Review of Systems
The review of systems is a sequential, comprehensive method of eliciting patient symptoms on an organ system basis. The review of systems may reveal undiagnosed medical conditions unknown to the patient. This review
can be extensive when performed by a physician for a patient with complicated medical problems.’ However, the review of systems conducted by the dentist before . oral surgery should be guided by pertinent answers obtained from the history. For example, the review of the cardiovascular system in a patient with a positive history of ischemic heart disease includes questions concerning chest discomfort (during exertion, eating, or at rest), palpitations, fainting, and ankle’ swelling. Such questions help the dentist decide whether to perform surgery at all or alter the surgical or anesthetic methods. If anxiety controlling adjuncts such as intravenous (IV) and inhalation sedation are planned, the cardiovascular, respiratory, ‘and nervous systems should always be reviewed; this can disclose previously diagnosed problems that may jeopardize successful sedation. In the role of the oral health -. ,specialist, the dentist is expected to perform a -quick review of the head, ears, eyes, nose, mouth, and throat all every patient, regardless of whether other systems are reviewed. Items to be reviewed are outlined in Box, 1-4. The need to review organ systems in addition to those in the axiomatically region depends on clinical circumstances. The cardiovascular and respiratory systems commonly require evaluation before oral surgery or sedation (Box 1-5). If no changes have occurred, the patient should still sign the record indicating the lack of change (see Fig. 1-1).