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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? • “When in doubt, cut it out” • “Oral CDX” TMJ dysfunction Cervical Lymph Glands Periodontal evaluation Periodontal Screening and Recording (PSR) Orthodontic Evaluation Cosmetic Evaluation • • • SMILE EVALUATION FORM Patient Name ________________________________________ Size and outline form – – – – Width of centrals __________ Length of centrals __________ W/L ratio __________ Golden proportions ____:_____:____ – – Is the midline centered? Is the smile canted – – – The teeth are properly mesially inclined Mesial/distal incline which need correction Leave teeth as is, even though not properly inclined – – – Incisal edges properly follows lip line Reverse smile Deficiency (describe) – – – – Contact points proper (gingival migration posteriorly) Gradation of teeth proper Arch form proper Correction necessary – – – Good gingival symmetry/ correction Good height and contour/ correction Gingival zenith correct/ correction – – – – – Molar occlusion _______ Crowding Deep bites Cross bites Evidence of bruxing • Midline and canting • Axial Inclination • Lip line vs. Incisal edge of teeth • Extra hard tissue guidelines • Soft tissue conditions • Occlusion _______ _______ _______ _______ (1.6:1:0.6) (75-80%) Date ____________ Treatment Planning • Educate your patient • Prioritize • Minimize anesthetic • Present different options as needed • Work out finances before starting • Schedule consults for complex treatment plans. Dental politics • How do you tell someone that their dental work is defective?
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