xray prescription for Kathy Brown case

[Guest guest]

Name: Kathy BrownDOB: 5th jan 1967Address: #XYZ Street, London.

1).Owing to provisional diagnosis of Chronic Periodontitis would like to request for Dental Panoramic Tomography to view bone loss,assessment of the teeth present,periapical region and pulp,adjacent teeth displacement and resorption due to lump in the palate.

2).Owing to provisional diagnosis of Benign Salivary Gland Neoplasm would like to request for Upper standard occlusal view to view the size and extent of the lesion and periapical assessment of upper teeth.

Assuming pt's next appointment is on 20/2/2012.

xray requested back on 20/2/2012 for viewing and appropriate pt managemnet.

Sign:

Gdc candidate number or name.

Correct me if wrong,

Radhika.

From: doc_smriti <doc_smriti@...>Subject: Re: New guidelines case discussions Date: Wednesday, February 15, 2012, 11:45 PM

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..> > >>

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