will help u understand what things should be asked in diagnosis of periodontology dept

1. IMPORTANCE OF
HISTORY TAKING
AND
EXAMINATION
IN
PERIODONTICS
AYESHA ZAHEER
POSTED IN PERIODONTICS
HOUSE OFFICER

2. • first and foremost step in the successful diagnosis and treatment planning
• planned professional conversation with the patient that enables the pt. to communicate their symptoms.
• Interest, warmth and compassion by the clinician during history establish a rapport with the pt. and to gain confidence
• Good clinician start examining the pt. when he walks into the clinic

3. Taking the history of pt. we often relies on info provided by the pt.
Means that awareness of dentist about the history, feelings and attitudes of pt. and their ability to communicate with
them are among the most imp task
The effectiveness o taking and registering medical history is based on having constructive relationship with the pt.

4. Name
Age To recognize age specific diseases
o Juvenile periodontitis
o Pre pubertal periodontitis
o Pubertal gingival conditions
Gender to recognize gender specific conditions
o Changes associated in pregnancy
o Pre pubertal periodontitis
Juvenile
Social status
Occupation
Ppl working in chemical factories may be erosion associated with dentinal sensitivity, workers exposed to abrasive
dust may have severe abrasion, or any carpenter or tailer might have abrasion ,health care workers may be become
carriers of transmissible disease
Address for any specific conditions like fluorosis

5. Chief complaint
Brief statement of pt. to basically to know about the active problem.
Ideally there should be open ended questions
HOPC
every symptom and sign in the chronological order
If pain, then OLD CARTS
If lesion, when he first noted, mode of development, symptom and treatment
If bleeding gums, time of onset, spontaneous/while brushing/while eating
Periodontal pain is usually felt dull and deep in bone and is usually relieved by clenching teeth. Sharp pain is usually
of endodontic region
Swelling should be noted if its chronic or acute

6. • Many medical problems have a significant effect on
dental treatment and vice versa
• Dentist’s awareness of disease and medication
• May be related to diagnosis
• Importance to be explained to the pt. often omit info
that he cannot relate to their dental problems
• Precautionary measures indicated in some cases
MEDICAL HISTORY

7. • We record pts attitude towards previous dental treatment
• previous dental treatment
• frequency of past visits
• prev. periodontic, endodontic treatment
• reason for tooth loss,
• fluoride history
• radiation or other therapy for oral and facial lesions
• orthodontic treatment duration and termination

8. MEDICATION
Many pts are on medications for systemic condition
IMMUNIZATIONS
Covid19, HBV
BREIF GYNECOLOGICAL HISTORY
For pregnant pt. surgical treatment should be avoided, if necessary then carried out in second
trimester of pregnancy
PERSONAL HISTORY should be asked about oral hygiene and dietary habits ,any adverse habits
as they can affect the treatment plan
Details about oral hygiene measures. Frequency and technique of brushing

9. CLINICAL EXAMINATION
Extraoral and intraoral
Extraoral
Intraoral examination
Oral hygiene
Oral malodor
oral mucosa and other structures like buccal mucosa, fom, frenum, soft palate, hard palate, vestibule
Hard tissues
number of teeth,wasting diseases, Occlusion, food impaction, proximal contacts, tooth mobility
Pathological migrations because of premature post. Contact, tongue thrusting habit
Sensitive to percuss
Examination of gingiva
Recognition of gingival inflammation
Color
Contour
Consistency
Surface texture

10. Radiographic examination
• Presence and absence of laminar dura
• Width of periodontal membrane space
• Height and form of interdental bone
• Overhanging margins of the restorations
• Status of interradicular area
• Presence and absence of periodontal pocket
• Quality of bone
• Furcation involvement

11. Achieving a correct diagnosis
Communicating with the patient
Informing the patient about his situation
Designing treatment planning
Determining appropriate prognosis
Managing the patient
Keeping data
Attaining communication between doctor and dentist
Discovering preventive factors
Preparing legal documentation
Developing clinical studies, and
Providing educational programs
Referral to any physician
Further investigations
Research

12. Have a good day