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Endo > Clinical Examination and Testing > Flashcards

Clinical Examination and Testing Flashcards

1
Q

What do you need to find out in the patient interview?

A
  1. Complete medical history
  2. Rx Medicaitions
  3. Supplements
  4. Chief Complaint
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2
Q

What is included/supplemental in a complete medical history?

A
  • blood glucose
  • PT time
  • Pregnancy test
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3
Q

What should you document from the patient interview?

A

a. Get an accurate Health History and Meds Taken
b. Patient’s CC, symptoms & related dental HX
c. Are other tests needed? (M.D. consult, etc. p.r.n.)
d. How can you help them: Expectations/Desires

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4
Q

What is the outline of an objective examination?

A
  1. VITAL SIGNS
  2. EXTRAORAL EXAMINATION
  3. INTRAORAL EXAMINATION
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5
Q

What vital signs do you need to get during the examination?

A
  • Blood Pressure
  • Respiratory rate
  • Pulse
  • Temperature should be taken in patients reporting swelling or signs and symptoms
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6
Q

What do you need to notice on an extraoral examination?

A

GENERAL APPEARANCE
- Skin tone
- Facial Asymmetry
- Swelling
- Discoloration, redness
- Extraoral scars or sinus Tract
- Lymphadenopathy

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7
Q

What would you look for during an intraoral examination?

A
  • Tenderness
  • Swelling
  • Unusual texture, color or
    composition
  • Draining sinus tract (DST)
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8
Q

Take at least ___ probings on each tooth in the area of suspicion

A

6

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9
Q

What is important to look for during periodontal eval?

A

blanching

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10
Q

How do you test a tooth for mobility?

A

Turn the probe around; add a mirror handle on the lingual/palatal and wiggle the tooth to test mobility

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11
Q

Why test tooth mobility?

A

determine status of PDL

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12
Q

What does this show?

A

DST
- draining sinus tract

can insert Gutta Percha to determine location origin

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13
Q

What is percussion during an intraoral examination?

A
  • gently tapping on the tooth (incisal or occlusal surface)
  • do not start with the suspected tooth
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14
Q

Why should you not start with the suspected tooth during endo testing (percussion, etc.)?

A

You are trying to establish a BASE-LINE of normal response for this patient

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15
Q

Maintain a ___________ of percussion technique on ALL teeth tested

A

CONSISTANCY

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16
Q

Radiographs must be ________ in quality

A

Diagnostic

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17
Q

_____________ films are required to see the surrounding tissues

A

Peri-Apical

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18
Q

What type of peri-apical films can be used to view surrouding tissues?

A

Straight-on and Angled P/A

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19
Q

Bite Wing film on posteriors to determine…

A

RESTORABILITY

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20
Q

What is the definition of a sensibility test?

A

ability to respond to stimulus, and hence this is 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

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21
Q

What are the rules for thermal and EPT testing in the mouth?

A
  1. Teeth to be tested are properly ISOLATED & DRYED
  2. Place COLD cotton pellet on facial tooth surface
  3. Patient’s hand should go up immediately (If NOT hold cotton on tooth until it does)
  4. Observe the seconds until patient’s hand goes down
  5. Then go to next tooth and repeat
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22
Q

What are you looking for during thermal and EPT testing?

A
  1. What is NORMAL for this patient at this time
  2. What is decidedly DIFFERENT for a particular tooth
  3. The TIME to RECOVERY is much more important than the SEVERITY of PAIN reported
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23
Q

What is signficant for thermal cold testing?

A

the period of time to return to normal following cold stimulation

24
Q

What is NOT signficant for thermal cold testing?

A

The intensity of discomfort

25
Q

A “lingering” discomfort for more than _____ seconds is significant.

A

20-30

26
Q

Normal discomfort is _____ seconds but varies from patient to patient.

A

3-8

27
Q

All endo testing results mean NOTHING without _________ for each Patient

A

BASE-LINE

28
Q

Sensitivity to COLD is considered to be a symptom of…

A

EARLY pulpal inflammation

29
Q

Sensitivity to _____ is considered to be a symptom of EARLY pulpal inflammation

A

COLD

30
Q

Sensitivity to HOT is a sign of…

A

LATE stage of pulpal inflammation

31
Q

Sensitivity to ____ is a sign of LATE stage of pulpal inflammation

A

HOT

32
Q

Why is sensitivity to hot a sign of later state pulpal inflammation?

A

indicates that gas is being produced via deterioration of the pulp

33
Q

When would a patient find relief from cold water and may even bring cold water with them?

A

LATE stage pulpal inflammation

34
Q

Heat testing is NOT performed unless the chief complaint of the patient is pain produced by…

A

warm liquids

35
Q

Normal teeth are or are not sensitive to HOT?

A

are not

36
Q

How do you perform a heat test?

A
  • If hot testing is required, (isolate 1 tooth at a time with rubber dam).
  • Heat water to 140 degrees F and drip on isolated tooth.
  • Keep cold water handy to cool tooth if hot sets it off
37
Q

What does it indicate if you get no response on a single tooth with a normal baseline on other teeth?

A

may mean Necrotic Pulp - RCT indicated

38
Q

If no response (NR) on most or all teeth:

A

Probably older person and you should TEST WITH EPT

39
Q

What should you test with if thermal testing is unclear?

A

EPT

40
Q

What is EPT?

A

electric pulp tester

41
Q

How do you perform an EPT (electric pulp tester)?

A
  • DRY the teeth and ISOLATE with Cotton Rolls.
  • Place a small dab of tooth paste (conductor) on facial of each tooth to be tested.
  • Must develop BASE-LINE first here also.
42
Q

What does a low EPT reading mean?

A

healthy

43
Q

What does a high EPT reading mean?

A

possibly necrotic

44
Q

Can you do EPT (electric pulp tester) with crowns?

A

No

45
Q

What if you have symptoms on a tooth with NO Caries, NO Trauma, NO Restorations?

A

Suspect an axial crack

46
Q

How do you test for an axial crack?

A
  • Radiographs
  • Biting Tests with “Tooth Slooth”
  • Periodontal probing
  • Transillumination
47
Q

What does a tooth slooth allow for?

A

This Instrument allows us to have the patient bite on individual cusp tips to help identify an axial crack.

48
Q

What happens to a normal tooth during transillumination?

A

normal tooth lights up like a light bulb

49
Q

What happens to a cracked tooth during transillumination?

A

An Axial Crown Fracture will NOT allow light to pass through the line of fracture

50
Q

What might need to be removed to view a crack?

A

restoration

51
Q

Where is the number 1 prevalence of cracks?

A

Mandibular 2nd Molar

52
Q

Where is the number 2 prevalence of cracks?

A

Maxillary Premolars

53
Q

What are periodontal ways to suspect an axial crack?

A
  • drop-off pocket
  • unusual bone loss
54
Q

Is this tooth treatable or non-treatable?

A

treatable

55
Q

Is this tooth treatable or non-treatable?

A

non-treatable

56
Q

THE accuracy of your diagnosis and the appropriateness of your treatment depends entirely upon…

A
  • The thoroughness of your Clinical Examination & Clinical Testing
  • Your Interpretation of Results, Symptoms and Radiographs
57
Q

Everything you do following an inaccurate diagnosis is…

A

WRONG

Endo (18 decks)

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