Dental Procedures & Techniques- Ch 28/TEST/COMPLETE

Detection

the process of identifying the presence of something, such as teeth imperfection or decay in dentistry.

extraoral

outside the oral cavity

furcation

space or branching between two roots of a tooth

intraoral

located within the oral cavity

Mobility

the ability to move; in dentistry, it refers to the movement of teeth within its bone structure

morphologically, morphologic, morphology

branch of biology that deals with form and structure

palpation

to examine by touch, such as feeling for abnormalities within soft tissue

probing

to explore or examine within the use of an instrument

restoration

bringing something back to its natural or normal state, an example is the use of a dental material to restore a tooth

Why Patients Seek Dental Care

As a new patient to begin dental care

As an emergency patient when in pain or experiencing discomfort

For consultation with a specialist

As a returning patient for continued assessment and care

Dental Assistant Duties

Assist the patient with completion of patient information forms

Take and record vital signs

Chart and record the dentist’s findings during the extraoral and intraoral examinations

Expose intraoral and extraoral radiographs

Take preliminary impressions and fabricate diagnostic models

Take extraoral and intraoral photographs

Organize the patient record

Prepare for the case presentation

Visual Evaluation

The examination always begins with a visual evaluation of the patient’s extraoral and intraoral conditions

Enables the dentist to determine an overall assessment of the type of dental care received previously

Reveals any existing conditions that have not been treated

Specific examination areas include the following:

Face

Lips

Soft tissue within the mouth

Tongue

Tooth structure

Restorations

Missing teeth

Palpation

The examiner uses his or her fingers and hands to feel for:

• Texture

• Size

• Consistency of the hard and soft tissue

This technique is especially useful for detecting extraoral swelling and is the primary way of detecting swollen lymph nodes

Instrumentation

The use of instruments to examine the teeth and surrounding tissues

Type of instruments commonly utilized to examine the teeth: Mouth mirror and explorer

Type of instrument used to examine the gingival tissues: Periodontal probe

Detection: Dentist uses an explorer to detect imperfections in tooth surfaces

Probing: Dentist or dental hygienist uses the periodontal probe to assess the gingiva for the presence of periodontal pockets

Digital Imaging

Caries lesions

Occlusion and TMJ analysis and diagnosis

Digital radiography: Intraoral and extraoral

Patient education

Shade matching

The computer-aided design/computer-aided manufacturing (CAD/CAM) system and intraoral imaging

Digital Photography

A diagnostic tool used for intraoral and extraoral structures

It provides the dentist and patient with a visual means of identifying and understanding specific problems

Recording the Dental Examination

Charting symbols, abbreviations, and color coding can be used in the recording process to indicate various conditions and existing restorations

Specific criteria that must be known before charting include the following:

• Black’s classification of cavities

• Tooth diagrams

• Tooth-numbering systems

• Color coding

• Abbreviations

Tooth Diagrams

Anatomic and geometric designs are the most frequently used dental charting systems

Anatomic diagram: Illustrations resemble the actual crown and root of the tooth

Geometric diagram: Circle represents each tooth

• The circle is divided to represent each tooth surface

Tooth-Numbering Systems

Universal numbering system

• Begins with the maxillary right third molar and concludes at the mandibular third molar

ISO/FDI system

• Assigns a two-digit number to each tooth

Palmer notation system

• Uses a bracket to designate the four quadrants of the mouth

Color coding

A visual notation to differentiate between treatment that has already been completed and treatment that still needs to be completed

• Black or blue symbols represent dental work that has been completed

• Red symbols indicate treatment that needs to be completed at future dental appointments

Once work has been completed, you will mark over the red with a black or blue notation to indicate that the work has been completed

Black’s Classification of Cavities

Standard classification system is universal to all dentists and is used to describe the location of decay and the best method for restoring a tooth

Black’s original classification included Class I through Class V

Class VI was added at a later date

Abbreviations

For single-surface restorations, charting abbreviations are based on the names of the tooth surfaces

B—buccal

D—distal

F—facial

I—incisal

L—lingual

M—mesial

O—occlusal

In multiple-surface restorations, two or more surfaces are involved

• The combined surfaces become one name on which the abbreviation is based

The rule for combining two surfaces is to substitute the letter “o” for the -al ending of the first surface

• For distal and occlusal, disto-occlusal (DO)

• For mesial, distal, and occlusal, mesio-occlusodistal (MOD)

Charting

Dental charting systems are available in a variety of diagram styles

Symbols are placed on the tooth diagram of the dental record to represent the various treatments and the types of dental material used to restore the tooth or teeth

Important to learn the charting symbols for treatment to be completed as well as for treatment already provided

Clinical Examination of the Patient

Role of the clinical assistant is to escort the patient to the clinical area for the examination process

You will follow a routine protocol for the patient

The patient is seated in the dental treatment area, draped with a patient “napkin,” and positioned for the dentist to begin the examination

Soft Tissue Examination

Involves a complete examination of the cheeks, mucosa, lips, lingual and facial alveolar bone, palate, tonsil area, tongue, and floor of the mouth

This examination requires the use of visual assessment and palpation

• The purpose is to detect any abnormalities in the head and neck area of the patient

Examination and Charting of the Teeth

The dentist examines each surface of each tooth and dictates findings to the dental assistant, who records the findings on the clinical examination form of the patient’s record

It is essential that all entries are recorded correctly and accurately

Examination and Charting of the Periodontium

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 measuring greater than 3 mm

Presence of furcation involvement

Mobility

The Treatment Plan

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

Treatment Plan Presentation

On completion of a thorough clinical examination, an appointment will be scheduled to present the treatment plan to the patient

• Typically, a 30-minute to a 1-hour appointment without interruptions is scheduled for the patient

It is important to have available the diagnostic tools to present the case

• The dentist should have readied the patient chart, radiographs, diagnostic casts, and treatment plans

Other visual aids might include the following:

• Before-and-after photographs

• Diagnostic casts of similar cases

• Models of proposed appliances

The patient is made comfortable, and the dentist takes care to present all information in terms that the patient can understand

After the presentation has been made, the dentist or finance manager will present the fee estimate for each treatment option

The patient is encouraged to ask questions and to discuss the advantages and disadvantages of each plan

When the patient makes a decision and accepts a treatment plan, he or she is giving informed consent for treatment

• The finance manager will explain the payment plans and make necessary financial arrangements with the patient

When these arrangements have been completed, the patient is scheduled for treatment

Label type of tooth issue from 1-6

1. Class 1- decay on the occlusal surfaces in the pits and curves

2. Class 2 (posterior)- decay on proximal surfaces of posterior teeth

3. Class 3 (anterior)- Mesial and distal decay

4. Class 4 (anterior)- decay is on mesial or distal side that includes incisal edge

5. Class 5 (posterior)- Gum line decay also known as cervical decay

6. class 6- decay that is on the cusp tips

Abbreviations

For single-surface restorations, charting abbreviations are based on the names of the tooth surfaces, which are?

Single Abbreviations:

B—buccal

D—distal

F—facial

I—incisal

L—lingual

M—mesial

O—occlusal

The rule for combining two surfaces is to substitute the letter “o” for the -al ending of the first surface

For distal and occlusal, disto-occlusal (DO)

For mesial, distal, and occlusal, mesio-occlusodistal (MOD)

Soft Tissue Examination

Involves a complete examination of the cheeks, mucosa, lips, lingual and facial alveolar bone, palate, tonsil area, tongue, and floor of the mouth

This examination requires the use of visual assessment and palpation. The purpose is to detect any abnormalities in the head and neck area of the patient

Examination and Charting of the Periodontium

Specific periodontal findings to be recorded include the following:

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 measuring greater than 3 mm

Presence of furcation involvement

Mobility

The Treatment Plan

Types of treatment plans

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

Treatment Plan Presentation

On completion of a thorough clinical examination, an appointment will be scheduled to present the treatment plan to the patient

Typically, a 30-minute to a 1-hour appointment without interruptions is scheduled for the patient

It is important to have available the diagnostic tools to present the case

The dentist should have readied the patient chart, radiographs, diagnostic casts, and treatment plans

Other visual aids might include the following:

Before-and-after photographs

Diagnostic casts of similar cases

Models of proposed appliances

The patient is made comfortable, and the dentist takes care to present all information in terms that the patient can understand

After the presentation has been made, the dentist or finance manager will present the fee estimate for each treatment option

The patient is encouraged to ask questions and to discuss the advantages and disadvantages of each plan

The patient is made comfortable, and the dentist takes care to present all information in terms that the patient can understand

After the presentation has been made, the dentist or finance manager will present the fee estimate for each treatment option

The patient is encouraged to ask questions and to discuss the advantages and disadvantages of each plan

When the patient makes a decision and accepts a treatment plan, he or she is giving informed consent for treatment

The finance manager will explain the payment plans and make necessary financial arrangements with the patient

When these arrangements have been completed, the patient is scheduled for treatment