clinical examination and testing Flashcards
The Objective of Clinical
Testing is to?
The Objective of Clinical
Testing is to reproduce
chief complaint and find
an etiology for the
patient ́s pathosis.
Clinical Testing is
performed based on?
performed based on CC.
info to collect during pt interview
- CHIEF COMPLAINT & Relevant Dental HX.
- Complete Medical HX (supplemental as necessary)
Blood Glucose
PT time
Pregnancy test - Rx Medications Taken (dose/
frequency) - Supplements
or other non Rx
DRUGS
when to do interview and vital signs
Do the Patient Interview and Vital Signs together
starting with the walk back from the waiting are
Intraoral Examination
when its an emergency
new pt?
If it is emergency or pain related: Do a “problem focused exam”
If it’s a new patient; Do the
prescribed exam sequence
tests used in AOS
You can do palpation/
percussion testing,periodontal
probing and mobility testing in
the specific Area Of Suspicion
(AOS)
what to note in intraoral exam
note tissue color,
consistency swelling , DST, and
any inconsistencies or
irregularities.
Periodontal and Mobility testing methods
Take at least 6 probings on each tooth.
Turn the probe around; add a
mirror handle on the lingual/
palatal and wiggle the tooth to
test mobility
Palpation
what to look for?
gently feel the Tissues
Look for:
Tenderness
Swelling
Unusual texture, color or
composition
Draining sinus tract (DST)
root palpation due to ortho
can lead to roots being placed outside the bone and can be palpated, leads to some discomfort but not pain
A DST usually is associated with?
Pulp is expected to be _________?
pain?
A DST usually is associated with a CHRONIC Apical
Abscess;
Pulp is expected to be necrotic Most are minimal pain or none due to drainage.
tracing DST?
trace with gutta percha cones and radiograph
percussion testing
where to start? why?
gently tap on the teeth
NEVER start on the suspected tooth!!
You are trying to establish a BASE-LINE of normal response for this patient
Begin your percussion testing GENTLY in an area of the mouth NOT RELATED to the
Area Of Suspicion
MAINTAIN a CONSISTANCY of
percussion technique on ALL teeth tested
how to determine post teeth restorability?
Appropriate Radiographs for diagnostic purposes
Radiographs must be “Diagnostic” in quality
Peri-Apical films are required to see the surrounding tissues
Straight-on and Angled P/A (Shift Shot 20º change in horizontal angulation)
Bite Wing film (B/W XR) on posteriors to determine RESTORABILITY
Pulp Sensibility Test
Assessment of pulp sensory response.
Sensibility test is defined as an ability to respond to stimulus,
and this is therefore an accurate and appropriate term for typical and common clinical pulp tests, such as thermal and electrical tests, given that they do not detect or measure the blood supply of the dental pulp