ORAL DIAGNOSIS: EXAMINATION OF THE B.

STAINS
TEETH - May result from developmental disturbances
4TH YEAR 2ND SEM MIDTERM whereby the normal pattern of enamel
prisms and dentinal tubules are disturbed
EXAMINATION OF THE TEETH Ex. Amelogenesis Imperfecta and
- Done systematically Dental fluorosis
- Every dental procedure; requires radiograph - May result from intrinsic pigments formed
Methods of examination include inspection with from the time of development or after the
the naked eye: teeth have fully formed
• Mouth mirror - May arise from the introduction of
• Sharp explorer medicaments into the root canals and pulp
• Radiographic examination chambers during root canal therapy
• Vitality test - The use of tobacco is the most frequent
Consider the following in the examination of the cause of staining
teeth: o Cleaning will remove only the
• Color and stain external tobacco stains
• Size o Any stains of dentin, fissures and pits
• Form will be difficult to remove
• Structure and number
• Erosion, abrasion, attrition SIZE, FORM, STRUCTURE, AND NUMBER
• Fractures - May be altered by developmental
• Vitality disturbances
• Carious lesion
A. SIZE
• Contract relationship
1. Macrodontia
2. Microdontia
COLOR AND STAIN
B. FORM
A. COLOR - Developmental disturbances:
- Inherent color is determined by the o Geminated teeth
translucency and thickness of the enamel o Fused teeth
and by the thickness of the underlying o Concrescence
dentin. o Enamel pearls
- Color may show considerable variation: o Dens in dente
o PRIMARY TEETH o Turner’s teeth
▪ Generally bluish white o Odontomas
o PERMANENT TEETH o Hutchinson’s incisors
▪ More opaque with variations o Mulberry molars
of gray and yellow hues - Hereditary Alterations
- As the person grows older the enamel o Enamel hypoplasia
becomes worn and thinner o Dentinogenesis imperfecta
- Dentin becomes thicker, teeth become o Dentin dysplasia
yellowish or grayish yellow o Amelogenesis imperfecta
- Hydrogen peroxide whiten the tooth but can
weaker the tooth.
 C. NUMBER
1. Anodontia
a. Complete
b. Partial
o Maxillary lateral incisors
o Mandibular second bicuspids
o Congenital absence is an important
consideration in orthodontic treatment
and space management
2. Supernumerary teeth
o Refers to an increase in the normal
number of teeth present in the
dentition
o May interfere with normal eruption
EROSION, ABRASION, ATTRITION, AND
FRACTURES
A. EROSION
- Results from a chemical process and the
defects are usually limited to the labial and
buccal surfaces of the teeth
- Defects may vary in shape from saucerlike
depression to deep wedge-like grooves
B. ABRASION
- Refers to the mechanical wearing of the
tooth structure by physical agents such as
toothbrushes, abrasive powers…
- May affect any hard dental surfaces
C. FRACTURES
- May involve both crowns and roots
- Coronal fractures are obvious
- Root fractures require radiographic
evaluation
- Factors to consider in evaluation
fractures:
o Presence of direct pulpal involvement
o Pulpal involvement secondary to
injury to the apex
- Pulp testing immediately after a fracture is
not recommended because most fractured
teeth are hypersensitive to electric
stimulation
D. ATTRITION
VITALITY
- A questionable teeth should be examined
for vitality based on:
o Patient’s history
o Clinical examination of the teeth
o Radiographic signs of disease
CARIOUS LESION
- They examiner should remove any debris
and dry the teeth before attempting to
examine them for carious lesions.
1. Examination begins with a specific tooth
and proceeds systematically throughout
the arches.
o All surfaces of the tooth examined
completely before proceeding to the
next tooth
2. Examination of the proximal surfaces
o Difficult
o Use of explorers and radiographs
o Periodic examination is indicated for
all individuals
o New carious lesions may develop
within 6mons.
o Factors initiating dental caries:
1. Exposure of cementum
2. Improper extension of
restorations
3. Malposed teeth
AREAS WHERE CARIOUS LESIONS
FREQUENTLY DEVELOP:
- Pits and fissures
- Developmental grooves of the occlusal
surfaces of the teeth
- Interproximal surfaces
AREAS LESS COMMONLY AFFECTED
- Labial
- Buccal
- Lingual surfaces
 CONTACT RELATIONSHIP

DENTAL FLOSS is used to determine the tightness

of contact areas throughout the mouth
- Make use of suitable dental floss to permit
adequate evaluation of the proper contact
relationship.
- Requirements:
o Thin, round, unwaxed nylon
o Should pass through the area without
being torn or shredded
o Tearing or shredding of floss is
indicative of dental caries or
overhanging restoration

IMPROPER CONTACT RELATIONSHIP

- Indicated when the floss is easily pulled
through the contact area
- Gingival tissues show evidence of food
impaction