Diagnostics: Initial Consultation
The initial consultation is to assess the patient’s current dental status and determine which, if any, detailed investigations or referral are necessary before arriving at a diagnosis.
The first point to ascertain is the reason for attending, which can be pain, dissatisfaction with previous dentists, referral, coercion by family, friends and colleagues regarding poor dental health and/or appearance, second opinion, or a personal desire to improve dental health and aesthetics.
Dental history taking includes the following:
- Attitude to oral health;
- Regular or occasional attender;
- Dental records, models, photographs and radiographs from previous dentist(s);
- Dental phobias;
- Hobbies or habits that affect the dentition, e.g. playing a wind instrument;
- Sports, occupational hazards, or other risky activities;
- Persona and expectations about dental treatment;
- Financial status.
The extra-oral examination consists of a visual and tactile assessment. The skeletal structure, tegumental (skin) structure and the musculature are scrutinised, and deviations from the norm or pathological changes are noted.
- Skeletal: facial shape (ovoid, tapering, rectangular or square), facial profile (class I, II or III base), zygomata (prominent, receding), angle of mandible (prominent, receding), temporomandibular joint (TMJ) (deviation and/or clicking during movement, hypo- and hyperplasia of condyles) and maxilla (parallelism, prominent, receding, canting).
- Tegumental: swellings, lacerations, bruising, scarring (e.g. healing of previous disease or surgery, or result of facial cosmetic procedures), indelible tattoos, suppuratio/>