(BQ) Part 1 book “History taking and clinical examination in dentistry“ has contents: Introduction, methods of recording a case history, general information, chief complaint, history of present illness, previous dental history, medical history, personal dental history, clinical examination, extraoral examination.
History Taking and Clinical Examination in DENTISTRY History Taking and Clinical Examination in DENTISTRY Charu M Marya BDS MDS PhD Professor and Head Department of Public Health Dentistry Sudha Rustagi College of Dental Sciences and Research Faridabad, Haryana, India Foreword Rahul J Hegde The Health Sciences Publishers New Delhi | London | Philadelphia | Panama Jaypee Brothers Medical Publishers (P) Ltd Jaypee-Highlights Medical Publishers Inc City of Knowledge, Bld 237, Clayton Panama City, Panama Phone: +1 507-301-0496 Fax: +1 507-301-0499 Email: cservice@jphmedical.com Suite 835, Philadelphia, PA 19106, USA Jaypee Brothers Medical Publishers (P) Ltd 17/1-B Babar Road, Block-B, Shaymali Mohammadpur, Dhaka-1207 Bangladesh Mobile: +08801912003485 Email: jaypeedhaka@gmail.com Jaypee Brothers Medical Publishers (P) Ltd Bhotahity, Kathmandu, Nepal Phone: +977-9741283608 Email: kathmandu@jaypeebrothers.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2014, Jaypee Brothers Medical Publishers The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and not necessarily represent those of editor(s) of the book All rights reserved No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The publisher is not associated with any product or vendor mentioned in this book Medical knowledge and practice change constantly This book is designed to provide accurate, authoritative information about the subject matter in question However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications It is the responsibility of the practitioner to take all appropriate safety precautions Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book This book is sold on the understanding that the publisher is not engaged in providing professional medical services If such advice or services are required, the services of a competent medical professional should be sought Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com History Taking and Clinical Examination in Dentistry First Edition: 2014 ISBN 978-93-5152-393-2 Printed at Dedication I would like to thank my wife Dr Vandana for standing beside me throughout my career and writing this book She has been my inspiration and motivation for continuing to improve my knowledge and move my career forward She is my rock, and I dedicate this book to her Contributors Anil Gupta MDS Professor and Head Department of Pedodontics SGT Dental College, Hospital and Research Institute Gurgaon, Haryana, India Anirban Chatterjee MDS PhD Professor and Head Department of Periodontology and Implantology Oxford Dental College Bengaluru, Karnataka, India Avinash J MDS Professor and Head Department of Public Health Dentistry Kalinga Institute of Dental Sciences Bhubaneswar, Odisha, India Bhumija Gupta BDS AEGD GPR Clinical Faculty Eastman Institute for Oral Health University of Rochester Rochester, New York, USA Gaurav Sharma MDS Reader Department of Oral Medicine and Radiology Sudha Rustagi College of Dental Sciences and Research Faridabad, Haryana, India Hind Pal Bhatia MDS Professor and Head Department of Pedodontics Manav Rachna Dental College Faridabad, Haryana India Navin Anand Ingle MDS Professor and Head Department of Public Health Dentistry KD Dental College and Hospital Mathura, Uttar Pradesh India Pradeep Tangade MDS Professor and Head Department of Public Health Dentistry Kothiwal Dental College and Research Centre Moradabad, Uttar Pradesh India Rajendra Gowda Patil MDS Professor and Head Department of Oral Medicine and Radiology Kothiwal Dental College and Research Centre Moradabad, Uttar Pradesh India viii History Taking and Clinical Examination in Dentistry SM Kotrashetti MDS Professor Department of Oral and Maxillofacial Surgery KLE VK Institute of Dental Sciences Belgaum, Karnataka, India Vandana Dahiya MDS Department of Conservative Dentistry and Endodontics Haryana Civil Medical Services Faridabad, Haryana India Foreword It gives me great pleasure to write a foreword for History Taking and Clinical Examination in Dentistry The approach adopted by the author should be a great help to those taking history and doing examination for diagnosis and treatment planning in dentistry The idea of taking symptom complexes and then describing the diagnostic possibilities with guides to the management both of the disease itself and of the symptoms will be valuable to all who have to deal with problems of this sort I hope that it will be valuable to all those who have to deal with the clinical differential diagnosis It should be of particular use to teaching faculty, undergraduate and postgraduate dental students and dental practitioners It is the sort of book that should be in the hands of students of dentistry entering the clinics during their clinical postings Rahul J Hegde (Executive Member, Dental Council of India) Vice-Principal, Professor and Head Department of Pediatric Dentistry Bharati Vidyapeeth University Dental College Navi Mumbai, Maharashtra, India President, Indian Society of Pediatric Dentistry Senate Member, Maharashtra University of Health Sciences Preface The most important core skills for dental students to master are history taking and clinical examination This book has been written with the philosophy that the acquisition of clinical skills is most effectively undertaken at the chairside This book should be used as a companion, to be taken in the clinics where the information is most needed The book begins with a system of history taking followed by chapters covering clinical examination and diagnosis Each stage of the examination starts with a detailed step-by-step description of the examination method complemented by relevant illustrations, diagrams and tables This book is intended primarily for use at the outset of clinical training; once students have achieved proficiency in the basic skills of interviewing and examining, the book should also prove useful for revision This book was written keeping in mind the problems faced in clinics by undergraduate and postgraduate students regarding history taking, clinical examination, diagnosis and treatment planning as no book is available in the market focusing specifically on these topics Charu M Marya Acknowledgments I would like to express my gratitude to many people who provided support, read, wrote, offered comments, allowed me to quote their remarks and assisted in the editing, proofreading and design I would like to thank my parents for allowing me to follow my ambitions throughout my childhood Ever indebted to my mother for her encouragement and my father, my guide My brother Dr Kirti Mohan Marya for standing by me always and sister Dr Priya Nagpal for her prayers I also thank my wonderful children: Akshat and Dewang for always making me smile My family, including my in-laws, have always supported me throughout my career and authoring this book and I really appreciate it I want to acknowledge my family’s contribution, for putting up with my absences, both mental and physical Many persons generously gave their time in the preparation of the first of its kind book History Taking and Clinical Examination in Dentistry I would like to convey my grateful thanks to all the contributors for their cooperation and enthusiasm for the publication of this book In addition, special appreciation is to be mentioned for Dr Ruchi Nagpal, Dr Sukhvinder, Dr Amit Rekhi who provided high quality logistic and editing support during the preparation of this book My thanks also go to my colleagues at the Sudha Rustagi College of Dental Sciences and Research, Faridabad (Haryana), who have given encouragement and support at key times in the development of this book and have contributed for creating a stimulating and congenial environment for me to work I would like to thank Mr Dharamvir Gupta (Chairman), Mr Deepak Gupta (Secretary), Prof (Dr) Indushekar (Principal) and Dr Vishal Juneja (CEO), Sudha Rustagi College of Dental Sciences and Research, Faridabad for their encouragement and support in this venture 150 History Taking and Clinical Examination in Dentistry Fig 10.9: Examination of preauricular nodes Fig 10.10: Examination of postauricular nodes Extraoral Examination 151 Fig 10.11: Examination of internal jugular chain Fig 10.12: Examination of supraclavicular chain 152 History Taking and Clinical Examination in Dentistry If a node is palpable, record the: •• Site •• Size: Measure using Vernier calipers •• Texture: Soft (in case of infection), rubbery hard (in case of Hodgkin’s disease), stony hard (in case of secondary carcinoma) •• Tenderness to palpation: In case of infection •• Fixation to surrounding tissues may suggest metastatic cancer •• Coalescence in case of tuberculosis •• Number of nodes: Multiple in case of glandular fever, leukemia, etc Palpable node characteristics: •• Acute infection: Large, soft, painful, mobile, discrete, rapid onset •• Chronic infection: Large, firm, less tender, mobile •• Lymphoma: Rubbery hard, matted, painless, multiple •• Metastatic cancer: Stony hard, fixed to underlying tissues, painless Area of Lymphatic Drainage of Face The face has three lymphatic territories: The upper territory: Including the greater part of the forehead, the lateral halves of the eyelids, the conjunctiva, the lateral part of the cheek and the parotid area, drains into the preauricular (parotid) nodes The middle territory: Including a strip over the median part of the forehead, the external nose, the upper lip, the lateral part of the lower lip, the medial halves of the eyelids, the medial part of the cheek and the greater part of the lower jaw, drains into the submandibular nodes The lower territory: Including the central part of the lower lip and chin, drains into the submental nodes Extraoral Examination 153 TEMPOROMANDIBULAR JOINT Temporomandibular joint (TMJ) is the site of articulation between the mandible and the skull, specifically the area about the articular eminence of the temporal bone This bilateral joint functions to open and close the jaws and to approximate the teeth of the opposing arches during mastication The articulation consists of parts of the mandible and temporal bones, which are covered by dense, fibrous connective tissue and are surrounded by several ligaments (Fig.10.13) The TMJ is a ginglymoarthrodial joint, a term that is derived from ginglymus, meaning a hinge joint, allowing motion only backward and forward in one plane, and arthrodia, meaning a joint which permits gliding motion of the surfaces The right and left TMJ form a bicondylar articulation and ellipsoid variety of the synovial joints, similar to knee articulation Interposed between the two bones is a fibrous articular disc, compartmentalizing the joint into two separate synovial-lined cavities Several pairs of muscles attached to Fig 10.13: Anatomy of temporo-mandibular joint 154 History Taking and Clinical Examination in Dentistry the mandible produce the movements necessary to suckle, ingest, masticate food, swallow, yawn, and produce speech The importance is to determine deviation of jaw from the midline during the opening and closing of the jaws Causes of Jaw Deviation Traumatic injuries of the joint Infection of the jaw Fractures of the jaw Muscular hypertrophy and hypotrophy The lateral mandibular range of motion or movement is assessed “normal to 10 mm” by having the patient to occlude the teeth and then slide the jaw in both directions The range of movement from midline and any pain, location and severity is recorded Maximum interincisal opening: As a general guide, mobility is considered to be reduced if the subject is unable to open his or her jaw to the width of two fingers (