3/4: Types of Dental Clinical Examinations

Question 1

The foundation of any form of successful treatment is _________________

Answer 1

Accurate diagnosis

Question 2

What is diagnosis the bridge between?

Answer 2

The study of disease and the treatment of illness

Question 3

_______ before you _______

Answer 3

Inform; perform

Question 4

If it isn’t written, it ___________________

Answer 4

Didn’t happen

Question 5

What are types of clinical examinations?

Answer 5

• comprehensive dental diagnosis
• periodic/recall/recare diagnosis
• diagnosis of a specific problem
• emergency diagnosis
• screening diagnosis

Question 6

The diagnostic method can be modified to most effectively do what?

Answer 6

Address the needs of the patient (Chief complaint)

Question 7

What does the diagnostic method alter?

Answer 7

The amount of diagnostic information collected initially and the scope of diagnostic decisions made by the clinician

Question 8

What are examples of chief complaints that require immediate attention?

Answer 8

Pain, acute infection, bleeding or traumatic injury

Question 9

What can chief complaints also be a request for?

Answer 9

Less urgent care

Question 10

What do you do if a patient reports several complaints?

Answer 10

List in order of priority, AS STATED BY THE PATIENT

Question 11

What is the most extensive diagnostic assessment?

Answer 11

Comprehensive dental diagnosis (initial dx, IOE)

Question 12

What is comprehensive dental diagnosis appropriate for?

Answer 12

The patient who requests total dental care and HAS NOT BEEN EVALUATED PREVIOUSLY

Question 13

What patients are comprehensive dental diagnosis used for?

Answer 13

• patient of record who has not been seen in several years (3-5)
• patient of record who has had major change in medical/dental history

Question 14

What starts the minute you see the patient when performing a comprehensive dental diagnosis?

Answer 14

Physical exam and assessment

Question 15

What does a detailed medical history assess?

Answer 15

Systemic diseases
Surgeries
Current medications (both RX and OTC)
Allergies
Establish ASA class

Question 16

What is included in a comprehensive dental diagnosis?

Answer 16

Physical exam and assessment
Detailed medical history
Intra/extra oral evaluation and perioral/periodontal conditions
Dental radiographs
Diagnostic casts

Question 17

What does comprehensive dental diagnosis data reflect?

Answer 17

The patient’s initial status, which serves for comparison later in assessing treatment effectiveness

Question 18

What requires a considerable time, but provides a sound diagnostic foundation for comprehensive dental care?

Answer 18

Comprehensive dental diagnosis

Question 19

What does comprehensive dental diagnosis protect the clinician by?

Answer 19

Documenting the patient’s initial status if treatment complications lead to accusations of sub-standard care

Question 20

What are medical emergencies typically seen in a dental office?

Answer 20

Vasovagal syncope (63%)
Angina (12%)
Epileptic seizures (10%)
Choking (5%)
Asthma (5%)
Vasovagal syncope

Question 21

What is periodic (recall) appropriate for?

Answer 21

A patient who requests total dental care when the results of a prior comprehensive dental diagnosis are available

Question 22

What do you assume in a periodic diagnosis?

Answer 22

Portion of past information is still accurate but other aspects of the patient’s medical/dental history may have changed

Question 23

What month interval are periodic diagnosis?

Answer 23

6 month

Question 24

What is the goal in a periodic diagnosis?

Answer 24

Identify the conditions that have changed and supplement the prior database so that it reflects the patient’s current status

Question 25

What is a periodic diagnosis as simple as?

Answer 25

Asking patient if there has been changes since the last appointment (always good practice regardless of the time interval)

Question 26

What is a periodic diagnosis as complex as?

Answer 26

Repeating most of the comprehensive dental diagnosis

Question 27

What do updates that come from a periodic exam do for a dentist?

Answer 27

Refamiliarize the dentist with the patient's original conditions and provides the new findings for comparison

Question 28

What do you do if a different clinical conducted the original diagnosis?

Answer 28

The current dentist must confirm the accuracy of prior data and record current findings prior to diagnosis decisions (almost like doing a comprehensive exam)

Question 29

What is the dentist frequently asked to provide an opinion regarding?

Answer 29

A specific problem - for a recently evaluated patient (second opinion)

Question 30

What is the soap evaluation an effective approach to?

Answer 30

Such situations if the available diagnostic database is current and accurate - soap form is in axium

Question 31

What is "s" in the SOAP form?

Answer 31

S-Subjective information or symptoms of the condition as supplied by the patient. Patient's chief concern or complaint. It is recorded in the patient’s own words S- “Toothache on the upper right for the last 2 weeks-getting worse.” Patient reports pain to cold and hot, duration 5-10 minutes, loss of sleep and requires Motrin 3-4 x day

Question 32

What is the "O" in the SOAP form?

Answer 32

O-Objective or physical findings of the clinician. Includes visual findings, periodontal assessment, clinical tests (percussion, palpation, vitality tests) O- # 3Grossly decayed (+) response to percussion & palpation,(-) swelling, mobility. #3 is non-vital to electric pulp testing(EPT), no apical change interpreted on the periapical radiograph

Question 33

What is the "A" in the SOAP form?

Answer 33

A-Analysis or clinical impression of the condition by the clinician This is the diagnosis A-Caries, necrotic pulp, -tooth is restorable

Question 34

What is the "P" in the SOAP form?

Answer 34

P-Plan or recommended management of the problem. May be specific treatment, referral, or dismissal of the condition as clinically insignificant P- Discussed treatment options including RCT and crown vs. extraction. Risk/benefits of each procedure explained. Patient prefers RCT and understands that the tooth may need crown lengthening procedure

Question 35

What are emergency diagnosis designed to manage?

Answer 35

A chief complaint such as pain, bleeding, or acute infection that requires immediate attention

Question 36

What is the comprehensive diagnostic evaluation sacrificed in?

Answer 36

The interest of providing attention to the urgent problem

Question 37

What is limited in most aspects to the chief complaint?

Answer 37

Physical examination

Question 38

What can be demanding because the patient's concern of the "CC" can interfere with obtaining an adequate patient history?

Answer 38

Emergency diagnosis

Question 39

What do screening diagnosis answer?

Answer 39

A specific question about the patient

Question 40

What are screening diagnoses evaluation limited to?

Answer 40

Obtaining the information needed to answer the question without accepting comprehensive diagnosis or treatment responsibility for the patient

Question 41

Why do institutions rely on screening diagnosis?

Answer 41

To determine the patient's general dental treatment needs *see this when students are looking for board lesions

Question 42

What is the most common symptom arising in the mouth, face, and neck area?

Answer 42

Pain

Question 43

What is the most common reason for emergency appointments?

Answer 43

Pain

Question 44

What is pain?

Answer 44

Subjective and unlike an ulcer, there may be nothing to assess visually

Question 45

What do you need to be as a dentist?

Answer 45

Good listener and have good follow up questions

Question 46

What are questions to ask when diagnosing pain?

Answer 46

How would you describe the pain? - dull/throbbing, sharp/stabbing, burning - when did you first notice it? - is the pain continuous or does it go away? How long does it last? - does it wake you up at night? - Has it gotten better/worse or stayed the same? - anything make it worse? anything make it better? - have you taken anything for the pain?

Question 47

Pain arising from pathology is usually _________

Answer 47

Unilateral

Question 48

What may indicate an inefective organ?

Answer 48

Swelling, discharge, bad taste, bad breath, elevated temperature, malaise or cervical lymphadenopath