This list can be useful for the easy to forget additions when taking histories. When details are provided by the patient we should always be asking, how does this affect my dentistry and does more need to be carried out to investigate this?
Every clinical book you touch will state how important it is to take and note accurate histories. This is why we have our checklists that help us to carry out a logical format of questioning.
Below are some of the areas that can still be overlooked and pointers to kick start the brain to enquire more where necessary.
As mentioned in the previous lesson, understanding patient behaviours is critical to tailor the treatment plan specifically to their needs. A dental history provides us with patients' past experience with us as a profession and could give a valuable indication of their motivation and potential commitment to future treatment and maintenance.
We are not dieticians but obtaining information regarding frequency of sugar and acidity of the food/ drink could be crucial in finding out the aetiology of their current oral conditions. (2)
This information will also help the predictability of any future treatment. For example: Restorations placed in patients who are unwilling to alter their sugar intake could fail early. (2)
It is our duty to inform the patient with the risks that have at least a 1% chance of occurring. We also need to take into account more significant factors if applicable; for example: an Oral surgeon when consenting for a General anaesthetic will warn of complications such as a 1-2 in 200,000 chance of ID nerve injury when dealing with molars in close proximity and the anaesthetist will discuss the possibility of a 1 in 100,000 chance of fatal complications (3).
In addition, we must also inform the patient of risks that could be significant specifically to them. This is impossible to do without knowing our patients. The commonly used scenario is the Obo player.
This list is not exhaustive, but it does cover the main topic areas our mind should go to when taken patient histories.
1. Odell EW. Cawson's Essentials of Oral Pathology and Oral Medicine E-Book. Elsevier Health Sciences; 2017 May 2.
2. Usha C, Sathyanarayanan R. Dental caries-A complete changeover (Part I). Journal of conservative dentistry: JCD. 2009 Apr;12(2):46.
3. Lanier WL. A three-decade perspective on anesthesia safety. The American Surgeon. 2006 Nov 1;72(11):985-9.
NHS General Anaesthesia Risks/ Complications
Adverse Drug Reactions BNF
SDCEP Anxiety Questionnaire
BAOS Anxiety Questionnaire
GDC Standards - Consent
Delivering Better Oral Health (DBOH)
Yeung CA, Goodfellow A, Flanagan L. The truth about sugar. Dental update. 2015 Jul 2;42(6):507-12.
Dhadwal AS, Baysa A. ’Educating the educated’: a report of an undergraduate medical student with multiple carious lesions and poor dietary habits. Dental Update. 2017 Jun 2;44(6):532-8.
Book: Lewis MA, Lamey PJ. Oral Medicine in Primary Dental Care. Springer; 2019 Jun 21.
