Transcript Clinical Oral Examx

Oral Health-General Health
The Clinical Oral Exam
William T. Schlosser, DMD
[email protected]
www.drschlosser.com
WHY YOU NEED TO KNOW?
bi-directional
ORAL HEALTH ----------------- GENERAL HEALTH
relationship
Periodontal Disease --Inflammation -- Bone and Tooth Loss - Poor diet -- Obesity -- Type 2 diabetes
CORNERSTONE#1:
OPTIMAL LIFESTYLE
We advise optimal dental care to ward off
periodontal disease, which can double or even
triple the threat of a heart attack or stroke. In
addition, studies have linked good oral health to
a longer life and lower risk for a wide range of
disorders from colds and flu to diabetes and
even dementia.
BEAT THE HEART ATTACK GENE P. 222
OPPORTUNITIES
• Pregnancy
• Well Child
• Sick Visit
• Trauma
EXAM TYPES
• Comprehensive
• Limited
• Periodic
• Periodontal
• TMD
• ?Medical Oral Health Exam?
EXAM
A. Take out removable teeth
B. Anatomy
C. Common medical office presentation and findings
• TMD
• Trauma/pain
• Lesions
• Periodontal disease
• Prenatal/infant/child
CRITERIA SHEET
• Skin, cognition,
speech and
communication
• Symmetry
• TMJ
• Lymph nodes
• IntraOral Exam
• Teeth
• Occlusion
• Smilesforlife.org
Skin, cognition,
speech and
communication
Symmetry
Skin, cognition,
speech and
communication
Symmetry
TMD
•
Track mandible
direction
•
Joint sounds
•
Muscle tenderness
•
Missing teeth
•
Tooth wear
•
Bite shift
Lymph Nodes
HPV
Intraoral Exam
EXAM PARTICIPATION
TEETH
OCCLUSION
“REALITY CHECK”
MEDICAL OFFICE OCCURANCES
TMD
Trauma/Pain
Periodontal Disease
Lesions
Parent/Infant/Child
TMD
• Anatomy
• Signs/Symptoms
• Molar/Ear
• Treatment
• Self-help sheet
• Referrals
• RX vs OTC
TRAUMA/PAIN
Avulsion
o Deciduous vs permanent
o Re-implantation
o Root care
o Storage medium
o Splinting
Luxated
Fractured
Abscess
Extraction post-op
•
•
•
•
•
LESIONS
Lichen planus
RAU vs HSV
Candidiasis/Angular Chelitis
Cancer
Tori
PERIODONTAL DISEASE
• Identify
• Implications
– Diet
– CVD/stroke
– Blood sugar
– Tooth loss
• Malodor
– Sinus infection
– White patches
– Strep vs tonsil stones
PRENATAL/INFANT/CHILD
• diet
• eruption
• self-care
• medications
• teething/ears
• fluoride
• dental home
• nutrition
• baby bottle/sippy cup
• hygiene
• orthognathic
•
•
•
Treacher Collins
Pierre Robin
cleft lip/palate
• tetracycline
OTHER CONNECTIONS
• Medication lists
• Referral
– Terminology
• Pre-med
– Joint replacement
• Hypertension/CVD
• Cancer/Chemo
– Tooth prognosis
– Decay risk
– Prevention
• Bisphosphonates
• Fluoride/MI paste
OTHER CONNECTIONS
• Dry mouth
– Ageing
– Meds
– Systemic medications
– Treatments:
•
•
•
•
•
•
•
•
•
•
•
RX fluoride
Biotine
Sugar-free gum
Saliva substitutes
Xylitol
Alcohol-free mouthwash
Breath thru nose
Cool mist moisturizer at night
H2O
Stop tobacco
Limit caffeine
OTHER CONNECTIONS
• Reflux
– GERD
– Erosion
• Pneumonias/inhaling
• Sleep apnea/snoring
• Type 1 Diabetes
(CPAP)
• Blood thinners
increased bacterial
load
• Lupus
• Scleraderma
OTHER CONNECTIONS
• Lichen planus
• Acromegaly
• Sjorgen
disease/syndrome
• Bulimia
G.V. BLACK
“The professional person has no right to be
other than a continuous student”.
William T. Schlosser, DMD
[email protected]
www.drschlosser.com