Essentials of Human Disease in Dentistry

Mark Greenwood

• Publisher: Wiley-Blackwell
• Year: 2018
• ISBN:
  9781119251859
• Edition: 2
• Topic: Medicine
• Subtopic: Dentistry

A comprehensive guide to providing effective dental treatment and care to patients affected by diseases

Essentials of Human Disease in Dentistry, Second Edition takes an integrated approach to dentistry and how it relates to general medicine, surgery, pharmacology, therapeutics, pathology and microbiology. Building on the success of the Textbook of Human Disease in Dentistry, this new edition has been updated with a new layout, featuring key topics, learning objectives and practical clinical advice in each chapter.

This accessible guide is structured around the systems of the body and covers all major diseases and conditions with their aetiology, symptoms, and treatments. The focus is on the relevance of particular diseases and their drug treatment in relation to dentistry and patient dental management.

This vital resource:

• Promotes a better understanding of how to provide effective dental treatment to patients affected by diseases
• Presents illustrative examples and helpful clinical photographs throughout
• Includes a new chapter on the importance of understanding shock
• Features self-assessment questions at the end of each chapter, and a companion website hosting downloadable images from the book

Essentials of Human Disease in Dentistry, Second Edition is an invaluable resource for undergraduate dentistry students as well as newly qualified dentists preparing for the MFDS exam.

CHAPTER 1
Clinical examination and history taking

M Greenwood

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Key topics

• Essential components of a medical history
• Key issues that may arise from the medical history

Learning objectives

• To be familiar with the main components of a medical history.
• To be aware of the medical terms used in taking a medical history, and their meaning.
• To be aware of the normal vital signs.

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Components of a medical history

The medical history aims to:

• Enable the formulation of a differential diagnosis or diagnosis
• Put the patient’s disease process into the correct medical and social context.
• Establish a rapport with the patient.

Clinicians engaged in obtaining medical histories should introduce themselves to the patients and give their designations. The taking of the history may then commence and should follow a scheme similar to that shown in Table 1.1.

Table 1.1 Areas to be covered in a medical history.

Presenting complaint

History of presenting complaint

Past medical history

Allergies

Past dental history

Drugs

Social history

Family history

Psychiatric history

Presenting complaint

The presenting complaint can be recorded in medical terms, but often is better expressed in the patient’s own words. When recording the history in writing, quotation marks should be placed around the patient’s words. In a verbal case presentation, it should be stated that the patient’s own words are being used. It is important to avoid presumptive diagnoses in the presenting complaint. For example, patients do not present with iron deficiency anaemia; they may present with symptoms that arise from it. It should be remembered that symptoms are the features of the illness that the patient describes; signs are physical findings obtained by the clinician.

History of the presenting complaint

The history of the presenting complaint should be a chronological but succinct account of the patient’s problem. It is important to start at the onset of the problem and describe its progression. Symptoms should be similarly described.

Points to include when asking patients about pain are as follows:

• Site
• Character – for example, tight/band-like (in the chest, suggestive of cardiac origin)
• Does the pain radiate anywhere?
• Onset – sudden or gradual
• Severity (ask the patient to rate on a scale of 1–10, with 10 being the most severe)
• Duration
• Exacerbating/relieving factors (including the use and efficacy of medication)
• Preceding events or associated features
• Has the pain occurred before? / Is it getting better or worse?

Past medical history

It is worth asking a generic set of opening questions – for example, ‘Do you have any heart or chest problems?’ Questioning should then focus on specific disorders – for example, asthma, diabetes, epilepsy, hypertension, hepatitis, jaundice or tuberculosis. It is also worth specifically asking about any previous problems with the arrest of haemorrhage. Past problems with intravenous sedation or general anaesthesia should be noted. It is worth ask...