The first consultation is the most important moment in any medical act. Because you find what you look for, but you look for what you know!
It is in this circumstance that the practitioner can begin to get to know the patient and try to understand any problems or needs. Even when the patient is already known, his or her needs may be new or changed, and only with careful listening can they emerge adequately.
The first consultation is essential to check and study the well-being of the stomatognathic apparatus and to thoroughly assess its components: teeth and gums, muscles and glands, and temporomandibular joint (TMJ).
The actual examination can begin once the collection of information and the anamnesis, the salient health elements pertaining to the patient, has been completed. The importance of the anamnesis is absolute: without complete information and knowledge of the patient’s pre-existing clinical picture and lifestyle habits, the examination would be incomplete and lacking the necessary elements for diagnostic completion. Moreover, it is essential to learn of any pre-existing and/or concomitant systemic pathologies, or allergies to materials or drugs that could interfere with the therapies to be proposed.
The specialist odontostomatological examination should consider not only the teeth and their integrity, but the entire stomatognathic apparatus! Careful observation of the gums and the possible presence of lesions, retractions or pockets is necessary, but also the palpation of the latero-cervical lymph nodes and the evaluation of the oral mucous membranes and tongue in search of any abnormalities or dyschromia, which could be a sign of alterations to be adequately investigated to exclude precancerous lesions. Attention should also be paid to the function of the temporomandibular joint and its opening/closing movements, in order to identify any problems such as clicking or jerking.
That is why the first consultation becomes the most important moment for the patient: it is at this stage that the doctor, on the basis of his experience, makes the diagnosis that is preparatory to therapy. Trivialising the first visit means disrespecting the patient and minimising the role of the examining clinician.
