Diagnosis of Gum disease
Gum disease Diagnosis: Book Excerpts
Diagnosis of Gum disease: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Gum disease:
Diagnostic Tests for Gum disease: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Gum disease.
BLEEDING GUMS:
Ask the following questions:
(Algorithmic Diagnosis of Symptoms and Signs)
- Are there abnormalities on examination of the teeth or gums? The gums may be swollen, as in phenytoin use and early scurvy, and bleed on slight pressure, as in pyorrhea or other conditions. There may be ulceration of the tongue, gums, and buccal mucosa. There may be an isolated dental caries that is causing bleeding. Excessive tartar may be noted on the teeth.
- Is there an enlarged spleen or a systemic rash? The presence of an enlarged spleen should bring to mind Hodgkin's disease, leukemia, lupus erythematosus, thrombocytopenia purpura, and aplastic anemia. A systemic rash that is due to petechiae is common in any disorder that might cause thrombocytopenia.
- Is there a positive Rumpel-Leede test? This would test for capillary fragility, and it may be positive in scurvy, thrombocytopenia purpura, leukemia, and other disorders that depress the platelet count. It will also be positive in disorders of platelet function such as von Willebrand's disease.
DIAGNOSTIC WORKUP
A CBC, sedimentation rate, chemistry panel, ANA titer, and coagulation profile are basic studies that need to be done. If these are negative, referral to a dentist or periodontist would be appropriate. X-rays of the teeth need to be done to look for dental caries, abscesses, and pyorrhea. X-rays of the teeth will also help identify scurvy. A plasma or platelet ascorbic acid level needs to be done if scurvy is suspected. If syphilis is suspected, a VDRL test needs to be done.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
SWOLLEN GUMS AND GUM MASS:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The approach to the diagnosis is to rule out systemic disease by checking other organs by physical examination and laboratory tests (see below). Once this is complete, refer the patient to a periodontist. When making a referral, it is wise to have the patient return or call back with the results of the examination after seeing the specialist. In this way, one can be ready to do a further diagnostic workup should the periodontal examination be negative.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
Gum bleeding [Gingival bleeding]:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If gum bleeding isn’t an emergency, obtain a history. Find out when the bleeding began. Has it been continuous or intermittent? Does it occur spontaneously or when the patient brushes his teeth or flosses? Have the patient show you the site of the bleeding, if possible.
Find out if the patient or any family members have bleeding tendencies; for example, ask about easy bruising and frequent nosebleeds. How much does the patient bleed after a tooth extraction? Does he have a history of liver or spleen disease? Next, check the patient’s dental history. Find out how often he brushes his teeth, flosses, and goes to the dentist and what kind of toothbrush and floss he uses. Has he seen a dentist recently? To evaluate nutritional status, have the patient describe his normal diet and alcohol intake. Finally, note the prescription and over-the-counter drugs he takes.
Next, perform a complete oral examination. If the patient wears dentures, have him remove them. Examine the gums to determine the site and amount of bleeding. Gums normally appear pink and rippled with their margins snugly against the teeth. Check for inflammation, pockets around the teeth, swelling, retraction, hypertrophy, discoloration, and gum hyperplasia. Note obvious decay, discoloration, foreign material such as food, and absence of teeth.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Gum bleeding [Gingival bleeding]:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If gum bleeding isn’t an emergency, obtain a history. Find out when the bleeding began. Has it been continuous or intermittent? Does it occur spontaneously or when the patient brushes his teeth or flosses? Have the patient show you the site of the bleeding if possible.
Find out if the patient or any family members have bleeding tendencies; for example, ask about easy bruising and frequent nosebleeds. How much does the patient bleed after a tooth extraction? Does he have a history of liver or spleen disease? Next, check the patient’s dental history. Find out how often he brushes his teeth, flosses, and goes to the dentist, and what kind of toothbrush and floss he uses. Has he seen a dentist recently? To evaluate nutritional status, have the patient describe his normal diet and intake of alcohol. Finally, note any prescription and over-the-counter drugs he takes.
Next, perform a complete oral examination. If the patient wears dentures, have him remove them. Examine the gums to determine the site and amount of bleeding. Gums normally appear pink and rippled with their margins snugly against the teeth. Check for inflammation, pockets around the teeth, swelling, retraction, hypertrophy, discoloration, and gum hyperplasia. Note obvious decay, discoloration, foreign material such as food, and absence of any teeth.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Gum swelling:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After ruling out pregnancy or the use of phenytoin or similar prescription drugs as the cause of gum swelling, take a history. Have the patient fully describe the swelling. Has he had it before? Is it localized or generalized? Find out when the swelling began, and ask about any aggravating or alleviating factors. Is the swelling painful? Then explore the patient’s medical history, focusing on major illnesses, bleeding disorders, and pregnancies. Also check his dental history. Does he wear dentures? If so, are they new? Ask about use of alcohol and tobacco, which are gum irritants. Then have the patient describe his diet to evaluate nutritional status. Ask about his intake of citrus fruits and vegetables.
Next, inspect the patient’s mouth in a good light. If he wears dentures, ask him to remove them before you begin. As you examine the gums, characterize their color and texture, and note any ulcers, lesions, masses, lumps, or debris-filled pockets around the teeth. Then inspect the teeth for discoloration, obvious decay, and looseness.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Gum bleeding:
History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If gum bleeding isn’t an emergency, obtain a history. Find out when the bleeding began. Has it been continuous or intermittent? Does it occur spontaneously or when the patient brushes his teeth or flosses? Have the patient show you the site of the bleeding, if possible.
Find out if the patient or any family members have bleeding tendencies; for example, ask about easy bruising and frequent nosebleeds. How much does the patient bleed after a tooth extraction? Does he have a history of liver or spleen disease? Next, check the patient’s dental history. Find out how often he brushes his teeth, flosses, and goes to the dentist. Also ask the patient what kind of toothbrush and floss he uses. Has he seen a dentist recently? To evaluate nutritional status, have the patient describe his normal diet and intake of alcohol. Finally, note any prescription and over-the-counter drugs he takes.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Gum bleeding [Gingival bleeding]:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If gum bleeding isn't an emergency, obtain a history. Find out when the bleeding began. Has it been continuous or intermittent? Does it occur spontaneously or when the patient brushes his teeth or flosses? Have the patient show you the site of the bleeding, if possible.
Find out if the patient or any family members have bleeding tendencies; for example, ask about easy bruising and frequent nosebleeds. How much does the patient bleed after a tooth extraction? Does he have a history of liver or spleen disease? Next, check the patient's dental history. Find out how often he brushes his teeth, flosses, and goes to the dentist and what kind of toothbrush and floss he uses. Has he seen a dentist recently? To evaluate nutritional status, have the patient describe his normal diet and alcohol intake. Finally, note the prescription and over-the-counter drugs he takes.
Next, perform a complete oral examination. If the patient wears dentures, have him remove them. Examine the gums to determine the site and amount of bleeding. Gums normally appear pink and rippled with their margins snugly against the teeth. Check for inflammation, pockets around the teeth, swelling, retraction, hypertrophy, discoloration, and gum hyperplasia. Note obvious decay, discoloration, foreign material such as food, and absence of teeth.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
SWOLLEN GUMS AND GUM MASS:
Approach to the Diagnosis
(Differential Diagnosis in Primary Care)
The approach to the diagnosis is to rule out systemic disease by
checking other organs by physical examination and laboratory tests (see
other useful tests below). After this is complete, refer the patient to a periodontist. When making a referral, it is
wise to have the patient return or call back with the results of the
examination after seeing the specialist. In this way, one can be ready to do
a further diagnostic workup should the periodontal examination be negative.
» READ BOOK EXCERPT ONLINE »
Source: Differential Diagnosis in Primary Care, 2007
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