In the Facially Generated Treatment Planning Workshop at Spear, one of the primary topics of discussion is helping patients change their awareness, their ownership and understanding of their present condition. 

dental examination guide

To us, things seem so obvious that it’s difficult to see how the findings can fail to be significant for a patient. It’s one of the reasons we use photography; it’s why we practice co-discovery; it’s why “case presentation” of solutions doesn’t usually work; it’s why we are often frustrated by the lack of action taken by patients who profess an appreciation and desire for dental health. Anything that helps the patient see what we see is helpful.

The Examination Checklist can help you show your patients the comprehensive nature of the examination you’ve learned to provide in the Facially Generated Treatment Planning and Occlusion workshops, and get them to ASK for treatment using the Four-Part Tour of the Mouth.

The treatment planning protocol that Frank developed follows this format: Esthetics, Function, Structure and Biology (EFSB). The checklist provides a vehicle for the patient to get a “report” they can read, ask about (we HOPE), and take home as a reminder of the discussion.

As Frank Spear was walking us through a patient, making observations step by step, I realized that a checklist of those observations would provide awareness beyond the exam. This awareness could dramatically change how the patient perceives what’s happened, they can see the scope of the areas you examined and can ask you to talk about the areas you checked.

The sheet has your practice name and contact information and lists the observations you made at the exam. Boxes that are checked create “asking” points for the TEAM to talk about. Notes can be written on the sheet if appropriate to send home with the patient. Each section of the checklist provides a series of boxes that can be checked if you would like the patient to be aware of something that you have observed. They can ASK. Esthetics is “Appearance.”

Appearance Observations:

  • Tooth Position
  • Tooth Arrangement
  • Tooth Color
  • Tooth Wear
  • Gingival Display
  • Gingival Levels
  • Papilla Position/ Contact Length

Function is “Bite.”

Bite Observations:

  • TM Joint Sounds
  • TM Joint Pain
  • Muscle Pain
  • Tooth Wear
  • Tooth Fracture
  • Tooth Mobility
  • Malalignment of Teeth

Structure is “Tooth Condition.”

Tooth Condition Observations:

  • Decay
  • Cracks/Craze Lines
  • Fractures
  • Erosion
  • Failing Fillings and Restorations
  • Missing Teeth
  • Missing Teeth Which Need Replacement
  • Teeth That Will Need Future Attention

Biology is “Biologic.”

Biologic Observations:

  • Gingival Inflammation
  • Gingival Recession
  • Bone Loss
  • Gingival or Bone Hyperplasia
  • Pathology Around the Tooth Root
  • Pulpal Inflammation
  • Abnormal X-Ray Findings

This report gives the patient something to look at and help them remember. Be sure to record what has been reported for future reference. There is nothing worse than telling a patient about something and then failing to follow-up or not being aware of what was reported. To help your practice implement the EFSB checklist check out our module on the Spear Digital Suite within the Team Development section. It will help your practice team create understanding and protocol around the use of the checklist in your practice. 

(Click this link for more dentistry articles by Dr. Gary DeWood.)

Gary DeWood, D.D.S., M.S., Spear Faculty and Contributing Author


Commenter's Profile Image Barry Polansky
January 30th, 2014
Gary --that is an excellent checklist for the "science" of the examination...but what about the "art" of the examination. In other words how do we take the exam from the left side of the brain to the right side of the brain---where all of the decision making abilities lie?
Commenter's Profile Image Gary DeWood
January 30th, 2014
Thank you for asking Barry! The checklist is specifically designed to assist dental teams in making that move. Without recognition of the science the art can not be practiced. The checklist helps the dental team move the discussion to the experience of what is discovered in the examination by focusing the patient's attention on what the doctor sees. A tool, like many others, intended to bring the patient and the doctor into communication with each other. Thanks for identifying the connection that must be made if the checklist is to serve as the powerful tool that it can.
Commenter's Profile Image Barry Polansky
February 3rd, 2014
Thanks Gary--I guess that's what it means to "get it off the shelf."