Examination of orthodontic patientsBY: HAFEEZ O. AZEEZTEMILOLUWA A. OGUNLEYE
OUTLINE•Introduction•History taking•Clinical examination•Orthodontic examination•Diagnosis and Treatment planning
Introduction •Orthodontic diagnosis involves the thorough and careful collection of patients data in a systematic manner to help in identification of the nature and cause of malocclusion.•Diagnosis includes; patient's presenting complaints, history taking, examination and collection of appropriate records and investigation. •All this information are put together to formulate appropriate treatment plan based on the treatment objectives.
History Taking1.BIODATA•Name: For communication, identification and interaction Age: diagnosis and treatment planning, growth modification procedures, surgical procedures and developmental considerationSex: treatment planning e.g the timing of growth spurts are different in males and females, females reach puberty and growth spurts earlier than males Address and occupation: Helps to evaluate socio-economic status and for record purposes
Presenting complaint•The patient’s presenting complaints should be recorded in his/her owns words•This helps the clinician in identifying the priorities and desires of the patient.
Past Medical History•In obtaining the medical history the clinician must always ask some pertinent questions such as:1.The last time a physician was seen2.History of hospitalization3.Present of any systemic illnesses
4. Any medications currently taken5. Information regarding allergies6.History of blood transfusions and heart problems7.pre-natal and post-natal history
Past dental history•The dental history of patient helps in assessing patient’s and parent attitudes towards dental health, clinicians will like to know the following:1.Previous dental visit and experience2.Procedures carried out3.History of trauma to dentition
Family and social history•Questions related to patient’s and parents occupation are asked•History related to inherited pattern of condition:I.In patient with class III malocclusion it will be good to inquire about similar facial pattern of relatives to confirm the skeletal nature of malocclusion.II.Class II Division 2 malocclusion tends to run in families indicating a genetic predisposition. •Oral hygiene habits e.g how often does patient brushes, what is used to brush the teeth, what techniques are employed.
•Texture of toothbrush used( soft, medium or hard)•Does your gum bleed when you brush your teeth•Consumption of refined carbohydrates.
Clinical examination•General examination: height and weight, gait, parlor, cyanosis,body temperature, jaundice etc are noted.•Extra oral examination: 1.Temporomandibular joint:patient is examined for symptoms of temporo- mandibular joint problems such as clicking, crepitus, pain in the masticatory muscles, limitation of jaw movement, hypermobility and morphological abnormalities.