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Ch 28. Oral Diagnosis And Treatment Planning. 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
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Ch 28 Oral Diagnosis And Treatment Planning
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
Palpation • Examination technique • Use fingers and hands to feel for texture, size and consistency of hard and soft tissue
. • 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
Radiography • Used in the examination: • Identify • Decay • Defective restorations • Advanced periodontal conditions • Pathology • Developmental conditions • Other abnormalities
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
Photography • Intraoral • Extraoral • Provides visual means of ID and understanding of specific problems
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
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
Color Coding • Red • Condition that needs to be done • Blue • Condition that has already been done • Black • Existing may not need any treatment
Charting Symbol • Know how to chart each type of condition • Refer to your complete in class charts
Abbreviations • Know each abbreviation for single surfaces • Know each abbreviation for multiple surfaces
Soft tissue examination • Complete examination of • Cheeks • Mucosa • Lips • Lingual and facial alveolar bone • Palate • Tonsil area • Tongue • Floor of mouth • Visual and palpation
Examination and charting teeth • Thorough assessment of each tooth • Using instruments, check each surface of each tooth and detect findings
Examination and Charting of Periodontium • Assess tissue that support the teeth • Gingiva • Cementum • Periodontal ligament • Alveolar • Supporting bone structures • Using radiographs
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
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
Treatment plans as well as patient charts are legal documents • Must be done in blue or black ink • Must be clear, concise and legible