B- CHIEF COMPLAINT

THE UNDERLYING CAUSE FOR THE PATIENT’S VISIT TO THE

DENTIST IS KNOWN AS THE CHIEF COMPLAINT .
IT IS RECORDED IN THE PATIENT’S OWN WORDS AND IN
CHRONOLOGICAL ORDER IF THE PATIENT HAS MORE THAN
ONE COMPLAINT .
COMMON ORAL CHIEF COMPLAINTS
INCLUDE :

• PAIN
• SORES (ULCERS) .
• SWELLING .
• BURNING SENSATION .
• PARAESTHESIA AND NUMBNESS
• BLEEDING .
• HYPERSENSITIVITY WITH THERMAL
CHANGES .
• LOOSE TEETH .
 9- OCCLUSAL PROBLEM .
10- DELAYED TOOTH ERUPTION .
11- XEROSTOMIA (DRY MOUTH) .
12- PTYALISM (TOO MUCH SALIVA) .
13- BAD TASTE .
14- HALITOSIS (BAD ODOR) .
15- TMJ PROBLEMS .
16- ESTHETIC
C- HISTORY OF CHIEF COMPLAINT

LEARNING MORE ABOUT THE CHIEF COMPLAINT

=
"HISTORY OF THE PRESENT ILLNESS."
 [1] ONSET
(A) CHARACTER OF ONSET:

SUDDEN (ABRUPT), GRADUAL , INSIDIOUS

(B) DATE OF ONSET:

SHOULD BE RECORDED IN DAY, MONTH AND YEAR.
WHEN COMPARED TO DATE OF PRESENTATION, THE
DURATION CAN BE DEDUCED.
 [2] DURATION:

• RECORDED IS HOURS, DAYS, WEEKS, MONTHS,

YEARS, INCLUDING PERIODS OF REMISSIONS &
EXACERBATIONS.

* SHORT DURATION (HOURS – DAYS) :

CHARACTERISTIC FOR ACUTE CONDITIONS.

* WEEKS–MONTHS : CHARACTERISTIC FOR

CHRONIC CONDITIONS AND NEOPLASTIC
LESIONS

* YEARS: CHARACTERISTIC FOR CHRONIC

CONDITIONS AND BENIGN NEOPLASMS
 [3] CHARACTER AND SEVERITY :

• SEVERITY : (MAINLY OF PAIN) : THIS WILL BE AFFECTED

BY PAIN THRESHOLD OF PATIENT AND MAY BE DESCRIBED
AS : MILD, MODERATE OR SEVERE.

• CHARACTER : OF PAIN MAY BE

(1) THROBBING PAIN MEANS FLUID ACCUMULATION
E.G.: PUS ACCUMULATION IN ACUTE DENTO ALVEALAR
ABSCESS
(2)LANCINATING, STABBING, SHOOTING OR ELECTRIC
SHOCK LIKE PAIN: PAIN OF NERVE ORIGIN E.G. HERPES
ZOSTER, POST HERPETIC NEURALGIA AND PAROXYSMAL
TRIGEMINAL NEURALGIA..
(3) INTERFERENCE WITH SLEEP AND WORK: ACUTE
DENTAL PAIN E.G. ACUTE PULPITIS.
 [4] LOCATION AND SITE:

* LOCATION : IS THE ANATOMICAL AREA : TONGUE, CHEEK,

GINGIVA, ETC..

* SITE: IS THE SPECIFIC AREA IN AN ANATOMICAL LOCATION

E.G. LATERAL ASPECT OF THE TONGUE
 [5] COURSE:

COULD BE RECORDED AS:

• PROGRESSIVE: (INCREASING IN SEVERITY)
E.G. TUMOURS, ACUTE INFLAMMATORY
LESIONS.

• REGRESSIVE ( DECREASING IN SEVERITY)

E.G. SELF DRAINED ABSCESS.

• RECURRENT, INTERMITTENT, REMISSION

AND EXACERBATION
[6] HISTORY OF RECURRENCE:

• THE HISTORY OF PREVIOUS OCCURRENCE OF THE LESION

MAY BE OF IMPORTANCE IN DIAGNOSIS, E.G. RAU,
ERYHTHEMA MULTIFORM.
 [7] DISTRIBUTION:
(A)THE LESION MAY BE:
(1) SOLITARY E.G. TRAUMATIC ULCER

(2) MULTIPLE

i) UNILATERAL E.G. HERPES ZOSTER

ii) BILATERAL WHICH ARE EITHER:

- SYMMETRICAL E.G. LICHEN PLANUS OR -

- ASYMMETRICAL(RANDOM) E.G. ERYTHEMA MULTIFORME.

(B) LESIONS MAY BE RESTRICTED TO ONE REGION OF THE ORAL

CAVITY
-ANTERIOR PART AS PRIMARY HERPETIC GINGIVOSTOMATITIS
-POSTERIOR PART AS HERPANGINA.

(C) THE LESIONS MAY BE

INTRA ORAL ONLY E.G. TRAUMATIC ULCER, RAU
EXTRA + INTRA-ORAL E.G. DERMATOLOGIC DISEASES WITH ORAL
MANIFESTATIONS AS LICHEN PLANUS, LUPUS ERYTHEMATOSUS.
 [8] PRECIPITATING FACTORS AND
RELATION TO OTHER ACTIVITIES:

* PAIN MAY INCREASE BY EATING, SWALLOWING, COLD OR

HOT DRINKS: WHICH ARE THEN CALLED "PRECIPITATING
FACTORS" (PPT).