Physical Evaluation and Treatment Planning in Dental Practice

The authors Gza T. Terzhalmy, DDS, MA, is Professor and Dean Emeritus in the School of Dental Medicine at Case Western Reserve University in Cleveland, Ohio, USA. Michaell A. Huber, DDS, is Adjunct Professor in the Department of Comprehensive Dentistry at UT Health San Antonio School of Dentistry in San Antonio, Texas, USA. Lily T. Garca, DDS, MS, FACP, is Professor and Dean of the University of Nevada, Las Vegas, School of Dental Medicine in Las Vegas, Nevada, USA. Ronald L. Occhionero, DDS, is Professor and Associate Dean for Administration at Case Western Reserve School of Dental Medicine in Cleveland, Ohio, USA.

Preface to the Second Edition ix Preface to the First Edition xi List of Contributors xiii About the Companion Website xv 1 Introduction to the Clinical Process 1 1.1 Essential Elements of the Clinical Process 1 1.2 Quality Management in the Clinical Process 2 1.3 PatientDoctor Communication in the Clinical Process 3 1.4 Characteristics of the PatientDoctor Relationship 6 1.5 Documentation of the Clinical Process 6 1.6 Designations and Abbreviations 10 1.7 Summary 18 Suggested Reading 18 2 The Historical Profile 19 2.1 Patient Identification 20 2.2 Chief Complaint (Problem) 20 2.3 Dental History 21 2.4 Medical History 21 2.5 Family History 22 2.6 Social History 22 2.7 Review of Organ Systems 23 2.8 Summary 35 Suggested Reading 36 3 Basic Procedures in Physical Examination 39 3.1 Inspection 39 3.2 Palpation 53 3.3 Percussion 53 3.4 Auscultation 54 3.5 Olfaction 54 3.6 Evaluation of Function 54 3.7 Summary 61 Suggested Reading 61 4 Examination of the Head and Neck 63 4.1 Examine the Head and Face 63 4.2 Examine the Ears and Temporomandibular Joints 98 4.3 Examine the Nose 99 4.4 Examine the Eyes 101 4.5 Examine the Hair 106 4.6 Examine the Neck 109 4.7 Examine the Lymph Nodes 113 4.8 Conclusion 116 Suggested Reading 117 5 Examination of the Oral Cavity 123 5.1 Examine the Vermilion of the Lips 123 5.2 Examine the Labial and Buccal Mucosa 131 5.3 Examine the Hard Palate 142 5.4 Examine the Soft Palate and Tonsillar Area 149 5.5 Examine the Tongue 152 5.6 Examine the Glossopharyngeal (IX) and Vagus (X) Nerves 157 5.7 Examine the Floor of the Mouth 158 5.8 Examine the Gingivae 161 5.9 Examine the Teeth 168 5.10 Summary 171 Suggested Reading 172 6 Radiographic Examination 177 6.1 Radiographic Examination of the New Patient 178 6.2 Radiographic Examination of the Recall Patient 179 6.3 Introduction to Radiographic Interpretation 180 6.4 Radiographic Manifestations of Common Conditions 181 6.5 Conclusion 201 Suggested Reading 201 7 Laboratory Methods 203 7.1 Hematology Screening 204 7.2 Evaluation of Hemostasis 205 7.3 Biochemical Tests 208 7.4 Tissue Studies 211 7.5 Summary 214 Suggested Reading 214 8 Diagnostic and Treatment Planning Considerations for Orofacial Pain 215 8.1 Subjective Information 216 8.2 Objective Findings 217 8.3 Plan: Treatment Options 221 8.4 Summary 224 Suggested Reading 224 9 Evidence-Based Treatment Planning in Restorative Dentistry 227 9.1 Historical Perspective 227 9.2 Etiology of Dental Caries 228 9.3 Caries Lesion Detection, Assessment and Diagnosis 230 9.4 Primary Caries Lesion Diagnosis and Risk Assessment 234 9.5 Developing a Minimally Invasive Evidence-Based Treatment Plan Predicated on Caries Risk 235 9.6 Diagnosis and Treatment of Root Caries Lesions 241 9.7 Clinical Detection and Diagnosis of Secondary or Recurrent Caries Lesions 242 9.8 Repair Versus Replacement of Direct Restorations 243 9.9 Summary 244 Suggested Reading 244 10 Periodontal and Peri-Implant Examination 249 10.1 Periodontal Evaluation 250 10.2 Establishing a Periodontal Diagnosis 256 10.3 Basic Principles of Periodontal Treatment Planning 262 10.4 Peri-Implant Examination and Diagnosis 264 10.5 Summary 264 References 265 11 Oral and Maxillofacial Surgery 269 11.1 Introduction 269 11.2 Medical History 270 11.3 Chief Complaint (CC) 270 11.4 History of Present Illness (HPI) 270 11.5 Past Medical History 271 11.6 Past Surgical History 271 11.7 Medications 271 11.8 Allergies 271 11.9 Social History 272 11.10 Last Meal 272 11.11 Review of Systems (ROS) 272 11.12 Physical Examination 272 11.13 Medical Status 275 11.14 Anesthesia Requirements 276 References 294 12 Endodontic Evaluation 295 12.1 Introduction 295 12.2 Pulp Status 297 12.3 Periradicular Status 299 12.4 Imaging Assessment 302 12.5 Additional Clinica