examination and preventiondentistry.sbmu.ac.ir/uploads/dental_terminology-chapter__7.pdf · initial...

Chapter 7

•Examination and prevention

Wednesday, May 25, 2016 Golbarg Kolahi 1

Initial examination

• Taking a general health history

• Checking vital signs

• Making a visual assessment

• Palpating head structures and mouth condition

• Examining oral cavity


Diagnostic test

• Radiographs

• Alginate impression

• Photography by extra and intra oral cameras


Health history

• Chief complaint

• medications taken

• General medical condition

• Allergies

• Past history of surgeries and illnesses

• Medical doctor’s name

• Emergency contact numbers


Vital signs

• Blood pressure

• Respiration

• Temperature

• Pulse

• pain


Visual assessment

• Symmetric face

• Asymmetric face


Facial imbalance conditions


Trismus

• Tension or contraction of mastication muscles


Dysphagia

• Difficulty in swallowing


Bell’s palsy

• A sudden, temporary unilateral facial paralysis with unknown cause

• Swelling of the facial nerve from immune or viral infection


TMJ

Temporomandibular joint

• Union of the joints of temporal and mandibular bones


Assessment of external lip

structure


Philtrum

• Median groove on the external edge of the upper lip to the base

of the nose.


Commisure

• Corners of the mouth where the lips meet.


Vermillion border

• Border where the pink-red lip tissue meets the facial skin.

Wednesday, May 25, 2016 Golbarg Kolahi 15l

Palpation

• method of determining the condition of a tissue using finger pressure

is palpating an area.


Palpation test

• Lymph nodes

• Neck muscles

• Lips, cheek, tongue and mouth tissue for swellings and irregularities

• TMJ area for movement and tenderness


Stethoscope

• A device for ausculating the joint area and blood flow in the carotid

arteries in the neck.


Examination of the oral tissue

• Done by regular halogen lighting .


Examination of the oral tissue

• Tongue is grasped by a gauze pad and extended to full length

• Gingiva and cheek areas are palpated


Diseases of oral cavity


Oral lesion

• Altered inflammatory tissue or infected by caused:

• Infection, hemorrhage, ulceration, melanoma, fat deposits, amalgam

tattoos, dilated veins.


Pericoronitis

• Inflammation around the crown of a tooth

• Happening normally with erupting third molar tooth.


ANUG

(Acute necrotic ulcerative gingivitis)

• Highly inflamed and dying gingival tissue


Cellulitis

• Inflammation or infection extending to nearby connective tissues


Fistula

• Tissue opening for pus drainage


Aphtous ulcer

• Small, painful ulcer within the mouth.


Thrush

• Fungus infection of mouth or throat as white patches on the tissue.


Candida albicans

• Sore, white plaque areas resulting from long term antibiotic therapy

permitting fungus buildup


Herpes simplex virus

• Virus caused vesicles or watery pimples that burst and crust .


Herpes simplex virus

(Fever blisters)

• When vesicles appear on the lips.


Gingivostomatitis

• When vesicles appear on the oral mucosa.


Cheilosis

• Inflammation of the corners of the lips.


Causes of Cheilosis

• Vit.B deficiency

• Candidiasis

• Ill fitting denture


Geographic tongue

• Flat, irregular red lesions on the backside of the tongue


Hairy tongue

• Small black or dark brown projections resembling hairs arising from

backside of the tongue.

• Caused by medication or drug treatment


Fissured tongue

• Deep crack in the center of the tongue dorsum.


Circumvallate papillae

• Large mushroom-shaped papillae on the posterior dorsum of the tongue.


Oral Cancer

• If suspicious lesions are detected in the mouth they could be

examined by excision and biopsy to determine their malignancy.


Detection of Carious Lesions

• using an explorer

• Using a laser caries detector hand piece unit to measure the fluorescence

level of undetected caries


Dental caries

• Decay

• Carious lesions


Streptococcus Mutans Bacteria

• Producing acid that causes tooth tissue to be destroyed through

decalcification and demineralization of the enamel and its matrix

spreading into other tissue structures.


Types of dental decay

• Incipient

• Rampant

• Recurrent

• Arrested


Incipient Caries

• Beginning decay


Rampant Caries

• Widespread and growing decay


Recurrent Caries

• Decay occurring under or near repaired margins of tooth restorations.


Arrested Caries

• Decay showing no progressive tendencies


Decays according to the destruction

of tooth surface

• Simple cavity

• Compound cavity

• Complex cavity


Simple Cavity

• Involving one surface


Compound Cavity

• Involving two surfaces of a tooth, charted as mesioocclusal(MO) or

distoocclusal(DO)


Complex Cavity

• Involving more than two surface charted as mesioocclusodistal(MOD)


Operative classification

• Class I through class VI based on the carious surfaces .


Periapical Abcess

(Gum Abcess)

• The cause of necrosis(death)of pulp tissue.


Stages of pulp irritation

• Hyperemia

• Pulpalgia

• Pulpitis


Hyperemia

• Increase in blood and lymph vessels as a result of pulp irritation


Pulpalgia

• Tooth ache as a result of pulp irritation and infection


pulpitis

• Inflammation and swelling of pulp tissue which leads to pulp necrosis.


Miscellaneous Maladies


Abrasion

• Wearing away of tooth structure from abnormal causes such as malocclusion

or bad habits


Erosion

• Destruction of tooth structure as a result of disease or chemicals such as

stomach acid.


Attrition

• Wearing away a tooth structure from normal causes like chewing or

mastication.


Ankylosis

• Tooth fixation, retention of deciduous tooth past exfoliation time, or

retention of permanent teeth that are fixed in the tooth sucket because of

absence of periodontal ligaments.


Avulsion

• Forcible removal of tooth


Bruxism

• Grinding of teeth esp. during sleep or as a bad habit


Abfraction

• Loss of tooth surface in the cervical area caused by grinding or compression forces

results in hypersensitivity of the area


Acid etching

• Loss of enamel surfaces on the lingual side of anterior teeth caused by

stomach acid fluids.


Alginate Impression


Negative Reproduction

• Each cusp or protrusion in the tooth becomes as a dent in the impression.


Positive Cast

• A gypsum reproduction of the patient’s mouth. Also called a STUDY

MODEL. Has two parts:

• Anatomical Portion

• Art Portion


Anatomical Portion

• Part of the cast reproducing the teeth and gingiva.


Art Portion

• Part of cast added to make an esthetic base support


Bite registration

• Piece of a wax material or pad placed into the patient’s mouth to register

the occlusion pattern when biting down on it.


Articulation

• Placement of positive cast into patient’s bite or articulating position.


Home Preventive Techniques

• Proper tooth brushing

• Proper flossing

• Diet correction


Home Preventive Techniques

done in a Dental Facility


Fluorosis

• Condition causing molting and discoloration of enamel tissue.


Systemic Fluoride

• Fluoride taken orally as water, drops, vitamins


Topical fluoride

• Fluoride being placed upon the tooth surface as gels, liquids, pastes.


Prevention Aids


Rinse

• Anti-plaque mouth rinses containing therapeutic chemicals that reduce

plaque.


Mouthwash

• Breath freshening rinse that may reduce pellicle.


Disclosing dyes


• Red/blue food coloring or sodium fluorescein solution being placed

upon tooth surface to stain or disclose the plaque.

Dentifrice

• Tooth powder or toothpaste for cleaning teeth and preventing halitosis


Floss holder and threads

• Devices used to hold or insert floss under bridgework and between teeth


Interdental brushes and picks

• Handles holding small brush tips to be inserted between the teeth and

into sulcus areas.


Wooden picks or flat balsam

wedges

• Stimulates interproximal gingival tissue circulation


Water irrigation machines

• Electrically powered water spray devices having pulsating tips for rinsing

interproximal areas.


Diet Plans

• Fewer cariogenic or caries forming meals and snacks

• Maintaining a balanced diet

• Keeping with a food pyramid of values


Dental facility preventive

practices

• Some decay-preventive procedures practiced in a dental facility


Fluoride application


Sealant application

• Placement of gel or liquid acrylic material on cleaned and acid-etched

occlusal surfaces for tooth covering and protection


Selective adjustment

(enamoplasty)

• Deep occlusal pits or fissures eliminated by selective abrasive or grinding

of some enamel surfaces results in lower chance of deep carious lesions.


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