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Chp 14: Clinical Exam: EOIO Exam and Dental Evaluation (Six steps to EOIO,…
Chp 14: Clinical Exam: EOIO Exam and Dental Evaluation
Six steps to EOIO
Visual exam
Palpation/Touch
Instrumentation
Percussion
Electrical Test
Auscultation/Sound
Self: 5 our of six steps are completed in the student clinic. We do not perform electrical test in clinic
Is oral cancer screening
Dental Evaluation
Dental charting completed during this step
Evaluation number of teeth, including missing (congenital or otherwise), reason for missing (e.g. perio, endo, or resto related), impacted, etc
Self: In clinic we complete initial dental evaluation by ourselves, then proceed to check/correct with dds
Detect and document suspected caries using G.V. Black's classification. DDS gives official diagnosis
Record restorations (composite, amalgam, inlay, onlay, crowns, bridges, implants, etc)
Malpositioning or proximal contact relationships (e.g. diastemas, drifting teeth,crowding, tipping, open contacts)
Assess tooth wear
Attrition: tooth-to-tooth, e.g. malocclusion
Abrasion: tooth-to-object
Abfractions: cervial third noncarious lesion
Erosion: chemical wearing away of tooth structure from non-caries etiology
Also check for intraoral appliances (e.g. ortho, retainers, splinting wires)
Tooth Stain Evaluation
Intrinsic: endogenous, from within the tooth
Grayish brown: Tetracycline
Brownish red/bluish black: Nonvital tooth, pulpal discoloration
Yellowish brown: dentin exposure/thinning of enamel (e.g. in older patients)
Whitish brown: decalcification
Extrinsic: exogenous, on tooth surface
Brown: tobacco, coffee/tea, chlorhexidine
Black-line: gram (+) rods, normal
Green stain: poor oral hygiene, chromogenic bacteria
Self: Extrinsic staining removed via scaling and polishing in clinic on our patients
Stains roughen tooth surface and allow for adherence of bacteria, increasing risk of inflammation/periodontal diseases
Best success in stain removal is to identify source and "fix it"
Dentinal Hypersensitivity
Is short, sharp, painful response to stimuli of exposed dentin. Often occurs on areas of recession/exposed root structure
Self: experienced myself temporarily after whitening for a couple of weeks!
Affects as much as 8-30% of U.S. adult population
Identification/diagnosis can be difficult, due to needing to rule out all other sources of possible pain (e.g. caries, endo, fracture)