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

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Periodontal evaluation

Periodontal Screening and Recording (PSR)

Orthodontic Evaluation

Cosmetic Evaluation

• SMILE EVALUATION FORM• Patient Name ________________________________________ Date ____________• 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– Is the midline centered?– Is the smile canted

• 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– Incisal edges properly follows lip line– Reverse smile– Deficiency (describe)

• Extra hard tissue guidelines– Contact points proper (gingival migration posteriorly)– Gradation of teeth proper– Arch form proper– Correction necessary

• Soft tissue conditions– Good gingival symmetry/ correction– Good height and contour/ correction– Gingival zenith correct/ correction

• Occlusion– Molar occlusion _______– Crowding _______– Deep bites _______– Cross bites _______– Evidence of bruxing _______

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?