Re: New guidelines case discussions

[Guest guest]

hi,lastly ask about patient wishes/expectations from us.

>

> Hi,

> I am sure everyone preparing for part 2 must have gone thru the new guidelines

for Dtp.. There are 5 major changes for which we need to practice..

> 1. Taking history with Note making.

> 2. Written provisional diagnosis.

> 3. Written justification of radiograph.

> 4. Written description of a radiograph.

> 5. Written treatment plan.

>

> Starting today, I will be posting a series of cases that we've all probably

discussed before, but have not covered, these finer aspects, on which, we'll now

be marked..

> So.. Lets start!

>

> Case 1. (ORE CASE JAN 2008)

> patient complains of loose lower anteriors,(assuming, due to lack of feedback-

31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming

from 1 year), incidental finding-multiple radiolucencies in mandible.

>

> I'll start with the history notes.. Please add or correct if required..

>

> Name: Kathy Brown

> DOB: 5th jan 1967

> Add: #XYZ Street, London

> Occ: Newsreader

> Marital status: Married, 2 children- living separately.

>

> C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> 2. lump on roof of mouth - 1 yr

> HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to

heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of

gum disease, no h/o trauma.

>

> 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

>

> PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

>

> PMH: h/o diabetes 5 yrs- metformin 500mg BD.

>

> SH: Smokes 10 cig/day last 10 yrs,

> Alc- 10 units/week- beer

> No Parafunct habit.

> Sugar/carb intake-low

> Fizzy/citrus intake- low

>

> Regards,

> Smriti

>

> P.S Please add to these notes if required and your opinion in general. Will

continue with the provisional diagnosis in some time.. Please add new cases as

well for discussion.. It might be a good idea to use the same subject or heading

so that we can find them easily while revising..

>

[Guest guest]

hoc;write exact place(left/right/middle) of the palate.

>

> Hi,

> I am sure everyone preparing for part 2 must have gone thru the new guidelines

for Dtp.. There are 5 major changes for which we need to practice..

> 1. Taking history with Note making.

> 2. Written provisional diagnosis.

> 3. Written justification of radiograph.

> 4. Written description of a radiograph.

> 5. Written treatment plan.

>

> Starting today, I will be posting a series of cases that we've all probably

discussed before, but have not covered, these finer aspects, on which, we'll now

be marked..

> So.. Lets start!

>

> Case 1. (ORE CASE JAN 2008)

> patient complains of loose lower anteriors,(assuming, due to lack of feedback-

31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming

from 1 year), incidental finding-multiple radiolucencies in mandible.

>

> I'll start with the history notes.. Please add or correct if required..

>

> Name: Kathy Brown

> DOB: 5th jan 1967

> Add: #XYZ Street, London

> Occ: Newsreader

> Marital status: Married, 2 children- living separately.

>

> C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> 2. lump on roof of mouth - 1 yr

> HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to

heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of

gum disease, no h/o trauma.

>

> 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

>

> PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

>

> PMH: h/o diabetes 5 yrs- metformin 500mg BD.

>

> SH: Smokes 10 cig/day last 10 yrs,

> Alc- 10 units/week- beer

> No Parafunct habit.

> Sugar/carb intake-low

> Fizzy/citrus intake- low

>

> Regards,

> Smriti

>

> P.S Please add to these notes if required and your opinion in general. Will

continue with the provisional diagnosis in some time.. Please add new cases as

well for discussion.. It might be a good idea to use the same subject or heading

so that we can find them easily while revising..

>

[Guest guest]

very true pratheeba, very imp point- if at the side it could be of odontogenic

origin.. thanks a lot for the additions..

Also forgot to mention size and contour.

And for PMD- diabetes- controlled/uncontrolled.

Provisional diagnosis-

1. Chronic periodontitis??

2. Benign salivary gland neoplasm??

> >

> > Hi,

> > I am sure everyone preparing for part 2 must have gone thru the new

guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > 1. Taking history with Note making.

> > 2. Written provisional diagnosis.

> > 3. Written justification of radiograph.

> > 4. Written description of a radiograph.

> > 5. Written treatment plan.

> >

> > Starting today, I will be posting a series of cases that we've all probably

discussed before, but have not covered, these finer aspects, on which, we'll now

be marked..

> > So.. Lets start!

> >

> > Case 1. (ORE CASE JAN 2008)

> > patient complains of loose lower anteriors,(assuming, due to lack of

feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate

(assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> >

> > I'll start with the history notes.. Please add or correct if required..

> >

> > Name: Kathy Brown

> > DOB: 5th jan 1967

> > Add: #XYZ Street, London

> > Occ: Newsreader

> > Marital status: Married, 2 children- living separately.

> >

> > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > 2. lump on roof of mouth - 1 yr

> > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to

heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of

gum disease, no h/o trauma.

> >

> > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

> >

> > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in

past.

> >

> > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> >

> > SH: Smokes 10 cig/day last 10 yrs,

> > Alc- 10 units/week- beer

> > No Parafunct habit.

> > Sugar/carb intake-low

> > Fizzy/citrus intake- low

> >

> > Regards,

> > Smriti

> >

> > P.S Please add to these notes if required and your opinion in general. Will

continue with the provisional diagnosis in some time.. Please add new cases as

well for discussion.. It might be a good idea to use the same subject or heading

so that we can find them easily while revising..

> >

>

[Guest guest]

Continuing with the case...

Which radiographic view(s) do you think are justified??

1. Do you think IOPA of 31,32 is justified?

My opinion- No. Both teeth are grade 3 mobile with poor prognosis. Highly

unlikely that they can be saved. An IOPA will not add the diagnosis or treatment

plan. (????? please add. I am not very sure)

2. DPT??

Yes. will serve 2 purposes- 1. generalised bone loss can be measured to aid in

periodontal maintenance. 2. may give an idea of the palatal lesion(though not a

good one, because palate falls outside its focal trough)

3. Maxillary Occlusal view??

yes. to see extent of lesion on palate/ signs of palatal perforation..

Other special investigations:

1. Full mouth perio charting.

2. Biopsy of lesion on palate.

3. Vitality tests 31,32.

??? what else??

> > >

> > > Hi,

> > > I am sure everyone preparing for part 2 must have gone thru the new

guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > 1. Taking history with Note making.

> > > 2. Written provisional diagnosis.

> > > 3. Written justification of radiograph.

> > > 4. Written description of a radiograph.

> > > 5. Written treatment plan.

> > >

> > > Starting today, I will be posting a series of cases that we've all

probably discussed before, but have not covered, these finer aspects, on which,

we'll now be marked..

> > > So.. Lets start!

> > >

> > > Case 1. (ORE CASE JAN 2008)

> > > patient complains of loose lower anteriors,(assuming, due to lack of

feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate

(assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > >

> > > I'll start with the history notes.. Please add or correct if required..

> > >

> > > Name: Kathy Brown

> > > DOB: 5th jan 1967

> > > Add: #XYZ Street, London

> > > Occ: Newsreader

> > > Marital status: Married, 2 children- living separately.

> > >

> > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > 2. lump on roof of mouth - 1 yr

> > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive

to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H

of gum disease, no h/o trauma.

> > >

> > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

> > >

> > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in

past.

> > >

> > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > >

> > > SH: Smokes 10 cig/day last 10 yrs,

> > > Alc- 10 units/week- beer

> > > No Parafunct habit.

> > > Sugar/carb intake-low

> > > Fizzy/citrus intake- low

> > >

> > > Regards,

> > > Smriti

> > >

> > > P.S Please add to these notes if required and your opinion in general.

Will continue with the provisional diagnosis in some time.. Please add new cases

as well for discussion.. It might be a good idea to use the same subject or

heading so that we can find them easily while revising..

> > >

> >

>

[Guest guest]

Hi sorry to comment, I maybe wrong first diagnosis is acceptable but the other one benign salivary gland neoplasm (where do you find salivary glands in palate other than minor ones) and the swelling is hard according to the history what biopsy is feasible furthermore if 31 and 3e are grade 3 mobile why do we need vitality tests? I may be wrong so please do correct me.Thank youSent from my BlackBerry® wireless deviceFrom: "doc_smriti" <doc_smriti@...>Sender: Date: Wed, 15 Feb 2012 18:15:40 -0000< >Reply Subject: Re: New guidelines case discussions Continuing with the case...Which radiographic view(s) do you think are justified??1. Do you think IOPA of 31,32 is justified? My opinion- No. Both teeth are grade 3 mobile with poor prognosis. Highly unlikely that they can be saved. An IOPA will not add the diagnosis or treatment plan. (????? please add. I am not very sure)2. DPT??Yes. will serve 2 purposes- 1. generalised bone loss can be measured to aid in periodontal maintenance. 2. may give an idea of the palatal lesion(though not a good one, because palate falls outside its focal trough)3. Maxillary Occlusal view??yes. to see extent of lesion on palate/ signs of palatal perforation..Other special investigations:1. Full mouth perio charting.2. Biopsy of lesion on palate. 3. Vitality tests 31,32.??? what else?? > > >> > > Hi,> > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice.. > > > 1. Taking history with Note making.> > > 2. Written provisional diagnosis.> > > 3. Written justification of radiograph.> > > 4. Written description of a radiograph.> > > 5. Written treatment plan. > > > > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..> > > So.. Lets start!> > > > > > Case 1. (ORE CASE JAN 2008)> > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.> > > > > > I'll start with the history notes.. Please add or correct if required..> > > > > > Name: Kathy Brown> > > DOB: 5th jan 1967> > > Add: #XYZ Street, London> > > Occ: Newsreader> > > Marital status: Married, 2 children- living separately.> > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.> > > 2. lump on roof of mouth - 1 yr > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.> > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.> > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past. > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.> > > > > > SH: Smokes 10 cig/day last 10 yrs,> > > Alc- 10 units/week- beer > > > No Parafunct habit.> > > Sugar/carb intake-low> > > Fizzy/citrus intake- low> > > > > > Regards,> > > Smriti> > > > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..> > >> >>

[Guest guest]

Hi.. Please don't apologise.. You have raised very valid points.

Its true that palate has only minor salivary glands, but they can develop benign

growths, the most common being pleomorphic adenoma. A slow growing, asymptomatic

hard growth on palate could mean anything, including, ofcourse,a torus. I was

quite confused myself but chose salivary gland neoplasm because in my opinion a

torus would have been present for a longer duration. But then again a photograph

would be very helpful. Also, as Veena pointed out palpation of the lump would

help us in identifying a bony lesion. And then the site too would be helpful.

But it can, in all possibilities, be a torus.

> > > >

> > > > Hi,

> > > > I am sure everyone preparing for part 2 must have gone thru the new

guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > 1. Taking history with Note making.

> > > > 2. Written provisional diagnosis.

> > > > 3. Written justification of radiograph.

> > > > 4. Written description of a radiograph.

> > > > 5. Written treatment plan.

> > > >

> > > > Starting today, I will be posting a series of cases that we've all

probably discussed before, but have not covered, these finer aspects, on which,

we'll now be marked..

> > > > So.. Lets start!

> > > >

> > > > Case 1. (ORE CASE JAN 2008)

> > > > patient complains of loose lower anteriors,(assuming, due to lack of

feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate

(assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > >

> > > > I'll start with the history notes.. Please add or correct if required..

> > > >

> > > > Name: Kathy Brown

> > > > DOB: 5th jan 1967

> > > > Add: #XYZ Street, London

> > > > Occ: Newsreader

> > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > 2. lump on roof of mouth - 1 yr

> > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing

+nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

> > > >

> > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in

past.

> > > >

> > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > Alc- 10 units/week- beer

> > > > No Parafunct habit.

> > > > Sugar/carb intake-low

> > > > Fizzy/citrus intake- low

> > > >

> > > > Regards,

> > > > Smriti

> > > >

> > > > P.S Please add to these notes if required and your opinion in general.

Will continue with the provisional diagnosis in some time.. Please add new cases

as well for discussion.. It might be a good idea to use the same subject or

heading so that we can find them easily while revising..

> > > >

> > >

> >

>

[Guest guest]

Sorry forgot to discuss the other points:

A fine needle aspiration cytology can be used for firm lesions.

Regarding vitality tests, I think u are right, they wouldn't aid much in

diagnosis or treatment plan.

> > > > >

> > > > > Hi,

> > > > > I am sure everyone preparing for part 2 must have gone thru the new

guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > > 1. Taking history with Note making.

> > > > > 2. Written provisional diagnosis.

> > > > > 3. Written justification of radiograph.

> > > > > 4. Written description of a radiograph.

> > > > > 5. Written treatment plan.

> > > > >

> > > > > Starting today, I will be posting a series of cases that we've all

probably discussed before, but have not covered, these finer aspects, on which,

we'll now be marked..

> > > > > So.. Lets start!

> > > > >

> > > > > Case 1. (ORE CASE JAN 2008)

> > > > > patient complains of loose lower anteriors,(assuming, due to lack of

feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate

(assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > > >

> > > > > I'll start with the history notes.. Please add or correct if

required..

> > > > >

> > > > > Name: Kathy Brown

> > > > > DOB: 5th jan 1967

> > > > > Add: #XYZ Street, London

> > > > > Occ: Newsreader

> > > > > Marital status: Married, 2 children- living separately.

> > > > >

> > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > > 2. lump on roof of mouth - 1 yr

> > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing

+nt, no F/H of gum disease, no h/o trauma.

> > > > >

> > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

> > > > >

> > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t

in past.

> > > > >

> > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > > >

> > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > > Alc- 10 units/week- beer

> > > > > No Parafunct habit.

> > > > > Sugar/carb intake-low

> > > > > Fizzy/citrus intake- low

> > > > >

> > > > > Regards,

> > > > > Smriti

> > > > >

> > > > > P.S Please add to these notes if required and your opinion in general.

Will continue with the provisional diagnosis in some time.. Please add new cases

as well for discussion.. It might be a good idea to use the same subject or

heading so that we can find them easily while revising..

> > > > >

> > > >

> > >

> >

>

[Guest guest]

Thank you.Sent from my BlackBerry® wireless deviceFrom: "doc_smriti" <doc_smriti@...>Sender: Date: Wed, 15 Feb 2012 19:37:53 -0000< >Reply Subject: Re: New guidelines case discussions Hi.. Please don't apologise.. You have raised very valid points. Its true that palate has only minor salivary glands, but they can develop benign growths, the most common being pleomorphic adenoma. A slow growing, asymptomatic hard growth on palate could mean anything, including, ofcourse,a torus. I was quite confused myself but chose salivary gland neoplasm because in my opinion a torus would have been present for a longer duration. But then again a photograph would be very helpful. Also, as Veena pointed out palpation of the lump would help us in identifying a bony lesion. And then the site too would be helpful. But it can, in all possibilities, be a torus. > > > >> > > > Hi,> > > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice.. > > > > 1. Taking history with Note making.> > > > 2. Written provisional diagnosis.> > > > 3. Written justification of radiograph.> > > > 4. Written description of a radiograph.> > > > 5. Written treatment plan. > > > > > > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..> > > > So.. Lets start!> > > > > > > > Case 1. (ORE CASE JAN 2008)> > > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.> > > > > > > > I'll start with the history notes.. Please add or correct if required..> > > > > > > > Name: Kathy Brown> > > > DOB: 5th jan 1967> > > > Add: #XYZ Street, London> > > > Occ: Newsreader> > > > Marital status: Married, 2 children- living separately.> > > > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.> > > > 2. lump on roof of mouth - 1 yr > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.> > > > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.> > > > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past. > > > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.> > > > > > > > SH: Smokes 10 cig/day last 10 yrs,> > > > Alc- 10 units/week- beer > > > > No Parafunct habit.> > > > Sugar/carb intake-low> > > > Fizzy/citrus intake- low> > > > > > > > Regards,> > > > Smriti> > > > > > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..> > > >> > >> >>

[Guest guest]

This link might help in the explanation;http://adc-final-exam.blogspot.com/2011/06/lump-on-palate.html From: doc_smriti <doc_smriti@...> Sent: Wednesday, February 15, 2012 7:37 PM Subject: Re: New guidelines case discussions

Hi.. Please don't apologise.. You have raised very valid points.

Its true that palate has only minor salivary glands, but they can develop benign growths, the most common being pleomorphic adenoma. A slow growing, asymptomatic hard growth on palate could mean anything, including, ofcourse,a torus. I was quite confused myself but chose salivary gland neoplasm because in my opinion a torus would have been present for a longer duration. But then again a photograph would be very helpful. Also, as Veena pointed out palpation of the lump would help us in identifying a bony lesion. And then the site too would be helpful. But it can, in all possibilities, be a torus.

> > > >

> > > > Hi,

> > > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > 1. Taking history with Note making.

> > > > 2. Written provisional diagnosis.

> > > > 3. Written justification of radiograph.

> > > > 4. Written description of a radiograph.

> > > > 5. Written treatment plan.

> > > >

> > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..

> > > > So.. Lets start!

> > > >

> > > > Case 1. (ORE CASE JAN 2008)

> > > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > >

> > > > I'll start with the history notes.. Please add or correct if required..

> > > >

> > > > Name: Kathy Brown

> > > > DOB: 5th jan 1967

> > > > Add: #XYZ Street, London

> > > > Occ: Newsreader

> > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > 2. lump on roof of mouth - 1 yr

> > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.

> > > >

> > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

> > > >

> > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > Alc- 10 units/week- beer

> > > > No Parafunct habit.

> > > > Sugar/carb intake-low

> > > > Fizzy/citrus intake- low

> > > >

> > > > Regards,

> > > > Smriti

> > > >

> > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..

> > > >

> > >

> >

>

[Guest guest]

Thank you very much Ikbal for the link and Radhika for the x-ray prescription..

Will try to write the treatment planning notes tmrw.. Any links or examples

would be extremely helpful..

Kind Regards,

Smriti

> > > > >

> > > > > Hi,

> > > > > I am sure everyone preparing for part 2 must have gone thru the new

guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > > 1. Taking history with Note making.

> > > > > 2. Written provisional diagnosis.

> > > > > 3. Written justification of radiograph.

> > > > > 4. Written description of a radiograph.

> > > > > 5. Written treatment plan.

> > > > >

> > > > > Starting today, I will be posting a series of cases that we've all

probably discussed before, but have not covered, these finer aspects, on which,

we'll now be marked..

> > > > > So.. Lets start!

> > > > >

> > > > > Case 1. (ORE CASE JAN 2008)

> > > > > patient complains of loose lower anteriors,(assuming, due to lack of

feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate

(assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > > >

> > > > > I'll start with the history notes.. Please add or correct if

required..

> > > > >

> > > > > Name: Kathy Brown

> > > > > DOB: 5th jan 1967

> > > > > Add: #XYZ Street, London

> > > > > Occ: Newsreader

> > > > > Marital status: Married, 2 children- living separately.

> > > > >

> > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > > 2. lump on roof of mouth - 1 yr

> > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing

+nt, no F/H of gum disease, no h/o trauma.

> > > > >

> > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

swelling mouth or elsewhere.

> > > > >

> > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t

in past.

> > > > >

> > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > > >

> > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > > Alc- 10 units/week- beer

> > > > > No Parafunct habit.

> > > > > Sugar/carb intake-low

> > > > > Fizzy/citrus intake- low

> > > > >

> > > > > Regards,

> > > > > Smriti

> > > > >

> > > > > P.S Please add to these notes if required and your opinion in general.

Will continue with the provisional diagnosis in some time.. Please add new cases

as well for discussion.. It might be a good idea to use the same subject or

heading so that we can find them easily while revising..

> > > > >

> > > >

> > >

> >

>

[Guest guest]

THANKS IQBAL AND RADHIKA FOR YOUR HELP.REGARDSJASMINEOn Thu, Feb 16, 2012 at 5:20 PM, doc_smriti <doc_smriti@...> wrote:

 

Thank you very much Ikbal for the link and Radhika for the x-ray prescription.. Will try to write the treatment planning notes tmrw.. Any links or examples would be extremely helpful..

Kind Regards,

Smriti

> > > > >

> > > > > Hi,

> > > > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > > 1. Taking history with Note making.

> > > > > 2. Written provisional diagnosis.

> > > > > 3. Written justification of radiograph.

> > > > > 4. Written description of a radiograph.

> > > > > 5. Written treatment plan.

> > > > >

> > > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..

> > > > > So.. Lets start!

> > > > >

> > > > > Case 1. (ORE CASE JAN 2008)

> > > > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > > >

> > > > > I'll start with the history notes.. Please add or correct if required..

> > > > >

> > > > > Name: Kathy Brown

> > > > > DOB: 5th jan 1967

> > > > > Add: #XYZ Street, London

> > > > > Occ: Newsreader

> > > > > Marital status: Married, 2 children- living separately.

> > > > >

> > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > > 2. lump on roof of mouth - 1 yr

> > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.

> > > > >

> > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.

> > > > >

> > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

> > > > >

> > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > > >

> > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > > Alc- 10 units/week- beer

> > > > > No Parafunct habit.

> > > > > Sugar/carb intake-low

> > > > > Fizzy/citrus intake- low

> > > > >

> > > > > Regards,

> > > > > Smriti

> > > > >

> > > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..

> > > > >

> > > >

> > >

> >

>

[Guest guest]

ha ha..i meant cingulum rest actually...coz i studied a lot abt clasps and so on...and got away with it))Thank you for the info,yes sure I just forward that,cheers)) SincerelyLyudmyla From: Ikbal al-saffar <alsaffarikbal@...> Lyudmyla Huhley <huhley2006@...> Sent: Thursday, 16 February 2012, 17:29 Subject: Re: Re: New guidelines case discussions Hi ,i came across this book while searching for cingulum clasp i liked it a lot ,u can put it on the group if u like;http://books.google.co.uk/books?id=Jzy5RKBjVvsC & pg=PA78 & lpg=PA78 & dq=cingulum+clasp & source=bl & ots=quTD2tQYWR & sig=D82oK32Lh4Zvkl4Or15XOJZp9fk & hl=en & sa=X & ei=izQ9T6-BIYqf-waNkrS3BQ & ved=0CDMQ6AEwAg#v=onepage & q=cingulum%20clasp & f=falsealso i think u might have meant cingulum bar (also called dental bar)as aposed to cingulum clasp coz i went to a course and they talked about it you might want to

know;In the international literature and textbooks, the cingulum bar as a mandibular major connector is often neglected. It is a viable alternative to a lingual bar where the distance between the marginal gingivae and the mucolingual fold is restricted. It also provides indirect retention and thereby eliminates the need for a conventional indirect retainer. Patient comfort with an RPD with a cingulum bar seems

acceptable because the connector forms one unit with the anterior teeth. The replacement of a lost natural anterior tooth with a denture tooth is not difficult. The metal bulk of the bar may be a disadvantage and esthetics may be compromised if spacing is present. Marked lingual inclination of the anterior teeth prevents the use of a cingulum bar.kind regardsikbal From: Lyudmyla Huhley <huhley2006@...> "alsaffarikbal@..." <alsaffarikbal@...> Sent: Thursday, February 16, 2012 2:42 PM Subject: Re: Re: New guidelines case discussions

Thank you for the link,this site is amaizing!!!cheers SincerelyLyudmyla

[Guest guest]

you are welcome.i just have a question befor we get carried away with all these x-rays ...are we as GDPs allowed to take all these xray views or just PA and maybe occlusal and as soon as we see it is not dental abscess (ie cyst or tumor or...)we refer for the specialist to decide what view to take ?mnay thanks From: jasmine chopra <contactjasmine288@...> To:

Sent: Thursday, February 16, 2012 5:27 PM Subject: Re: Re: New guidelines case discussions

THANKS IQBAL AND RADHIKA FOR YOUR HELP.REGARDSJASMINEOn Thu, Feb 16, 2012 at 5:20 PM, doc_smriti <doc_smriti@...> wrote:

Thank you very much Ikbal for the link and Radhika for the x-ray prescription.. Will try to write the treatment planning notes tmrw.. Any links or examples would be extremely helpful..

Kind Regards,

Smriti

> > > > >

> > > > > Hi,

> > > > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > > 1. Taking history with Note making.

> > > > > 2. Written provisional diagnosis.

> > > > > 3. Written justification of radiograph.

> > > > > 4. Written description of a radiograph.

> > > > > 5. Written treatment plan.

> > > > >

> > > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..

> > > > > So.. Lets start!

> > > > >

> > > > > Case 1. (ORE CASE JAN 2008)

> > > > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > > >

> > > > > I'll start with the history notes.. Please add or correct if required..

> > > > >

> > > > > Name: Kathy Brown

> > > > > DOB: 5th jan 1967

> > > > > Add: #XYZ Street, London

> > > > > Occ: Newsreader

> > > > > Marital status: Married, 2 children- living separately.

> > > > >

> > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > > 2. lump on roof of mouth - 1 yr

> > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.

> > > > >

> > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.

> > > > >

> > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

> > > > >

> > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > > >

> > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > > Alc- 10 units/week- beer

> > > > > No Parafunct habit.

> > > > > Sugar/carb intake-low

> > > > > Fizzy/citrus intake- low

> > > > >

> > > > > Regards,

> > > > > Smriti

> > > > >

> > > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..

> > > > >

> > > >

> > >

> >

>

[Guest guest]

i think for this case under special investigations we will just ask for maxillary acclusal view or oblique occlusal view to see extent of lesion in palate or any perforation in palate.. thats it and refer in treatment plan accordingly.. we dont have to talk about biopsy coz we cant read it specialist will do that.. if it seems nothing to be related to teeth in adjacent quardrant from history like pain or any other symptoms like he had some pain in the past but no pain now.. thaen only we can think about PA to rule out dental cause.. otherwise its not reconmmended to take too many xrays in guidelines.. just only need what is required..I could be wrong in my explaination.. PLEASE DO CORRECT ME.THANX From: Ikbal al-saffar <alsaffarikbal@...> " " < > Sent: Thursday, 16 February 2012 5:48 PM Subject: Re: Re: New guidelines case discussions

you are welcome.i just have a question befor we get carried away with all these x-rays ...are we as GDPs allowed to take all these xray views or just PA and maybe occlusal and as soon as we see it is not dental abscess (ie cyst or tumor or...)we refer for the specialist to decide what view to take ?mnay thanks From: jasmine chopra <contactjasmine288@...> To:

Sent: Thursday, February 16, 2012 5:27 PM Subject: Re: Re: New guidelines case discussions

THANKS IQBAL AND RADHIKA FOR YOUR HELP.REGARDSJASMINEOn Thu, Feb 16, 2012 at 5:20 PM, doc_smriti <doc_smriti@...> wrote:

Thank you very much Ikbal for the link and Radhika for the x-ray prescription.. Will try to write the treatment planning notes tmrw.. Any links or examples would be extremely helpful..

Kind Regards,

Smriti

> > > > >

> > > > > Hi,

> > > > > I am sure everyone preparing for part 2 must have gone thru the new guidelines for Dtp.. There are 5 major changes for which we need to practice..

> > > > > 1. Taking history with Note making.

> > > > > 2. Written provisional diagnosis.

> > > > > 3. Written justification of radiograph.

> > > > > 4. Written description of a radiograph.

> > > > > 5. Written treatment plan.

> > > > >

> > > > > Starting today, I will be posting a series of cases that we've all probably discussed before, but have not covered, these finer aspects, on which, we'll now be marked..

> > > > > So.. Lets start!

> > > > >

> > > > > Case 1. (ORE CASE JAN 2008)

> > > > > patient complains of loose lower anteriors,(assuming, due to lack of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump in palate (assuming from 1 year), incidental finding-multiple radiolucencies in mandible.

> > > > >

> > > > > I'll start with the history notes.. Please add or correct if required..

> > > > >

> > > > > Name: Kathy Brown

> > > > > DOB: 5th jan 1967

> > > > > Add: #XYZ Street, London

> > > > > Occ: Newsreader

> > > > > Marital status: Married, 2 children- living separately.

> > > > >

> > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > > > 2. lump on roof of mouth - 1 yr

> > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain, sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on brushing +nt, no F/H of gum disease, no h/o trauma.

> > > > >

> > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no ulceration/bleeding/discharge. hard, no colour change, no h/o of similar swelling mouth or elsewhere.

> > > > >

> > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental t/t in past.

> > > > >

> > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > > >

> > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > > > Alc- 10 units/week- beer

> > > > > No Parafunct habit.

> > > > > Sugar/carb intake-low

> > > > > Fizzy/citrus intake- low

> > > > >

> > > > > Regards,

> > > > > Smriti

> > > > >

> > > > > P.S Please add to these notes if required and your opinion in general. Will continue with the provisional diagnosis in some time.. Please add new cases as well for discussion.. It might be a good idea to use the same subject or heading so that we can find them easily while revising..

> > > > >

> > > >

> > >

> >

>

[Guest guest]

hi every one i have question regarding asking for investigation1)about lump in palate : are we supposed to ask for occlusal views???? because as i heard in dental clinic in uk just PA and BITEWING and DPT are carried out , and for other x ray pt will be refer to hospital.so probably in real situation not every dentist has access to occlusal veiw for diagnosis.im very confused regarding this point , please some one help.2) also about biopsy: are we supposed to refer every case, or should we explain to pt that we will do biopsyyour help will be much

appreciateregards From: doc_smriti <doc_smriti@...> Sent: Wednesday, 15 February 2012, 20:54 Subject: Fw: Re: New guidelines case discussions

An excellent point jasmine, I think the incidental finding will be after examining the DPT. which will be given to us after the provisional diagnosis. So our final diagnosis and treatment plan will be based on the DPT finding. Unfortunately that seems to leave no scope for further questioning because we have to write the treatment plan before we can talk to the patient again..

Swelling of the jaw should definitely be covered in the history.. Thanks a lot for adding that..

Regards,

Smriti

> > >

> > > > > >

> > >

> > > > > > Hi,

> > >

> > > > > > I am sure everyone preparing for part 2 must have gone thru the

> > new guidelines for Dtp.. There are 5 major changes for which we need to

> > practice..

> > >

> > > > > > 1. Taking history with Note making.

> > >

> > > > > > 2. Written provisional diagnosis.

> > >

> > > > > > 3. Written justification of radiograph.

> > >

> > > > > > 4. Written description of a radiograph.

> > >

> > > > > > 5. Written treatment plan.

> > >

> > > > > >

> > >

> > > > > > Starting today, I will be posting a series of cases that we've all

> > probably discussed before, but have not covered, these finer aspects, on

> > which, we'll now be marked..

> > >

> > > > > > So.. Lets start!

> > >

> > > > > >

> > >

> > > > > > Case 1. (ORE CASE JAN 2008)

> > >

> > > > > > patient complains of loose lower anteriors,(assuming, due to lack

> > of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump

> > in palate (assuming from 1 year), incidental finding-multiple

> > radiolucencies in mandible.

> > >

> > > > > >

> > >

> > > > > > I'll start with the history notes.. Please add or correct if

> > required..

> > >

> > > > > >

> > >

> > > > > > Name: Kathy Brown

> > >

> > > > > > DOB: 5th jan 1967

> > >

> > > > > > Add: #XYZ Street, London

> > >

> > > > > > Occ: Newsreader

> > >

> > > > > > Marital status: Married, 2 children- living separately.

> > >

> > > > > >

> > >

> > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > >

> > > > > > 2. lump on roof of mouth - 1 yr

> > >

> > > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

> > sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on

> > brushing +nt, no F/H of gum disease, no h/o trauma.

> > >

> > > > > >

> > >

> > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

> > ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

> > swelling mouth or elsewhere.

> > >

> > > > > >

> > >

> > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental

> > t/t in past.

> > >

> > > > > >

> > >

> > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > >

> > > > > >

> > >

> > > > > > SH: Smokes 10 cig/day last 10 yrs,

> > >

> > > > > > Alc- 10 units/week- beer

> > >

> > > > > > No Parafunct habit.

> > >

> > > > > > Sugar/carb intake-low

> > >

> > > > > > Fizzy/citrus intake- low

> > >

> > > > > >

> > >

> > > > > > Regards,

> > >

> > > > > > Smriti

> > >

> > > > > >

> > >

> > > > > > P.S Please add to these notes if required and your opinion in

> > general. Will continue with the provisional diagnosis in some time.. Please

> > add new cases as well for discussion.. It might be a good idea to use the

> > same subject or heading so that we can find them easily while revising..

> > >

> > > > > >

> > >

> > > > >

> > >

> > > >

> > >

> >

> >

> >

>

[Guest guest]

Hi,

Regarding your 2nd question about biopsy: As a GDP, we can do a biopsy only if

WE plan to treat the patient on the basis of the biopsy, if the patient has to

be referred for treatment, then u have to refer for biopsy as well.. Also, all

suspected malignant lesions have to be referred. And all excisional biopsies

have to be referred..

Regarding the first question: I have not come across any document that states

which radiographs can be prescribed by a GDP. The only concern expressed by all

radiation protection guidelines is justification of exposure.. I hope someone

working in a dental practice could let us know if there is any such restriction.

Regards,

Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > Hi,

> > > >

> > > > > > > I am sure everyone preparing for part 2 must have gone thru the

> > > new guidelines for Dtp.. There are 5 major changes for which we need to

> > > practice..

> > > >

> > > > > > > 1. Taking history with Note making.

> > > >

> > > > > > > 2. Written provisional diagnosis.

> > > >

> > > > > > > 3. Written justification of radiograph.

> > > >

> > > > > > > 4. Written description of a radiograph.

> > > >

> > > > > > > 5. Written treatment plan.

> > > >

> > > > > > >

> > > >

> > > > > > > Starting today, I will be posting a series of cases that we've all

> > > probably discussed before, but have not covered, these finer aspects, on

> > > which, we'll now be marked..

> > > >

> > > > > > > So.. Lets start!

> > > >

> > > > > > >

> > > >

> > > > > > > Case 1. (ORE CASE JAN 2008)

> > > >

> > > > > > > patient complains of loose lower anteriors,(assuming, due to lack

> > > of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump

> > > in palate (assuming from 1 year), incidental finding-multiple

> > > radiolucencies in mandible.

> > > >

> > > > > > >

> > > >

> > > > > > > I'll start with the history notes.. Please add or correct if

> > > required..

> > > >

> > > > > > >

> > > >

> > > > > > > Name: Kathy Brown

> > > >

> > > > > > > DOB: 5th jan 1967

> > > >

> > > > > > > Add: #XYZ Street, London

> > > >

> > > > > > > Occ: Newsreader

> > > >

> > > > > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > > > >

> > > >

> > > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > >

> > > > > > > 2. lump on roof of mouth - 1 yr

> > > >

> > > > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

> > > sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on

> > > brushing +nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > > > >

> > > >

> > > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

> > > ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

> > > swelling mouth or elsewhere.

> > > >

> > > > > > >

> > > >

> > > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental

> > > t/t in past.

> > > >

> > > > > > >

> > > >

> > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > > > >

> > > >

> > > > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > >

> > > > > > > Alc- 10 units/week- beer

> > > >

> > > > > > > No Parafunct habit.

> > > >

> > > > > > > Sugar/carb intake-low

> > > >

> > > > > > > Fizzy/citrus intake- low

> > > >

> > > > > > >

> > > >

> > > > > > > Regards,

> > > >

> > > > > > > Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > P.S Please add to these notes if required and your opinion in

> > > general. Will continue with the provisional diagnosis in some time..

Please

> > > add new cases as well for discussion.. It might be a good idea to use the

> > > same subject or heading so that we can find them easily while revising..

> > > >

> > > > > > >

> > > >

> > > > > >

> > > >

> > > > >

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

also i forgot to mention, my freind husband is a dentist who is working in uk, he mentioned that other than bitewing and dpt and PA , all other xray will be refer From: doc_smriti <doc_smriti@...> Sent: Tuesday, 21 February 2012, 13:54 Subject: Re: New guidelines case discussions

Hi,

Regarding your 2nd question about biopsy: As a GDP, we can do a biopsy only if WE plan to treat the patient on the basis of the biopsy, if the patient has to be referred for treatment, then u have to refer for biopsy as well.. Also, all suspected malignant lesions have to be referred. And all excisional biopsies have to be referred..

Regarding the first question: I have not come across any document that states which radiographs can be prescribed by a GDP. The only concern expressed by all radiation protection guidelines is justification of exposure.. I hope someone working in a dental practice could let us know if there is any such restriction.

Regards,

Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > Hi,

> > > >

> > > > > > > I am sure everyone preparing for part 2 must have gone thru the

> > > new guidelines for Dtp.. There are 5 major changes for which we need to

> > > practice..

> > > >

> > > > > > > 1. Taking history with Note making.

> > > >

> > > > > > > 2. Written provisional diagnosis.

> > > >

> > > > > > > 3. Written justification of radiograph.

> > > >

> > > > > > > 4. Written description of a radiograph.

> > > >

> > > > > > > 5. Written treatment plan.

> > > >

> > > > > > >

> > > >

> > > > > > > Starting today, I will be posting a series of cases that we've all

> > > probably discussed before, but have not covered, these finer aspects, on

> > > which, we'll now be marked..

> > > >

> > > > > > > So.. Lets start!

> > > >

> > > > > > >

> > > >

> > > > > > > Case 1. (ORE CASE JAN 2008)

> > > >

> > > > > > > patient complains of loose lower anteriors,(assuming, due to lack

> > > of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump

> > > in palate (assuming from 1 year), incidental finding-multiple

> > > radiolucencies in mandible.

> > > >

> > > > > > >

> > > >

> > > > > > > I'll start with the history notes.. Please add or correct if

> > > required..

> > > >

> > > > > > >

> > > >

> > > > > > > Name: Kathy Brown

> > > >

> > > > > > > DOB: 5th jan 1967

> > > >

> > > > > > > Add: #XYZ Street, London

> > > >

> > > > > > > Occ: Newsreader

> > > >

> > > > > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > > > >

> > > >

> > > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > >

> > > > > > > 2. lump on roof of mouth - 1 yr

> > > >

> > > > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

> > > sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on

> > > brushing +nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > > > >

> > > >

> > > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

> > > ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

> > > swelling mouth or elsewhere.

> > > >

> > > > > > >

> > > >

> > > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental

> > > t/t in past.

> > > >

> > > > > > >

> > > >

> > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > > > >

> > > >

> > > > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > >

> > > > > > > Alc- 10 units/week- beer

> > > >

> > > > > > > No Parafunct habit.

> > > >

> > > > > > > Sugar/carb intake-low

> > > >

> > > > > > > Fizzy/citrus intake- low

> > > >

> > > > > > >

> > > >

> > > > > > > Regards,

> > > >

> > > > > > > Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > P.S Please add to these notes if required and your opinion in

> > > general. Will continue with the provisional diagnosis in some time.. Please

> > > add new cases as well for discussion.. It might be a good idea to use the

> > > same subject or heading so that we can find them easily while revising..

> > > >

> > > > > > >

> > > >

> > > > > >

> > > >

> > > > >

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

Not even every practice has OPG machine,so what shall we tell in the exam? SincerelyLyudmyla From: Sara Assarian <sara.assarian@...> "doc_smriti@..." <doc_smriti@...> Cc: " " < > Sent: Tuesday, 21 February 2012, 17:01 Subject: Re: Re: New guidelines case discussions

also i forgot to mention, my freind husband is a dentist who is working in uk, he mentioned that other than bitewing and dpt and PA , all other xray will be refer From: doc_smriti <doc_smriti@...> Sent: Tuesday, 21 February 2012, 13:54 Subject: Re: New guidelines case discussions

Hi,

Regarding your 2nd question about biopsy: As a GDP, we can do a biopsy only if WE plan to treat the patient on the basis of the biopsy, if the patient has to be referred for treatment, then u have to refer for biopsy as well.. Also, all suspected malignant lesions have to be referred. And all excisional biopsies have to be referred..

Regarding the first question: I have not come across any document that states which radiographs can be prescribed by a GDP. The only concern expressed by all radiation protection guidelines is justification of exposure.. I hope someone working in a dental practice could let us know if there is any such restriction.

Regards,

Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > Hi,

> > > >

> > > > > > > I am sure everyone preparing for part 2 must have gone thru the

> > > new guidelines for Dtp.. There are 5 major changes for which we need to

> > > practice..

> > > >

> > > > > > > 1. Taking history with Note making.

> > > >

> > > > > > > 2. Written provisional diagnosis.

> > > >

> > > > > > > 3. Written justification of radiograph.

> > > >

> > > > > > > 4. Written description of a radiograph.

> > > >

> > > > > > > 5. Written treatment plan.

> > > >

> > > > > > >

> > > >

> > > > > > > Starting today, I will be posting a series of cases that we've all

> > > probably discussed before, but have not covered, these finer aspects, on

> > > which, we'll now be marked..

> > > >

> > > > > > > So.. Lets start!

> > > >

> > > > > > >

> > > >

> > > > > > > Case 1. (ORE CASE JAN 2008)

> > > >

> > > > > > > patient complains of loose lower anteriors,(assuming, due to lack

> > > of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump

> > > in palate (assuming from 1 year), incidental finding-multiple

> > > radiolucencies in mandible.

> > > >

> > > > > > >

> > > >

> > > > > > > I'll start with the history notes.. Please add or correct if

> > > required..

> > > >

> > > > > > >

> > > >

> > > > > > > Name: Kathy Brown

> > > >

> > > > > > > DOB: 5th jan 1967

> > > >

> > > > > > > Add: #XYZ Street, London

> > > >

> > > > > > > Occ: Newsreader

> > > >

> > > > > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > > > >

> > > >

> > > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > >

> > > > > > > 2. lump on roof of mouth - 1 yr

> > > >

> > > > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

> > > sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on

> > > brushing +nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > > > >

> > > >

> > > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

> > > ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

> > > swelling mouth or elsewhere.

> > > >

> > > > > > >

> > > >

> > > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental

> > > t/t in past.

> > > >

> > > > > > >

> > > >

> > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > > > >

> > > >

> > > > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > >

> > > > > > > Alc- 10 units/week- beer

> > > >

> > > > > > > No Parafunct habit.

> > > >

> > > > > > > Sugar/carb intake-low

> > > >

> > > > > > > Fizzy/citrus intake- low

> > > >

> > > > > > >

> > > >

> > > > > > > Regards,

> > > >

> > > > > > > Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > P.S Please add to these notes if required and your opinion in

> > > general. Will continue with the provisional diagnosis in some time.. Please

> > > add new cases as well for discussion.. It might be a good idea to use the

> > > same subject or heading so that we can find them easily while revising..

> > > >

> > > > > > >

> > > >

> > > > > >

> > > >

> > > > >

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

One of my friend told me other than MRI and ct you should ask for other X-ray inex am because in real life every practice has different kind of machins and some practice even refer the pt for occlusal view ,but in exam we should ask for it

From:

Lyudmyla Huhley <huhley2006@...>;

To:

< >;

Subject:

Re: Re: New guidelines case discussions

Sent:

Tue, Feb 21, 2012 8:16:41 PM

Not even every practice has OPG machine,so what shall we tell in the exam? SincerelyLyudmyla From: Sara Assarian <sara.assarian@...> " doc_smriti@... " <doc_smriti@...> Cc: " " < > Sent: Tuesday, 21 February 2012, 17:01

Subject: Re: Re: New guidelines case discussions

also i forgot to mention, my freind husband is a dentist who is working in uk, he mentioned that other than bitewing and dpt and PA , all other xray will be refer From: doc_smriti <doc_smriti@...> Sent: Tuesday, 21 February 2012, 13:54 Subject: Re: New guidelines case discussions

Hi,

Regarding your 2nd question about biopsy: As a GDP, we can do a biopsy only if WE plan to treat the patient on the basis of the biopsy, if the patient has to be referred for treatment, then u have to refer for biopsy as well.. Also, all suspected malignant lesions have to be referred. And all excisional biopsies have to be referred..

Regarding the first question: I have not come across any document that states which radiographs can be prescribed by a GDP. The only concern expressed by all radiation protection guidelines is justification of exposure.. I hope someone working in a dental practice could let us know if there is any such restriction.

Regards,

Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > Hi,

> > > >

> > > > > > > I am sure everyone preparing for part 2 must have gone thru the

> > > new guidelines for Dtp.. There are 5 major changes for which we need to

> > > practice..

> > > >

> > > > > > > 1. Taking history with Note making.

> > > >

> > > > > > > 2. Written provisional diagnosis.

> > > >

> > > > > > > 3. Written justification of radiograph.

> > > >

> > > > > > > 4. Written description of a radiograph.

> > > >

> > > > > > > 5. Written treatment plan.

> > > >

> > > > > > >

> > > >

> > > > > > > Starting today, I will be posting a series of cases that we've all

> > > probably discussed before, but have not covered, these finer aspects, on

> > > which, we'll now be marked..

> > > >

> > > > > > > So.. Lets start!

> > > >

> > > > > > >

> > > >

> > > > > > > Case 1. (ORE CASE JAN 2008)

> > > >

> > > > > > > patient complains of loose lower anteriors,(assuming, due to lack

> > > of feedback- 31,32 grade 3 mobile, from last 1 year,BPE 222/342) and lump

> > > in palate (assuming from 1 year), incidental finding-multiple

> > > radiolucencies in mandible.

> > > >

> > > > > > >

> > > >

> > > > > > > I'll start with the history notes.. Please add or correct if

> > > required..

> > > >

> > > > > > >

> > > >

> > > > > > > Name: Kathy Brown

> > > >

> > > > > > > DOB: 5th jan 1967

> > > >

> > > > > > > Add: #XYZ Street, London

> > > >

> > > > > > > Occ: Newsreader

> > > >

> > > > > > > Marital status: Married, 2 children- living separately.

> > > >

> > > > > > >

> > > >

> > > > > > > C/o: Patient complains of 1. loose lower front teeth since 1 yr.

> > > >

> > > > > > > 2. lump on roof of mouth - 1 yr

> > > >

> > > > > > > HOPI: 1. noticed 1 yr bk, increase since last 4 mnths, no pain,

> > > sensitive to heat & cold +nt, no sour taste/smell or pus, bleeding on

> > > brushing +nt, no F/H of gum disease, no h/o trauma.

> > > >

> > > > > > >

> > > >

> > > > > > > 2. Lump on palate since 1 yr, no sudden increase, no pain, no

> > > ulceration/bleeding/discharge. hard, no colour change, no h/o of similar

> > > swelling mouth or elsewhere.

> > > >

> > > > > > >

> > > >

> > > > > > > PDH: irregular attender, brush 1/day, no m/w or floss, no dental

> > > t/t in past.

> > > >

> > > > > > >

> > > >

> > > > > > > PMH: h/o diabetes 5 yrs- metformin 500mg BD.

> > > >

> > > > > > >

> > > >

> > > > > > > SH: Smokes 10 cig/day last 10 yrs,

> > > >

> > > > > > > Alc- 10 units/week- beer

> > > >

> > > > > > > No Parafunct habit.

> > > >

> > > > > > > Sugar/carb intake-low

> > > >

> > > > > > > Fizzy/citrus intake- low

> > > >

> > > > > > >

> > > >

> > > > > > > Regards,

> > > >

> > > > > > > Smriti

> > > >

> > > > > > >

> > > >

> > > > > > > P.S Please add to these notes if required and your opinion in

> > > general. Will continue with the provisional diagnosis in some time.. Please

> > > add new cases as well for discussion.. It might be a good idea to use the

> > > same subject or heading so that we can find them easily while revising..

> > > >

> > > > > > >

> > > >

> > > > > >

> > > >

> > > > >

> > > >

> > >

> > >

> > >

> >

>

[Guest guest]

Hi,

Was just going thru 'essential skills for dentists' Oxford univ press, and it

says that UK undergrads are expected to be able to take and interpret the

following radiographs

Intraoral:

bitewings

periapicals

occlusals

Extraoral

DPT

Lateral Ceph.- usually only in specialist ortho practices

Lateral oblique views of jaws- not common

So, as a GDP, these would be the ones that we can prescribe.

Regards,

Smriti

>

> One of my friend told me other than MRI and ct you should ask for other X-ray

inex am because in real life every practice has different kind of machins and

some practice even refer the pt for occlusal view ,but in exam we should ask for

it

>

[Guest guest]

Hi everyone

Can someone please recommend a book or website for reporting X-rays...

Thanks