making a diagnosis Flashcards
what are the steps involved in making a diagnosis?
history (gives diagnosis in 75% of cases)
examination (signs)
(provisional diagnosis)
special tests/ investigations
definitive diagnosis
treatment plan
when does the extraoral examination start?
as soon as they walk through the door
what should be assessed in the extraoral examination?
- Tempromandibular Joints
- Muscles
- Nodes
- Symmetry
- Aesthetics
what are the steps involved in history taking?
complaining of
history of presenting complaint (how long)
past medical history (smoking NOT included- social)
past dental history
social history
how do you examine muscles?
ask patient to clench jaw and palpitate
- feel areas of muscles of mastication
- temporalis
- masseter
what can enlarged lymph nodes be a result of?
- infection/inflammation process
- or a malignant neoplasm (primary or metastatic)
what can distinguish the reason for enlarged lymph nodes?
clinical characteristics
eg firm, fixed, non-painful suggests malignant neoplasm
what could unsymmetrical face suggest?
- swelling
- neoplasm (abnormal mass of cells)
- enlarged muscle from chewing one side
- clenching/grinding (bruxism)
what steps are involved in an intraoral examination?
Identify signs of disease or complicating factors for treatment
- Look
Soft tissues
Hard tissues
- Listen
Percussion (tap on teeth eg blunt noise indicates abcess)
- Feel (palpate)
Mobility or tenderness
where are common sites of oral cancer?
floor of mouth and tongue
what are special investigations which can be taken in an examination?
Sensitivity / Vitality Test (electrical pulp test- is tooth alive?/ sensitivity test by cold ethyl chloride (less accurate))
Mobility tests (on adjacent teeth)
Radiographs
Plaque Score
Biopsy
what is a provisional diagnosis?
more tests/ referral is required to confirm
what is a biopsy?
taking a small sample of tissue so that it can be examined under a microscope to confirm a diagnosis eg SSC
how would you check perio status?
Probing
- Pocket depth
- Bleeding on probing
- Subgingival calculus
- Plaque retention factors
what information does a diet diary assist with?
prognostic and diagnosis
- hidden sugar
