Diagnostics: History Taking
History taking is the first stage before embarking on dental treatment. Recent medical advances have prolonged life expectancy, and age-related and chronic illness treated with long-term medication influences an individual’s medical status. Furthermore, the ever increasing elderly population retain more of their natural teeth, requiring regular dental maintenance. Collating a patient’s history is not confined to medical anamnesis, but also takes account of familial medical traits and social habits. All these factors can, and may, affect dental procedures.
Family Medical History
There is widespread consensus among physicians that many diseases have a genetic origin, and a sibling may harbour genes which may or may not manifest as an eventual ailment. Also, many diseases are multi-factorial, and even if a given gene for a specific disease is possessed, it is not a foregone conclusion that disease will follow. For example, having a gene for cardiac problems does not mean that a myocardial infarction is inevitable. If diet, smoking and lassitude are controlled, an individual with a cardiac family history may never suffer a heart attack. The same is applicable with a family history of chronic periodontitis.
However, knowing the family medical background helps risk assessment and tailoring treatment plans unique for each patient. For example, an individual with a family history of diabetes and periodontitis will require more frequent periodontal maintenance to prevent activation of the offending gene(s) leading to periodontal destruction.
Many patients are reticent to divulge social practices since they do not perceive that this will influence their dental care. A caring and sympathetic approach is necessary, combined with detailed explanations, to obtain this information. For example, smoking, drug addiction or alcohol abuse affect many dental procedures and their prognosis. Another increasingly prevalent dental ‘disease’ is