ORAL DIAGNOSIS
4 YEAR 2ND SEM MIDTERM
TH
REGINAL EXAMINATION (GERERAL
EXAMINATION)
REGIONAL EXAMINATION
- Specialized examination procedures that
focus on a specific area of the body that
represents the scope of treatment
responsibility of a particular specialty
- Example: Oral maxillofacial region
THREE (3) PHASES OF THE REGIONAL
EXAMINATION
1. Facial examination
2. Oral examination
3. Dental examination
GENERAL OBSERVATION
1. Body Habitus
2. Gait
3. Respiration
4. Speech
BODY HABITUS
- Weight status versus height
- Body proportions
- Height/weight versus age
- Overt topographic changes
- Types:
o Asthenic – very slender 10%
o Hyposthenic – slender 35%
o Sthenic – average 50%
o Hypersthenic massive 5%
GIGANTISM
- a very rare condition that happens when a
child or adolescent has high levels of
growth hormone in their body, which
causes them to grow very tall.
ACROMEGALY
- Causes distinctive characteristic facies
and other features:
o Big hands
o Big feet
- hormonal disorder that develops when
your pituitary gland produces too much
growth hormone during adulthood.
MARFAN’S SYNDROME
- Tall and thin and has an arm span that
exceeds his/her height
- Other features associated with marfan’s
syndrome:
o Arachnodactyly
o Hyper extensibility of joints
o Dissecting aneurysms
CLEIDOCRANIAL DYSOSTOSIS
- Is an inherited disorder of bone
development, characterized by absent or
incompletely formed collar bones,
abnormal shape of the skull with
depression of the sagittal suture,
characteristic facial appearance, short
stature, and dental abnormalities
- Features:
o Incomplete or absent collar bone
o Ability to touch shoulders together
in front of body
o Loose joints
o Delayed closure of fontanelles
o Low nasal bridge
o Occipital, parietal, frontal bossing
o Short forearms
o Short fingers
TOOTH ABNORMALITIES
- Failure to lose the primary at the expected
time
- Slow eruption of secondary teeth
- Extra teeth (supernumerary teeth)
- Peg teeth
- Delayed formation or absence of teeth
 OBESITY • Conduction
abnormalities are
- Patient tends to be overweight
occasionally present
- To be able to measure obesity -> Body
due to hypokalemia and
Mass Index (BMI) = weight divided by
electrolyte
height square (kg/m2)
abnormalities
o Normal weight: 18.5 to 24.9
• Cardiomyopathy
o Overweight: 25.0 to 29.9
4. Gastrointestinal complications
o Obese I: 30.0 to 34.9
• Reduced taste
o Obese II: 35.0 to 39.9
o Obese III: 40 and above • Parotid enlargements
- Conditions associated with obesity: • Peptic ulcers
o Hypertension 5. Metabolic concerns may
o Coronary heart disease include
o Diabetes mellitus - • Impaired glucose
o Hypothyroidism – lack of tolerance
production of thyroid hormone • Increased cholesterol
o Steroid intake levels
o Cushing’s disease • Protein deficiency
o Dystrophia adiposogenitalis
SCOLIOSIS
ASTHENIC
- Abnormal lateral curvatures of the spine
- May exhibited: - Having an uneven level of shoulder
o Hyperthyroidism
LORDOSIS
o Diabetes mellitus
o Substance abuse - An abnormal inward curve of the lumbar
o Malignant conditions – spine
immunosuppressive conditions - May be an asset to women
o Anorexia nervosa - (+) difficulty to supine position during
o Chronic obstructive pulmonary treatment -> putting the patient an upright
disease (COPD) – particularly or stand up position in dentistry
emphysema
KYPHOSIS
ANOREXIA NERVOSA
- Is a curving of the spine that causes a
- Is an eating disorder characterized by: bowing of the back
o Refusal to maintain a healthy body - Hereditary
weight
o An intense fear of gaining weight
o A distorted perception of the shape
of the body
- Physical complications of anorexia
nervosa:
1. Weakness and exhaustion due
to malnutrition
2. Osteoporosis may occur due to
decreased calcium, decreased
phosphorus, and decreased
magnesium
3. Cardiovascular problem
• Bradycardia and low
blood pressure
*TMJ: contribution to back conditions: TMJ
problems may be cause by spine abnormalities*
ASCITES
- Describes the condition of pathologic fluid
accumulation within the abdominal cavity
RHEUMATOID ARTHRITIS
- Inherited developmental or degenerative
problem
- Acquired to over or constant consumption
of food that is rich in uric acid

ANASARCA
CYANOSIS
- Generalized swelling or massive edema
- Caused by ischemia or lack of
(also called as anasarca) is a common
oxygenation of tissues.
sign in severely ill people
- Bluish discoloration of tissues. They are
most readily seen on the:
o Lips
o Nailbeds
o Mucosal surfaces
- They suggest lack of oxygenation of tissue
probably representing cardio-pulmonary
problems
BACTERIAL ENDOCARDITIS
- Metastatic infection of dental interest
- Endocardium: outer covering / outer
muscle
Signs:
- Splinter hemorrhage
- Conjunctival petechiae
- Janeway lesions
- Osler nodes
MACULO-PAPULAR LESIONS OF Prophylactic antibiotics: 2grams of antibiotics
SECONDARY SYPHILIS 1hr prior to dental procedure (bleeding
- There may be some difficulty in eliciting a procedures)
history due to disease to the nature of the Management:
disease.
Antibiotics
 FINGER CLUBBING RESPIRATORY RATE
- Is suggestive of chronic obstructive - Normal Rate: 12-20bpm
pulmonary disease - Problems usually exist if the rate falls
below 10 or goes beyond 24
MCCARTHY’S FUNCTIONAL RESERVE
CLASSIFICATION
Class I – NO dyspnea on normal course of
activities
Class II- SLIGHT dyspnea on normal course of
activities
Class III – SEVERE dyspnea on normal course of
activities

EDEMA Class IV – dyspnea even at rest

- Normally, when skin is depressed by a GAIT

finger, it will bounce back to form once the - Manner of walking of aa person may
finger is removed suggest an existing or previous medical
- Edematous tissue will remain pitted conditions such as stoke, injury to the
- Usually seen in patients with renal legs, trauma from an accident
problems -
GANGRENE OF THE FOOT
- “diabetic foot”
- Candidate for amputation
- Peripheral vascular changes results in
lack or absence of blood supply
- Peripheral nerves are being affected
- Untreated diabetes
- Treated diabetes but over intake of
glucose