treatment

Copyright © 2005 by Elsevier Inc. All rights reserved.

Oral Diagnosis and Treatment Planning

Chapter 28


IntroductionSound dental care begins with a thorough

examination of the head and neck areas and the oral cavity.


Patients Will Seek Dental Care

• As a new patient

• For an emergency of a specific problem

• For consultation with a specialist

• As a returning patient for continued care


Techniques Used for Assessment

• Visual evaluation: provides an overall assessment of existing conditions.

– Soft tissue

– Tooth structure

– Restorations

– Missing teeth


Techniques Used for Assessment-cont’d

• Palpation: the examiner’s fingers and hands are used to evaluate hard and soft tissue.

• Instrumentation: the use of instruments to examine the teeth and surrounding tissues.

– Detection

– Probing



• Intraoral and Extraoral Radiography provides indispensable tools for identifying:

– Decay

– Defective restorations

– Advanced periodontal conditions

– Pathology

– Developmental conditions

– Abnormalities


Fig. 28-3 and Fig. 28-4 Intraoral and extraoral radiographs



• Intraoral Imaging allows the use of a video system:

– To magnify an image for better evaluation

– For easier access to difficult areas

– For photocopying images for insurance

– For case simulation or presentation

– For medical and legal documentation


Fig. 28-5 Intraoral imaging



• Intraoral and Extraoral Photography

– Provides a visual means to identify and understand specific problems.


Fig. 28-6 Photography used in dentistry


Recording the Dental Examination

• Specific criteria required to know prior to charting:

– Black’s classification of cavities

– Tooth diagrams

– Tooth numbering systems

– Color coding

– Charting


Fig. 28-7 Black’s classification of cavities


Fig. 28-8 Anatomic diagram for charting


Fig. 28-9 Geometric diagram for charting


Fig. 28-10 A, Universal numbering system


Fig. 28-10 B, ISO/FDI numbering system


Fig. 28-9 C, Palmer Notation System


Fig. 28-11 Color coding in charting(Courtesy of Eaglesoft)


Soft Tissue Examination

– Extraoral Features

• Face, neck, tissue changes, skin abrasions, lips

• Cervical lymph nodes

• Temporomandibular joint

• Oral habits

– Intraoral Features

• Interior of the lips

• Oral mucosa

• Tongue

• Floor of the mouth


Examination and Charting of the Periodontium

• Specific periodontal findings to be recorded:

– Overall health condition of gingiva

– Signs and location of inflammation

– Location and amount of plaque and calculus

– Areas of unattached gingiva

– Areas of periodontal pockets measuring greater than 3 mm

– Presence of furcation involvement

– Dental mobility scale


Dental Mobility Scale


Description of Probing Scores


The Treatment Plan

• Levels of Care

– Level I, Emergency Care: relieves immediate discomfort.

– Level II, Standard Care: restores to normal function.

– Level III, Optimum Care: restores to maximum function

• Treatment Plan Presentation

• Recording Dental Treatment

treatment

Documents

dental treatment

emergency care

continued care

standard care

optimum care

introduction sound dental

assessmentcontd palpation

assessment visual evaluation