1 - Diagnosis & Tx Planning Flashcards
What is a treatment plan?
The sequential guide for the pt’s care as determined by the dentists diagnosis for the restoration to and/or maintenance of optimal oral health
What needs to be done BEFORE tx planning?
- Chief Complaint
- Medical History
- Dental History
- Radiographs
- Head, Neck and Oral Cancer Exam
- Periodontal Exam
- Hard Tissue Exam
- Occlusion Exam
- Articulated Diagnostic Casts
- Consults by Specialists if needed
What is the definition of a chief complaint?
Subjective statement made by a patient describing the
* most significant or serious symptoms or
signs of illness
* or dysfunction that caused him or her to seek dental care
A chief complaint is always written in the __________ own ________
Patients; words
What are types of dental chief complaints?
- Fractured tooth
- Pain and swelling
- Exudate and bleeding
- Cosmetic
- Teeth cleaning
What is the definition of a medical history?
the patient’s past and present which may contain relevant information bearing on their health past, present, and future
What is medical history an account of?
all medical events and problems a person has experienced is an important tool in the management of the patient
What are examples of CHRONIC medical conditions?
- Diabetes
- High Blood Pressure
- High Cholesterol
- Thyroid Conditions
- Heart Conditions
- Liver Conditions
- Kidney Conditions
- Neurological/Mental
Health Conditions - Lung Conditions
- Auto Immune Diseases
- Cancer
- HIV
What are examples of ACUTE medical conditions?
- Bell’s Palsy
- Upper respiratory infection
- Trauma
- Flu
- Ear infections
- Appendicitis
- Etc…..
Are you more likely to see acute or chronic conditions in a dental office?
Chronic
What is the definition of dental history?
written documentation of a patient’s oral health covering all particulars of disease and therapy
What are examples of closed-ended dental questions?
- Are you in pain?
- Did you want your teeth cleaned?
- Do you want a partial to replace these teeth?
- Are you in good health?
- Do you take any medications?
What are examples of open-ended dental questions?
- How did you lose your tooth?
- Tell me about your last dental appointment.
- What brought you in today?
- Why did you decide against a root canal?
- What is hurting you today?
What kind of screening radiograph do you give an edentulous pt?
Panoramic radiograph
What kind of screening radiograph do you give a partially edentulous (less than 10 teeth) pt?
Panoramic and PAs of remaining teeth
What kind of screening radiograph do you give a dentulous pt w/ no significant history of dental disease?
panoramic and 2-4 BWs, isolated Pas
What kind of screening radiograph do you give a dentulous pt w/ history of dental disease?
FMX
What kind of screening radiograph do you give a dentulous pt w/ history of dental disease & third molars?
FMX and panoramic
What is an oral cancer screening?
Examination performed by a dentist or doctor to look for signs of cancer or precancerous conditions in your mouth
What is the goal of oral cancer screening?
Identify mouth cancer early, when there is a greater chance for a cure
What are diagnostic tools used for a head, neck and oral exam?
VELScope, brush biopsy
What is a perio exam an exam of?
Exam of teeth and dental implants
What is a perio exam done to evaluate?
Topography of the gingiva and related structures
What does a perio exam measure?
Probing depths
Width of keratinized tissue
Gingival recession
Attachment level
What are measurements from a perio exam used to evaluate?
The health of subgingival areas
What measurements help assess clinical furcation status and detect endodontic-periodontal lesions?
Bleeding on probing and suppuration
What does a perio exam assess the presence, degree, and/or distribution of?
Plaque/biofilm, calculus, and gingival inflammation
What needs to be charted from a hard tissue exam?
- Previous Dental Work
- Positional Conditions (Rotated Teeth, Tipped Teeth, etc.)
- Diagnostic Conditions (Caries, Defective restorations, Occlusal Wear, Abfractions/Erosions, etc.)
- Endodontic Conditions (Periapical Abscess, Symptomatic tooth, Sinus Tract, etc)
What does an occlusal exam measure?
Orthodontic classification
Occlusal interferences
Centric relation
What is the definition of occlusal interference?
Any tooth contact that inhibits the remaining occluding surfaces from achieving stable and harmonious contacts
What are 3 signs of INstability?
- Hypermobility of teeth
not related to
Periodontal disease. - Excessive Wear
- Change in tooth
position
What are 5 signs of stability?
- Tempromandibular Joints are healthy
and stable - All teeth are firm
- No excessive wear
- All teeth have stayed in their present
position - Supporting Structures are healthy
What are 5 requirements for stability?
- Stable TMJ
- Anterior guidance in harmony with mandibular
function - Non interfering posterior teeth
- All teeth in vertical harmony with contraction of elevator muscles.
- All teeth in horizontal harmony with the neutral
zone
What does it mean to have non interfering posterior teeth?
- Equal intensity contacts in Centric Relation
Occlusion (CRO) or Centric Occlusion (CO) - Posterior disclusion when condyles leave
Centric Relation
What does it mean to have all teeth in horizontal harmony with the neutral zone?
Neutral zone definition is the area where the forces exerted by the tongue are
balanced by the forces exerted by the musculature of the cheek and lips
When should mounted casts be mounted with a facebow transfer?
for extensive (3 units or more) crown and bridge work and for removable partial dentures
What should be taken to tx planning appts with faculty when formalizing a tx plan?
UNmounted casts
What is required for anterior crowns, FPDs and/or veneers?
Custom guide table
What are things that would require a consult by a specialist?
- Periodontal Disease
- Removable Prosthodontic Treatment
- Fixed Prosthodontic Treatment (but not single crowns)
- Oral Lesion
- Oral Surgery for Multiple Extractions
