Introduction to Oral Medicine and Oral Diagnosis: Patient Evaluation

FDSRCS The overall goal for all oral healthcare professionals is to deliver and maintain optimal health for their patients. Oral medicine clinicians are involved with two major types of consultations: those that they initiate for their own patients as a request from another healthcare professional; and those in response to a request for help with a patient of another healthcare professional. The process of obtaining, evaluating, and assessing a patient's oral and overall health status can arbitrarily be divided into seven major parts. These include: history and examination, establishing a differential diagnosis, obtaining necessary consultations, as well as appropriate laboratory tests, final diagnosis, formulating a plan of action, initiating treatment, and follow-up assessment of response to treatment. The chapter discusses the patient's record is customarily organized according to the components of the history, physical examination, diagnostic summary, plan of treatment, and medical risk assessment.