Examination,Diagnosis1.ppsx
- 1. Examination, Diagnosis, and Treatment Planning By: Dr. P. Mahjoub 1
- 2. Recommendations for Pediatric Oral Health Assessment, Preventive Services, and Anticipatory Guidance/Counseling 2
- 3. Initial Parental Contact With The Dental Office The information recorded by the receptionist during this conversation constitutes the initial dental record for the patient Filling out a patient information form is a convenient method of collecting the necessary initial information 3
- 4. Preliminary Medical And Dental History Familial history Child’s social and psychological development History of hospitalization for general anesthetic and surgical procedures The presence of current illnesses or history of relevant disorders Potentially communicable infectious conditions Current recommended childhood immunization schedule Previous care in the dentist’s office Current oral hygiene habits Previous and current fluoride exposure 4
- 5. Clinical Examination General growth and health Chief complaint, such as pain Extraoral soft tissue and temporomandibular joint evaluation Intraoral soft tissue Oral hygiene and periodontal health Intraoral hard tissue Developing occlusion Caries risk Behavior 5
- 6. Clinical Examination General growth and health • Size, stature, gait, or involuntary movements • Hair, head, face, neck, and hands - Elevated temperature - Cold, clammy hands or bitten fingernails - Callused or unusually clean digit - Clubbing of the fingers or a bluish color in the nail beds - Head lice - Ringworm - Impetigo 6
- 7. Clinical Examination General growth and health 7
- 8. Clinical Examination General growth and health 8
- 9. Clinical Examination General growth and health 9
- 10. Clinical Examination General growth and health 10
- 11. Clinical Examination General growth and health 11
- 12. Clinical Examination Chief complaint 12
- 13. Clinical Examination Extraoral soft tissue and temporomandibular joint evaluation • Palpation of the patient’s neck and submandibular area - Unusual tenderness or enlargement • Speech - The positions of the tongue, lips, and perioral musculature during speech, while swallowing, and at rest • Palpating the head of each mandibular condyle • Observing the patient while the mouth is closed (teeth clenched), at rest, and in various open positions 13
- 14. Clinical Examination Extraoral soft tissue and temporomandibular joint evaluation 14
- 15. Clinical Examination Intraoral soft tissue • The buccal tissues, lips, floor of the mouth, palate, and gingiva • The tongue and oropharynx - Enlarged tonsils accompanied by purulent exudate • Any unusual breath odors and abnormal quantity or consistency of saliva 15
- 16. Clinical Examination Intraoral soft tissue 16
- 17. Clinical Examination Oral hygiene and periodontal health • Periodontal screening and recording program (PSR) - Early detection of periodontal diseases with a simplified probing technique and minimal documentation - Following eruption of the permanent incisors and the first molars - Immunodeficient children are especially vulnerable to early loss of bone support 17
- 18. Clinical Examination Intraoral hard tissue and Developing occlusion • The patient’s facial profile and symmetry • Molar, canine, and anterior segment relationships • Dental midlines • Relation of arch length to tooth mass • More detailed evaluation and analysis are indicated when significant discrepancies are found during critical stages of growth and development • The teeth should be inspected carefully for evidence of carious lesions and hereditary or acquired anomalies • The teeth should also be counted 18
- 19. Clinical Examination Behavior • Wright’s clinical classification: - Cooperative - Lacking in cooperative ability - Potentially cooperative • Frankl behavior rating scale: - Rating 1: Definitely negative - Rating 2: Negative - Rating 3: Positive - Rating 4: Definitely positive 19
- 20. Uniform Dental Recording Basic requirements for a tooth-charting system: 1. Simple to understand and teach 2. Easy to pronounce in conversation and dictation 3. Readily communicable in print and by wire 4. Easy to translate into computer input 5. Easily adaptable to standard charts used in general practice 20
- 21. Uniform Dental Recording The Universal system Permanent teeth uses the numbers 1 to 32, beginning with the upper right third molar (no. 1) and progressing around the arch to the upper left third molar (no. 16), down to the lower left third molar (no. 17), and around the arch to the lower right third molar (no. 32). The primary teeth are identified in the universal system by the first 20 letters of the alphabet, A through T. 21
- 22. Uniform Dental Recording The two digit system • The first digit indicates the quadrant and the second digit the type of tooth within the quadrant • Quadrants are allotted the digits 1 to 4 for the permanent teeth and 5 to 8 for the primary teeth in a clockwise sequence, starting at the upper right side • Teeth within the same quadrant are allotted the digits 1 to 8 (primary teeth, 1 to 5) from the midline backward 22
- 23. Radiographic examination When indicated, radiographic examination for children must be completed before a comprehensive oral health care plan can be developed Subsequent radiographs are required periodically to enable detection of incipient caries lesions or other developing anomalies 23
- 24. Treatment Proposed The individual teeth that require restorative procedures, endodontic therapy, or extraction are listed Gingival areas requiring follow-up therapy are also noted 24