Ch 28

1. Ch 28 Oral Diagnosis And Treatment Planning

2. Exam and Dx Techniques • Visual Evaluation • Overall assessment of previous dental care and existing conditions • Soft tissue—pink and uniform in color • Tooth structure—uniform in color and morphologically sound and intact • Dentist uses mouth mirror and dental light • Restorations—evaluate for discrepancies and complete coverage of tooth structure • Missing teeth

3. Palpation • Examination technique • Use fingers and hands to feel for texture, size and consistency of hard and soft tissue

4. . • Instrumentation • The type of instruments selected should accomplish the following • Detection • Use of a sharp pointed explorer, to detect imperfections in enamel surfaces--decay • Probing • To measure the sulcus for loss of gingival attachment or bone loss

5. Radiography • Used in the examination: • Identify • Decay • Defective restorations • Advanced periodontal conditions • Pathology • Developmental conditions • Other abnormalities

6. Intraoral Imaging • Used like a miniature video camera • Allows the dentist to use computer monitor • Provides • Magnification of an image for evaluation • Easier access for areas that are difficult to view • Access to photocopy for insurance verification • Case simulation or case presentation • Medical and legal documentation

7. Photography • Intraoral • Extraoral • Provides visual means of ID and understanding of specific problems

8. Black’s Classification of Cavities • Class I • Pits and fissures posterior teeth • Class II • Proximal surfaces of posterior teeth • Class III • Proximal surfaces of anterior teeth • Class IV • Proximal surfaces of anterior teeth including incisal edges • Class V • Gingival 1/3 of facial or lingual surfaces of all any tooth • Class VI • Incisal edge of anteriors and/or cusp tips of posterior teeth

9. Tooth Numbering Systems • Universal Numbering System • 1-32 , right to left • International Standards Organization system • Two-digit number to each tooth, UR 1, UL 2, LL 3 and LR 4 • Palmer Notation System • Brackets for four quads

10. Color Coding • Red • Condition that needs to be done • Blue • Condition that has already been done • Black • Existing may not need any treatment

11. Charting Symbol • Know how to chart each type of condition • Refer to your complete in class charts

12. Abbreviations • Know each abbreviation for single surfaces • Know each abbreviation for multiple surfaces

13. Soft tissue examination • Complete examination of • Cheeks • Mucosa • Lips • Lingual and facial alveolar bone • Palate • Tonsil area • Tongue • Floor of mouth • Visual and palpation

14. Examination and charting teeth • Thorough assessment of each tooth • Using instruments, check each surface of each tooth and detect findings

15. Examination and Charting of Periodontium • Assess tissue that support the teeth • Gingiva • Cementum • Periodontal ligament • Alveolar • Supporting bone structures • Using radiographs

16. Types of Treatment Plans • Level I: Emergency Care • Relieves immediate discomfort • Level II: Standard Care • Restores the dentition to normal function • Level III: Optimum Care • Restores the dentition to maximum function and an esthetically pleasing result. • KNOW these in detail

17. Treatment Plan Presentation • Case presentation is done in private setting, such as a conference room or office • Items to have available • Before and after photos • Diagnosis cast of similar cases and patient cast • Models of proposed appliances, ie dentures, implants, crowns, etc • Patient chart • X-rays • Treatment plans

18. Treatment plans as well as patient charts are legal documents • Must be done in blue or black ink • Must be clear, concise and legible