Oral Diagnosis is a critical part of planning in dentistry. An article published in Nature has a good description of this subject with references that you may find useful for a more detailed exploration.
A person goes to the dentist’s office because of pain, because of regular maintenance procedures to keep the teeth and gums healthy, because something needs to be repaired, or because they want to look better.
A thorough dental “check-up” includes collecting information about the patient’s oral condition and for surrounding tissues, totally – including soft tissue examination (hard and soft palate, mucosa of cheeks, tongue and under the tongue), joint examination, checking for swelling in lymph nodes in the neck region as a sign of infection, evaluating the bone in and around the mouth, and checking the teeth and supporting periodontal tissue. And, above all, is the patients CHIEF COMPLAINT – referring to what brings the patient to the dentist in the first place. This is what the patient SAYS, which is often the most important data of all in the diagnosis. But, sometimes the most important thing is what the patient DOESN’T SAY – mostly related to stress and anxiety that they might not even recognize they are experiencing, and how it impacts the oral structures and appearance.
In reality, it is also important for the dentist to know something about the patient’s financial capabilities – for if they need an expensive procedure to correct any problem in the optimum way, it may not be affordable.
Depending on what is found during this thorough examination, the patient may be referred to a specialist (in the dental or medical field), a variety of procedures may be planned, or a simple cleaning is performed and a six month followup is scheduled. The dentist must determine what is actually needed based on all of the collected information and its detailed analysis.
We will discuss TREATMENT PLANNING in a later section (visit Chapter VI.1) – but the PLAN is always based on the sum total of all of the collected information for the particular individual.
In this Section – we will discuss data collection itself:
- Soft Tissue Examination
- Periodontal charting
- Esthetic evaluation
- Anxiety and patient well-being
- Health History and other observations
The diagnosis of particular problems follows the acquisition of all of the pertinent information – and many possible diagnoses were discussed earlier, in Section III – so it should be fairly clear what we are looking for.
This section is solely tasked with providing you with the sense that there is an organized, thorough, systematic and comprehensive approach to the identification of abnormalities in every patient’s mouth, and these findings are critical for the accurate diagnosis of problems and causes.
NOTE – there are many disease states that produce symptoms or observations in the mouth – some of these are painful and some not. The not painful ones are often the most serious – for there are serious illnesses and cancers that show up in the mouth first! One of the classic signs of HIV-AIDS shows up in the mouth first (see Karposi’s Sarcoma). And – if you see a canker sore in your mouth – at least it looks like a canker sore, but it didn’t attract your attention due to the pain, because there is NO pain – you should have it checked immediately, because it is consistent with various types of cancer.