{"id":122,"date":"2023-06-22T11:15:17","date_gmt":"2023-06-22T11:15:17","guid":{"rendered":"https:\/\/teeth.gushogg-blake.uk\/?p=122"},"modified":"2026-04-07T13:12:31","modified_gmt":"2026-04-07T13:12:31","slug":"face-focused-initial-assessment","status":"publish","type":"post","link":"https:\/\/teeth.gushogg-blake.uk\/index.php\/2023\/06\/22\/face-focused-initial-assessment\/","title":{"rendered":"Face Focused Initial Assessment"},"content":{"rendered":"\n

Gallery:<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

CBCT:<\/p>\n\n\n\n

\n
\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n
\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n
\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n
\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/figure>\n\n\n\n

Panoramic. My LR8 (lower right 8\/third molar\/wisdom tooth) is mesially (towards the center line) inclined and impacted here. We’re attempting to upright it with Invisalign as of April 2026.<\/p>\n\n\n\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n

Airway:<\/p>\n\n\n\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n

Assessment:<\/p>\n\n\n\n

Chief Complaints<\/h3>\n\n\n\n

Bite, TMJ issues, appearance of jaw<\/p>\n\n\n\n

Signs & Symptoms<\/h3>\n\n\n\n
    \n
  • Hx. of smoking (quit at 17)<\/li>\n\n\n\n
  • extraction of U\/L 4\u2019s<\/li>\n\n\n\n
  • snoring<\/li>\n\n\n\n
  • TMJ popping\/discomfort<\/li>\n\n\n\n
  • ringing in ears<\/li>\n\n\n\n
  • daytime fatigue<\/li>\n\n\n\n
  • grinding during the day<\/li>\n\n\n\n
  • bite feels off\/uncomfortable<\/li>\n<\/ul>\n\n\n\n

    Clinical Exam Conditions<\/h3>\n\n\n\n
      \n
    • Head Posture: Forward Head Posture<\/li>\n\n\n\n
    • Facial Features: Allergic Eye Shiners, Excessive Buccal Corridors<\/li>\n\n\n\n
    • Vertical Upper Jaw Position: Mild Vertical Maxillary Excess<\/li>\n\n\n\n
    • TMJ Pain (R\/L): Mild<\/li>\n\n\n\n
    • Masseter Pain (R\/L): Moderate<\/li>\n\n\n\n
    • Anterior Temporalis Pain (R\/L): None<\/li>\n\n\n\n
    • Posterior Digastric Pain: None<\/li>\n\n\n\n
    • SCM Pain: None<\/li>\n\n\n\n
    • Trapezius Pain: Moderate<\/li>\n\n\n\n
    • Maximum Opening: > 50 mm (55)<\/li>\n\n\n\n
    • TMJ Dysfunction: No Clicking\/Popping<\/li>\n\n\n\n
    • Deviation\/Deflection: No Deviation\/Deflection on Opening<\/li>\n\n\n\n
    • Indicator Line: 42 mm<\/li>\n\n\n\n
    • Intermolar Width: 31 mm<\/li>\n\n\n\n
    • Mallampati: Class IV<\/li>\n\n\n\n
    • Tonsils: Grade 1<\/li>\n\n\n\n
    • Tori: None<\/li>\n\n\n\n
    • Exostosis : Mild<\/li>\n\n\n\n
    • Tongue Posture: Low rest posture<\/li>\n\n\n\n
    • Tongue Features: Scalloping<\/li>\n\n\n\n
    • TRMR – TIP: Grade 3 – < 50%<\/li>\n\n\n\n
    • LPS Overflow: Grade 4 – >50%<\/li>\n\n\n\n
    • Upper Arch Alignment: WNL<\/li>\n\n\n\n
    • Lower Arch Alignment: Mild Crowding<\/li>\n\n\n\n
    • Overjet: Mild<\/li>\n\n\n\n
    • Overbite: Moderate Dental Deep Bite<\/li>\n\n\n\n
    • Relative AP Molar Relationship: Class II Molars<\/li>\n\n\n\n
    • Transverse Dental Relationship: Edge to Edge Bite R to L<\/li>\n\n\n\n
    • Missing Teeth: Missing U&L 4\u2019s<\/li>\n\n\n\n
    • Other Problems: Still has wisdom teeth, LR8 mesially inclined<\/li>\n\n\n\n
    • Airway MCA: 153.6mm2<\/sup> (at risk for OSA less than 150mm2<\/sup>)<\/li>\n<\/ul>\n\n\n\n

      Assessment<\/h3>\n\n\n\n
        \n
      • Sleep Disordered Breathing<\/li>\n\n\n\n
      • TMJ Dysfunction<\/li>\n\n\n\n
      • Ankyloglossia<\/li>\n\n\n\n
      • Hypotrophy – Maxilla<\/li>\n\n\n\n
      • Hypotrophy – Mandible<\/li>\n<\/ul>\n\n\n\n

        Treatment Recommendations<\/h3>\n\n\n\n
          \n
        • Refer for Surgery Consult<\/li>\n\n\n\n
        • Refer for General Dentist Visit [root canal for discolored lower incisor]<\/li>\n\n\n\n
        • Comprehensive Orthodontic\/Surgical Treatment<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

          Gallery: CBCT: Panoramic. My LR8 (lower right 8\/third molar\/wisdom tooth) is mesially (towards the center line) inclined and impacted here. We’re attempting to upright it with Invisalign as of April 2026. Airway: Assessment: Chief Complaints Bite, TMJ issues, appearance of jaw Signs & Symptoms Clinical Exam Conditions Assessment Treatment Recommendations<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-122","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/posts\/122","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/comments?post=122"}],"version-history":[{"count":4,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/posts\/122\/revisions"}],"predecessor-version":[{"id":143,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/posts\/122\/revisions\/143"}],"wp:attachment":[{"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/media?parent=122"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/categories?post=122"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/teeth.gushogg-blake.uk\/index.php\/wp-json\/wp\/v2\/tags?post=122"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}