CHAPTER 2 DENTAL   EXAMINATIONS INTRODUCTION PATIENT   PREPARATION The  dental  examination  is  one  of  the  basic professional  services  provided  by  the  Navy  dental team. Soon after you entered the military service, you received   your   first   dental-oral   examination   to determine  your  dental  health.  Throughout  your service  with  the  Navy,  you  will  receive  annual  or periodic   dental   examinations.   The   results   of   these examinations   are   recorded   in   your   individual   U.S. Navy  Medical  Outpatient  and  Dental  Treatment Record  (NAVMED  6150/21-30).  The  preparation  of the   NAVMED   6150/21-30   is   discussed   in   Dental Technician,   Volume   1,   chapter   2.   The   Forensic Examination  Section,  which  is  located  on  the  inside back   cover   of   the   NAVMED   6150/21-30,   will   be discussed  in  this  chapter  since  it  covers  an examination. Your  responsibility  is  to  assist  the  dentist  in  all areas  of  dental  examinations.  You  must  be  able  to understand and complete various dental forms used in the  examination  process  that  become  a  part  of  the NAVMED 6150/21-30. Information on dental examinations  and  related  forms  can  be  found  in  the Manual of the Medical Department, NAVMED P-117, chapters 6 and 15. Dental examinations are performed by dentists in different areas of the dental clinic. The Oral Diagnosis Department has the responsibility of providing dental examinations   and   holding   "sick-call"   hours,   while dentists and auxiliary personnel (hygienists and Dental Technicians) in other departments of the dental clinic also  perform  oral  examinations.  This  chapter concentrates   on   your   duties   in   pre-examination, examination types, occasions for dental examinations, dental   classifications,   designations,   charting   and abbreviations,  recording  dental  treatment,  additional dental treatment forms, and patient dismissal. PRE-EXAMINATION  DUTIES Before seating a patient for a dental examination, ensure  that  the  operatory  is  neat  and  professional  in appearance.  Make  sure  the  area  is  clean  and  the equipment  is  disinfected. The patient may be nervous, so try to put him/her at ease   by   using   the   communication   skills   that   were discussed in Dental Technician, Volume 1, chapter 2, "Technical  Administration  and  Responsibilities." Introduce yourself and ask the patient for his or her dental  record.  Open  the  record  and  scan  the  Dental Health   Questionnaire,   NAVMED   6600/3.   Look specifically  for  "yes"  answers  if  the  questions concerning contagious or infectious diseases, such as Hepatitis   (Type),   Human   Immunodeficiency   Virus (HIV), cold sores (herpes, etc.) were checked. When a patient  has  a  "yes"  answer,  notify  the  dentist  before treatment. When  the  patient  is  seated,  make  him  or  her  as comfortable as possible. Adjust the headrest and place the chair in the working position favored by the dentist, usually the fully reclined position shown in figure 2-1. In  this  position,  the  patient's  head  is  level  with  the dentist's elbow when the dentist is seated on the dental stool. After  you  have  seated  the  patient  and  positioned the chair, turn on the operating light. To avoid shining the light in the patient's eyes, focus the light beam on the area beneath the patient's chin. Then, turn off the light until the dentist is ready to start the examination. When the dentist is ready, turn on the light and rotate the light up to the mouth. Next you will need a patient napkin to drape the patient.  A  patient  napkin  holder  attaches  the  patient napkin in place around the neck area. If the patient is a woman wearing lipstick, give her a tissue and politely ask her to remove the lipstick before the examination begins. If the patient is wearing dentures or removable partial dentures, ask him/her to remove them and place them  in  a  cup  of  water.  The  dentist  will  need  them standing by to evaluate proper fit and condition during the exam. A patient who is wearing corrective glasses should be asked to leave them in place during the exam, while a  patient  not  wearing  corrective  glasses  should  be given eye protection. 2-1