Читать книгу Principles of Dentoalveolar Extractions - Seth Delpachitra - Страница 17

Any medical or dental intervention requires a comprehensive patient history. This includes: a detailed medical history, including current and past medical treatments; documentation of known drug allergies and reactions; a social history comprising occupation and use of alcohol, cigarettes, and illicit substances; prior surgeries, dental treatments, and adverse outcomes; and, finally, the patient's chief complaint or main concerns.

Secondary to this is the clinical assessment of the patient's orofacial region, including both extraoral and intraoral examination. This should include an assessment of the temporomandibular joint, soft and hard tissue pathologies, and the presence of any dental pathology. Simultaneously, a difficulty and risk assessment for dentoalveolar surgery can be undertaken, paying particular attention to mouth opening, gingival biotype, gag reflex, patient anxiety, and previous heavily restored dentition.

Diagnostic tests should be carried out as necessary, including pulp testing, palpation for mobility, and percussion testing. A periodontal probe can be used to examine partially erupted or unerupted teeth, to assess soft tissue opercula, or to explore other communications with the oral cavity.

The patient's psychological state and level of anxiety can be assessed by asking how well they have tolerated dental treatment in the past. This aspect of the assessment is important; by virtue of temperament, some patients will require a more detailed discussion about their treatment, and some may request or require treatment with sedation or general anaesthesia.