Dental Diagnosis

     Diagnosis is the specific description of the presenting dental problem.

     I divide all dental disease into three categories: cavities (not "decay"), gum problems (not "periodontal disease") and bite problems (not "occlusal discrepancy"). I then decide their short term (not "acute") or long term (not "chronic") nature. All diagnosis may be simply categorized:

	Short Term	Long Term
Cavities
Gums
Bite

     You may need to stretch the above definitions on occasion. For example, a periapical lesion in a non-vital tooth which is associated with trauma (not decay) could defy categorization but I would still list it under cavities since most non-vital teeth are associated with decay.

     After properly reviewing the past medical and dental history, radiographs and clinical data you may then make a diagnosis regarding the chief complaint. You should keep in mind the bigger picture of the overall clinical problem as you focus on the chief complaint.

     In the actual patient record I prefer to record my dental diagnostic notes, and to some degree the chosen treatment plan, graphically. The long list of written dental notes in a typical dental school record are not easily grasped visually. This can obscure the bigger picture of diagnosis and treatment planning.

     On a blank piece of paper I will draw a plus sign so that I can represent the four quadrants of the mouth. I then use Palmer notation which is a tooth numbering system that starts from the central incisors (#1) and goes back to the wisdom teeth (#8). With this system tooth number 11 using standard notation would be described as the upper left #3. It would be draw on the diagram below as 3 in the upper right corner since you are looking at the patient's face in this diagram. If you get used to making your diagnostic notes with your own visual notes you will ultimately find it much easier to plan treatment.