Dental History Taking Quiz

Dental History Taking

• GDC Learning Outcomes: Explain general and systemic diseases' relevance to oral health. Describe properties of relevant medicines and discuss their application in patient management. Recognize and record detailed contemporaneous patient histories.

Intended Learning Outcomes

• Recognize when to use open and closed questions.
• Explore patient concerns and investigate further.
• Identify intervention opportunities.

What is a Dental History?

• Includes many factors like Attendance, reasons for past treatment, financial factors, past dental experiences, family dental history, presenting complaints, changes to dental practice, pain history, past/current oral hygiene routines, current perceptions of their oral health, value placed on their health, past/current diet, friends' dental experiences. and the current perceptions of the dental team.

Why Take a Dental History?

• Gain insight into the patient.
• Build rapport and trust.
• Provide reassurance to the patient.
• Guide decision-making processes.
• Important for medico-legal reasons.

Epic Template - Dental History Questions

• What treatment has been provided in the last 5 years?
• How many restorations does the patient have?
• Missing teeth? Is it heavily restored?
• History of fractured teeth/fillings and associated sensitivity?
• Are the teeth worn?
• Do gums bleed during brushing or spontaneously?
• Past treatment problems?
• Are any teeth painful or sensitive?

SOCRATES Method for Pain Assessment

• Site: "Where is the pain?" "Can you point to the tooth or area in question?"
• Onset: "When did the pain start?" "Did it come on suddenly or gradually?"
• Character: "How would you describe the pain?" (e.g., aching, sore, throbbing, sharp). "Is the pain constant or does it come and go?"
• Radiation: "Does the pain spread elsewhere?"
• Associations: "Are there any other symptoms that seem associated with the pain?" (e.g., bad taste, fever).
• Time course: "How has the pain changed over time?"
• Exacerbating/Relieving Factors: "Does anything make the pain better? (e.g. analgesics). "Does anything make it worse or trigger it? (e.g., cold, touch, lying down).
• Severity: "On a scale of 0-10, how severe is the pain, if 0 is no pain and 10 is the worst pain you've ever experienced?"

Additional Dental History Questions (Epic Template)

• Dental attendee: Does the patient have their own general dentist (GDP)? When was their last visit to the GDP and the previous one? Does the dentist guide when to come back, or do they decide? Do they only visit when experiencing pain? How often does the patient visit their hygienist?
• Mouthguard: Does the patient wear a mouthguard? What is it for? Was it made by a dentist? How long have they worn it for?
• Orthodontic Treatment: Have they ever had braces? Which type? How long were they on for? When were they removed? What were the teeth like before? Considering braces?
• Dentures: Do they have full or partial dentures? How long have they been wearing them? Why were the teeth removed? How do they care for their dentures? Are they happy for the dentures to be removed?
• Previous Periodontal Rx: To patient's knowledge, do they suffer from gum disease? How would they rate their gum health? Do their gums currently bleed? How long do they bleed for? History of bleeding gums? How long has this been going on? Any family history of gum problems?
• Scaling with: Hand instruments or power driven scalers? Last scaling visit (weeks/months/years), who was it with (hygienist/dentist)? Specific scaling appointment length (20/30/60 minutes)? Number of appointments?
• LA Use: Patient anxiety? Sensitivity? Deep pockets? Lots of inflammation?
• Additional Issues: Any apprehension receiving dental care? General or procedure-specific concerns. History of previous issues. Past problems relating to dental treatment? Parafunctional habits.
• Oral Hygiene History: Tooth brushing frequency, method, duration, toothbrush changes, charging habits.
• Toothpaste: Type of toothpaste used, fluoride content knowledge, usage amount. Spit or rinse?
• Interdental Cleaning: Use of interdental cleaning tools, frequency, and change schedules.
• Tongue Cleaning: Use of tongue cleaning tools, frequency.

Moving on

• Thank the patient.
• Explain the next steps.

Your Turn

• Work in groups (one actor per group).
• Swap roles.
• Identify any missed areas in the history.
• Share experiences collected.

Further Reading

• Greenwood M. Essentials of Medical History-Taking in Dental Patients. Dental Update.
• Rushworth B, Kanatas A (eds). Oxford Handbook of Clinical Dentistry.
• FGDP(UK). Clinical Examination and Record Keeping.

Test your knowledge on the importance of dental history taking and its relevance to patient management. This quiz covers aspects like patient concerns, appropriate questioning methods, and factors influencing oral health. Enhance your skills in recognizing valuable information vital for effective dental care.