, therefore, to put it differently, to summarize, to conclude, having
considered all of the above
To show cause or effect: accordingly, as a result, because, consequently, for this
purpose, hence, otherwise, since, then, therefore, thereupon, thus, to this end, with this
object, for this reason, obviously
To introduce counterargument:
others might believe
alternatives to others -some, people believing…., it, the author or a name, my opponents
alternatives to might - may, could, do, have
alternatives to believe – contend, assert, argue, maintain, claim, say, aver, allege
To introduce rebuttal:
However,…
But I believe the evidence shows….
While that might seem convincing,….
I think you will agree, however, that…
Nevertheless, I still contend…
21
Quoting/Paraphrasing Sources
Sample Sentence Starters
According to source …
A recent report in source states…
Source reports that …
An important fact from source is…
According to a recent study by source…
Source has determined that…
Research from source reveals that…
In order to solve the problem, source claims that…
Based on a recent study, source believes that…
Source has concluded that…
According to source and source…
22
Parenthetical Citations
Since 1988, the Modern Language Association (MLA) has recommended citing sources
in the text with parentheses rather than in footnotes or endnotes. Parenthetical citations
are there to give credit when the writer directly quotes someone, uses a visual from a
source, or paraphrases information that is not common knowledge from a source. The
following information must be cited:





Direct quotes
Statistics
Visuals
Opinions of experts/authors
Specific facts that are not common knowledge
Parenthetical citations should be kept as brief as possible. They should only provide
enough information for the reader to be able to locate them easily on the Works Cited
page at the end of the paper. The basic elements of parenthetical citations are:
1. The author’s last name
2. A shortened form of the title (when the author’s name is not given or when there
are multiple works by the same author)
3. The page number (if there is one)
Whenever possible, place the citation BEFORE the punctuation mark at the end of the
sentence containing the borrowed information. In extended quotations, such as lines of
poetry, the citation is placed after the final punctuation mark.
Works on the Internet are cited just like printed works. Web documents generally do not
have fixed page numbers, so these numbers are often omitted from parenthetical citations.
To avoid confusion when citing more than one Web page by a single author or Web
pages with the same title, include the final element of the URL. For example (Hansen,
michalos.html).
If the author’s name is mentioned in the text when quoted, only a page number is
necessary in the parentheses.
If you add a word or words in a quotation, you should put brackets around the words to
indicate that they are not part of the original text.
Jan Harold Brunvand, in an essay on urban legends, states: "some individuals
[who retell urban legends] make a point of learning every rumor or tale" (78).
23
If you omit a word or words from a quotation, you should indicate the deleted word or
word by using ellipsis marks, which are three periods (...) preceded and followed by a
space. For example:
In an essay on urban legends, Jan Harold Brunvand notes that "some individuals
make a point of learning every recent rumor or tale ... and in a short time a lively
exchange of details occurs" (78).
Place quotations longer than four typed lines in a free-standing block of text, and omit
quotation marks. Start the quotation on a new line, with the entire quote indented one
inch from the left margin; maintain double-spacing. Only indent the first line of the
quotation by a half inch if you are citing multiple paragraphs. Your parenthetical citation
should come after the closing punctuation mark. When quoting verse, maintain original
line breaks. (You should maintain double-spacing throughout your essay.) For example:
Nelly Dean treats Heathcliff poorly and dehumanizes him throughout her
narration:
They entirely refused to have it in bed with them, or even in their room,
and I had no more sense, so, I put it on the landing of the stairs, hoping it
would be gone on the morrow. By chance, or else attracted by hearing his
voice, it crept to Mr. Earnshaw's door, and there he found it on quitting his
chamber. Inquiries were made as to how it got there; I was obliged to
confess, and in recompense for my cowardice and inhumanity was sent out
of the house. (Bronte 78)
The following page shows examples of the most commonly used parenthetical citations.
Pay close attention to the use or absence of punctuation. The easiest way to determine
what goes in a citation is to look at the source card you wrote for that source and use
whatever the first element on that source card may be. In most cases it is the author’s last
name. If not, then use what you have. The page number you wrote on the note card will
complete the citation.
NOTE: EVERY CITATION MUST HAVE A MATCHING SOURCE LISTED ON
THE WORKS CITED PAGE, AND EVERY SOURCE LISTED ON THE WORKS
CITED PAGE MUST HAVE A CITATION SOMEWHERE IN THE PAPER.
24
Parenthetical Citation Examples
(Cohen 76)
one author
(76)
author’s name mentioned in the text
(Smith and Jones 103)
two authors
(Johnson et al. 149)
more than two authors
(Scott)
no page numbers available; interview
(Woolf 2: 115)
source has multiple volumes; this is volume 2
(Berstein 101; Strubb 8)
two sources cited at once
(Jones, The History… 31)
author has more than one work cited
(Sound and Poetry 44)
book/pamphlet cited; no author or author’s name
mentioned in the text
(“Hunger” 14)
short work/article cited; no author or author’s name
mentioned in text
(“Nordstrom,”npta.com)
web page cited; end of URL supplied for clarity
(“Solar…”)
web page cited (no page numbers used)
(qtd. in Lester 2)
indirect quotation; original speaker identified in text
25
Preparing a Works Cited Page
The final page of a research paper is a Works Cited page. This is a list of all the WORKS
that were CITED in the paper. If there is no corresponding citation in the paper, the
source cannot be listed on the Works Cited page. As shown in the sample on the
following page, the Works Cited page is written according to the rules of the Working
Bibliography.

It must be in alphabetical order according to the first letter of the first element of
the work. In the case of “A”, “An”, or “The”, the next word is used to determine
alphabetical placement on the Works Cited page.

If more than one work begins with the same word, the second word is used to
determine alphabetical placement (and so on).

If an author has more than one work on the list, three hyphens are used to replace
the author’s name in the second and/or subsequent works.

Reverse indentation is used. The source begins at the left-hand margin, and
subsequent lines are indented five spaces.

The page is double-spaced as is consistent with the entire research paper.

Numbering is never used to list the works.

There are no extra spaces between entries.

If an entry begins with a number, treat the number as a word for the purpose of
alphabetizing. For example, “12 Ways to Floss” should be alphabetized as if it
began “Twelve Ways….”
26
Last name #
Works Cited
“Acrylic Adventure.” Nails. Nov. 1997: 104-106.
“Acrylic Nails.” 12 Sept. 1997. 23 Oct. 1998 <http://www.pamcoacrylic.nails.com/
ntmessg/2645.html>.
Ahern, Jerry. West’s Textbook of Cosmetology. New York: Wadsworth, 1995.
Berne, Betty. “Nine-inch Nails.” Vogue June 1997: 173-176. Resource/One. CD-ROM.
UMI-PROQUEST. Aug. 1997.
Cosmetology. New York: Sheridan House, 1999.
“Dirty Nails.” The Edell Health Journal (Jan. 1990): 6 pgs. Search Bank. 8 Oct. 1998
<http://sbweb2.med.iacnet.com/infotrac/session/794>.
Furjanic, Sheila, and Jacqueline Flynn, eds. Milady’s Art and Science of Nail
Technology. Philadelphia: Milady’s Pub. Co., 1991.
Hamaker, Amy. “Clients Speak Out!” Nailpro. Aug. 1996:121-127.
---. “Norwegian Nails.” Nailpro. Aug. 1997: 158-161.
Kurt, Thomas L. Telephone interview. 12 June 1999.
Oleksey, Bette. Personal interview. 2 Oct. 1999.
Owens, Barbara (owensb@aol.com). “Acrylic Nails.” E-mail to Nikeeya Parsons
(niki@ravenet.com). 13 Aug. 2000.
“A Perfect Ten.” Seventeen Dec. 1998: 78.
“Primer for Nails.” Acrylicnails.com 8 Oct. 1997<http://www.acrylicnails.com/
vi03000.html>.
27
Research Paper – General Appearance

The paper must be typed on a computer-generated word processing program.

The paper should be double-spaced throughout.

The paper should have 1” margins all around.

The paper should be in 12-point Times New Roman font

A research paper does not need a title page. Instead, the following information
should be listed at the left-hand margin: the student’s name, the instructors’
names, English 12 and period, and the date (each on individual lines.) The next
line contains the title centered. The first word, last word, and all principle words
in the title should be capitalized. No other emphasis is needed.

A running header should be set up which includes the student’s last name and
page number. This header should appear at the upper right-hand corner, ½” from
the top of the page.

The paper should be fastened with a single staple in the upper left-hand corner.
The following pages contain a sample Senior Challenge paper from Action Plan through
final draft.
28
To:
Mrs. Wolhar, Ms. K Smith, and Mrs. Christina Smith
From:
Ima Student
Date:
September 12, 2006
Subject:
My Action Plan for Senior Challenge
For my problem “What do you do for a patient who is in the need of dentures?” I plan on
taking these steps in finding my information. My source and paper requirements include
having two books or periodicals, two Internet sites, and one interview. To locate my
sources of information, I will look online and use the key terms such as dentures, custom
trays, denture materials, skills, impression material, and skills. Sites that will be helpful in
finding this information would be search engines such as google.com and ask.com which
will assist me in locating web sites that have helpful information. Books will also be a
component I use. My shop books, as well as books I will check out in the library, will be
useful. Pamphlets found in dental offices will also hold information I could use.
Interviews will give me additional information from people in the dental field. I have
three people in mind that I could contact. They are Dr. Karen Carter, my dentist; Dr.
Hazuda, a past employer; and Barbara McKane, a past co-worker. These three people are
good candidates because they work with materials used in taking impressions and have
exposure to making and working with dentures. To contact them, I plan on calling and
making an appointment for an interview at a time that works best for them.
In addition to my paper, I am expected to construct a hands-on component or demonstrate
a skill related to my problem. I feel a demonstration of making a custom tray or taking an
impression would be best. Either of these would help me demonstrate I have an
understanding of the process it takes to construct dentures.
Assisting me during the Senior Challenge process will be my mentor, Mrs. K. Smith. I
know I need to meet with Mrs. K. Smith at least four times this semester. I will talk to her
after school so we can set a date and time to meet.
If anyone has questions or concerns, please feel free to contact me in school (my schedule
is below), by e-mail, or on my cell phone. My e-mail address is Imastudent@AOL.com.
My cell phone number is (302) 555-1234.
Period 1/2
Period 3/4
English 12
Math IV
Mrs. C. Smith
Mrs. M. Smith
Period 5/6 Co-op
Period 7/8 Co-op
29
Ima Student
September 25, 2006
Topic: Replacing a full set of teeth
Controlling Purpose or Thesis Statement:
Having to depend on Social Security does limit her options; however, Mrs. Elwood can
still receive a set of teeth. Her options include receiving either denture-supported
implants or dentures to replace the missing teeth.
PQS Questions:
1. What can cause a person to lose her teeth?
2. Why is it important for an edentulous person to replace her teeth?
3. What options are available for the edentulous person who desires to replace her
teeth?
4. What are dentures?
5. What is the procedure for making and fitting dentures?
6. What expenses can a patient who chooses to get dentures expect?
7. How does a person care for her dentures?
8. What are the advantages and disadvantages of dentures?
9. What are implant-supported dentures?
10. What is the procedure for making and placing implants?
11. What expenses can a patient who chooses to get implant-supported dentures
expect?
12. How does a person care for implant-supported dentures?
13. What are the advantages and disadvantages of implant-supported dentures?
14. How does a person choose between dentures and implant-supported dentures?
15. What is the dental assistant’s role in the care and treatment of an edentulous
patient?
30
Interview Questions
Name of interviewee:
Place of interview:
Date of interview:
Estimated time:
______________________
______________________
_______________________
________________________
1. What do you have to consider when determining the type of replacement for
permanent teeth?
2. How long would you say it takes for the oral cavity to shift enough to need to
adjust the dentures?
3. How often do you have denture patients return for adjustments?
4. How long does it take for the implants to be finished?
5. How many parts are there in an implant, and what are the parts?
6. What are some of the problems that can occur due to implants?
7. How much do implants cost, and what is a breakdown of the cost?
8. What are the most frequently asked questions from your patients?
9. What are the steps of the procedure?
10. Who gives the procedure, and what type of schooling do they have?
31
Ima Student
September 28, 2006
Interview Questions
With Dr. Karen Carter (family dentistry)
Q. What do you have to consider when determining the type of replacement for
permanent teeth?
 Successful previous wear of dentures
 Bone height and width
 Desires and what they are looking for: improvement or intentions.
Q. How long would you say it takes for the oral cavity to shift enough to need to adjust
the dentures?
 Every person’s mouth has a different pace.
 Implants maintain the bone.
Q. How often do you have denture patients return for adjustments?
 If it is successful, not often
 Usually if the denture is broken lose or they are having trouble.
Q. How long does it take for the implants to be finished?
 It depends on the person and what type they are receiving.
 The average implant insert takes 3 months to heal the gums
 Then you train the gum with a (cover) that takes a month
 Abutment about 4-8 months.
Q. How many parts are there to the implant?
 3 different parts
Q. How often do you see implant patients after they had their procedure?
 Once a year
Q. What problems can occur with implants?
 They could not be anchored in securely
 Some medical conditions can be, but they aren’t a limiting factor
 Implants can be lost but not often; because of how it was anchored
(usually).
Q. How much do the implants cost?
 Average &1,500- $2,000
 The abutment is about $100
 Crown $900-$1,200
 Denture implant: Implant + denture- $1,000-1,500
32
Q. With the denture implants would you only add 2 implants to anchor the denture?
 The more implants in the harder it is to remove.
 It all depends on the person and their needs
Q. What are the most frequently asked questions?
 It is going to hurt?
 Cost
Q. What is used to drill in the implant?
 A torqued drill with adjustable widths and lengths
Q. Who does the procedure?
 To place the implant - a periodontist or an oral surgeon
 Some dentists can specialize in implants and can do it in the office.
Name of interviewee: Dr. Karen Carter
Place of interview: Family Dentistry
Date of interview: September 28, 2006
Estimated time: 30 minutes
33
Ima Student
October 11, 2006
Senior Challenge Detailed Paper Outline
I. Introduction:
A. “A patient, Mrs. Elwood, comes into the dental office without teeth and is
on Social Security; what can be done to address her needs?”
B. More and more Americans are in need of false teeth because of
unfortunate accidents, periodontal disease, or other occurrences. How does
a person know what is the best way to go about replacing their teeth? Two
possible options are implant-supported dentures and dentures.
Determining which solution is best requires a consultation with the dentist.
C. The best solution for my patient would be dentures since cost is a limiting
factor.
II.
Problem:
A patient without any teeth comes to the dentist. The dental team will work
with the patient to determine which type of false teeth appliance would best
meet the patient’s needs and/or budget. Replacing the missing teeth will allow
the patient to eat and speak more normally and feel more self-confident. The
appliance will also help maintain the patient’s facial structure.
A. Causes of the Problem: There are several reasons a person might lose their
teeth. Some of the most common are:
1. One cause of tooth loss is as the result of an accident such as a
car crash or a fight.
2. A second cause of tooth loss is poor oral hygiene.
a. Poor oral hygiene results from decreased brushing and
flossing.
b. When a patient visits the dentist, as she should do every
six months, the hygienist will clean and check her teeth
for plaque/calculus buildup and decay.
c. The dentist will intervene and attempt to correct any
problems resulting from ineffective homecare.
d. Neglecting the dentist’s instructions for homecare can
make any problem worse.
3. A third cause of tooth loss is periodontal disease.
B. Consequences of the Problem: The patient is directly affected by this
problem. They will be the primary “victim” throughout the whole process.
1. Being edentulous could lead to difficulty eating.
2. The loss of one’s teeth can lead to a loss of self-confidence.
3. Also the muscles around the mouth will soon deteriorate if not
properly supported by the teeth.
III. Potential Solutions
A. First Option – Implant-Supported Dentures
1. Implants are a type of false tooth that is embedded into the gum
34
and bone.
2. The implants are stable because they are placed into the bone
and gum.
3. Implants have four different parts: the screw/cylinder, the
abutment, the bar attachment system, and the denture.
4. Placing the implants requires several steps.
a. An incision is made in the gum and a hole drilled in the
jawbone to hold the fixture.
b. The gums are sutured over the implant.
c. The gums are allowed to heal for two-six months during
which time a temporary denture is worn.
d. The implants are uncovered and a healing abutment
collar is worn for ten to fourteen days.
e. After two weeks, the permanent abutment is placed and
an impression is taken of the gums and implants.
f. The impression is used to create the bar attachment
system and teeth.
g. The final denture is created and fitted.
5. Implants are esthetically pleasing and relatively easy to
maintain.
6. The cost of the implant-supported denture is based on the costs
of several different procedures.
B. Second Option - Dentures
1. A denture is devise of false teeth that is placed over the patient’s
gums.
2. Each pair of dentures includes a maxillary (top teeth) and a
mandible (bottom teeth).
3. Fitting a patient with dentures requires several appointments.
a. At the very first appointment, the dentist will determines
if the oral cavity will allow proper support to hold and
maintain a denture.
b. At the second appointment impressions are taken. This
will be the bite registration.
c. Appointment three is the wax try in.
d. The fourth appointment will be the anterior try in.
e. The last appointment is scheduled when the dentures are
finished. The dentures are placed into the patient’s
mouth to make sure all is fitted correctly. If adjustments
need to be made, then another appointment will be
scheduled. If not, the dentist will send the patient home
with a satisfied smile and homecare instructions.
4. Taking care of the denture is important.
5. The cost of dentures depends on the complexity and quality of
the fixture.
35
IV. Preferred Solution
A. Ms. Elwood could be a candidate for either option.
B. Because of her financial limitations, dentures are the better choice.
36
Ima Student
October 20, 2006
Outline
I. Introduction
A. Briefly State Problem
B. Background Material/Bridge
C. Thesis/Solution
II. Problem
A. Fully State Problem
B. Causes of the Problem
C. Consequences of the Problem
III. Potential Solutions
A. First Option – Implant-Supported Dentures
1. Description
2. Procedure
3. Maintenance
4. Cost
B. Second Option - Dentures
1. Description
2. Procedure
3. Maintenance
4. Cost
IV. Preferred Solution - Dentures
A. Option Chosen
B. Reason for Choice
37
Ima Student
Mrs. Wolhar
Mrs. Smith
English 12, Period 1-2
1 November 2006
Replacing a Full Set of Teeth
Mrs. Kristine Elwood enters the dental office; she warmly greets the receptionist with a
toothless smile. It quickly becomes apparent that she will need to replace her permanent teeth
with an appliance containing a full set of artificial teeth. After Mrs. Elwood is seated in the
dental chair, the dental assistant kindly asks her if she has ever considered replacing her missing
teeth. Mrs. Elwood’s response is, “Yes, having teeth would make life much easier; however,
living on Social Security restricts my budget.” Having to depend on Social Security for financial
assistance does limit her options; however, Mrs. Elwood can still receive a set of teeth. Her
options include receiving either denture-supported implants or dentures to replace the missing
teeth.
Tooth loss can occur for several reasons. One cause is loss due to an accident or physical
injury. “Teeth may be injured during a fall or a sport activity. A tooth may be knocked out”
(“Mouth and Dental”). This occurrence is not as infrequent as many might think. People who are
engaged in sports are most likely to have this problem.
A second cause of tooth loss is poor oral hygiene. Poor oral hygiene begins as soon as a
person decreases their brushing and flossing activity. “Good oral hygiene is the back bone of
preventing dental disease” (Taintor and Taintor 17). “When we do not properly care for our
teeth, plaque, a sticky substance, loaded with bacteria, clings to our teeth” (Balshi 6). When
plaque is not removed after 24 hours, it begins to harden. The microorganisms in the plaque start
to produce acid that will erode the tooth structure. This acid eventually affects the gums if the
plaque is not properly removed. When a person has their regular dental check-up, the hygienist
Student 2
checks for plaque and will remove any buildup. If a dentist notices evidence of weak points in
homecare, the dentist will intervene and correct the situation as best she can (Taintor and Taintor
16). Should the patient neglect the dentist’s instructions, more calculus (tartar or calcified
deposits on the teeth) will develop. Soon the gums will begin to recede exposing the root of the
tooth (Balshi 6). “The roots are coated with cementum, a substance softer than enamel, which is
the hard thin coating covering the outer layer of the tooth, making them susceptible to decay”
(Balshi 6). Once the roots are exposed, the tooth is not firmly secured in the mouth and will fall
out.
Associated with poor oral hygiene is periodontal disease, which is a third cause of tooth
loss. Periodontal disease can be caused by either smoking or an increase in bacteria in the mouth
due to poor oral hygiene. The disease affects the tooth root, gums, supporting tissues, and bone
of the tooth. “The disease takes a rather predictable course, starting with bleeding gums and
advancing to swollen, inflamed and painful gums, ending with loosening teeth and then tooth
loss” (Schissel and Dodes 6). To detect the presence of periodontal disease, the dentist and
hygienist will use a periodontal probe to measure the pocket depth of the gums. Using this
method, the dentist can measure the degree of periodontal disease by the height of the gum.
When the probe reaches one-three millimeters, the gum is considered healthy. When the probe
reaches four, the gum is considered to be in the beginning stages of periodontal disease. A
measurement of five or higher would necessitate immediate treatment if the teeth and gums can
be saved. This treatment may include gum surgery. If the gum recedes too far from the teeth, the
pocket between the gum and the tooth becomes infected, gum tissue and bone are destroyed, and
the teeth may loosen and fall out or require extraction (“Periodontal …”).
1
Student 3
Once a patient begins to experience tooth loss, they face several challenges. One
significant challenge is difficulty eating. Teeth assist in chewing and breaking up food into
smaller particles for the body to digest. When teeth are no longer present, there is an absence of
hard surfaces to grind and shred food. This limits the variety of food choices a patient can eat.
Many patients who need to limit their choices do not enjoy the food choices available to them
(Davis). Soft foods will be most comfortable for the patient; however, they are not always the
most tasty to eat.
Leaving the house to go out in public requires confidence for anyone; when teeth are
missing, a person’s level of confidence is diminished. The patient feels embarrassed, so she
avoids eating, laughing, and going out in public, and she avoids forming close relationships
(Davis). This lack of self-confidence is a challenge to the patient because it affects her daily
activities. She is not able to enjoy the lifestyle to which she is accustomed.
A further challenge is dealing with the changes in facial appearance that occur with tooth
loss. “If teeth are lost due to caries or periodontal disease, the jawbone which held the missing
teeth will begin to deteriorate. In extreme circumstances, all of the alveolar process is lost, with
only the basal bone of the maxilla and mandible remaining” (Serio 10). When the alveolar
process is lost, the support structure for the teeth is gone, and the bones in the mouth begin to
resorb. This changes the base that the facial muscles rest on; the realigning of the facial muscles
changes the structure of the facial features. It is important to resolve the problem of missing teeth
so the muscles around the jawbone do not shrink or realign. Once the structure of the oral cavity
changes, it can be readjusted, but requires support to remain stable and functional. Artificial teeth
can be used to support the jaw and facial structure.
2
Student 4
Determining and discussing what type of appliance is appropriate will be the first step in
addressing the edentulous patient’s problem. One possible solution for a patient needing a full set
of artificial teeth would be implant-supported dentures. “The implants themselves are tiny
titanium posts which are inserted into the jawbone where teeth are missing” (Ettinger). “It acts as
an anchor for a false tooth or a set of false teeth” (Davidoff). Using implants to replace a full set
of teeth requires using a screw/cylinder inserted into the gum and bone, an abutment attached to
each screw/cylinder, and a bar attachment system designed to hold the denture in place attached
to the abutments. This is considered to be an implant-supported denture. The implants securely
hold the denture in the oral cavity. Implants supporting the denture can eliminate problems such
as dentures shifting and sores that are created from movement. “Dental implants integrate with
your jawbone, helping to keep the bone healthy and intact” (“Dental…”).
When a periodontist or oral surgeon places implants in the oral cavity, she makes an
incision in the gum and uses a torquing drill to cut a hole through the bone in order to place the
fixture. Different drill widths and lengths are used to create the proper-sized hole (Carter). Once
placed, the fixtures are covered by the gums, which are then sutured together. The gums will take
from two to six months to heal. A denture can be worn after approximately four weeks following
the procedure. If a denture is not already in use, a temporary denture will be made before the
surgery. Once the temporary denture is finished, a copy of it will be used as a guide to help the
surgeon place the implants in the proper positions for the bar attachment system (“ImplantSupported…”). Holes are drilled in the copy of the denture, so the surgeon can see where the
implants should be placed (“Implant-Supported…”). Once healed, the implants will be
uncovered by making an incision in the gums. A healing abutment collar, a round piece of metal,
3
Student 5
will be placed on the head of each implant for ten to fourteen days (“Implant-Supported…”).
After the two weeks, the permanent abutment will replace the healing collar. Once the gums are
healed enough, an impression will be taken of the gums and implants. This allows a model to be
used to construct the framework and teeth (“Implant-Supported…”). The framework consists of
a bar attachment system. This system attaches to the abutments, and the denture clips to it. After
the metal bar is adjusted and properly secured, the teeth are set in wax and will be tried in the
patient’s mouth. Following necessary adjustments, the dental lab will create the final denture.
Once the denture is constructed and set in acrylic, it will be clipped into the bar attachment
system, so it is secured in the oral cavity. For all practical purposes, the patient now has her full
set of teeth. “After a short time, you will experience a restored confidence in your smile and your
ability to chew and speak” (“Dental …”).
The denture must be removed and cleaned at least twice a day. The patient must go to the
dentist to have the dentures cleaned once every three months. At cleaning visits, the dentist will
check the fit and bite of the dentures. Any movement of the dentures can create sores, so regular
checking is necessary to avoid the development of irritation. The dentist will also check the
plastic clips, which usually need to be replaced every six to twelve months (“Implant-Supported
…”).
The patient must be aware that the cost for implant-supported dentures is based on
several procedures, not one. The surgical fee for the placement of the implant can range from
$900-$2,100. Many oral surgeons charge by the implant, with costs ranging from $1,500-$2,000
per fixture. The abutments cost around $395 each. The bar attachment and denture are an
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Student 6
additional charge. The general dentist’s fees, which include the manufacturer’s price and a
maintenance fee, will add to the total cost.
Mrs. Elwood may also consider dentures to solve her problem. “Generally made of
plastic or cast metal, dentures are custom-fitted to match and adhere to the upper or lower
jaw”(Doundoulakis 40). Dentures fit over the gums and are held in place by suction. They are
used to retain the oral cavity’s shape when they are in place inside the mouth. A full set of
dentures includes a maxillary (top teeth) and a mandible (bottom teeth). Dentures range in cost
from $500-$2,500. With dentures suction can be a problem, more so with the mandible because
of its horseshoe shape. This suction problem leaves the patient uncomfortable and prone to sores
since the dentures are shifting and sliding around.
Fitting a patient with dentures requires several appointments. Each appointment
accomplishes a task needed to create the final product. First, a consultation will be scheduled.
The consultation includes a discussion with the dentist concerning what is to be expected during
this procedure and an examination of the oral cavity to determine if it will provide proper support
to hold and maintain the denture. During the appointment, X-rays will be taken to assure the
dentist that the oral cavity is free of disease and any jaw conditions that would rule out the use of
dentures (Schissel and Dodes 113). Impressions will also be taken with an edentulous tray at this
appointment. Beading wax or a similar material will be used to cover the edges of the tray to
create a muscle mold to achieve closer adaptation of the impression tissues in the mucobuccle
fold (Bird and Robinson 838). The alginate impression will be used to fabricate a custom tray for
the next appointment. At the second appointment, elastometric impression material will be used
to fill the custom tray inserted into the patient’s mouth; this assures accuracy when the lab
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Student 7
creates the base plate and occulsal rims. The dental lab builds the base plate onto the master
casts, and then the occlusal rims are built of wax and attached to the base plate. During the third
appointment the base plate, which has been returned to the dental office, is checked for fit. The
occlusal rims are removed from the master cast, and the dentist records the vertical dimensions,
occlusal relationship, smile line, and canine eminence. This is necessary to ensure accurate bite
and comfortable fit. This appointment also includes finding the correct mold, shade, and material
that will be used for the artificial teeth. An occlusal registration, which includes the centric
relation, protrusion, retrusion, and lateral excursion, is required. These terms are all movements
of the patient’s jaw; the exaggerated motions simulate the actual movements of the mandible as
it functions in the acts of mastication, biting, yawning, and speaking (Bird and Robinson 839).
All of the information gained from this appointment will be sent to the dental laboratory and
used to create a wax try-in. Once the wax try-in is created, it returns to dental office, and the tryin appointment will be scheduled. The wax try-in consists of the base plate with the artificial
teeth that are set in wax. The patient will reenact the exaggerated movements that were done
during the third appointment. When the try-in fits and feels comfortable, it will be sent back to
the dental lab for the proper adjustments to be made and will be set in acrylic. Lastly, the
insertion appointment will include the patient trying on the final product - the denture. The
patient will get a feel for the denture by speaking and biting. If any part of the denture creates
sore spots, the dentist will make the necessary adjustments. After the patient feels comfortable in
the dentures, the dentist will send the patient home with a satisfied smile and homecare
instructions. In the beginning, the denture may feel awkward or bulky; however, the patient will
eventually become accustomed to wearing them (“Removable …”).
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Student 8
Taking care of the denture is important. Rinsing off food particles and brushing the
denture is suggested. Hand soap or mild dishwashing detergent is fine to use as long as the
denture is not exposed to harsh abrasives. When the patient is sleeping, the denture can be either
worn or removed. If the denture is removed, it must be kept moist. “At night, the denture should
be placed in a soaking solution or water”. “Over time, adjustments may be necessary”
(“Removable …”). The oral cavity could shift if the dentures are not fitting properly. Returning
to the dentist is important if the dentures become uncomfortable or break. Dentures can fall out if
they are not inserted properly, so being cautious is important. Dentures will improve a patient’s
outlook and daily activities by giving the patient confidence while eating, speaking, and smiling.
Like implant-supported dentures, the cost of dentures includes several appointments and
materials. The dentures range in price from a few hundred to a few thousand dollars, depending
on the complexity and quality of the workmanship and materials (“Dentures …”). Generally,
they are less expensive than implant-supported dentures.
Discussing the desires of what the patient is looking for whether it is improvement or
intentions determines the route the patient will decide to take (Carter). Mrs. Elwood’s initial
consultation revealed that she was on a restricted budget. Therefore, even though she is
physically a candidate for either option, due to her strict budget she must stay with the least
expensive appliance - dentures. While implants would keep the denture more stable in the oral
cavity, Mrs. Elwood cannot afford the cost of the implants. Dentures will supply enough stability
of the oral cavity for her to perform daily tasks such as speaking and eating. By wearing
dentures, Mrs. Elwood will solve her problem of being edentulous and still stay within her
budget.
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Student 9
Works Cited
Balshi, Thomas, et al. A Patient’s Guide to Dental Implants. Omaha, Nebraska: Addicus, 2003.
Bird, Doni L., and Debbie S. Robinson, eds. Modern Dental Assisting. Seventh ed. Philadelphia:
Saunders, 2002.
Carter, Karen. Personal interview. 28 Sept. 2006.
Davidoff, Robert. “Frequently Asked Questions about Dental Implants.” The Dental Implant
Source. 1996-2006. 25 Sept. 2006 <http://www.dental-implants.com/index.html>.
Davis, D. M. et al. “The Emotional Effects of Tooth Loss: A Preliminary Quantitative Study.”
British Dental Journal 188.9 (May 2000). Rpt. in BDJ. Nature. 1 Nov. 2001. 13 Oct.
2006 <http://www.nature.com/bdj/journal/v188/n9/full/4800522a.html>.
“Dental Implant Treatment Options.” American Academy of Periodontology. 11 June 2004. 26
Oct. 2006 <http://www.perio.org/consumer/2mb.htm>.
“Dentures Cost and Dentures Prices (sic).” Dental Find Dentist Directory. 26 Oct. 2006
<http://www.dentalfind.com/Denture_Cost/>.
Doundoulakis, James. “Tooth Replacement.” The Perfect Smile. New York: Healthy Living,
2004. 40-41.
Ettinger, David B. “Dental Implants.” Delaware Center for Oral Surgery and Dental Implants.
24 Oct. 2006 <http://www.deoms.com/den_index.html>.
“Implant-Supported Denture.” Colgate World of Care. 22 Feb. 2005. 23 Oct. 2006
<http://www.colgate.com/app/Colgate/US/OC/Information/OralHealthAtAnyAge/
Seniors/DenturesAndDentalImplants/ImplantSupportedDenture.cvsp>.
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“Mouth and Dental Injuries.” WebMD. 17 Nov. 2004. 18 Oct. 2006
<http://www.webmd.com/hw/dental/hw240709.asp>.
“Removable Partial Dentures.” American Dental Association. 14 Mar. 2005. 26 Oct. 2006
<http://www.ada.org/public/topics/dentures_partial_faq.asp>.
“Periodontal (Gum) Diseases.” American Academy of Periodontology. 10 Mar. 2006. 26 Oct.
2006 <http://www.perio.org/consumer/2a.html>.
Schissel, Marvin J.and John E. Dodes. “For the Dental Consumer.” Afterword. The Whole Tooth.
By Schissel and Dodes. New York: St. Marvins, 1997. 49 86 112-117 133.
Serio, Francis G. Dental Health. Jackson: UP of Mississippi, 1998. 10-12 44-46.
Tainor, Mary Jane, and Jerry F. Taintor. The Complete Guide to Better Dental Care. New York:
Facts on File, 1997
9
Student, Ima. “Replacing a Full Set of Teeth.” Paul M. Hodgson VocationalTechnical High School. 7 November 2006.
Problem Statement – A patient, Mrs. Elwood, comes into the dental office without teeth
and is on Social Security; what can be done to address her needs?
Once Mrs. Elwood entered the dental office, it became apparent that she would be in
need of a full set of artificial teeth. Since her income comes primarily from Social
Security, Mrs. Elwood felt purchasing an appliance would be out of the question. Even
with her limited income, Mrs. Elwood can still receive a set of teeth. Replacing her teeth
is important due to the effects missing teeth can have on the oral cavity. Without teeth,
patients experience difficulties eating, a decrease in self-confidence, and changes in facial
features. These problems can be diminished once a patient is fitted with a full set of
artificial teeth. Two solutions are available for Mrs. Elwood, either implant-supported
dentures or dentures. Implants are integrated into the jawbone to act as an anchor for a set
of teeth. Implants eliminate the problem of shifting and sliding that dentures tend to cause
and keep the oral bones healthy and intact. Due to the surgery involved, the cost of
implants is high. Dentures fit right over the gum, using suction to stay in place. Dentures
tend to slide around in the oral cavity, causing sores. The average cost of dentures is
usually lower than that of implants. Although implant-supported dentures are more secure
in the oral cavity than dentures, this solution is too expensive for Mrs. Elwood’s budget.
Dentures will be less expensive and will also help maintain the structure of the oral cavity
well enough for her to eat what she desires and feel self-confident.
Ima Student
March 9, 2007
Panel Presentation Outline
I. Introduction
A. Greeting
B. Overview
II. Problem
A. Fully State Problem
B. Causes of the Problem
C. Consequences of the Problem
III. Potential Solutions
A. First Option – Implant-Supported Dentures
1. Description
2. Procedure
a. Describe steps involved
b. Demonstrate dental assistant’s role
3. Maintenance
4. Cost
B. Second Option - Dentures
1. Description
2. Procedure
a. Describe steps involved
b. Demonstrate dental assistant’s role
3. Maintenance
4. Cost
IV. Preferred Solution - Dentures
A. Option Chosen
B. Reason for Choice
V. Conclusion
A. Thank Panel
B. Invite Questions
1