A Good Diagnosis

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HealthWiki > Where There Is No Dentist > Chapter 6: Examination and Diagnosis > A Good Diagnosis

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In this chapter:

 

In this chapter:

You are making a diagnosis when you decide what a person’s problem is and what is causing it. To do this, you need information. You need to make a careful examination to make a good diagnosis.

Learn all you can about the person’s problem:

1. Ask questions about the problem.

2. Look at the person’s face. Think about the person’s age.

3. Examine the mouth more carefully than before.

4. Touch the place that is sore.

1. Ask the person about the problem. Give a sick person a chance to describe how he is feeling. Listen. Think about what possibly is happening in his mouth. You may have an idea about what the person has. Now try to find out more by asking questions:
   • What is the problem? Ask him to talk about the pain, swelling, bleeding, or whatever he is feeling.
   • Where does it feel that way? See if he can put his finger on the tooth or place that is bothering him.
   • When do you have the most pain? Find out if it happens all the time or only some of the time (for example, when he drinks something very cold).
   • When did it start? Find out if he has already had this problem before. Ask how he took care of it.
   • Have you had an accident or injury lately? Infection still inside the bone from an old injury in the mouth can make a sore on his face, or can start swelling.
   • Are you having other problems? A head cold or fever can make the teeth hurt.
   • How old are you? Think about a new tooth coming into the mouth.
   After you hear the answers to your questions, decide if your original idea is the correct diagnosis. If not, try to think of another possibility and ask more questions. This is the scientific method of making a diagnosis. For a good explanation of scientific method, see Chapter 17 of Helping Health Workers Learn.
   

   Train midwives to examine their patients’ mouths. When they send patients to you for dental care, they can give you helpful information about their health.

   
   

   Find out if a person is pregnant. A pregnant person’s gums can easily become infected, causing them to bleed. Or they may have more tooth decay. This does not have to happen. If a pregnant person takes extra care of their teeth and gums, they can prevent most dental problems. But if they already have a problem, do not wait for the baby’s birth before offering help. You can treat a pregnant person’s mouth problems now. In fact, this may be an important way of protecting the baby as well.
2. Look at the person.
   People have some problems more often at certain ages. When a person first comes in to see you, notice his age. Then, before you ask him to open his mouth, look at his face for a sore or swollen area.
   

   SWELLING
   CHILD	YOUNG PERSON	ADULT
   Swelling can come from: mumps an infection in the spit gland a tooth abscess	Swelling can come from: the third molars ("wisdom teeth") growing in a tooth abscess	Swelling can come from: a tooth abscess a broken jaw a tumor




A SORE
CHILD	YOUNG PERSON	ADULT
A sore can come from: impetigo Vincent’s infection	A sore can come from: fever blisters a tooth abscess	A sore can come from: a tooth abscess a bone infection (osteomyelitis)




3. Examine inside the mouth. Remember what the person said, the person’s age, and what you saw. Now look more closely at the problem area.

   Let me think: 1. Pain all the time 2. Swollen face 3. Large cavity      in molar ABSCESS?

   Look at the teeth: Is a new one growing in? Is a tooth loose? Is there a dark (dead) tooth? Look at the gums: Are they red? Is there any swelling? Do they bleed? Are the gums eaten away between the teeth?

Look also for sores on the inside of the cheek or lips, and on the tongue.




4. Touch the sore place. Touching is a good way to find out how serious the problem is. This will help you decide which treatment to give.
   Push gently against each tooth in the area of pain to see if a tooth is loose. Rock the loose tooth backward and forward between your fingers, to see if it hurts when you move it.

   Using the end of your mirror, tap against several teeth, including the one you suspect.
   There is probably an abscess on a tooth that hurts when you tap it.	I must take out your tooth. It has an abscess.

   
   Press against the gums with cotton gauze. Wait a moment, and then look closely to see if they start bleeding. Then use your probe gently to feel under the gum for tartar. Carefully scrape some away. Wait and look again to see if the gums bleed. When gums bleed, it is a sign of gum disease.

This page was updated:17 May 2024