This document provides an overview of case history, diagnosis, and treatment planning procedures. It discusses collecting information such as the chief complaint, medical history, history of present illness, and examinations including general, extraoral, intraoral, and diagnostic assessments. Indices for gingivitis and plaque are described. Various diagnostic aids for dental caries are listed. Phases of treatment planning including systemic, preparatory, corrective, preventive, and maintenance are outlined.

1. Department Of Pedodontic
& Preventive Dentistry
Topic: Case History,Diagnosis &
Treatment planning
Presented by:
Chavan Sneha S.(intern)
Guided by:
Dr. Kranti Kumar
Dr. Mayur Bhattad

2. Chief Complaint
 The chief complaint is usually the reason
for the patient's visit.
 It is stated in patient's own words in
chronological order of their appearance
& their severity.
 The chief complaint aids in diagnosis &
treatment therefore should be given
utmost priority.


3. Medical History
 Child under any physician
care
 Medication & allergy
 Hospitalisation
 Blood transfusion
 Immunization status of child

4. History of Present illness
 Elaborate on the chief complaint in detail
 Ask relevant associated symptoms
 The symptoms can be elborated in terms of:
a) Mode & cause of onset
b) Duration
c) Location-localised,diffuse,
radiating,referred
d) Progression-continous or
intermittent
e) Aggravating & Relieving factors
f) Treatment taken

5. Prenatal,Natal & Postnatal History
Prenatal History
a) Health of mother during
pregnancy
b) Diseases to mother
c) Accident/ traum during
pregnancy
d) Abnormal fetal position

6. Natal History
a) Trauma, Childhood disease
b) Rh incompatibility
c) Neonatorum jaundice
Postnatal History
a) Feeding Habit: Breast feeding
or bottle

7. EXAMINATION
General examination
It begins with the first appearance of
child along with the parents.The child
should be checked for:
a) Gait
b) Built
c) Height
d) Posture
e) Speech
f) Icterus
g) Cynosis
h) Nails

8. Cyanosis

9. Extraoral examination of Head &
Neck
a) Shape of Head
b) Shape of Face
c) Facial profile &
symmetry
d) Eyes
e) Ears
f) Nose
g) Neck
h) TMJ
i) Lymph nodes

10. a) b) C)
Classification of Head type:
a) Mesocephalic head
b) Dolicocephalic head
c) Brachycephalic head

11. Facial Profile:
a) b) c)
a) Straight profile
b) Convex profile
c) Concave profile

13. Examination of lymphatic group
around skull base:
a) Submental
b) Submandibular
c) Parotid
c)Postauricular
d) Occipital

15. Intaoral examination of Head & Neck
A) Oral soft tissue :
a) skin/lips
b) Mucosa
c) Palate
d) Gingiva
e) Tongue
f) Tonsils/adenoids

16. B) Oral hard tissue evaluation :
Federation Dentaire Internationale (FDI)
scoring system :
a) Two-digit system.
b) Proposed by FDI has been adopted by the WHO
& by other organizations such as international
association of Dental Research.
c) The first digit indicates the quadrant 5 to 8 for
primary dentition .
d) The second digit indicates the tooth within the
quadrant 1 to 5 for primary dentition.
Upper Right Upper Left
55 54 53 52 51 61 62 63 64 65
85 84 83 82 81 71 72 73 74 75
Lower Right Lower Left

17. INDICES
A)Gingival index
Developed by Loe H & Silness P in 1963.
For assessing severity of gingivitis & its location
by examining qualitative changes of gingival
tissues.
METHODS:
The severity of gingivitis is scored on all teeth
or on selected index teeth.
INDEX TEETH:
16,12,24,36,32,44
Tissues surrounding each toth divided into 4-
gingivalscoring units
DISTO-FACIAL PAPILLA
FACIAL MARGIN
MESIO-FACIAL PAPILLA
LINGUAL GINGIVAL MARGIN

18. Scoring criteria for the Gingival Index:
0=Absence of inflammation-Normal Gingiva
1=Mild inflammation,slight change in color,slight
edema,No Bleeding on probing
3=Severe inflammation,marked
redness,ulceration,spontaneous bleeding.
Calculation of the indrx:
The scores around each tooth are totalled & divided
by 4-the gingival index of individual tooth is
obtained.
Totalling all the scoresvper tooth & dividing by the
number of teeth examined provides the gingival
index scores per person.
Inference: Score of 0.1 - 1.0=Mild Gingivitis
Score of 1.1 -2.0=Moderate Gingivitis
Score of 2.1 - 3.0=Severe Gingivitis

19. B)Plaque Index:
Described by Silness P & Loe H in 1964.
This index measures the thickness of plaque
on the gingival one third.
Good validity & reliability.
Used as full mouth index/simplified index.
INDEX TEETH:
16,12,24,36,32,44.
Areas examined:
Disto-facial
Facial
Mesio-facial &
Lingual surface of the tooth.

21. Diagnostic aids in
Dental
Caries

22. Various diagnostic aids used in dental caries:
 Visual method
 Visual tactile method with light ,mirror,and
gentle probing
 Meticulous clinical visual method involving floss
 Visual method with temporary elective tooth
separation with/without impression of
approximal lesion.
 Caries activity test
 Radiographic methods
 Electrical conductance method
 Fiber-optic transilluminition(FOTI) method
 Quantitative laser flourescence method
 Ultrasonic detection
 Dye penetration method

23. PERIOTEMP
 The PEROTEMP measures elevated
 tempratures in the periodontal pocket
 surrounding the teeth
 If an elevated temprature reading is
 detected,this equates with the degree of
inflammation that is occuring at a specific gingival
site
 This inflammation directly relates to the
 presence of periodontal disease

24. COMPUTER-ASSISTED DENSITOMETRIC IMAGE
ANALYSIS SYSTEM
 Video camera measures
the light trasmitted through
a radiography and the
signal from the camera are
converted into gray-scale
images.
 highersensitivity and a high
degree of reproducibility
and accuracy.

25. PHASES OF TREATMENT PLANNING
SYSTEMIC
PHASE
-Antibiotic
prophylaxis
-Sedation
PREPARATORY PHASE
-Behavior management
-Oral prophylaxis
-Caries control
-Orthodontist consultation
-Oral surgical procedure
-Endodontic therapy
MAINTENENCE PHASE
-Recall after3-6months
-Review of oral health status
-Reinforcement of home care measure
-Motivation & re-counselling of parents
-Follow up of treatment planning
CORRECTIVE PHASE
-Restorative dentistry
-Prosthetic reahabilitation
-Early orthodontic
intervention
PREVENTIVE
PHASE
-Caries risk
assessment
-Fluoride
application
-Pit & fissure
sealent
-Diet counselling

26. THANK
YOU !!!