Lecture 3 - Introduction to diagnostic sciences.pdf

1 INTRODUCTION TO DIAGNOSTIC SCIENCES 181 PCS 2023 www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved. ...

1 INTRODUCTION TO DIAGNOSTIC SCIENCES 181 PCS 2023 www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  2 Lecture Outline 1 What is Diagnosis? 2 Dental Diagnostic Sciences 3 How we do diagnosis? www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  3 Clinical Case Scenario: Layan, a five years old female, presented to your clinic with a severe pain in the left side of her lower jaw (mandible). -What is the cause of pain? -What is the appropriate treatment for this case? www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  4 Definition: - The word is derived from the Greek words: dia = which means “by” and gnosis= which means “knowledge” - Diagnosis is organizing the findings into a descriptive term that could explain the patients condition www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  5 Lecture Outline 1 What is Diagnosis? 2 Dental Diagnostic Sciences 3 How we do diagnosis? www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  6 Dental Diagnostic Sciences Branches of Diagnostic Sciences: Is that branch of dental sciences that deals with the patient at the early stages of his/her 1 Oral diagnosis/Medicine management. It involves thorough examinations 2 Oral Pathology and investigations of a given disease in the oral cavity and its Your Title related areas. 3 Oral Radiology School attendance and performance www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  7 Lecture Outline 1 What is Diagnosis? 2 Dental Diagnostic Sciences 3 How we do diagnosis? 1.History 2.Clinical Examination 3.Investigation 4.Analysis of information 5.Diagnosis 6. Treatment plan www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  8 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  9 Diagnostic Process It is all the steps that are done to collect information about the problem www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  10 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination I. History www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  11 I. History The reasons for taking history from the patient are: To have positive professional relationship To get information that will aid in diagnosis To collect medical and dental information that may interfere with specific treatment www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  12 I. History Types of History: Chief complaint History of the chief complaint (case history) Medical history Past dental history Personal history www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  13 Clinical Case Scenario: A five years old female presented to your clinic with a severe pain in the left side of her lower jaw (mandible). The pain started two days go. This is her first time to visit a dentist. She is asthmatic and allergic to Penicillin. - What is the chief complaint? - What is the history of the chief complaint? - What is her medical history? - What is her past dental history? - What is her personal history? www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  14 Answers: - Chief complaint: pain in the left side of her lower jaw - History of the chief complaint : pain started two days go - Medical history : Asthmatic – Allergic to Penicillin - Past dental history: never been to dentist before - Personal history : Female – 5 years old www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  15 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination II. Clinical Examination www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  16 II. Clinical Examination Types of Clinical Examination: General examination Extra-oral examination Intra-oral examination www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  17 II. Clinical Examination 1- General examination including: Body stature Nutritional status Posture Body movement Speech www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  18 II. Clinical Examination 2- Extra-Oral Examination including: Skull Hair Eyes Ears Nose Symmetry of the face Neck Lymph nodes Temporomandibular joint TMJ www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  19 Auscultation Palpation of TMJ Palpation of TMJ www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  20 II. Clinical Examination 3- Intra-oral Examination including: Mouth opening (average range of normal mouth opening is 35-55mm which is equal to the width of three fingers) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  21 II. Clinical Examination 3- Intra-oral Examination including: Lips Saliva Teeth (number, color, size, caries, missing teeth, extracted teeth, fractured teeth) Tooth supporting tissues (inflammation of the gingiva, mobility of the teeth) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  22 II. Clinical Examination 3- Intra-oral Examination including: Oral mucosa (change in color, swellings, ulcers) Bones (any abnormality on the palate, maxilla or mandible) Occlusion www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  23 A YouTube video showing the technique of extra and intraoral examination https://www.youtube.com/watch?v=JPP1l0J0VsI www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  24 II. Clinical Examination Techniques of clinical examination: 1-Inspection 2-Palpation 3-Probing 4-Percussion 5-Vitality tests of the teeth (Cold test - Heat test - Electric Test) 6-Auscultation www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  25 Techniques of clinical examination Inspection Palpation Probing Percussion Vitality tests This is done by visual This is done by feeling or By using a dental probe a process of tapping or The tooth is examined for examination using the naked pressing the structure, usually (explorer) which is considered staking the tissues with vitality by some tests as: eyes by using the fingers of the as one of the diagnostic fingers or instruments. The - Cold or heat application hands (digital examination) instruments resulting sounds are - Electric pulp testers. compared with normal. percussion www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  26 II. Clinical Examination Palpation This is done by feeling or pressing the structure, usually by using the fingers of the hands (digital examination) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  27 II. Clinical Examination Probing By using a dental probe (explorer) which is considered as one of the diagnostic instruments. www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  28 II. Clinical Examination Percussion a process of tapping or staking the tissues with fingers or instruments. The resulting sounds are compared with normal percussion www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  29 II. Clinical Examination Vitality tests (Heat Test) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  30 II. Clinical Examination Vitality tests (Electric pulp testers) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  31 Doppler auscultation for TMJ https://www.speareducation.com/spear-review/2012/11/doppler-auscultation-at-the- www.companyname.com examination © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  32 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination III. Investigation www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  33 Adjunctive Diagnostic Methods 1 2 3 Oral Radiology Oral Pathology Oral Microbiology www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  34 Oral Radiology Dental radiographs (x-rays) are among the most valuable diagnostic tools available to the dentist Types of dental radiographs: a- Intra-oral images b- Extra-oral images c- Advanced imaging modalities www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  35 Types of Dental Radiographs Intra-oral Extra-oral Advanced imaging Radiographs Radiographs modalities (shows entire tooth, from the crown to the root tip on a single film) Periapical x-ray (captures the crowns of the top Computed Tomography and bottom Panoramic x-ray teeth on a single film) (captures the entire mouth in a single image, including the teeth, upper and lower jaws, Bitewings x-ray surrounding structures and tissues) www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  36 Adjunctive Diagnostic Methods 1 2 3 Oral Radiology Oral Pathology Oral Microbiology www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  37 Pathology: is the study of disease Oral pathology: is concerned with the diseases of oral and para-oral structures, including oral soft tissues and Oral Pathology mucous membranes and the teeth, jaws, and salivary glands It involves: removal of a small piece of tissue (biopsy) to determine the presence or extent of a disease by microscopic examination (under a microscope) and/or culture www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  38 Adjunctive Diagnostic Methods 1 2 3 Oral Radiology Oral Pathology Oral Microbiology www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  39 Oral Microbiology The study of the microorganisms of the oral cavity and the interactions between the oral microorganisms with each other and with the host Most of the investigations undertaken involve the growth and subsequent analysis of one or more bacterial species under various culture conditions www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  40 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination IV. Analysis of Information www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  41 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination V. Diagnosis www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  42 V. Diagnosis To diagnose: is to identify and determine the nature and cause of the disease or injury www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  43 Diagnostic Process Treatment History Plan Analysis of Investigation Information Diagnosis Clinical examination VI. Treatment Plan www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  44 VI. Treatment Plan Treatment plan is the formulation of a strategy that could help to solve as many of the patient’s dental problems as possible. A plan is prepared according to the patient’s: - needs - priorities - financial resources www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  45 Treatment Plan www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.  46 Lecture Summary 1 What is Diagnosis? It is organizing the findings into a descriptive term that could explain the patients condition 2 Dental Diagnostic Sciences 1.Oral diagnosis/Medicine 2.Oral Pathology 3.Oral Radiology 3 How we do diagnosis? 1.History 2.Clinical Examination 3.Investigation 4.Analysis of information 5.Diagnosis www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved. 6.Treatment plan  47 www.companyname.com © 2016 Jetfabrik Multipurpose Theme. All Rights Reserved.