Why use photography
-legal documentation---court or for treatment progress/outcomes
-communication---patient education/ dental labs
-Portfolios---educational/presentations
1-Implied Consent
2-Express Consent
3-Informed Consent
1-sufficient when getting information to provide healthcare w/in circle of care---describing oral lesion
2-be obtained when you share personal info for purposes other than health care--presentations
3-to take and use photos
- verbally- w/ note in chart---is fine if its for documentation for patients treatment only
- signature---when for purposes besides personal health
HIPAA & Photography
-eyes are blocked out
-Pixellating, but if patient is identifiable then must block out or try something else
-Patients can revoke consent
When Documenting make sure...
-clean mirrors
-no fog
-saliva free area
-position patient, retractors, and mirrors properly
-dont alter the photo
Front Surface Mirrors
-avoids double image
-reflective surface is at surface
-non front= reflective surface is beneath glass
left- full arch
middle- wide buccal
right- narrow buccal
1-Retractor Cleaning
2- Mirror Cleaning
1-autoclaved
2-wiped w/ soap, dry w/ towel, wrap in towel, autoclave...no sterilization solutions
1-Relxed Facial Image
2-profile
1-inter pupillary line/incisal plane
2-center of frame is approximately 1 cm anterior to tragus
-Front Maximum Intercuspation
-unilateral retractors
-photograph behind patient
-photos = inverted
Front Maximum Intercuspation
-Bilateral retractors
-photographer is in front of patient
1- Maxillary Arch
2- Mandibular Arch
1-photographer behind patient w/ bilateral retractors
2-tongue is position in back of the mirror, photographer is in front w/ bilateral retractors
L & R Lateral in occlusion
-photographer on contra lateral side of quadrant, focus in mirror...use a bilateral but uni retractor is preferred
Patient Record
-recall what has happened
-work out dispute
-look for potential pitfalls
-everyone on same page
Adv of electronic health records
-legible
-customized views
-quality/convenient
-patient participation
-accuracy of diagnoses
-care coordination
-cost saving
-quick retrieval
-organized + less paper
Disadv of Health Record
-significant start up costs
-less patient time
-little compatibility of different systems
Disadv to checkbox history
-patients might not understand questions
-patient goes through it too quick
-dentist may look for positive response and thats it
-no in depthness
Patient Assessment
-History
-Clinical Exam
-Radiology
-Assessment/DX
-Treatment Plan
-Treatment
-Prescription
Vital Signs
-measures statistics to assess body functions
-temperature, pulse, BP, and resp rate
-gives a baseline
Treating Minors
-minor = anyone under 18
exceptions= minor is pregnant, is married, emancipated, is an emergency
Epidemiology
study of health and disease states in population
- heredity
- behavior
- physical
- social
1-prevalance
2-Incidence
3- Index
4-Caries / Wars
1- # of individuals w/ disease in population at specific point of time
2- #of individuals in pop who experience new disease during specific period of time
3-standard of rating a disease on scale w/ upper and lower limits
4- = rejection from service: 1914 + 1939
DMF Index
D= decayed
M= missed
F= filled
DMFT= denotes decay, mising, filled teeth
DMFS= denotes decay, missing, filled surface
Contributing Factors to Caries
-tooth
-bacteria in biofilm
-time
-diet
Bacterial Infection
-unerupted teeth dont develop from caries
- Strep Mutan and Lactobacilli
Diet
-Critical pH= 5.5 stephens curve
-
Physiological Equilibrium of Caries
-local environment of teeth
-Dynamics
-Demin/Remin process
-continous exchange of minerals between surface/biofilm saliva
-imbalance in equilibrium
Initial Carious Process
-bacterial acids dissolve tooth structures=loss of minerals
-subsurface porosities= inital white spot lesion
Carious Lesions/Time
-Chronic
---also because of environment/personal factors
Preventative Caries
Minimize- bad bacteria, acids, and (sugars)
Maximize- awareness, environment, fluoride, saliva
Caries Stats
-25% of population experience 75% of disease
-increase in less developed countries
-epidemic in emerging country
---inc in caries when dec in income
