Patient Assessment Flashcards
patient assessment: aims & objectives
- Introduction to pediatric dentistry
- Risk assessment and oral exam
- Prevention of dental diseases
- Treatment of dental diseases
history taking: order
- chief complaint
- dental history
- medical history
- current medical treatment
- pregnancy history
- growth and development
- family and social history
establishes the reason for the patient’s visit
chief complaint
OLD CHARTS
- onset
- location
- duration
- characteristics of pain
- aggravating/alleviating factors
- radiation
- time
- severity
reason for knowing the characteristics of pain
- know level of pain
- proper diagnosis and treatment options
included in dental history
- previous dental treatment
- attitude of child/patient towards the treatment
included in other dental history
- oral habits
- oral hygiene
- dietary
included in oral habits
- type
- duration
- frequency and intensity
included in oral hygiene
- frequency and method of brushing
- type of brushing and frequency of replacement
- use of fluoridated/non-fluoridated toothpaste
- assessment of plaque index
included in dietary
diet chart
diet chart indicates the following:
- cariogenicity of diet
- frequency
- nutritional deficiency
included in medical history
- review of systems
- current medical history
included in current medical history
- medications
- current treatment
- immunization
types of immunization
- MMR
- BCG
- DPT
- Polio
- Hepa B
- Dengvaxia
- COVID-19
included in pregnancy history
- length of confinement
- birth weight
- APGAR scores
- antenatal, perinatal problems esp. during delivery
- prematurity and treatment in special/neonatal intensive care nursery
included in growth and development
- developmental milestones
- speech and language development
- motor skills
- socialization
included in family and social history
- family history of serious illness
- family pedigree tree
- school performance in class
- speech and language problems
- pets/hobbies or other interests
- parent’s occupation
reason for knowing patient’s hobbies or interests
- build trust and rapport with patient
- get to know patient, socialize, and keep them focused
reason for knowing parent’s occupation
financial capacity of parents
included in clinical examination
- extraoral exam
- intraoral exam
- special exam
general appraisal of the child’s wellbeing
extraoral exam
assessed during extraoral examination
- facial symmetry and profile
- eyes
- skin color and appearance
- TMJ
- lymph nodes
*swelling, clubbing
assessed during intraoral examination
- soft tissues (+ oropharynx, tonsils, uvula)
- oral hygiene and periodontal status
- dental hard tissues
- occlusion and orthodontic relations
- quantity and quality of saliva
thorough; details the current state of the dentition and plan of future treatment
charting
special examinations
- radiography
- pulp testing
- blood investigation
- microbial investigation
- anatomical pathology
- caries activity test
- photography
- caries risk assessment
- diagnostic casts
most common radiograph used in pediatric dentistry
bitewing
other imaging exams
- computerized axial tomography scan
- magnetic resonance imaging
- nuclear medicine
- ultrasonography
- CBCT
pulp testing
- electric stimulation
- thermal
- percussion
- mobility
- transillumination
blood investigation
- chemical chemistry
- complete blood count w/ differential white cell count
microbial investigation
- culture of MOs
- antibiotic sensitivity
- serology
- direct and indirect immunofluorescence
anatomical pathology tests
- histologic exam and biopsy specimen
- hard tissue sectioning
caries activity test
- diet history
- salivary flow rate
- salivary buffering capacity
- S. mutans and lactobacillus colony count
provides invaluable record of growing children
photography
important as legal document in cases of abuse and trauma or as an aid in the diagnosis of anomalies or syndromes
photography
essential in orthodontic or complex restorative treatment planning and for general record keeping
diagnostic casts
initiated only after the complete and comprehensive diagnosis is obtained
treatment planning
developed in an organized and efficient sequence to provide care
treatment planning
most critical step in the successful future management of the child and parent
treatment planning
philosophy of treatment planning
- Gain the trust and cooperation of the child
- Make an accurate diagnosis and devise a treatment plan appropriate to the child’s need
- Comprehensive preventive care(fluoride therapy,
sealants, oral hygiene instruction) - Deliver care in a manner the child finds acceptable
- Use materials and techniques which provide effective and long lasting results
advantages of treatment planning
- Commits operator in advance to a certain sequence of care.
- Provides estimated time required to complete the treatment.
- Fee payments can be arranged.
occurs when there is no treatment plan
- disorganized and inefficient
- dissatisfaction and confusion
treatment priorities
- Emergency procedures
- Plaque control program
- Restorative therapy
- Ortho and Prostho
- Patient Recall
accurately inform the parents of the following:
- Dental needs of the child
- Restorative procedures required
- Amount of time required to perform the projected
procedures - Total cost of rendering the services
- Preventive measures
problems should be discussed in the following manner:
- Point out the problem using casts, radiograph or the
patient’s mouth - State probable cause of the problem
- State the outcome of the problem
- Show how the problem will be resolved
- Stress the benefit the patient will receive from the
treatment
