2. Diagnostic Method Diagnosis Diagnosis means `through knowledge` and entails acquisition of data about the patient and their complaints using the senses: ObservingHearingTouching Smelling sometimes

3. Diagnostic Method The purpose of diagnosis is to be able to offer the most: * Effective and safe treatment * Accurate prognostication

4. 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

5. 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

6. 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

8. 1- 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.

9. Diagnostic Method 1- Collection of Information  It is Diagnostic Data Base  It provides basis for comparison of:  Disease Progress  Effectiveness of treatment

10. Diagnostic Method 1- Collection of Information Data Base consists of:Patient HistoryPhysical ExaminationAdjunctive diagnostic procedures

11. Diagnostic Method

12. 2- Evaluation of Information Organize & Compare with past experienceCorrelate unusual findings to identify disease Assess the accuracy of information & resolve contradiction by: a- Tests b- Repeat tests Clinician must stay objective.

13. Diagnostic Method - Clinicians searches for association & pattern among the data collected. - Clinicians will mentally relate findings with knowledge of: * Normal Variation * Characteristics of disease * Comparison support preliminary decision Correct Diagnosis 2- Evaluation of Information

14. Diagnostic Method a- Organizing Diagnostic Information: * Recognize contributory from non-contributory information. * Some general information relates to several problems & appear in more than one category e.g, fever, weight loss. * Physical assessment * Dental conditions * Non-dental conditions 2- Evaluation of Information

15. Diagnostic Method b- Preliminary Decision of Diagnostic Information: * Must be made to identify the patient’s diagnostic problem & determine the approach to diagnosis. This is determined by: i) Relationship of findings e.g, dental pain on cold. ii) Reliability (Signs & Symptoms). iii) Consistency (Obesity & Hypertension). iv) Clinical Significance (tonsillectomy). 2- Evaluation of Information

16. Diagnostic Method * If comparison does not support preliminary decision * Incorrect Diagnosis * Re-evaluate history * Re-evaluate Examination 2- Evaluation of Information

17. Diagnostic Method 3- Diagnostic Decisions A hypothesis that may be correct OR not

18. 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

19. 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

20. Diagnostic Method 4- Re-assessment Testing the hypothesis: a) Additional tests b) An appropriate treatment Predict response

21. Diagnostic Method * After management Re-evaluate symptoms * Re-examine the affected region hypothesis testing * Accurate Diagnosis + appropriate treatment Good Response 4- Re-assessment

22. Diagnostic Method Diagnosis is made by the clinical examination, which comprise the: History, this offers the diagnosis in about 80% of cases Physical examination Investigations Sometimes

23. Types of Clinical Examinations 1- Comprehensive Dental Diagnosis 2- Re-call Diagnosis 3- Diagnosis of specific problem (SOAP) 4- Emergency Diagnosis 5- Screening Diagnosis

24. 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

25. 2- Re-call Diagnosis * To identify the condition that have changed in comprehensive examination Reflects the patient’s current status * If a different dentist conducted the original diagnosis, the current dentist must confirm the accuracy of previous data. * Record the current findings then diagnose. Types of Clinical Examinations

26. 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

27. 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

28. 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

29. Evaluation of Diagnostic Information & Classification of Abnormalities Collecting Diagnostic Information Systemic Medical consultation Modify dental Tx Plan & Tx Dental Diagnosis Tx Plan & Tx Non-dental DDx Dx (clinical impression) Tx Initial clinical management Re-assessment