Skip to content

Prerequirments

= Anatomy

== oral mucosa,teeth and gums

Prerequirments

  • Mouth mirror

  • Explorer

  • Teeth

  • Masticatory Mucosa (Keratinized) Found in the gingiva and hard palate Designed to withstand friction from chewing

  • Lining Mucosa (Non-keratinized) Found in the cheeks, lips, soft palate, floor of the mouth, and ventral tongue More flexible and movable

  • Specialized Mucosa Found on the dorsum of the tongue (contains taste buds)

upper and lower labial sulci

cheek mucosa

Tongue

floor of mouth

palate

hard palate

softpalate

throat

salivary glands

lining mucosa

ulcers of oral mucosa

site,shape,floor,base,edge

keratin and non-keratin

removable

non removable

congenital

acquired

traumatic

Lumps Xerostomia Halitosis Teeth Malocculsion Gingiva

pericoronitis

colour gingiva

  • periodic oral evaluation — established patient
  • limited oral evaluation — problem focused
  • oral evaluation for a patient under three years of age and counseling with primary caregiver
  • comprehensive oral evaluation — new or established patient
  • detailed and extensive oral evaluation — problem focused,by report
  • re-evaluation — limited, problem focused (established patient;not post operative visit)
  • comprehensive periodontal evaluation — new or established patient

Pre-diagnostic Services - screening of a patient - assessment of a patient

Models(odontograms) - pre treatment=> diagnostic - Treatment planning - During treatment - post treatment - again pre treatment

Patient record

  • chief complaint
  • background information
  • history of present illness Demographic information
  • Name
  • History
    • personal history
    • Medical history
    • persent illness history
      • dental history

Consultant • Clinical assessment (provisional diagnosis method) - General examination - psychological - physiological - local examination - Extraoral - Head(⅓) - Face(⅔) - shape/structure - symmetry - profile - Devergence - jaw-relations - proportions - Intraoral - Lip - Tongue

    - Gingiva
        - colour
        - size
        - Texture
        - contour
        - consistency
        - Bleeding on probe
        - position

    - Teeth
        - Type of dentition 
        - Tooth Presence
            - Number
                - ==Missing (= present)
                - ==supernumerary==
                - ==impacted==
            - Position
        - Tooth structure 
            - Segment 
                - flurosis
                - hypoplasia
                - stains
                - wasting
                - Bridge
            - Single
                - Decayed
                    - class
                    - Depth
                    - Type
                - Filled
                - Fractured
                - inclined
                - crown
        - Occlusal trauma
        - Occlusion
        - periodontal status
            - gingivitis
            - pockets
            - mobility
            - furcution
- Functional
  • Provisional Diagnosis
  • History centered diagnosis
  • Investigation Diagnosis
  • Diagnosis
  • prophylaxis
  • prognosis
  • Treatment plan

Referral - Treatment progress

Principles of treatment

Date

Examiner name

Patient ID

Name

For Identification

Date

Questioning technique

Rapport

Types of questions

Open=Tell me about the pain. Closed=What does the pain feel like? Leading= Does the pain feel like an electric shock?

Pros

Cons

When

Step -1 A detailed history

Personal history/Demographic details

The age, gender, ethnic group and occupation of the patient should be noted routinely; even though apparently trivial, such information is occasionally critical.

For Age related diseases or conditions Gender related Ethic groups habit related Occupational related

Dental history

Medical history

A medical history is important because it aids the diagnosis of oral manifestations of systemic disease. Some medical conditions they have there don't know or aware of it

These are specific evaluation so Last is better

History of the present complaint

It is the reason to visit the doctor which is in a symptoms of patient for treatment and suggests the diagnosis and

It is patient own words so hints patient's psychology

Types of symptoms or complaints - pain - Burning sensation - Bleeding - Loose teeth - occlusal problem - Halitosis - swelling - xerostomia - Bad taste - Repair

History of Present Illness of present complaint

Pain and it's chronology,causes,functions Character,severity,duration❗

It is imperative to obtain patients’ consent for any procedure, including examination. Requirements for consent

CLINICAL EXAMINATION(odontogram)

First, look at the patient, before looking into the patient’s mouth.

Extral Oral

Intra Oral

Examination of Nondental Structures(Soft tissues)

![[SmartSelect_20240622_112658_Drive.jpg]]

Oral hygiene Lips Gingiva Floor of the mouth Buccal mucosa Tongue Palate Tonsils and adenoids

Examination of Dental Structures(hard tissues)
Teeth

Difference between deciduous and permanent teeth Stains and calculus Percussion test Mobility and depressibility test Dental arch irregularities Occlusion Presence of periodontal pocket Furcation involvement Pulp testing or vitality testing Thermal testing Heat testing

  • Enamel opacities/hypoplasia are assessed on index teeth(14, 13, 12, 11, 21, 23, 24, 36, 46) using DDE index (43-52) while dental fluorosis is assessed using Dean's criteria (53).
  • CPI (54-59) and loss of attachment (60-65) are assessed on index teeth (17/16, 11, 26/27, 36/37, 31,
  • Dentition status (crown and root) and treatment needs are recorded for maxillary teeth (66-113) and mandibular teeth (114-161). In maxillary and mandibular teeth, status of crown and root are recorded separately followed by treatment needs.
  • Prosthetic status for upper and lower arches are entered while prosthetic need in 164 and 165.
  • Dentofacial anomalies are assessed using dental aesthetic index (DAI) with boxes for entering number missing incisors, canines and premolars in the dentition category (166-167), crowding (168), spacing (169), diastema (170), largest anterior maxillary (171) and mandibular irregularities ( 172) in the space category and anterior maxillary (173) and mandibular overjet (174), vertical anterior open bite (175) and anteroposterior molar relation (176) in occlusion category.

Need for immediate care and referral such as life treatening conditions (177), pain or infection ( 178), other conditions (179) and referral ( 180) are entered as the case may be. Space at the bottom is earmarked for notes to enter any patient's information which .is important.

The fifth edition of WHO Oral Health Surveys - Basic Methods makes the following recommendations for oral health surveys.

• Dentition status should be recorded in compliance with Lhe recommendations given in previous editions of this manual. Recording of specific dental treau11ent needs for india,dual teeth is no longer recommended. 161 • Recording of periodontal status by sextants or index teeth has been modified to include assessment of gingival bleeding and recording of pocket scores for all teeth present. Presence of calculus is not recorded. The recommendation not to probe pocket depth in children less than 15 years of age remains unchanged. Loss of attachment should be recorded using index teeth except in children under 15 years of age, • Recording presence of enamel fluorosis is recommended. Calculation of tJ1e community fluorosis index. • Loss of tooth substance due to erosion as well as the number of teeth involved. • Orodental trauma includes injury to the mouth, including tJ,e teetJ,, lips, gingivae and tongue, and jaw bones. • Recording of presence of fixed or removable dentures has been included in tJ,e adult assessment form. • Examination of the oral mucosa and recording of extraoral conditions and their location using standardized coding are included. Most common oral lesions occurring in human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are also recorded. • The section on intervention urgency specifies the recommended level of treatment in response to acute oral problems and the need for immediate referral to special care. This may also include preventive care or routine dental care required for large carious lesions witJ, or witJ1out accompanying pa.in or evident infection. Urgent intervention may also be needed in cases of reported pain and obvious signs of severe infection.

Gingiva

Jaw swelling Asthetics

The soft tissues of the mouth should usually be inspected first. Examination should be systematic to include all areas of the mouth

Again present illness if you see mouth

Medical examination

Provisional diagnosis /Tentative diagnosis

Investigation

Final Diagnosis

Treatment plan

Consultation form

  • List the availabilities of following examination(tests)=> diagnosis(diseases)=>prognosis=>treatment(procedures)

Examination

Parts -All parts -Thier type -Thier manifestations -complaints(clinical features) - Differentiation diagnosis - group of individual changes = disease (confrimed) -disease(diagnosis) -Treatment plan -Treatment

Manifestations - Systemic - Local

Never trust what patient or others say because thier don't know about it and draws false conclusion.Believe the fact what is present meanwhile Patient also never trust what a doctor say by that principle.

Chief complaint

I.urgent phase II. control phase III. re-evaluation phase IV. definitive phase V.maintenance phase

Promotive Emergency Etiotropic/Preventive Sugrical/Curative Restorative/Rehabilitation Recall/Maintenance

Shape of head

Cephalic index = maximum skull width / maximum skull length

Mesocephalic = average shape of head = 76 -80 Dolicocephalic = long and narrow = <76 Brachycephalic =broad,short = 80 -85 Hyperbrachycephalic = extremely wider = >85

Face

Facial features: The following features on the face should be noted during diagnosis of the patient: Perioral features • Length of the lips • Lip fullness • Apparent support of the lips • Philtrum • Nasolabial fold • Mentolabial sulcus or labiomental groove • Labial commissures and modiolus • Width of the vermillion border. It influences the degree of tooth display • Size of the oral opening (Fig. 2.3). It also influences the degree of tooth display • Texture of the skin: (rough or smooth and light color). Rough texture skin will require the placement of rugged teeth. Wrinkles on the cheeks show decrease in vertical dimension. All the above-mentioned factors aid to determine the shade,shape and arrangement of teeth

Facial form

Face form and arch form

FI = morphological facial height/bizygomatic width

Mesoprosopic = average or normal face =84-88 = oral arch form Leptoprosopic =long and narrow = 88-93 = V arch form Hyperleptoprosopic = extremely long = >93 Europrosopic =broad and short = 79- 84 = U arch form Hypeuroprosopic =short = <79

  • ovoid
  • square
  • Tapering
  • Square tapering

Facial symmetry

  • asymmetry
  • Symmetry

Asymmetry seen in unilateral ankylosis,unilateral condylar hyperplasia,hemifacial hypertrophy or atrophy

Vertical plane = bird's view Transverse plane = occlusion

Profile of face(anterior posterior jaw relation)

Facial profile it determines the jaw relation and occlusion. - Class I: Normal or straight profile (Fig. 2.8) - Class II: Retrognathic profile (Fig. 2.9) - Class III: Prognathic profile (Fig. 2.10). Facial prodiagnosis can also be classified as: - Convex: Class II jaw relation - Concave: Class III jaw relation - Straight: Class I jaw relation.

Straight/orthognatic Convex/posterior divergent= acute angle = class 2 div 1 Concave/anterior divergent= obtuse angle = class Method - lateral view - index finger

Facial height(Vertical skeletal relationship )

Method - upper facial height (UFH) and lower facial height(LFH) - frankfort plane

⅓ ⅓ ⅓ - ⅓ - ⅔

  • TFH
  • UFH
  • MFH

  • LFH

  • decreased

  • normal
  • increased

Muscle tone It affect the stability of the denture. - Class I: Normal tension,tone and placement of the muscle of mastication and facial expression. No degeneration. - Class II: Normal muscle function but slightly decreased muscle tone. - Class III: Decreased muscle tone and function.

Muscle Development People with excessive muscle development have more biting force. • Class I:Heavy • Class II: Medium • Class III: Light.

Complexion The color of the eye, hair and the skin guide the selection of artificial teeth

  • pale skin = anemia
  • pallor = hypothyroidism,nephrosis,poor nourishment
  • rubby
  • bronzed
  • diffuse bluish purple
  • Lemon yellow
  • increased pigmentation

Lip

Nasolabial angle

  • normal = 110

Philtrum

Lipstep

  • class l = positive lip step
  • class ll = negative lip step
  • class lll = pronounced positive lip step

Lip mobility • Class I: Normal. • Class II: Reduced. • Class III: Paralysis.

Lip contact • Class I: lower lip slightly behind upper lip. • Class II: lower lip much behind upper lip. • Class III: lower lip ahead of upper lip.

Lip support - supported - unsupported

Length of the lips: It is an important determinant in anterior teeth selection

  • long
  • Normal
  • short

Health of the lips: The lips are examined for fissures,cracks or ulcers at the corners of the mouth.

Lip type - Competent lip - Incompetent lip - Potentially incompetent lip - Everted lip

Interlabial distance Incisor exposure Lip trap

Mentallabial sulucus Mentalis activitiy Chin position and prominence

TMJ movements can be classified as: • Class I: Co-ordinated • Class II: Jerky • Class III: Restricted.

  • normal
  • tender
  • clicking

Lymph nodes - palpable - non palpable

  • tender

  • non tender

  • movable

  • fixed

Neuromuscular

Speech - normal - affected

Postural rest position

Cyclic jaw movement

Intraoral

Teeth - missing - periodontal status - gingival status - plaque - calculus - stains - recession - mobility - perio pockets - tooth structure - attrition - abrasion - erosion - wear facets - malformed - abfaction - alignment of teeth(maxilla and mandible arch) - rotation - migration - diastema - crowding - retained root pieces - spacing - transposition - axial inclination

Dentition

Dental status - no.of teeth present , unerupted or missing, eruption status - any overretained or impacted - dental and occlusial anomalies i.e dental caries , restorations, malformation, hypoplasia,wear and discoloration - individual tooth irregularities i.e rotations, displacements, individual cross bite, inclinations that give rise to either crowding and spacing

  • no.of teeth
  • carious, missing, periapical Pathology, restorative ,root stumps

  • tender on percussion

  • calculus

  • stains
  • number of teeth present
  • number of teeth unerupted
  • supernumerary and missing teeth
  • shape,size,form of teeth
  • texture ;caries
  • restorated and endodontically treated
  • occlusal wear facets
  • prosthesis

Dental caries

History examination - pain - diet

Clinical Examination

  • class I
  • class ll
  • class lll

  • class IV

  • pit and fissure

  • smooth surface

  • root caries

  • amalgam

  • glass isomer

  • composite

  • incipient(upto enamel)

  • (upto dentin)

  • deep caries (upto pulp)

  • restored

  • to be restored

Occlusal analysis (relation of upper and lower arches)

Type of Occlusion Overjet Overbite Cross bite Open contact Food impaction(plunger cusp) Molar relation Canine relation Baumes Angles

  1. Maximum opening(incisal edges)
  2. Freeway space

  3. Curve of spee

  4. Anterior posterior relationship

  5. molar relation
  6. sub division
  7. canine relation
  8. incisor relation

  9. overjet

  10. Vertical relationship

  11. overbite

  12. Transverse relationship

  13. normal
  14. cross bite
  15. scissor bite
  16. buccal non occlusion
  17. lingual non Occlusion
  18. Unilateral

  19. bilateral

  20. Dental midline

Developmental defects

Fremitus test

Roentgenographic findings

Definitive prognosis

Oral mucosa - condition - Thickness - mucosal displace ability Saliva - quantity - quality Hard palate Soft palate - morphology - palatal throat form - proportional of lateral throat form - gauge reflex and palatal sensitivity - incisive papilla - rugae - mucosa - palatal vault - junction of hard and soft palate - posterior palatal seal area Bony undercuts Tori Frenal attachment Vestibule

Tongue

  • Tongue Size
  • tongue position

  • tongue shapes

    • lateral surface and floor of mouth(oral mucosa)
    • top of tongue(specalized mucosa)

Tongue

Tongue size House's classification of tongue sizes

- Class I: Normal in size,development and function.Sufficient teeth are present to maintain this normal form and function - Class II: Teeth have been absent long enough to permit a change in the form and function of the tongue. - Class III: Excessively large tongue. All teeth have been absent for a extended period of time,allowing for abnormal development of the size of the tongue.Insufficient denture can sometimes lead to the development of class-3 tongue.

Wright's classification of tongue positions - Class I: The tongue lies in the floor of the mouth with the tip forward and slightly below the incisal edges of the mandibular anterior teeth - ideal - Class II: The tongue is flattened and broadened but the tip is in a normal position (Fig. 2.73). - Class III: The tongue is retracted and depressed into the floor of the mouth, with the tip curled upward, downward or assimilated into the body of the tongue.

  • macroglossia
  • normal
  • macroglossia

Vestibule - maxilla - labial - buccal - mandible - labial - buccal - deep shallow

Tongue Shape Smith described two anatomic tongue types: • Broad flat thick: Better for border seal but may complicate impression procedures. • Long tapered narrow: Fewer problems during impression making but less effectiveness for lingual border.

Bone resorption

Residual ridge

  • arch size
  • arch shape
  • arch symmetry
  • ridge undercuts
  • ridge contour
    • maxilla
    • mandible
  • ridge relation
  • ridge parallelism
  • inter-maxillary space
  • mylohyoid ridge

Mucosa

Condition of mucosa(colour) • Class I: Healthy mucosa • Class II: Irritated mucosa • Class III: Pathologic mucosa.

Thickness of the mucosa(thickness) - Class I: Normal uniform density of mucosal tissue (approximately 1 mm thick). Investing membrane is firm but not tense and forms the ideal cushion for the basal seat of the denture. - Class II: (Fig. 2.15). It can be of two types: 1. Soft tissues have a thin investing membrane and are highly susceptible to irritation under pressure. 2. Soft tissues have mucous membranes that are twice the normal thickness. - Class III: Soft tissues have excessively thick investing membranes filled with redundant tissues. This requires tissue treatment.

Mucosal Displaceability

  • Type 1 : Tissues can be displaced approx 2 mm, cushion like yet no gross positional displacement
  • Type 2a: Tissue thinner than 2 mm usually unyielding often atrophic, with smooth surface and poor for developing good adhesion and leader seal.
  • Type 2b: Tissue thicker than 2 mm easily displaced, poor stress bearing (usually under ill-fitting dentures)
  • Type 3: Excessively flabby to the degree that surgical excision is needed.

lesion

Saliva

Saliva quantity - class 1: normal quantity and quality - class 2: excessive saliva with mucin - class 3 : xerostomia and tissue irritation Saliva quality - scanty - copious - normal

Hard palate • U-shaped:Ideal for both retention and stability (Fig. 2.41). • V-shaped: Retention is less, as the peripheral seal is easily broken (Fig. 2.42). • Flat: Reduced resistance to lateral and rotatory forces.

Soft palate - Class I: It is horizontal and demonstrates little muscular movement In this case more tissue coverage is possible for posterior palatal seal - Class II: Soft palate makes a 45° angle to the hard palate.Tissue coverage for posterior palatal seal is less than that of a class I condition (Fig. 2.45). - Class III: Soft palate makes a 70° angle to the hard palate. Tissue coverage for posterior palatal seal is minimum

Morphology of soft palate You and Zhu's classification of soft palate based on cephalometric appearance,palatal (DMFR 2008)36 throat form can be classified as: • Class I: Leaf shaped (Fig. 2.47) • Class II: Rat tail shaped (Fig. 2.48) • Class III: Butt-like shape (Fig. 2.49) • Class IV: Straight line (Fig. 2.50) • Class V: Distorted (Fig. 2.51) • Class VI: Crook shaped (Fig. 2.52).

Classification of Palatal Throat Forms

Class I: Large and normal in form, relatively with an immovable band of tissue 5-12 mm distal to a line drawn across the distal edge of the tuberosities (Fig. 2.53). Class II: Medium sized and normal in form,with a relatively immovable resilient band of tissues 3-5 mm distal to a line.drawn across the distal edge of the tuberosities (Fig. 2.54). Class III: Usually accompanies a small maxilla. The curtain of soft tissue turns down abruptly 3-5 mm anterior to a line drawn across the palate at the distal edge of the tuberosities

Proportion of Lateral Throat Forms Huang et al.(UP;2007) determined the proportion of lateral throat forms and found the following: Class l: 70% Class ll: 25% Class III: 5%

Gag reflex and palatal sensitivity - Class I: Normal - Class II: Subnormal (Hyposensitive) - Class III: Supernormal (Hypersensitive)

Classification of Bony Undercuts - Unfavorable undercuts/Bilateral undercuts: to stabilise the denture, surgical reduction may be necessary. - Unilateral undercuts: denture can be placed by changing the path of insertion or by relieving pressure areas.

Tori - Class I: Tori are absent or minimal in size.Existing tori do not interfere with denture construction (Fig. 2.60). - Class II: Clinical examination reveals tori of moderate size. Such tori offer mild difficulty in denture construction and use. Surgery is not required (Fig. 2.61). - Class III: Large tori are present. These tori compromise the function and fabrication of dentures. Such tori require surgical contouring or removal.

Muscle and Frenal Attachments - Class I: Attachments are placed away from the crest of the ridge. There is at least 0.5 inches distance between the attachment and the crest of the ridge= normal - Class II: Distance between the crest of the ridge and the attachment is around 0.25 to 0.5 inches.=Prominent - Class III: Distance between the crest of the ridge and the attachment is below 0.25 inches= Tongue tie

Classification of frenal attachments

- Class I: The frenum is located away from the crest of the ridge (Fig. 2.66) - Class II: The frenum is located nearer to the crest of the ridge (Fig. 2.67) - Class III: Freni encroach the crest of the ridge and may interfere with the denture seal. Surgical correction may be required Blanch test

Radiographic Assessment of Bone Resorption. Class I: (Mild resorption) loss of up to one-third of the vertical height. Class II: (Moderate resorption) loss of up to two-thirds of the vertical height. Class III: (Severe resorption) loss of more than two-thirds of the vertical height.

Residual Alveolar Ridge Arch size - Class I: Large (ideal retention and stability). - Class II: Medium (good retention and stability). - Class III: Small (difficult to achieve good retention and stability). Arch form - Class I: Square - Class II: Tapering - Class III: Ovoid Ridge contour • High ridge with flat crest and parallel sides (most ideal) • Flat ridge (Fig. 2.24) • Knife-edged ridge (Fig. 2.25).

Classification of maxillary ridge contour Class I: Square to gently rounded. Class II: Tapering or "V"-shaped. Class III: Flat.

Classification of mandibular ridge contour: Class I: Inverted "U"-shaped (parallel walls, medium to tall ridge with broad ridge crest) Class II: Inverted"U"-shaped (short with flat crest) (Fig. 2.27). Class III: Unfavorable

• Inverted"W"(Fig. 2.28) • Short inverted"V"(Fig. 2.29) • Tall,thin inverted"V"(Fig. 2.30) • Undercut

Ridge relation • Class I: Normal (Fig. 2.32) • Class II: Retrognathic (Fig. 2.33) • Class III:Prognathic (Fig. 2.34).

Ridge parallelism Class I: Both ridges are parallel to the occlusal plane Class II: The mandibular ridge diverts from the occlusal plane anteriorly Class III: Either the maxillary ridge diverts from the occlusal plane anteriorly or both ridges divert from the occlusal plane anteriorly

Inter-arch space Class I: Ideal inter-arch space to accommodate the artificial teeth (Fig. 2.38). Class II: Excessive inter-arch space (Fig. 2.39). Class III: Insufficient inter-arch space to accommodate the artificial teeth (Fig. 2.40

Adenoids facies

Examination of dental arch

Arch form

symmetry and shape - oval or normal - U - V

Coincidence of midline - congruent/concordant - incongruent/discordant

Alightment - crowding - spacing

Curve of spee

Apical bases - sagittal plane - vertical plane - transverse plane

Functional examination

  • postural rest position and inter-occlusal space
  • stomatognatic
  • orofacial dysfunction

Postural rest position.

Respiration - nasal - oral - ora-nasal Deglutition - normal - infantile Mastication - normal - abnormal Speech - normal - slurred - abnormal Path of closure - normal - deviation - deflected TMJ movements Postural rest position Incisor exposure at - rest - speech - smile

record

history

Ii. History of present illness 1. duration of tooth loss Upper: Lower: 2. Primary reason for loss of teeth a. periodontal disease b.Dental caries c.other 3. Previous Denture experience and it's duration

Socio- psychological status Patien

Remarks on existing partial denture - good or poor - cleanliness - stability - retention - vertical dimension - condition of the teeth - centric occlusion - extension of base

Radiographic examination - general - supporting teeth in detail - crown evaluation - root evaluation - crown root ratio - alveolar bone

Investigation - TLC - DLC - HB - BT - CT - ESR - urine examination for sugar - urine examination for albumin

  • plasma sugar

  • microscopic examination

  • blood urea

  • blood grouping
  • KFT
  • LFT
  • sickling test
  • P.S
  • biopsy
  • x rays
  • physician evaluation
  • local Anaesthesia sensitivity test
  • sugrical notes

Hospitalized result - cured - relieved - follow up - no change - expired

Intraoral

Oral hygiene status - ohi - debris and calculus

Examination of gingiva - colour - size - contour - position - surface texture - consistency - exudate - bleeding

PSR

Periodontal status

  • Pathological migration
  • furcution involvement
  • mobility

  • pockets -4 sides

  • pockets

  • mobility
  • furcution involvement
  • Pathological involvement

Mucogingival problems - pockets/recession mucogingival junction - frenal attachment - width of attached gingiva - depth of vestibule - tension test

  • emergency phase
  • preventive phase
  • restorative phase
  • endodontic/sugrical phase
  • interceptive/corrective phase
  • followup/maintanence phase

amalgam

Involved tooth Dental caries extent = incipient,deep,very deep. Opposing tooth = present/absent/plunger cusp

Procedures - cavity preparation type - cavity lining and matrix - pulp capping direct/indirect - temporary filling - permanent filling carving & finishing

pit and fissure/Glass isomer/composite

Involved tooth Dental caries: black class lll class IV Extent: incipient, deep , very deep Fracture: Ellis class I ,class ll,class III

Procedures - tooth prepration - pulp protection - acid etching and bonding - finishing and polishing

root canal

Involved tooth Lesion - dental caries (decay) - abrasion/erosion(resorption ) - injury (fracture) - intact - discolored - fractured - elis class restoration - type - duration Pain Swelling Sinus Percussion Mobility Periodontal status Pulp Vitality test - electrical - thermal Periapical status - lamina dure - lesion - size - shape - radiopaque border

ortho

prenatal

Informer - patient - father - mother Condition of mother during pregnancy Delivery - full term - premature Type - normal - forceps - caesarean

post-natal history

Feeding - breast - bottle - combined - duration, frequency,type

Milestones - sitting, crawling, standing,walking,running, speaking

Childhood diseases Trauma and accidents

Habits - finger - thumb sucking - nail biting - tongue biting - tongue thrusting - bruxism - mouth breathing - frequency, intensity, duration

Family history - malocclusion, consanguineous

Pubertal status.

Motivation for treatment

Nine Categories of the Ackermar and Proffit Diagram 1. Alignment (spacing, crowding) 2. Profile (convex, straight, concave) 3. Transverse deviation ( crossbites) 4. Sagittal deviation (Angle class) 5. Vertical deviation (deep bite, open bite) 6. Transsagittal deviation (combination of crossbite and Angle class) 7. Sagittovertical deviation (combination of Angle class and deep bite or open bite 8. Verticotransverse deviation (combination of deep bite or open bite with crossbite) 9. Transsagittovertical deviation (combination of problems in three planes of space)