Clinical detection: ‘information gathering’

The oral healthcare team (dentist, nurse, hygienist/therapist/oral health educator, laboratory technician, receptionist, practice manager), led by the principal dental practitioner, should all be involved in the decision-making processes and dental management of the patient, as part of the minimum intervention philosophy of oral/dental healthcare (see Figure 1.1 in Chapter 1). This care rationale is patientcentred, engaging with the patient to encourage them to take responsibility for their own oral health. The role of the oral healthcare team is to provide advice and guidance to help the patient to maintain oral health, as well as providing operative treatment to repair damaged hard and soft tissues. Sometimes the dentist will refer difficult cases to a specialist dentist for their opinion as to what the diagnosis and care plan should be. To manage patients successfully, there are five stages that must be followed (see Figure 2.1):… 1. Detecting clinical problems and their aetiology (see Chapter 2): • This involves detective work to help to gather clinically relevant and useful information, primarily using the skills of verbal history taking, oral examination, and relevant special investigations. 2. Diagnosis and risk assessment (see Chapter 3): • The art of interpretation of signs and symptoms/results from investigations to conclude with identifying the cause of the problem and the potential the individual patient has of developing further disease in the future or responding to treatment. Both aspects are critical to planning the overall care of the patient. 3. Prognosis (see Chapter 3): • The art of forecasting the course of a disease or problem, whether treated or not. 4. Formulation of an individualized patient care plan (see Chapters 3 and 4): • This must be underpinned by the non-invasive control of disease and lesion prevention, following the principles of minimum intervention oral care. • The care plan will also include itemized, costed, minimally invasive operative treatments when required. 5. Recall/re-assess/review (see Chapter 9): • Reviewing the outcomes of any care provided, re-assessing the patient’s response to evaluate whether knowledge/behavioural adaptations and adherence have helped to control and/ or prevent disease reoccurrence, and developing adaptive recall strategies/ intervals that are patient-centred, rather than generic and guideline-driven.