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A detailed and honest social history is vital when piecing together any clinical diagnostic puzzle. This case presentation highlights this, leading to a surprising diagnosis for both patient and clinician. Additionally, access to cone beam computed tomography (CBCT) has vastly widened diagnostic accuracy within the dental field, and this case emphasizes the importance of thorough training to identify, and interpret, incidental findings.
CPD/Clinical Relevance:
Injuries obtained under the influence of drugs might be missed without in-depth social history and appropriate imaging training.
Article
This case presentation underlines the importance of obtaining an accurate and honest social history when confronted with a challenging diagnostic conundrum. Following training in cone beam computed tomography (CBCT), dentists have access to a vast volume of radiographic image data. In this case, a surprising diagnosis was made by paying attention to incidental findings in the CBCT examination extending beyond the dento-alveolar zone, highlighting the importance of training to develop a broad knowledge base when using this powerful diagnostic tool.
A young adult patient called a practice dental emergency number during the second UK coronavirus lockdown complaining of ‘toothache’ like symptoms, as well as a swollen and painful upper jaw. The patient was triaged on the phone and prescribed a 5-day course of amoxicillin. No improvement was felt the following day, and they presented in person to their dental practice. The patient was a medically fit and well university student who disclosed occasional binge-drinking and was an irregular dental attender with no recent history of dental treatment.
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