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Diagnostic skills

BY Dr.Linda Maher. Diagnostic skills. Diagnosis. To identify or determine the nature and cause of a disease or injury through evaluation of the medical and dental history. it is obtained by careful and detailed history and examination.

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Diagnostic skills

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  1. BY Dr.Linda Maher Diagnostic skills

  2. Diagnosis To identify or determine the nature and cause of a disease or injury through evaluation of the medical and dental history. it is obtained by careful and detailed history and examination.

  3. treatment Differential diagnosis Definitive diagnosis

  4. 1\HISTORY TAKING • Aim of history taking is to reach aprovisional diagnosis • 1\personal data • 2\history of present complain(pain-swelling-discharge-duration) • 3\past medical history • 4\past dental history • 5\family history • 6\ social history

  5. 1\personal data • To establish communication with patient • Components of personal data: • 1\name • 2\gender • 3\age • 4\nationality • 5\occupation • 6\contact number

  6. 2\history of present complain • Pain , swelling ,discharge • Ask about • 1\onset and pattern (when , getting better or worst) • 2\frequancy(how often , how long it last) • 3\exacerbating and relieving factors • 4\location

  7. 3\past medical history • Why taking medical history ?? • Because certain medical conditions may require modifications in treatment plan or need prophylactic cover before dental procedures. • Ask about (heart diseases, lever diseases ,endocrine system ,hematological diseases ,medications ,pregnancy ….. etc

  8. 4\dental history • Past dental visits • History of previous filling • History of previous extractions ,any difficulties in extractions

  9. 5\family history and social history • Family history • inherited conditions (e.g. diabetes ,high blood pressure ….etc) • Social history • tobacco smoking, alcohol ….etc

  10. 2\EXAMINATION Techniques for examination 1\visual examination (look) 2\palpation (feel) 3\instrumentation 4\investigations

  11. EXAMINATION • 1\LOOK general appearance (paleness , jaundice ,cyanosis) • 2\PALPATE TMJ ,sub mandibular lymph nodes sub mental lymph nodes , cervical lymph nodes • 1\HARD TISSUE Teeth and occlusion • 2\SOFT TISSUE Buccal mucosa , labial mucosa , tongue, palate ,floor of the mouth EXTRA ORAL INTRA ORAL

  12. Palpation of Sub mandibular Lymph nodes

  13. Palpation of Sublingual Lymph nodes

  14. Palpation of Cervical lymph Nodes

  15. Palpation of TMJ (temporo Mandibular Joint) Tenderness- Clicking-deviation)

  16. Intra oral examination

  17. Intra oral Examination Of Tongue

  18. Intra oral Examination (all surfaces Should be Examined Systematically)

  19. 3\INVESTIGATIONs • The diagnosis and appropriate treatment may be obvious from the history and examination. • More frequently there are various possible diagnosis(differential diagnosis) and plan of investigation should be worked out to reach a (definitive diagnosis)

  20. . • Systematic identification of multiple possible alternative diseases presenting with similar signs and symptoms • DDx , DD • Final diagnosis reached out by an extensive workout on which therapy is based Differential diagnosis Definitive diagnosis

  21. TYPES OF INVESTIGATIONS 1\RADIOLOGICAL INVESTIGATIONS 2\HISTOPATHOLOGICAL INVESTIGATIONS 3\HEMATOLOGICAL INVESTIGATIONS

  22. A\RADIOLOGY • IMPORTANCE OF RADIGRAPHIC IMAGING: • 1\better visibility • 2\better evaluation • 3\in case presentation • 4\insurance purposes

  23. IMAGING TECHNIQUES 1\conventional radiographs 2\computerized tomography(CT) 3\magnetic resonance imaging (MRI) 4\ultra sound 5\use of contrast media with radiography or CT (e.g. sialography)

  24. B\HISTOPATHOLOGY • VALUE AND LIMITATION: • Removal of biopsy specimen for histopathological examination is the mainstay of diagnosis for diseases of mucosa, soft tissue ,and bone. • In few conditions, where it is not helpful in diagnosis it may still valuable to exclude other possible causes

  25. SATEPS: 1\TAKING BIOPSY SPECIMEN 2\DELIVERING THE SPECIMEN TO THE HISTOPATHOLOGY LAB 3\PROCESSING OF THE SPECIMEN BY THE HISTOPATHOLOGIST A\FIXATION B\DEHYDRATION C\PARAFFIN WAX D\ SECTIONING E\MOUNTING IN GLASS MICROSCOPE 4\LABORATORY REPORT

  26. C\HEMATOLOGY • IMPORTANCE OF BLOOD INVESTIGATIONS IN DENTAL FIELD: • 1\Diagnosis of systemic diseases which have oral manifestation (e.g. leukemia, myeloma, anemia's or leucopenia) • 2\ Diagnosis of haemostasis defects which greatly affect management(platelets dysfunction , coagulation factor’s deficiencies…etc)

  27. 4\Treatment plan • A written treatment plan is presented to the patient after the dentist has reviewed and evaluated all patient information gathered

  28. Assistant responsibilities • interviewing the patient • accurate charting and recording

  29. Patient record • It is a permanent document which reflects the patient’s information's and the quality of care given to the patient. • It also acts as an important source of data for research purposes

  30. Components of patients record • 1\patient’s information • 2\history of present illness • 3\past medical history • 4\past dental history • 5\family history • 6\social history • 7\written consent • 8\examination outcomes • 9\treatment plan

  31. THANK YOU

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