Download Chapter 7 Body Systems

Oral Diagnosis and
Treatment Planning
Chapter 28
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Chapter 28
Lesson 28.1
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Learning Objectives
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Pronounce, define, and spell the Key Terms.
List and describe the examination and
diagnostic techniques used in patient
assessment.
Discuss the role of the dental assistant in the
clinical examination.
List the six categories of the Black
classification of cavities.
(Cont’d)
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Learning Objectives
(Cont’d)
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Differentiate between anatomic and
geometric diagrams for charting.
Chart the correct restorative material for
either an existing restoration or a required
treatment.
Chart the correct symbol for either an existing
restoration or a required treatment.
Explain the color coding of a chart diagram.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Introduction
Sound dental care begins with a thorough
examination of the head and neck and the oral
cavity.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Reasons a Patient Seeks Dental
Care
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As a new patient
For an emergency or a specific problem
For consultation with a specialist
As a returning patient for continued care
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Techniques Used for Assessment
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Visual evaluation provides an overall
assessment of existing conditions.
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Soft tissue
Tooth structure
Restorations
Missing teeth
(Cont’d)
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Techniques Used for Assessment
(Cont’d)
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In palpation, the examiner uses the fingers
and hands to evaluate hard and soft tissue.
Instrumentation is the use of instruments to
examine the teeth and surrounding tissues.
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Detection
Probing
(Cont’d)
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Techniques Used for Assessment
(Cont’d)
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Radiography, both intraoral and extraoral,
provides indispensable tools for identifying:
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Decay
Defective restorations
Advanced periodontal conditions
Pathologic conditions
Developmental conditions
Abnormalities
(Cont’d)
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Fig. 28-3 (left) Example of an intraoral bite-wing radiograph.
Fig. 28-4 (right) Example of an extraoral panoramic radiograph.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Techniques Used for Assessment
(Cont’d)
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Intraoral imaging allows the use of a video
system:
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To magnify an image for better evaluation
For easier access to difficult areas
For photocopying images for insurance purposes
For case simulation or presentation
For medical and legal documentation
(Cont’d)
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Fig. 28-5 An intraoral imaging system is used to
make a diagnosis and educate the patient.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Techniques Used for Assessment
(Cont’d)
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Intraoral and extraoral photography
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Provides a visual means of identifying and
understanding specific problems.
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Fig. 28-6 Photographs are taken to provide a
visual evaluation of the patient.
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Recording the Dental Examination
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Specific criteria that must be known before
charting:
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Black classification of cavities
Tooth diagrams
Tooth-numbering systems
Color coding
Charting
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Fig. 28-7 Black classification of cavities
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Fig. 28-8 Example of a geometric diagram for
charting conditions of the mouth.
(From Gaylor LJ: The administrative dental assistant, ed 2, St Louis, 2007, Saunders.)
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Fig. 28-9 A, Universal numbering system.
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Fig. 28-9 B, International Standards Organization
System/Fédération Dentaire International System.
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Fig. 28-9 C, Palmer notation system
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Fig. 28-10 Example of color coding, with red used for existing problems
and black or blue for treatment that is completed.
(From Gaylor LJ: The administrative dental assistant, ed 2, St Louis, 2007 Saunders.)
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Fig. 28-11 Example of
charting conditions of the mouth.
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Fig. 28-11 Example of
charting conditions of the mouth
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Fig. 28-11 Example of
charting conditions of the mouth.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Chapter 28
Lesson 28.2
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Learning Objectives
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Describe the need for a soft-tissue
examination.
Describe the pocket depth and bleeding index
of the gingival tissues and how to record
them.
Discuss the importance of a treatment plan.
Chart the findings of the periodontal
examination correctly.
Copyright © 2009, 2006 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Soft-Tissue Examination
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Extraoral features
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Face, neck, tissue changes, skin abrasions, lips
Cervical lymph nodes
Temporomandibular joint
Oral habits
Intraoral features
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Interior of the lips
Oral mucosa
Tongue
Floor of the mouth
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Examination and Charting
of the Periodontium
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Specific periodontal findings to be recorded:
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Overall health condition of gingiva
Signs and location of inflammation
Location and amount of plaque and calculus
Areas of unattached gingiva
Areas of periodontal pockets larger than 3 mm
Presence of furcation involvement
Dental mobility scale
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Dental Mobility Scale
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Description of Probing Scores
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The Treatment Plan
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Levels of care
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Level I, emergency care, relieves immediate
discomfort.
Level II, standard care, restores the patient to
normal function.
Level III, optimum care, restores the patient to
maximum function
Presentation of treatment plan
Recording of dental treatment
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