Oral Medicine Lecture by Dr. Ahmad Fliah Hassan

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Questions and Answers

What is the primary focus of oral medicine?

Treating systemic diseases exclusively

Dealing with diseases of oral and paroral structures (correct)

Performing complex surgical procedures

Providing aesthetic dental treatments

Which step comes first in the effective approach to patient care?

Clinical examination

Taking medical history

Collecting personal information (correct)

Learning the chief complaint

The chief complaint should be recorded in what manner?

Deliberately simplified for clarity

In the patient's own words (correct)

As a summary of clinical findings

In medical jargon for accurate documentation

When collecting the history of the present illness, which aspect is least important?

Patient's educational background Signup and view all the answers

Why is it crucial to gather a thorough medical history before dental treatment?

To identify potential systematic conditions that may affect treatment Signup and view all the answers

Which of the following is NOT considered a part of personal information to collect?

Previous dental procedures Signup and view all the answers

What characteristic is most essential for the information gathered during the history of present illness?

To detail the entire course from first symptom to examination Signup and view all the answers

Clinical examination is critical in the patient evaluation process. This step is primarily followed after which stage?

Recording the history of present illness Signup and view all the answers

What is primarily assessed during the Review of Systems in a patient's medical history?

Undetected systemic diseases Signup and view all the answers

What aspect of medical history involves asking about lifestyle habits like alcohol or tobacco use?

Social history Signup and view all the answers

Which examination technique involves feeling for texture and size of a mass?

Palpation Signup and view all the answers

Which of the following systems is NOT included in the pertinent questions for systemic diseases?

Dermatological Signup and view all the answers

What should a clinician observe about the patient's general appearance during examination?

The patient's gait and behaviour Signup and view all the answers

What is the purpose of taking a family history in a medical examination?

To uncover possible genetic conditions Signup and view all the answers

What does percussion involve during a clinical examination?

Gently tapping to assess tenderness Signup and view all the answers

Which of the following conditions are NOT typically discussed in family history?

Allergies Signup and view all the answers

What characteristic of an ulcer might indicate it is associated with tuberculosis?

Undermined edges Signup and view all the answers

Which aspect of pain should be classified to understand the general quality of a patient's complaint?

Nature Signup and view all the answers

During the examination of oral ulceration, which feature is NOT relevant to assess?

Type of mouthwash used Signup and view all the answers

What does the presence of glossy, red, and edematous surrounding tissue around an ulcer typically indicate?

Acute inflammation Signup and view all the answers

Which of the following ulcer shapes is considered irregular?

None of the above Signup and view all the answers

What frequency of ulceration refers to how often the ulcers occur?

Number of ulcers Signup and view all the answers

When assessing pain, which of the following is NOT typically considered?

Type of anesthesia used Signup and view all the answers

Which feature would be most important to examine when characterizing the edges of an ulcer?

Edge type Signup and view all the answers

What is the normal respiratory rate range for a patient?

12-18 breaths/min Signup and view all the answers

Which condition might be indicated by the clinical observation of a patient appearing wasted and undernourished?

Malnutrition Signup and view all the answers

What vital sign indicates that a child's heart rate may be abnormal if it exceeds the typical maximum?

140 beats/min Signup and view all the answers

What is a potential sign of neurological deficits observed in the face during an examination?

Bell's palsy Signup and view all the answers

Which symptom might indicate the presence of cardiorespiratory problems when assessing a patient?

Finger clubbing Signup and view all the answers

What must be performed before starting an intraoral examination?

Remove all removable appliances Signup and view all the answers

What appearance of the eyes may indicate anaemia during a clinical examination?

Pale sclera Signup and view all the answers

Which of the following conditions might be indicated by the finding of petechiae in a patient?

Blood dyscrasia Signup and view all the answers

What is required for a proper specimen biopsy?

It should include normal tissue to provide context. Signup and view all the answers

Why is a scalpel preferred over cutting diathermy for biopsy specimens?

Cutting diathermy may cause distortion of tissues. Signup and view all the answers

What is the recommended fixative for a biopsy specimen?

10% formal saline. Signup and view all the answers

Which type of biopsy is best suited for small, localized soft swellings?

Excisional biopsy. Signup and view all the answers

What is a significant disadvantage of fine needle aspiration biopsy?

It may not yield a definitive diagnosis. Signup and view all the answers

Which imaging technique is most commonly used in dental practice?

Plain film radiography. Signup and view all the answers

What is a contraindication for using computerized tomography?

Pregnancy. Signup and view all the answers

What should be provided to the pathologist along with the biopsy specimen?

Clinical details documented. Signup and view all the answers

Study Notes

Definition of Oral Medicine

Focuses on diseases of oral and paroral structures and oral management of systemic diseases.

Effective Patient Care Approach

Steps include gathering personal information, chief complaint, medical and dental history, clinical examination.

Personal Information

Important for establishing rapport; includes name, age, sex, address, occupation, education, relationship status, and contact details.

Chief Complaint

Patient’s primary reason for seeking dental care; recorded in their own words for clarity.

History of Present Illness

Information gathered from symptom onset to examination; includes mode of onset, duration, relapse, intensity, nature, and previous treatments.
Key questions to ask:
- When did the problem start?
- What was noticed first?
- Any related symptoms?
- Improvements or worsening over time?
- Previous treatments sought?

Medical and Dental History

Evaluates any systemic conditions affecting dental treatment and identifies potential risks.
Past medical history to check allergies, hospitalizations, medications, and immunization history.
Review of systems covering major organ systems (Cardiovascular, Renal, etc.) to detect systemic diseases.

Social history includes lifestyle habits (e.g., alcohol, tobacco) and socioeconomic status.
Family history focuses on genetic conditions such as diabetes, hypertension, and cancer.

Clinical Examination Principles

Inspection: Visual evaluation for abnormalities like swelling, asymmetry, ulcers, etc.
Palpation: Feeling for texture, size, and tenderness of masses.
Percussion: Tapping to assess tenderness.
Auscultation: Listening for sounds using a stethoscope (e.g., TMJ evaluation).

Vital Signs Monitoring

Normal ranges:
- Respiratory rate: 12-18 breaths/min
- Heart rate: 60-80 beats/min (higher in children)
- Blood pressure: 120-140/60-90 mmHg
- Body temperature: 35.5 – 37.5°C (95.9 - 99.5°F)

Extraoral Examination

Observes general appearance, eyes, neck, hands, and scalp for systemic disease signs.
Specific observations like breathlessness indicating cardiorespiratory issues or facial asymmetry related to neurological deficits.

Intraoral Examination

Comprehensive assessment of oral mucosa and surrounding structures.
Utilize diagnostic instruments for proper evaluation of dental complaints such as oral ulceration or pain.

Oral Ulceration Assessment

Evaluate mode of onset, frequency, duration, size, shape, edge characteristics, and surrounding tissue condition.

Pain Assessment

Gather information on location, onset, duration, nature, severity, and provoking/relieving factors.

Biopsy Considerations

Include a small area of normal tissue for accurate diagnosis.
Use scalpel over diathermy for less distortion.
Ensure proper fixation and suturing post-biopsy.
Provide full clinical details for the pathologist.

Biopsy Techniques

Incisional Biopsy: Removes part of a lesion for typical cases.
Excisional Biopsy: Useful for small, localized lesions that may also require treatment.
Fine Needle Aspiration (FNA) Biopsy: Gathers sample from soft-tissue lesions; ultrasound may assist in guidance.

Imaging Techniques

Plain Film Radiography: Commonly used for diagnostics, includes intraoral and extraoral views.
Computerized Tomography: Provides detailed images of soft and hard tissue, useful for assessing tumors, fractures, and other conditions. Contraindicated in pregnancy.

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Description

This quiz focuses on the key concepts of oral medicine as presented by Dr. Ahmad Fliah Hassan. It explores the importance of understanding patients' medical histories, including allergies and systemic diseases, to minimize complications in dental care. Test your knowledge on how these factors impact treatment decisions in dentistry.