Wednesday, 28 July 2010


What is a diagnosis? This question comes up regularly on the clinic.

I see this as the beginning of the management of a patient - an essential step in determining not only treatment but also prognosis. It is a label that categorises a patient to help us help them.

As such, I don't necessarily see a diagnosis as only something relating to what we would normally recognise as a 'disease', that is, caries, perio, apical abscess, etc. A diagnosis may relate to other problems the patient has:
  1. orthodontic problem (e.g. crowding or increased overjet) 
  2. aesthetic problem (e.g. a median diastema that causes this particular patient concern - a problem others might not see as such)  
  3. functional problem (e.g. a lack of alveolar ridge, which results in problems retaining a denture)
A diagnosis does not necessarily mean we have to - or be able to - treat. There are pros and cons to most things and we would need to explain each to the patient. But by having a diagnosis we identify the problem and can agree it with the patient. Then we can work out how to manage it with the patient.

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