Oral Diagnosis and Assessment

Oral Diagnosis

• The art of using scientific knowledge to identify oral disease processes and distinguish one disease from another.

Types of Oral Diagnosis

• Comprehensive oral diagnosis: diagnostic assessment for all dental problems, including full history, clinical examination, and use of diagnostic aids.
• Emergency diagnosis: immediate diagnosis of a patient's complaint that requires immediate attention and management by the dentist.
• Spot (snap) diagnosis: rapid diagnosis in simple cases, based on minimal data.
• Differential diagnosis: collection and categorization of data to develop a list of two or more different diseases with common primary clinical presentation.
• Tentative (working or provisional) diagnosis: primary, uncertain diagnosis before all diagnostic data are assembled.
• Definitive (final) diagnosis: final diagnosis based on accurate appraisal of all available data, including case history, clinical examination, and special investigations.

Symptoms and Signs

• Symptoms: subjective complaints reported by the patient, such as pain, sensitivity, altered taste, and parathesia.
• Signs: objective findings detected by the examiner, such as discoloration, swelling, and tenderness to palpation.

Treatment Plan

• Emergency or immediate treatment plan: immediate attention and management of the patient's complaint.
• Comprehensive or long-range treatment plan: comprehensive treatment plan for all dental problems.

The Diagnostic Method

• The application of a scientific method to reach a final diagnosis, including:
  • Collection of information: patient history, clinical examination, and diagnostic aids.
  • Evaluation of the information: organization of collected data to determine its clinical significance.
  • Diagnostic decision: formulation of the diagnostic decision based on the evaluated data.
  • Reassessment: re-evaluation of the diagnostic decision.

Patient History

• Methods for obtaining a patient's history: printed questionnaires, patient interview, and combination of both.
• Chief complaint (CC): a statement of why the patient consulted the dentist, usually recorded in the patient's words.

Common Chief Complaints

• Pain: somatic, neurogenous, or psychogenic.
• Burning sensation: manifestation of viral and fungal infections, geographic and fissured tongue, and atrophy of tongue coating.
• Dentin sensitivity: caused by caries, trauma, and pulpitis.
• Paraesthesia and numbness: caused by vitamin deficiency, pressure on the mandibular nerve, and injury to the trigeminal nerve.
• Sensitivity: sensitivity to hot, cold, and sweets, resulting from decayed teeth, pulpitis, or exposed roots.
• Bleeding: bleeding or hemorrhage, accidentally or following surgery, including extraction.
• Swelling: soft tissue swelling, such as facial cellulitis, and hard tissue swelling, such as Paget's disease.
• Oral ulceration: ulceration of the oral mucous membrane, caused by different etiologic factors.
• T.M.J. disorders: patients with T.M.J. disorders may complain of clicking, pain, and limitation of jaw function.
• Functional disorders: complaints resulting from functional disorders, such as dysphagia, xerostomia, and bad breath.
• Esthetic problems: complaints resulting from orthodontic treatment, malposed teeth, or discolored or hypoplastic teeth.

Oral Diagnosis

• The art of using scientific knowledge to identify oral disease processes and distinguish one disease from another.

Types of Oral Diagnosis

• Comprehensive oral diagnosis: diagnostic assessment for all dental problems, including full history, clinical examination, and use of diagnostic aids.
• Emergency diagnosis: immediate diagnosis of a patient's complaint that requires immediate attention and management by the dentist.
• Spot (snap) diagnosis: rapid diagnosis in simple cases, based on minimal data.
• Differential diagnosis: collection and categorization of data to develop a list of two or more different diseases with common primary clinical presentation.
• Tentative (working or provisional) diagnosis: primary, uncertain diagnosis before all diagnostic data are assembled.
• Definitive (final) diagnosis: final diagnosis based on accurate appraisal of all available data, including case history, clinical examination, and special investigations.

Symptoms and Signs

• Symptoms: subjective complaints reported by the patient, such as pain, sensitivity, altered taste, and parathesia.
• Signs: objective findings detected by the examiner, such as discoloration, swelling, and tenderness to palpation.

Treatment Plan

• Emergency or immediate treatment plan: immediate attention and management of the patient's complaint.
• Comprehensive or long-range treatment plan: comprehensive treatment plan for all dental problems.

The Diagnostic Method

• The application of a scientific method to reach a final diagnosis, including:
  • Collection of information: patient history, clinical examination, and diagnostic aids.
  • Evaluation of the information: organization of collected data to determine its clinical significance.
  • Diagnostic decision: formulation of the diagnostic decision based on the evaluated data.
  • Reassessment: re-evaluation of the diagnostic decision.

Patient History

• Methods for obtaining a patient's history: printed questionnaires, patient interview, and combination of both.
• Chief complaint (CC): a statement of why the patient consulted the dentist, usually recorded in the patient's words.

Common Chief Complaints

• Pain: somatic, neurogenous, or psychogenic.
• Burning sensation: manifestation of viral and fungal infections, geographic and fissured tongue, and atrophy of tongue coating.
• Dentin sensitivity: caused by caries, trauma, and pulpitis.
• Paraesthesia and numbness: caused by vitamin deficiency, pressure on the mandibular nerve, and injury to the trigeminal nerve.
• Sensitivity: sensitivity to hot, cold, and sweets, resulting from decayed teeth, pulpitis, or exposed roots.
• Bleeding: bleeding or hemorrhage, accidentally or following surgery, including extraction.
• Swelling: soft tissue swelling, such as facial cellulitis, and hard tissue swelling, such as Paget's disease.
• Oral ulceration: ulceration of the oral mucous membrane, caused by different etiologic factors.
• T.M.J. disorders: patients with T.M.J. disorders may complain of clicking, pain, and limitation of jaw function.
• Functional disorders: complaints resulting from functional disorders, such as dysphagia, xerostomia, and bad breath.
• Esthetic problems: complaints resulting from orthodontic treatment, malposed teeth, or discolored or hypoplastic teeth.

This quiz covers the principles of oral diagnosis, including comprehensive and emergency diagnosis, and the use of diagnostic aids in identifying oral diseases.