Cheat Notes for Quality

[Dental Bytes][Feature Byte]
Cheat Notes for Quality:
dots.gif - 0.0 K
How thorough are your new patient examinations? Most of us wouldn’t overlook taking radiographs, reviewing the patient’s medical history, or charting existing conditions…..But – do we give the same attention to these 4 equally important components of the comprehensive dental exam?

Blood Pressure
Cancer Screen
Perio – Quick Screen
Occlusal Screen

The advantage when the same sequence of data is collected in an organized manner? “Errors of omission” are minimized.

dots.gif - 0.0 K
Blood Pressure:
Make the BP the first entry in the patient’s chart – (in fact this is a legal requirement in some states.) BP above 150/90 may necessitate a medical consult .dots.gif - 0.0 K

Cancer Screen:
Inform while you perform and document in the patient’s records.

image1. A sequence for Palpation of Lymph Nodes
Visualize this sequence as riding a “roller-coaster”.

clear.gif - 0.0 Kcheck.gif - 1.4 K Preauricular (In front of the ears)
clear.gif - 0.0 Kcheck.gif - 1.4 K Postauricular (behind the ears)
clear.gif - 0.0 Kcheck.gif - 1.4 K Inferior border of mandible
clear.gif - 0.0 Kcheck.gif - 1.4 K Beneath the chin
clear.gif - 0.0 Kcheck.gif - 1.4 K Anterior Cervical
clear.gif - 0.0 Kcheck.gif - 1.4 K Posterior Cervical


dots.gif - 0.0 K

2.A Sequence for Perioral & Intraoral Cancer Screen
Visualize this sequence as the high risk “cancer ring” or “donut”..

clear.gif - 0.0 Kcheck.gif - 1.4 K hard & soft palate
clear.gif - 0.0 Kcheck.gif - 1.4 K retromolar area.
clear.gif - 0.0 Kcheck.gif - 1.4 K floor of the mouth
clear.gif - 0.0 Kcheck.gif - 1.4 K lips
clear.gif - 0.0 Kcheck.gif - 1.4 K lateral borders of the tongue*
clear.gif - 0.0 Kcheck.gif - 1.4 K ventral surface of the tongue*
clear.gif - 0.0 Kcheck.gif - 1.4 K labial & buccal mucosa

* Most common sites for oral cancer

For an outstanding online tutorial (including photographs) on how to perform a clinical head and neck examination go to the Baylor College of Dentistry website. This tutorial also includes cancer warning signs & photos of Precancerous Lesions.

dots.gif - 0.0 K

Periodontal Quick – Screen:
There have been a number of suggested methods for quick-screening patients for periodontal disease. The method described here is an amalgamation of several different techniques. A perio screen can be a reliable tool to determine who will require a comprehensive periodontal examination.

dots.gif - 0.0 K


click here to clear form in order to print a copy.

If you are not comfortable using the traditional diagnostic terms, i.e. Perio Class I, Class II, etc. try using more functional terms such as:

Overall Periodontal Diagnosis:

clear.gif - 0.0 Kcheck.gif - 1.4 K Mild to Moderate Gingivitis
clear.gif - 0.0 Kcheck.gif - 1.4 K Moderate to Severe Gingivitis
clear.gif - 0.0 Kcheck.gif - 1.4 K Severe Gingivitis
clear.gif - 0.0 Kcheck.gif - 1.4 K Mild to Moderate Periodontal Disease
clear.gif - 0.0 Kcheck.gif - 1.4 K Moderate to Severe Periodontal Disease
clear.gif - 0.0 Kcheck.gif - 1.4 K Severe Periodontal Disease
clear.gif - 0.0 K

You won’t want to miss UCLA’s Periodontics Information Center. The Center is dedicated to collecting and presenting the most current and comprehensive information about periodontics on the internet.

dots.gif - 0.0 K

Occlusal Screen:
There are numerous number of aids that can help in the complete examination of masticatory disturbances. An occlusal screen may help identify those patients who will require a complete occlusal work-up prior to treatment.

dots.gif - 0.0 K

clear.gif - 0.0 Kcheck.gif - 1.4 K Is there pain when chewing or opening wide?
clear.gif - 0.0 Kcheck.gif - 1.4 K Does patient’s jaw click or pop?
clear.gif - 0.0 Kcheck.gif - 1.4 K Does patient clench during the day?
clear.gif - 0.0 Kcheck.gif - 1.4 K Does patient grind teeth at night?
clear.gif - 0.0 Kcheck.gif - 1.4 K Is there pain in face, jaws, neck, or near the ears?
clear.gif - 0.0 Kcheck.gif - 1.4 K Is there limited opening?
clear.gif - 0.0 Kcheck.gif - 1.4 K Palpate the TMJ while patient opens, closes moves laterally, protrudes.