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Transition 1: New Patient Assessment - Coggle Diagram

- - - - Social & family history: phys/psycho health can impact dental and general health:
        -married/kids- ages/ other dependents
        -Occupation/ job
        -Exposure to sunlight- skin & lip cancer, chef= caries
        -Personal circumstances: lifestyle/ work/ stress
        -Routine exercise- sports- risk of damaged teeth
        -location/ travel time/ difficulty attending
        -Recently abroad? tropical disease
        
        Habits:
        Smoking: smoker/ quit? How many a day/ how long?
        Attempts at quitting? Risks: perio disease, necrotising ulcerative gingivitis, oral cancer
        Betel quid or paan chewing with tobacco? Risk of oral cancer
        Alcohol consumption? Units per week? Risk of oral cancer, cirrhosis, risk of bleeding
        "Do you use any recreational drugs?"
        "Are you aware of grinding, clenching, or any other oral habits?"
        
        Diet Related Risk Behaviours:
        Diet: erosive, food/drinks, cariogenic
        Sugar intake frequency/ quantity and general diet quality
        
        request 4 day diet chart?- under further investigation. Juices, sugar, acidic drinks= erosive tooth wear
        Body weight relative to height if low-> eating disorder? bulimia= erosive tooth wear
        
        Family History:
        Hereditary condition suspected= health, age, MH of parents, grandparents, siblings, children
        Hereditary disorders: diabetes/ hypertension/ heart disease/ epilepsy/ breast cancer/ psychiatric conditions/ malignancies
        Oral: amelogenesis imperfecta/ aggressive periodontitis
  - - - -Gums: bleeding, soreness, food trap, bad breath
        -Prev prosthesis: broken, loose, anaesthetic, etc
        -Headaches, muscle pain, clicking/noises, movement
        History of accidents e.g. tooth loss, dentures, bridges
        Aesthetics: pt's assessment of own aesthetics
- - - - Lips:
        Visual exam: muscle tone, change in colour or texture, ulceration, patches herpetic lesions, angular cheilitis
        Lip competency/ incompetency 'competent lips' implies contact without strain when mandible is in rest position
        Palpate: bimanual palpation, look for lumps
      - Lymph Nodes Examination:
        lymph node palpable if abnormal
        Palpate from behind the patient
        If palpable, record: site, size, texture (soft, rubbery, hard), tenderness to palpation, fixation, coalescence (joining & merging of), no. of nodes
        
        Palpable Nodes Characteristics:
        -Acute infection: large, soft, painful, mobile, discrete, rapid onset
        -Chronic infection: large, firm, less tender, multiple
        Metastatic cancer: stony hard, fixed, painless
      - TMJ Examination:
        Observe range of movement:
        Maximum opening (measure at central incisors tip)
        Limitations and cause (pain or physical obstruction)
        -Observe lateral deviation
        -TMJ tenderness on palpation
        -TMJ sounds: clicks/ crepitus
        -TMJ locking/ dislocations
      - Muscles of Mastication:
        Examine for tenderness
        Test muscle attachment to bone- body not usually tender
        Lateral pterygoid: resistance to lateral excursion
        Medial pterygoid: not accessible to palpation
- - - - Importance of behaviours
        
        Reinforcement, demos, strategies for change