Oral and Maxillofacial Surgery: Diagnosis Overview

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Questions and Answers

Which of the following is NOT included in the extra oral examination?

  • Examination of Lymph Nodes
  • Examination of the Tempromandibular Joint
  • Observation of Body movement
  • Palpation for tender spots (correct)

What is the primary purpose of palpation during clinical examination?

  • To feel for tender spots and lumps (correct)
  • To measure respiratory rate
  • To auscultate internal sounds
  • To visually inspect the area for abnormalities

Which instrument is typically used for probing in dentistry?

  • Lacrimal Probe
  • Dental Probe (correct)
  • Dental Mirror
  • Dental Tweezer

During a clinical examination, which of the following is NOT one of the four routine procedures?

<p>Diagnosis (D)</p> Signup and view all the answers

Which vital sign is NOT typically measured during a clinical examination?

<p>Oxygen saturation (A)</p> Signup and view all the answers

What does percussion during a clinical examination assess?

<p>Internal sounds and responses from the patient (A)</p> Signup and view all the answers

In the context of clinical examination, which factor is NOT evaluated during inspection?

<p>Consistency of tissue (C)</p> Signup and view all the answers

Which of the following describes the examination of the salivary glands during clinical examination?

<p>It is part of the examination of the neck area (B)</p> Signup and view all the answers

What is used to reflect or retract the cheek and lips during an intraoral examination?

<p>Mouth mirror (C)</p> Signup and view all the answers

What does the extent of mouth opening typically get described in terms of?

<p>Number of fingers (D)</p> Signup and view all the answers

What should be examined on the ventral, lateral, and dorsal aspects of the tongue?

<p>Presence of papillae and any abnormalities (C)</p> Signup and view all the answers

In an intraoral examination, which condition is NOT typically assessed in the gingiva?

<p>Presence of occlusion type (A)</p> Signup and view all the answers

What term describes the condition where dentin is exposed due to wearing down of teeth?

<p>Attrition (B)</p> Signup and view all the answers

Which method is primarily used for examining hard and soft tissues that are hidden from direct view?

<p>Radiographic examination (A)</p> Signup and view all the answers

What aspect of pain does the term 'severity' refer to?

<p>The intensity of the pain experienced (D)</p> Signup and view all the answers

Which of the following best describes 'referred pain'?

<p>Pain that is felt in a different area from where the causative lesion is located (B)</p> Signup and view all the answers

Which of the following is a type of occlusion that involves a Class II condition?

<p>Disto occlusion (C)</p> Signup and view all the answers

Which of the following characteristics of pain describes a pain that is sharp and severe?

<p>Acute pulpitis pain (B)</p> Signup and view all the answers

What kind of additional tests might a clinician decide are necessary for diagnosis?

<p>Biopsy and cytology (A)</p> Signup and view all the answers

What is the significance of identifying aggravating factors in a patient's pain history?

<p>They can assist in diagnosing the underlying cause of the pain (A)</p> Signup and view all the answers

What is the primary focus of oral and maxillofacial surgery?

<p>Management of diseases, injuries, and defects of the human jaws (A)</p> Signup and view all the answers

Which of the following is NOT a step in the diagnostic process for oral surgery?

<p>Therapeutic intervention (C)</p> Signup and view all the answers

What type of pain is typically worse at meal times?

<p>Periodontal pain (B)</p> Signup and view all the answers

What is the purpose of taking an accurate case history?

<p>To assist in diagnosis and establish trust (A)</p> Signup and view all the answers

When obtaining a patient's pain history, what is the importance of understanding the timing of pain?

<p>It assists in identifying specific patterns that may suggest certain conditions (B)</p> Signup and view all the answers

Which statement correctly distinguishes between symptoms and signs in oral diagnosis?

<p>Symptoms are subjective problems; signs are objective findings. (A)</p> Signup and view all the answers

Which type of pain may be described as dull and throbbing, particularly associated with dental abscesses?

<p>Severe dental abscess pain (C)</p> Signup and view all the answers

How should a clinician approach history taking?

<p>Encouraging the patient to speak freely and listening carefully (C)</p> Signup and view all the answers

Which of the following is a common precipitating factor for pulpal pain?

<p>Cold temperatures (D)</p> Signup and view all the answers

What should be assessed when a patient presents with facial pain?

<p>Associated symptoms, relevant medical history, and patient's opinion (C)</p> Signup and view all the answers

What is one of the objectives of taking patient history?

<p>To provide necessary information for making a diagnosis (B)</p> Signup and view all the answers

Which symptom would indicate the need for further inquiry regarding a lump in the oral cavity?

<p>The lump has a fluctuating size (C), The lump is painful (D)</p> Signup and view all the answers

What type of issues might a clinician diagnose in oral surgery practice?

<p>Facial deformities and joint problems (C)</p> Signup and view all the answers

What past dental history should be included in the assessment of a patient?

<p>The frequency of previous dental visits (D)</p> Signup and view all the answers

How might a patient's medical history influence their treatment plan?

<p>It may lead to modifications in treatment protocols (C)</p> Signup and view all the answers

Why is it important to document a patient's history?

<p>It serves as a legal document for future references. (C)</p> Signup and view all the answers

When assessing a lump, why is it important to determine its size changes?

<p>Changing size can reflect underlying pathology (A)</p> Signup and view all the answers

What is the purpose of percussion in dental examinations?

<p>To detect tenderness in the sinuses (C)</p> Signup and view all the answers

Why is it essential to ask about systemic illnesses during a patient assessment?

<p>To relate oral manifestations to specific diseases (C)</p> Signup and view all the answers

What aspect regarding a lump should a clinician explore during assessment?

<p>If the lump was noticed due to pain or by others (C)</p> Signup and view all the answers

What is the main use of auscultation in a dental examination?

<p>To listen for sounds in the Tempromandibular Joint (D)</p> Signup and view all the answers

What is the significance of understanding a patient's past dental experiences?

<p>It can reveal patterns in treatment success or complications (B)</p> Signup and view all the answers

What does the extraoral examination NOT include?

<p>Visual assessment of the teeth (B)</p> Signup and view all the answers

Which area is NOT evaluated during the intraoral examination?

<p>Facial form (C)</p> Signup and view all the answers

What can pallor of the conjunctiva indicate during a dental examination?

<p>Anemia (C)</p> Signup and view all the answers

When assessing the temporomandibular joint (TMJ), what indicates a potential problem?

<p>Clicking or pain during palpation (C)</p> Signup and view all the answers

What does examination of the neck include specifically?

<p>Inspection for midline or lateral swelling (A)</p> Signup and view all the answers

Which condition is indicated by yellow discoloration of the sclera during examination?

<p>Hepatitis or obstructive jaundice (C)</p> Signup and view all the answers

Flashcards

Pain Duration

The length of time pain has been present.

Pain Site

The specific area where the patient feels pain.

Pain Radiation

When pain spreads to other areas.

Pain Characteristics

Describes the quality of pain (sharp, dull, throbbing).

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Pain Timing

Pain that occurs at specific times, like during meals or at night.

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Pain Aggravating Factors

Factors that make pain worse, such as hot or cold food.

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Pain Relieving Factors

Factors that relieve pain, like certain medications.

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Associated Symptoms

Symptoms that accompany pain, like fever or fatigue.

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History Taking

The process of gathering information about a patient's medical, dental, and personal history to aid in diagnosis and treatment.

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Symptoms

Subjective complaints reported by the patient, such as pain, numbness, or discomfort.

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Signs

Objective signs of disease that are observable by the clinician, such as swelling, redness, or ulcers.

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Oral Diagnosis

The art of using scientific knowledge to identify oral diseases and differentiate them from other conditions.

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History Taking in Oral Diagnosis

The first step in the diagnostic process, where the clinician gathers information about the patient's medical history, dental history, and current symptoms.

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Patient History in Oral Diagnosis

The collection of information from a patient that helps to understand their medical and dental background, including past illnesses, medications, and previous treatments.

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Patient Symptoms in Oral Diagnosis

The information gathered from a patient about their current symptoms and concerns, which helps the clinician pinpoint the cause of their problem.

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Clinical Examination in Oral Diagnosis

A careful and systematic examination of the patient's mouth and associated structures to detect any abnormalities or signs of disease.

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Additional Symptoms

Asking about the presence of other symptoms like swelling, discharge, or numbness can help determine the cause of pain.

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Medical History for Pain Diagnosis

Knowing the patient's medical history helps diagnose pain, especially if it's associated with past conditions like migraines, chronic stress, or heart problems.

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Patient's Perception of Pain

Asking about the patient's understanding of the pain's cause can reveal valuable insights into their perception and interpretation of the problem.

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Assessing a Lump

Asking about the duration, growth, and symptoms of a lump helps determine its nature, potential cause, and severity.

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Past Dental History

Knowing if the patient has a history of dental procedures, complications, and radiographs can help the oral surgeon plan appropriate treatments and avoid risks.

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Medical History Review

Medical history review helps diagnose oral manifestations related to systemic diseases and adjust the treatment plan to account for underlying conditions.

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Medical History and Current Illness

Knowing medical history and current illnesses is crucial for diagnosis and appropriate treatment planning.

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Medical History for Diagnosing Oral Manifestations

The patient's medical history can be used to identify potential systemic conditions with possible oral manifestations, like AIDS or Leukemia.

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Inspection (Visual Examination)

A physical examination method using visual observation to identify abnormalities like swelling, color changes, or asymmetry.

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Palpation

Examining by applying light pressure with the fingers or an instrument to assess tenderness, lumps, swelling, or teeth mobility.

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Percussion

A technique of tapping on a body part to assess the underlying tissue density and detect abnormalities based on the sound produced.

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Probing

Using an instrument (like a probe) to explore a cavity or structure.

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Auscultation

A physical examination method using a stethoscope to listen to the patient's internal sounds, such as heart rate or breathing.

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General Patient Evaluation

Evaluates overall patient health before focusing on specific areas. It involves examining posture, gait, facial form, nutrition status, speech, movement, skin, hair, and vital signs like temperature, pulse, blood pressure, and respiration.

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Head and Neck Examination

Examining the head and neck region to assess the temporomandibular joint, lymph nodes, salivary glands, bones of the skull, sinuses, ear, eye, and perioral tissues.

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Neck Examination

Examining the neck for signs of enlarged thyroid gland, lymph nodes, and swellings.

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Percussion (Dentistry)

A method of examining the body by tapping on different regions to assess underlying structures. In dentistry, it can be used to detect tenderness in sinuses and pain in teeth.

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Auscultation (Dentistry)

The process of listening to sounds within the body using a stethoscope. In dentistry, it's rarely used but can be helpful in evaluating the temporomandibular joint.

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General Examination (Dentistry)

The examination of the patient's overall appearance, including posture, gait, facial features, nutritional status, habits, speech, skin, hair, and nails.

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Head Examination (Dentistry)

Examination of the head to assess the temporomandibular joint (TMJ), lymph nodes, salivary glands, bones of the skull, sinuses, ears, eyes, and peri-oral tissues.

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Neck Examination (Dentistry)

Examination of the neck to assess the thyroid gland, lymph nodes, other midline structures, and muscles.

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Palpation (Dentistry)

The process of feeling or touching different parts of the body to detect abnormalities. It's a key component of the physical examination and helps assess the texture, size, and tenderness of tissues.

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Exophthalmos or Proptosis

A condition where the eyes bulge outwards. This can indicate various disorders, including thyroid problems.

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Pallor of Conjunctiva

A condition where the conjunctiva (the membrane covering the white part of the eye) appears pale, commonly indicating anemia.

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Mouth Opening

The width of the patient's mouth opening, usually measured in terms of how many fingers can fit.

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Oral Hygiene

Assesses the overall cleanliness of the mouth, ranging from "good" to "very poor."

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Tongue Examination

Visual examination of the tongue's underside, sides, and top for any abnormalities like cracks, sores, or bumps.

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Gingival Examination

Checking the gums for any swelling, color changes, or unusual growths.

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Teeth Examination

This involves examining the teeth for missing ones, any damage, loose teeth, cavities, and their overall health.

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Occlusion

The way your upper and lower teeth fit together when your mouth is closed, categorized as Class I (normal), Class II (overbite), or Class III (underbite).

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Radiographic Examination

X-rays used to help diagnose and monitor oral problems, particularly those involving hidden areas like bone.

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Biopsy

A procedure where a small sample of tissue is taken for microscopic analysis to help diagnose conditions.

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Study Notes

Oral and Maxillofacial Surgery

  • Is a dental specialty focused on the management of diseases, injuries, and defects of the jaws and associated structures.
  • Acts as a connecting link between medical and dental specialties.

Diagnosis in Surgery

  • Oral diagnosis is the identification of oral diseases and differentiation between various diseases using scientific knowledge.
  • Diagnostic process typically involves these steps:
    • History taking
    • Clinical examination
    • Investigation
    • Provisional diagnosis
    • Definitive diagnosis and treatment plan
  • Common conditions diagnosed in oral surgery include:
    • Dental and facial pain
    • Swelling (lumps, masses)
    • Ulcers
    • Injuries (to teeth, facial bones)
    • Temporomandibular joint problems
    • Patients with medical conditions
    • Facial deformities

History Taking

  • Taking an accurate case history is crucial in diagnosis.
  • A systematic approach is best, focusing on the patient's story and symptom details.
  • Clinicians should order the symptoms by their severity and importance.
  • Patient's words are important.

Symptoms and Signs

  • Symptoms are subjective experiences of the patient (e.g., pain, paresthesia).
  • Signs are objective observations by the clinician (e.g., swelling, ulcers).
  • Detecting signs and symptoms aids in diagnosis.

Objectives of Taking History

  • Gathering necessary information for diagnosis
  • Establishing a positive relationship and trust with the patient
  • Gaining information about the patient's medical, dental, and personal history.
  • Understanding patient's overall health, which might affect treatment and prognosis.
  • Creating a legal record.

How to Take a History

  • Encourage patients to explain symptoms in their own words.
  • Interrupt only to clarify or stop irrelevant discussion.
  • Summarize complaints in a clear, concise manner.
  • Record symptoms by importance (e.g., pain, swelling, bleeding).
  • Focus full attention on patient during history taking.

History of Present Illness (HPI)

  • Detailed description of current problem, focusing on:
    • Duration of complaint
    • Onset (date/manner)
    • Precipitating/predisposing factors
    • Characteristics of the pain (e.g., nature, severity, location, radiation)
    • Temperature features
    • Aggravating factors
    • Relieving factors
    • Associated constitutional symptoms
    • Course and progress
    • Type of therapy, provider, effect, and date
    • Other relevant information

Chief Complaints (CC)

  • The reason for the patient's visit, best described in the patient's words.
  • Examples include pain, swelling, ulcers, numbness, clicking, halitosis, bleeding, trismus.

Past Medical History (PMH)

  • Previous serious illnesses.
  • Childhood diseases.
  • Hospitalizations
  • Injuries (head, neck)
  • Allergies to medications.
  • List of medications in the last six months. 

Past Dental History (PDH)

  • Frequency of previous visits and procedures (e.g. extractions).
  • Any complications or difficulties (e.g. excessive bleeding).
  • Availability of previous dental X-rays.

Components of Medical History

  • All information gathered in past, present, and future to aid in diagnosis.
  • Past and current diseases can impact treatment plans and affect treatment.
  • Includes medications and their effect on the mouth.

Review of Systems

  • Comprehensive review of each body system (cardiovascular, respiratory, central nervous, genitourinary).
  • Evaluating signs and symptoms connected to the system.
  • Directing further investigation/referral as needed.

Clinical Examination

  • Extraoral Examination: assessing facial form, posture, gait, vital signs, nutrition, hair, body movement, skin condition, and areas of the head and neck, including lymph nodes, salivary glands.
  • Intraoral Examination: assessment of the teeth, oral tissues, temporomandibular joint, sinuses (maxillary), and perioral tissues, focusing on signs or symptoms related to the head and neck region.

Diagnostic Instruments

  • Dental mirrors.
  • Dental probes.
  • Tweezers
  • Visual inspection

Additional Diagnostic Tests

  • Biopsy
  • Aspiration
  • Radiographic examinations (such as X-rays, CT scans, MRIs)
  • Laboratory tests (e.g. blood tests)

Provisional, Definitive, and Treatment Plans

  • Components of the patient case summary.

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