Oral Diagnosis The foundation for building a healthy practice
Listen to your patient: Open ended questions
Consider the whole patient
Blood pressure
Full mouth series
Panoramic radiograph
Anterior peri-apical (PA)
Posterior PA
BW radiograph
Mixed Dentition
Abnormal path of eruption
Soft tissue exam
Common Pathology
Gingivitus
Gingivitus
Gum recession
Canker Sores
Cold sores (Herpes simplex)
Fistula
Amalgam tatoo
Geographic tongue
Mandibular Tori
Pericornitus
Fibrous Hyperplasia
Oral Yeast infection (Candida)
The golden question How long has it been there? How long has it been there? “When in doubt, cut it out” “When in doubt, cut it out” “Oral CDX” “Oral CDX”
TMJ dysfunction
Cervical Lymph Glands
Periodontal evaluation
Periodontal Screening and Recording (PSR)
Orthodontic Evaluation
Cosmetic Evaluation
SMILE EVALUATION FORM SMILE EVALUATION FORM Patient Name________________________________________Date____________ Patient Name________________________________________Date____________ Size and outline form Size and outline form –Width of centrals__________ –Length of centrals__________ –W/L ratio__________ (75-80%) –Golden proportions____:_____:____(1.6:1:0.6) Midline and canting Midline and canting –Is the midline centered? –Is the smile canted Axial Inclination Axial Inclination –The teeth are properly mesially inclined –Mesial/distal incline which need correction –Leave teeth as is, even though not properly inclined Lip line vs. Incisal edge of teeth Lip line vs. Incisal edge of teeth –Incisal edges properly follows lip line –Reverse smile –Deficiency (describe) Extra hard tissue guidelines Extra hard tissue guidelines –Contact points proper (gingival migration posteriorly) –Gradation of teeth proper –Arch form proper –Correction necessary Soft tissue conditions Soft tissue conditions –Good gingival symmetry/ correction –Good height and contour/ correction –Gingival zenith correct/ correction Occlusion Occlusion –Molar occlusion_______ –Crowding_______ –Deep bites_______ –Cross bites_______ –Evidence of bruxing_______
Treatment Planning Educate your patient Educate your patient Prioritize Prioritize Minimize anesthetic Minimize anesthetic Present different options as needed Present different options as needed Work out finances before starting Work out finances before starting Schedule consults for complex treatment plans. Schedule consults for complex treatment plans.
Dental politics How do you tell someone that their dental work is defective? How do you tell someone that their dental work is defective?