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Copyright © 2005 by Elsevier Inc. All rights reserved.
Oral Diagnosis and Treatment Planning
Chapter 28
Copyright © 2005 by Elsevier Inc. All rights reserved.
IntroductionSound dental care begins with a thorough
examination of the head and neck areas and the oral cavity.
Copyright © 2005 by Elsevier Inc. All rights reserved.
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
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Techniques Used for Assessment
• Visual evaluation: provides an overall assessment of existing conditions.
– Soft tissue
– Tooth structure
– Restorations
– Missing teeth
Copyright © 2005 by Elsevier Inc. All rights reserved.
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
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Techniques Used for Assessment-cont’d
• Intraoral and Extraoral Radiography provides indispensable tools for identifying:
– Decay
– Defective restorations
– Advanced periodontal conditions
– Pathology
– Developmental conditions
– Abnormalities
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Fig. 28-3 and Fig. 28-4 Intraoral and extraoral radiographs
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Techniques Used for Assessment-cont’d
• 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
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Fig. 28-5 Intraoral imaging
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Techniques Used for Assessment-cont’d
• Intraoral and Extraoral Photography
– Provides a visual means to identify and understand specific problems.
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Fig. 28-6 Photography used in dentistry
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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
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Fig. 28-7 Black’s classification of cavities
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Fig. 28-8 Anatomic diagram for charting
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Fig. 28-9 Geometric diagram for charting
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Fig. 28-10 A, Universal numbering system
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Fig. 28-10 B, ISO/FDI numbering system
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Fig. 28-9 C, Palmer Notation System
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Fig. 28-11 Color coding in charting(Courtesy of Eaglesoft)
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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
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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
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Dental Mobility Scale
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Description of Probing Scores
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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
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