Diagnostic Method

Diagnosis means `through knowledge` and entails acquisition of data about the patient and their complaints using the

senses:

Observing

Hearing

Touching

Smellingsometimes

Diagnostic MethodThe purpose of diagnosis

is to be able to offer the most:

* Effective and safe

treatment

* Accurate prognosticatio

n

Diagnostic Method

•Is to distinguish, to identify a disease by an investigation of the signs & symptoms.

Diagnose

•Is the process of evaluating the patient’s health, as well as the resulting opinions formulated by the clinician

Diagnosis

Diagnostic Method• Is the ART of using scientific

knowledge to identify oral disease process & to distinguish one disease from another.

Oral Diagnosis

• Is concerned with diagnosis & treatment, consultation, referral & other phases of patient management.

• It deals especially with the relation between oral & systemic diseases.

Oral Medicine

Diagnostic Method Accurate diagnosis depends on systemic approach to unique diagnostic change posed by every patient.

The most effective approach is by applying scientific method to clinical decisions.

Diagnostic Method

Diagnostic Method

Diagnostic Method1- Collection of Information

a) Detailed verbalization by the patient.

b) Features determined by the clinician’s examination

c) Data derived from adjunctive diagnostic procedures.

(Laboratory tests)Clinician must stay objective.

Diagnostic Method

1- Collection of Information

It is Diagnostic Data Base

It provides basis for comparison of:

Disease Progress

Effectiveness of treatment

Diagnostic Method

1- Collection of Information

Data Base consists of:

Patient History

Physical Examination

Adjunctive diagnostic procedures

Diagnostic Method

Diagnostic Method2- Evaluation of Information

Organize & Compare with past experience

Correlate unusual findings to identify disease

Assess the accuracy of information & resolve contradiction by:

a- Testsb- Repeat tests

Clinician must stay objective.

Diagnostic Method- Clinicians searches for association & pattern among the data collected.

2- Evaluation of Information

Diagnostic Method

2- Evaluation of Information

Diagnostic Method

2- Evaluation of Information

Diagnostic Method

* If comparison does not support preliminary decision

* Incorrect Diagnosis

* Re-evaluate history

* Re-evaluate Examination

2- Evaluation of Information

Diagnostic Method3- Diagnostic Decisions

A hypothesis that may be correct OR not

Diagnostic Method* Systemic: Don’t confuse physical assessment with

systemic diagnosis. “ confirm by medical

consultation”.

* Dental abnormality, e.g, caries, gingivitis,

periodontitis.

* Non-dental abnormality.

3- Diagnostic Decisions

Diagnostic Method* Non-dental abnormality: seen less common

less experience.

- Signs & Symptoms shared by many diseases.

- Compare with other disease producing the same

abnormality

Differential Diagnosis

3- Diagnostic Decisions

Diagnostic Method4- Re-assessment

Testing the hypothesis:a) Additional tests

b) An appropriate treatment

Predict response

Diagnostic Method* After management Re-evaluate symptoms

* Re-examine the affected region hypothesis

testing * Accurate Diagnosis + appropriate

treatment

Good Response

4- Re-assessment

Diagnostic MethodDiagnosis is made by the clinical

examination, which comprise the:

History, this offers the

diagnosis in about 80% of

cases

Physical examination

InvestigationsSometimes

Types of Clinical Examinations

1- Comprehensive Dental Diagnosis

2- Re-call Diagnosis

3- Diagnosis of specific problem

(SOAP)

4- Emergency Diagnosis

5- Screening Diagnosis

1- Comprehensive Dental Diagnosis

* Intra & Extra oral examination + adjunctive procedures.

* It serves for the following purposes:- Initial status

- For comparison in later assessment.- Protect the clinician later if complication

took place.- It takes time.

- It provides sound diagnostic foundation for comprehensive treatment.

Types of Clinical Examinations

2- Re-call Diagnosis

Types of Clinical Examinations

3- Diagnosis of specific problem (SOAP) evaluation

* Indicated if consultation is requested from other clinician & re-assessment of recent treatment

SOAP.

1- The reason for the evaluation is briefly stated.2- “S” Subjective information.

3- “O” Objective or physical findings.4- “A” Analysis or clinical impression of the

condition by the clinician.5- “P” Plan or recommend management for the

problem.

Types of Clinical Examinations

4- Emergency Diagnosis* Manage a chief complaint. e.g, pain, bleeding that requires immediate attention.

* Clinicians explores most aspects of history but limit examination to chief complaint.

Types of Clinical Examinations

5- Screening Diagnosis* It answers a specific question about the patient.

* The evaluation is limited to obtaining the information needed to answer this question only,

e.g, cancer screening clinic.

Types of Clinical Examinations

Systemic

Medical consultation

Modify dental Tx Plan & Tx

Dental

Diagnosis

Tx Plan & Tx

Non-dental

DDx

Dx (clinical impression)

Tx

Initial clinical management

Re-assessmen

t