Dental Health Assessment and Treatment Overview

 
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Definition of Terms
 
Disease
:  Is an active process that causes 
damage 
to the biological system.
Etiology
:  The cause of the disease (which causes the 
damage)
.
Diagnosis
:
  Is the determination of the 
diseases
 present of the biologic system by the analysis of 
disease indicators
 and 
risk factors
.
Diagnostic Opinion
:  Is an opinion of the diseases present, after the 
diagnosis
 is determined by the identification of 
risk factors
 and
disease indicators
.
Risk Factors
: An etiological 
challenge
 to the biological system that increases the 
risk (or probability)
 of initiating a 
disease
 process that
causes 
damage
 without treatment.
Disease Indicators
: The 
damage
 caused by the disease.  There are two types of 
disease indicators
:
 
1.  
Symptom
:  
Damage
 the patient can determine subjectively.
 
2.  
Sign
:  
Damage
 that any trained calibrated doctor can determine objectively and independently of others.
Risk Assessment
An assessment of the risk level (low, moderate, and high) which is impacted by the active diseases or risk factors present.
Risk
:  The 
probability
 that more 
damage
 will occur in the future to the biologic system without treatment based on the level of disease
indicators, and risk factors present at the time of the examination.
Prognosis
:  Prognosis is a 
prediction
 of the probable course of a disease or the outcome of the disease based on the risk level.
 
 
Hobby/Introduction Slide
Full Face Smile
 
Treatment Planning Case Presentation
 
 
 
 
Full Face Smile
M.I.P. Retracted
 
Treatment Planning Case Presentation
 
Medical History “
Positive
” Answers
 
 
Medical History “
Positive
” Answers
 
 
 
 
Dental History: Personal History
 
 
 
 
 
 
 
 
Dental History: Gum and Bone
 
 
>
 
>
 
>
 
>
 
>
 
>
 
 
Periodontal
 
Periodontal
 
Lateral Close-up Right
Lateral Close-up Left
 
Diagnostic Opinion: Periodontal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Periodontal: Risk Assessment
 
 
 
 
 
PERIODONTAL
 
Dental History: Tooth Structure
 
 
 
 
 
 
 
 
 
Biomechanical
Occlusal View Maxillary Arch
Occlusal View Mandibular Arch
 
Biomechanical
 
Diagnostic Opinion: Biomechanical
 
 
 
 
 
 
 
 
 
 
 
 
 
Occ. View Maxillary Arch
Occ. View Mandibular Arch
 
 
Biomechanical: Risk Assessment
 
 
 
 
 
BIOMECHANICAL
 
Dental History: Bite and Jaw Joint
 
 
 
 
 
 
 
 
 
Dental History: Bite and Jaw Joint
 
 
 
 
 
Functional: Jaw Joint Findings
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lateral View Full Face - Repose
Cephalometric Radiograph
 
Functional
 
Cephalometric Measurements
 
 
 
 
 
 
 
 
Cephalometric Tracing
Occlusal View Maxillary Arch
Occlusal View Mandibular Arch
 
Functional
Model/Scan Maxillary Arch
Model/Scan Mandibular Arch
 
Diagnostic Opinion: Functional
 
 
 
 
 
 
 
 
 
 
 
Functional Diagnosis
 
Functional: Risk Assessment
 
 
 
 
 
FUNCTIONAL
 
Dental History: Smile Characteristics
 
 
 
 
Repose
Smile
Duchenne
 
Full Face
Full Face Smile (Historical)
Full Face Smile (Present)
 
Dentofacial
 
Diagnostic Opinion: Dentofacial
 
 
 
 
 
 
 
 
Close-up Repose
Close-up Smile
 
Diagnostic Opinion: Dentofacial
 
 
 
Close-up Repose
Close-up Duchenne
 
Dentofacial: Risk Assessment
 
 
 
 
 
DENTOFACIAL
Retracted View – Upper/Lower Teeth Separated
 
Full Face – Kois Facial Reference Glasses
Full Face Smile
M.I.P. Retracted
 
Treatment Planning Case Review
 
 
Treatment Planning Case Review
Occlusal View Maxillary Arch
Occlusal View Mandibular Arch
 
Treatment Planning Case Review
Slide Note

22 Clinical Photographic views used for the Mentor Exam

Please refer to the Kois Center web site for the Intra Oral Photography help video.

Please make sure that all the photos are diagnostic and cropped/oriented correctly.

The Following Items are available under the Support Materials section of the

Kois Center Website: www.koiscenter.com/support-materials

Refer to Guide for Clinical Photography

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This comprehensive dental assessment covers personal history, gum and bone health, medication details, and periodontal risk assessment. The evaluation includes questions about dental fears, experiences, gum conditions, and more. Visual aids and images help in understanding the examination process and diagnosis stages. The prognosis ranges from good to hopeless based on the risk assessment of specific teeth.


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  1. First Name: Age: Occupation: Personality Type: Amiable Expressive Analytical Driver Immediate Concern Full Face Smile

  2. Full Face Smile M.I.P. Retracted

  3. List all MEDICATIONS, dosage, and significance. ASA (1-6)

  4. PERSONAL HISTORY YES NO 1. Are you fearful of dental treatment? How fearful, on a scale of 1 (least) to 10 (most) [____] 2. Have you had an unfavorable dental experience? 3. Have you ever had complications from past dental treatment? 4. Have you ever had trouble getting numb or had any reactions to local anesthetic? 5. Did you ever have braces, orthodontic treatment or had your bite adjusted, and at what age? 6. Have you had any teeth removed, missing teeth that never developed or lost teeth due to injury or facial trauma?

  5. GUM AND BONE YES NO 7. Do your gums bleed sometimes or are they ever painful when brushing or flossing? 8. Have you ever had or been told you have gum disease, gum or bone loss between your teeth, or had scaling and root planing? > 9. Have you ever noticed an unpleasant taste or odor in your mouth? > 10. Is there anyone with a history of periodontal disease in your family? > 11. Have you ever experienced gum recession, or can you see more of the roots of your teeth? > 12. Have you ever had any teeth become loose on their own (without an injury), or do you have difficulty eating an apple? > 13. Have you experienced a burning or painful sensation in your mouth not related to your teeth? >

  6. DATE:

  7. Gingivitis (Gum) Modified By Attachment Loss / Chronic Periodontitis (Bone Loss) Stage I (Mild) Stage II (Moderate) Stage III/IV (Advanced) Localized (< 30% of teeth) Distribution Pattern Generalized Molar/Incisor Secondary Occlusal Traumatism DATE: Recession Posterior Bite Collapse Oral Pathology Impaction Missing Teeth Other Lateral Close-up Right Lateral Close-up Left

  8. PERIODONTAL LOW MODERATE HIGH Risk Assessment PROGNOSIS GOOD FAIR POOR HOPELESS Specific (Individual Teeth & Rationale) GOOD FAIR POOR HOPELESS

  9. TOOTH STRUCTURE YES NO 14. Have you had any cavities within the past 3 years? 15. Does the amount of saliva in your mouth seem too little or do you have difficulty swallowing any food? 16. Do you feel or notice any holes (i.e. pitting, craters) on the biting surface of your teeth? 17. Are any teeth sensitive to hot, cold, biting, sweets, or do you avoid brushing any part of your mouth? 18. Do you have grooves or notches on your teeth near the gum line? 19. Have you ever broken teeth, chipped teeth, or had a toothache or cracked filling? 20. Do you frequently get food caught between any teeth?

  10. DATE:

  11. Occlusal View Maxillary Arch Occlusal View Mandibular Arch

  12. Caries Enamel Decalcification Defective Restorations Questionable Restorations Xerostomia Erosion Abrasion DATE: Structural Compromises Pulpal Pathology Defective Root Canal Treatment Concerns Crown Margin Location Concerns Missing Teeth Other Occ. View Maxillary Arch Occ. View Mandibular Arch

  13. BIOMECHANICAL LOW MODERATE HIGH Risk Assessment PROGNOSIS GOOD FAIR POOR HOPELESS Specific (Individual Teeth & Rationale) GOOD FAIR POOR HOPELESS

  14. BITE AND JAW JOINT ADAPTIVE MEDIATED YES NO 21. Do you have problems with your jaw joint? (pain, sounds, limited opening, locking, popping)? 22. Do you feel like your lower jaw is being pushed back when you try to bite your back teeth together? 23. Do you avoid or have difficulty chewing gum, carrots, nuts, bagels, baguettes, protein bars, or other hard, dry foods? 24. In the past 5 years, have your teeth changed (become shorter, thinner, or worn) or has your bite changed? 25. Are your teeth becoming more crooked, crowded, or overlapped? 26. Are your teeth developing spaces or becoming more loose? 27. Do you have trouble finding your bite, or need to squeeze, tap your teeth together, or shift your jaw to make your teeth fit together? 28. Do you place your tongue between your teeth or close your teeth against your tongue? ADAPTIVE MEDIATED

  15. BITE AND JAW JOINT BRAIN INITIATED YES NO 29. Do you chew ice, bite your nails, use your teeth to hold objects, or have any other oral habits? 30. Do you clench or grind your teeth together in the daytime or make them sore? 31. Do you have any problems with sleep (i.e. restlessness or teeth grinding), wake up with a headache or an awareness of your teeth? 32. Do you wear or have you ever worn a bite appliance? BRAIN INITIATED

  16. Range of Motion Head and Neck Discomfort Maximum Opening (Vertical): Frequency, Intensity (1>10), Duration Deviation on Opening: Muscle Palpation Right Left Left to Right Movement: Temporalis: Joint Sounds Masseter: Left Joint Right Joint Symptomatic Concerns: Left Joint Right Joint Joint Sounds Crepitus: Load Test: Joint Sounds Popping: Immobilization:

  17. Lateral View Full Face - Repose Cephalometric Radiograph

  18. Normal Actual 82 (+/- 3) SNA 79 (+/- 3) SNB 3 (+/- 2) ANB 32 (+/- 5) SN-MP UAFH/LAFH (N-ANS/ANS-ME) .8 103 (+/- 6) Upper Central to SN 90 (+/- 5) Lower Incisor to MP 135 (+/- 11) Interincisal Angle Cephalometric Tracing

  19. Occlusal View Maxillary Arch Occlusal View Mandibular Arch

  20. Attrition / Normal Force Model/Scan Maxillary Arch Minimal Moderate Severe Abfraction Primary Occlusal Traumatism TMD Airway Model/Scan Mandibular Arch Abnormal Neuromuscular Habits Compromised Occlusal Vertical Dimension Missing Teeth Other

  21. FUNCTIONAL LOW MODERATE HIGH Risk Assessment PROGNOSIS GOOD FAIR POOR HOPELESS Specific (Individual Teeth & Rationale) GOOD FAIR POOR HOPELESS

  22. SMILE CHARACTERISTICS YES NO 33. Is there anything about the appearance of your mouth (smile, lips, teeth, gums) that you would like to change (shape, color, size, display)? 34. Have you ever whitened (bleached) your teeth? 35. Have you felt uncomfortable or self conscious about the appearance of your teeth? 36. Have you been disappointed with the appearance of previous dental work?

  23. Repose Smile Duchenne

  24. Full Face Smile (Historical) Full Face Smile (Present)

  25. COLOR Acceptable Modify Developmental Disturbances FACIALLY RELATED TOOTH POSITION Close-up Repose 1. Maxillary Incisal Edge Position Acceptable Modify Acceptable Modify 2. Maxillary Posterior Occlusal Plane 3. Mandibular Incisal Edge Position Acceptable Modify Acceptable Modify 4. Mandibular Posterior Occlusal Plane 5. Intra-arch Tooth Position (Arrangement & Form) Midline Acceptable Modify Left Right Close-up Smile Axially Inclined Crowding / Overlap Acceptable Modify Diastema Acceptable Modify Rotations Acceptable Modify

  26. MAXILLARY 6a. Gingival Tissue Assessment Lip Dynamics Low Moderate High Close-up Repose Acceptable Modify Position / Horizontal Symmetry Acceptable Modify Scallop / Form Flat Moderate High MANDIBULAR 6b. Gingival Tissue Assessment Lip Dynamics Low Moderate High Acceptable Modify Position / Horizontal Symmetry Acceptable Modify Scallop / Form Flat Moderate High Close-up Duchenne Missing Teeth Other Patient s Vision

  27. DENTOFACIAL LOW MODERATE HIGH Risk Assessment PROGNOSIS GOOD FAIR POOR HOPELESS Specific (Individual Teeth & Rationale) GOOD FAIR POOR HOPELESS

  28. Retracted View Upper/Lower Teeth Separated

  29. Full Face Smile M.I.P. Retracted

  30. DATE:

  31. Occlusal View Maxillary Arch Occlusal View Mandibular Arch

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