Dental Examination
Discomfort Survey
Do you have any intraoral discomfort or difficulty?
The answer to this question provides information about the presence of difficulties that occurred during the intraoral examination, which are not the chief complaint for which the patient is seeking the dental examination.
Single choice:
🔘 Yes
🔘 No
🔘 Don't know
If yes, please specify.
Short text
Do you have any other extraoral (facial) discomfort or difficulty?
The answer to this question provides information about the presence of difficulties that occurred during the extraoral examination, which are not the chief complaint for which the patient is seeking the dental examination.
Single choice:
🔘 Yes
🔘 No
🔘 Don't know
If yes, please specify.
short text
Percussion Test
Percussion is a diagnostic test that is performed by tapping the instrument on the tooth surface.
This test is performed to evaluate inflammation of the periodontal ligament, which can be caused by an infection from dental pulp, periodontal pocket or trauma.
Single choice for each Tooth:
| Input | Meaning |
|---|---|
| - | No sensitivity |
| + | Mild sensitivity |
| ++ | Moderate sensitivity |
| +++ | Severe sensitivity |
Horizontal percussion
Horizontal percussion is performed by tapping the instrument on the buccal or vestibular surface of the tooth.
Vertical percussion
Vertical percussion is performed vertically with the longitudinal axis of the tooth, tapping on the occlusal surface or incisal edge.
Cold Test
Cold test is tooth sensibillity test that is performed by applying cold stimulus (cotton pellet sprayed with cold spray or an ice cube) to the tooth surface.
This diagnostic test is used to assess the health of the dental pulp by determining the sensory response of the pulpal nerve fibers. Based on the results of this test, the vitality of the pulp is indirectly evaluated.
Single choice for each Tooth:
| Input | Meaning |
|---|---|
| - | No reaction |
| + | Normal reaction |
| ++ | Extended reaction |
| +++ | Very strong reaction |
Specification (standard) for performing sensibility test with cold stimulus
For the purpose of performing the sensibility test with cold stimulus, use 1,1,1,2 tetrafluoroethane or propane-butane mixture (for example: EndoFrost, FriscoSpray, EndoIce, EndoIce F, Miracold Plus spray) and 5 mm cotton pellets ( cotton pellets No 2).
The sensibility test with cold stimulus is performed on the tooth that needs to be tested and the control tooth. The following can serve as a control tooth:
🔘 Contralateral tooth that does not show clinical signs of the dental disease (presence of carious lesion, secondary caries, wedge-shaped defects of the cervical area - abfraction, gingival recession with exposed dentin, discoloured crown of the tooth or presence of sinus tract).
🔘 An adjacent tooth that shows no clinical signs of disease.
The test area is isolated with cotton rolls.
The test is performed as follows:
- A 5 mm cotton pellet is completely soaked in a tetrafluoroethane or propane-butane mixture spray.
- A soaked cotton pellet is applied to the middle of the buccal / vestibular surface of the tooth.
- A cotton pellet is placed to the tooth until the patient raises his hand to feel the stimulus or for a maximum of 15 seconds.
If the patient does not feel the stimulus after 15 seconds, the cotton pellet is removed from the tooth and it is considered that the tooth does not react to the cold stimulus.
The test is performed first on the control tooth and then on the tooth that needs to be tested.
Two series of tests are performed:
First series:
- Application of cold stimulus to the control tooth
- Application of cold stimulus to the tested tooth
Second series:
- Application of cold stimulus to the control tooth
- Application of cold stimulus to the tested tooth
There is a break of at least 2 minutes between the two series of tests.
Using cold water, ice cubes and ethyl chloride as a testing agent is not acceptable.
Intraoral Palpation
Intraoral palpation is a diagnostic test performed by gently pressing with the fingertips to determine if there is discomfort, pain or tenderness of the examined tissues.
Single choice for each Quadrant:
🔘 Not checked
🔘 Not painful
🔘 Painful
Alveolar Ridge Palpation
Involves palpation of the maxillary and mandibular alveolar ridge.
Buccal/vestibular Sulcus Palpation
Involves palpation of upper and lower buccal/vestibular sulci.
Extraoral Palpation
Extraoral palpation involves palpation of the head and neck tissues and regional lymph nodes.
Single choice
🔘 Painful
🔘 Not painful
🔘 Not checked
If it's painful, please specify the area.
Short text
Periodontal Examination
Periodontal examination is a clinical examination of periodontal tissues. The examination includes assessment of the amount of plaque on the tooth surfaces, measurement of gingival pockets and assessment of tooth mobility.
Plaque Index Score
The plaque index is a measure of the state of oral hygiene. It is based on the measurement of soft and mineral deposits on the tooth surfaces of index teeth: 16, 12, 24, 36, 32 and 44 (FDI annotation).
It is performed by examining dental surfaces of the index teeth using a dental probe.
Each of the four surfaces of the teeth is given a score from 0-3. The scores from the four areas of the tooth are added and divided by four in order to give the plaque index for the tooth with the following scores and criteria:
Single choice for each Index Surface of each Index Tooth:
| Input | Meaning |
|---|---|
| 0 | No plaque |
| 1 | A film of plaque adhering to the free gingival margin and adjacent area of the tooth, which cannot be seen with the naked eye, only by using the probe. |
| 2 | Moderate accumulation of deposits within the gingival pocket, on the gingival margin and/or adjacent tooth surface, which can be seen with the naked eye. |
| 3 | Abundance of soft matter within the gingival pocket and/or on the tooth and gingival margin. |
Index Surfaces: M, D, V or B, P or L
Index Teeth: 16, 12, 24, 36, 32, 44
Sextant Periodontal Probing
The sextant probing represents a basic periodontal examination. This examination is a simple and rapid screening tool that is used to indicate the level of further examination needed and provide basic guidance on treatment needed. It represents a minimum standard of care for initial periodontal assessment.
All teeth in each sextant are examined with the exception of 3rd molars unless 1st and/or 2nd molars are missing, but only the highest score in the sextant is recorded.
All new patients should have the sextant probing recorded.
Single choice for each Sextant:
| Input | Meaning |
|---|---|
| 0 | Healthy |
| 1 | Bleeding after probing |
| 2 | Calculus detected, black band visible completely |
| 3 | Pocket 4-5 mm, black band on the gingival margin |
| 3F | 3 + Furcation involvement |
| 4 | Pocket 6mm or more, black band completely inside pocket |
| 4F | 4 + Furcation involvement |
| X | Excluded sextant (less than two teeth present) |
Based on the highest result from probing Index Surfaces M, D, V or B, P or L of each Tooth in Sextant.
Interpretation:
• For patients with scores 0, 1 or 2, the sextant probing should be recorded at every routine examination.
• For patients with score 3, more detailed periodontal charting is required: initial therapy including self-care advice (oral hygiene instruction and risk factor control) then, after initial therapy, a 6-point pocket probing in that sextant only, should be recorded.
• For patients with score 4, more detailed periodontal charting is required: a 6-point pocket probing throughout the entire dentition should be recorded.
Full Periodontal Probing
Full periodontal probing is a part of comprehensive periodontal examination.
It is performed by periodontal probing on six sites per each tooth. All probing depths are recorded and expressed in millimeters. It is used as a comprehensive examination for people with score 4 on basic periodontal examination and to evaluate the success of periodontal treatment.
Depth in milimeters for each Periodontal site.
Tooth Mobility Index
Tooth mobility index is a clinical tool used to evaluate the mobility of the present teeth.
It is performed by holding the tooth between the handles of the two instruments and moving it back and forth.
Single choice for each Tooth:
| Input | Meaning |
|---|---|
| 0 | Normal physiological mobility (less than 1mm) |
| 1 | Mobility up to 1mm in horizontal plane |
| 2 | Mobility greater than 1mm in horizontal plane |
| 3 | Severe mobility, greater than 2mm or vertical mobility |