naazimsnh02/dentalgemma-1.5-4b-it
Image-Text-to-Text • 5B • Updated
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[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 60 years old\nSEX: female\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 49 years old\nSEX: male\nOCCUPATION: retired\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Parafunctional habit affecting occlusion\nAGE: 48 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Parafunctional habit affecting occlusion\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. provide patient education on eliminating the habit.\n2. Use positive reinforcement and reminder therapy.\n3. Consider habit-breaking appliance if the habit persists beyond age 7.\n4. Monitor occlusion changes.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Parafunctional habit affecting occlusion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 69 years old\nSEX: male\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Best accounting software?"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Parafunctional habit affecting occlusion\nAGE: 25 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Parafunctional habit affecting occlusion\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. provide patient education on eliminating the habit.\n2. Use positive reinforcement and reminder therapy.\n3. Consider habit-breaking appliance if the habit persists beyond age 7.\n4. Monitor occlusion changes.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Parafunctional habit affecting occlusion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Traumatic ulcer\nAGE: 64 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Traumatic ulcer\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove or modify irritant (rough restoration, habit)\n2. Analgesia as needed (ibuprofen 600mg q8h)\n3. Topical steroid gel if inflammation present\n4. Review in 10-14 days\n5. Biopsy if not resolved by 3 weeks\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Traumatic ulcer |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Severe occlusal wear\nAGE: 62 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Severe occlusal wear\n**Etiology:** unknown\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Provide occlusal rehabilitation with full\u2011mouth restorations.\n2. Raise the vertical dimension gradually.\n3. Fabricate a night guard.\n4. Monitor temporomandibular joint.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Severe occlusal wear |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Reversible pulpitis\nAGE: 36 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Reversible pulpitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove caries and place a protective restoration.\n2. Monitor symptoms.\n3. Use desensitizing agents as needed.\n5. Consider pulp capping if indicated.\n6. Analgesic plan for post-operative sensitivity.\n7. Cold sensitivity expected to resolve in 1-2 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Reversible pulpitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 73 years old\nSEX: male\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Chronic apical periodontitis\nAGE: 28 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Tooth pain and swelling\n\nHISTORY: Patient reports pain in tooth #19 for 3 weeks, intermittent swelling, previous root canal 2 years ago\n\nCLINICAL FINDINGS: Tooth #19 shows large restoration, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows periapical radiolucency around tooth #19, previous root canal treatment visible\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Chronic apical periodontitis\n**Etiology:** infectious\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Nonsurgical retreatment of the root canal system (disinfection and re-obturation) and proper coronal seal.\n2. Consider apical microsurgery if retreatment is not feasible.\n3. Radiographic follow-up.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 3-6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Focus on interdental cleaning; consider antimicrobial mouthrinse\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Endodontic treatment of apical periodontitis\n\n"}] | wildstash_dental_instruct | Chronic apical periodontitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Enamel hypoplasia\nAGE: 16 years old\nSEX: female\nOCCUPATION: student\n\nCHIEF COMPLAINT: Tooth discoloration\n\nHISTORY: Parent reports white spots on child's teeth, sensitivity to hot/cold\n\nCLINICAL FINDINGS: White spots on multiple teeth, enamel defects, sensitivity to cold\n\nRADIOGRAPHIC FINDINGS: Bitewing radiographs show enamel hypoplasia on multiple teeth\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Enamel hypoplasia\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Provide desensitizing toothpaste.\n2. Apply topical fluoride varnish.\n3. Place preventive resin restorations if needed.\n4. Counsel on diet.\n5. Recall every 3 months.\n5. Consider resin infiltration or microabrasion for aesthetics.\n6. Monitor for caries development.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Enamel hypoplasia |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Aphthous ulcer\nAGE: 46 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Aphthous ulcer\n**Etiology:** immune-mediated\n**Rationale:** Recurrent, painful ulcers with typical clinical appearance and immune-mediated pathogenesis\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Remove the source of irritation.\n2. Prescribe topical corticosteroid gel or antiseptic mouthrinse.\n3. Provide reassurance.\n4. Review after two weeks.\n5. Perform biopsy only if the lesion persists beyond three weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 3-6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Aphthous ulcer |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Stage II periodontitis\nAGE: 82 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Patient presenting with Stage II periodontitis\n\nHISTORY: Patient reports persistent gum bleeding and bad breath for over a year, with recent tooth mobility\n\nCLINICAL FINDINGS: Generalized 4-5mm probing depths with localized 6-7mm pockets, 40% bleeding on probing, moderate mobility on #3 and #14\n\nRADIOGRAPHIC FINDINGS: Panoramic radiograph shows moderate horizontal bone loss 15-30% affecting multiple teeth, furcation involvement on #19\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Stage II periodontitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Scaling and root planing.\n2. Consider systemic antibiotics only in specific scenarios (e.\n3. , acute abscess, refractory cases).\n4. Consider localized flap surgery.\n5. Establish 3\u2011month maintenance.\n6. Provide smoking cessation counselling and support.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 4-6 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Focus on interdental cleaning; consider antimicrobial mouthrinse\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology/European Federation of Periodontology - Treatment of periodontal diseases\n\n"}] | wildstash_dental_instruct | Stage II periodontitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Gingival enlargement due to medication\nAGE: 47 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Gingival enlargement due to medication\n**Etiology:** inflammatory\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Perform professional cleaning.\n2. Provide meticulous plaque control instruction.\n3. Consider surgical reduction if no improvement.\n4. Review medications for gingival effects.\n5. Physician liaison for drug substitution (e.g., nifedipine \u2192 amlodipine).\n6. Trial of chlorhexidine rinse.\n7. Frequent maintenance every 3 months.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology/European Federation of Periodontology - Treatment of periodontal diseases\n\n"}] | wildstash_dental_instruct | Gingival enlargement due to medication |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Extraction in bisphosphonate therapy\nAGE: 31 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Extraction in bisphosphonate therapy\n**Etiology:** iatrogenic\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Consult the prescribing physician regarding bisphosphonate use.\n2. Consider (case-by-case) a temporary drug holiday recognizing limited evidence.\n3. Use atraumatic technique.\n4. Avoid unnecessary surgery.\n5. Prescribe antimicrobial mouthwash.\n6. Coordinate with physician.\n7. Close follow-up to monitor for MRONJ.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** Conditional\n**Reason:** case-by-case; emphasize atraumatic technique and CHX\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Oral and Maxillofacial Surgeons - Management of impacted teeth\n\n"}] | wildstash_dental_instruct | Extraction in bisphosphonate therapy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Chronic apical periodontitis\nAGE: 43 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Tooth pain and swelling\n\nHISTORY: Patient reports pain in tooth #19 for 3 weeks, intermittent swelling, previous root canal 2 years ago\n\nCLINICAL FINDINGS: Tooth #19 shows large restoration, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows periapical radiolucency around tooth #19, previous root canal treatment visible\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Chronic apical periodontitis\n**Etiology:** infectious\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Nonsurgical retreatment of the root canal system (disinfection and re-obturation) and proper coronal seal.\n2. Consider apical microsurgery if retreatment is not feasible.\n3. Radiographic follow-up.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 3-6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Focus on interdental cleaning; consider antimicrobial mouthrinse\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Endodontic treatment of apical periodontitis\n\n"}] | wildstash_dental_instruct | Chronic apical periodontitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 70 years old\nSEX: male\nOCCUPATION: retired\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Acute necrotizing ulcerative periodontitis\nAGE: 55 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Acute necrotizing ulcerative periodontitis\n**Etiology:** infectious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate debridement.\n2. Prescribe systemic antibiotics.\n3. Evaluate immune status.\n4. Provide nutritional counselling.\n5. Schedule close follow\u2011up.\n6. Prescribe antibiotics only if systemic signs (fever, malaise, spreading infection) or immunocompromise.\n5. Consider HIV/hematologic screening if indicated.\n6. Pain control and nutritional support.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 24-72 hours\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n4. Focus on interdental cleaning; consider antimicrobial mouthrinse\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology/European Federation of Periodontology - Treatment of periodontal diseases\n\n"}] | wildstash_dental_instruct | Acute necrotizing ulcerative periodontitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Mucocele\nAGE: 38 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Mucocele\n**Etiology:** unknown\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Surgical excision including adjacent minor salivary gland.\n2. Avoid self-trauma to the area.\n3. Biopsy if atypical or persistent.\n4. Reassess in 1-2 weeks.\n5. Document with clinical photo for baseline comparison\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks; sooner if changes\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Avoid trauma to the area; do not attempt to pop or drain\n5. Return immediately if lesion changes in size, color, texture, or becomes painful\n6. Seek evaluation if lesion persists >2 weeks or shows irregular borders/color variegation\n7. Report any new symptoms or concerns at recall visits\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Mucocele |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Implant\u2011supported overdenture\nAGE: 38 years old\nSEX: female\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Implant\u2011supported overdenture\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Place 2\u20134 implants strategically.\n2. Fabricate an overdenture with attachment system.\n3. Provide post\u2011operative care.\n4. Schedule regular maintenance visits.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology - Dental implant maintenance\n\n"}] | wildstash_dental_instruct | Implant‑supported overdenture |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Parafunctional habit affecting occlusion\nAGE: 56 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Parafunctional habit affecting occlusion\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. provide patient education on eliminating the habit.\n2. Use positive reinforcement and reminder therapy.\n3. Consider habit-breaking appliance if the habit persists beyond age 7.\n4. Monitor occlusion changes.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Parafunctional habit affecting occlusion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Reversible pulpitis\nAGE: 34 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Reversible pulpitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove caries and place a protective restoration.\n2. Monitor symptoms.\n3. Use desensitizing agents as needed.\n5. Consider pulp capping if indicated.\n6. Analgesic plan for post-operative sensitivity.\n7. Cold sensitivity expected to resolve in 1-2 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Reversible pulpitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "How to fix a computer?"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Tongue thrust habit causing open bite\nAGE: 28 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Tongue thrust habit causing open bite\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Myofunctional therapy exercises.\n2. Habit-breaking appliance.\n3. Orthodontic consultation within 1-2 months.\n4. Speech therapy evaluation if indicated.\n5. Airway assessment.\n6. Retention phase after correction.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Orthodontists - Clinical practice guidelines for orthodontics\n\n"}] | wildstash_dental_instruct | Tongue thrust habit causing open bite |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Reversible pulpitis\nAGE: 35 years old\nSEX: female\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Reversible pulpitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove caries and place a protective restoration.\n2. Monitor symptoms.\n3. Use desensitizing agents as needed.\n5. Consider pulp capping if indicated.\n6. Analgesic plan for post-operative sensitivity.\n7. Cold sensitivity expected to resolve in 1-2 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Reversible pulpitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Anterior open bite\nAGE: 24 years old\nSEX: female\nOCCUPATION: student\n\nCHIEF COMPLAINT: Bite problems\n\nHISTORY: Patient reports difficulty biting into food, speech problems\n\nCLINICAL FINDINGS: Anterior open bite 4mm, tongue thrust habit, normal posterior occlusion\n\nRADIOGRAPHIC FINDINGS: Lateral cephalogram shows anterior open bite, normal skeletal relationships\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: Tongue thrusting\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Anterior open bite\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Eliminate contributory habits.\n2. Close the bite with skeletal anchorage/TAD-supported mechanics (intrusion/extrusion as indicated) using aligners or fixed appliances.\n3. Assess for orthognathic surgery if skeletal divergence is significant.\n4. Retain with clear retainer and anterior bite-stop as needed.\n5. Airway and TMJ evaluation.\n6. High relapse risk - long-term retention strategy.\n7. Surgical option if skeletal component.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 4-6 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Association of Orthodontists - Orthodontic treatment planning\n\n"}] | wildstash_dental_instruct | Anterior open bite |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 68 years old\nSEX: male\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Complete edentulism\nAGE: 68 years old\nSEX: male\nOCCUPATION: retired\n\nCHIEF COMPLAINT: Denture problems\n\nHISTORY: Patient reports ill-fitting complete dentures, sore spots, difficulty eating\n\nCLINICAL FINDINGS: Complete edentulism, ill-fitting dentures, traumatic ulcers on alveolar ridges\n\nRADIOGRAPHIC FINDINGS: Panoramic radiograph shows complete edentulism, adequate bone height\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Complete edentulism\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Fabricate new complete dentures after thorough assessment.\n2. Adjust and reline as needed.\n3. Provide oral hygiene instructions.\n4. Schedule periodic recall.\n5. Review for sore spots at 24-72 hours.\n6. Set realistic outcome expectations.\n7. Consider implant overdentures as option.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American College of Prosthodontists - Complete denture therapy\n\n"}] | wildstash_dental_instruct | Complete edentulism |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Mucocele\nAGE: 50 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Mucocele\n**Etiology:** obstructive\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Provide patient education on avoiding local trauma.\n2. Recommend protective wax or occlusal adjustment if needed.\n3. Prescribe hyaluronic acid gel.\n4. Review in two weeks.\n5. Biopsy only for non\u2011healing lesions.\n6. Document with clinical photo for baseline comparison\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks; sooner if changes\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Avoid trauma to the area; do not attempt to pop or drain\n5. Return immediately if lesion changes in size, color, texture, or becomes painful\n6. Seek evaluation if lesion persists >2 weeks or shows irregular borders/color variegation\n7. Report any new symptoms or concerns at recall visits\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Mucocele |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 47 years old\nSEX: female\nOCCUPATION: manager\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Class I crowding\nAGE: 61 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Class I crowding\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Comprehensive orthodontic treatment with fixed braces.\n2. Align arch and create space with mild interproximal reduction.\n3. Retain with fixed retainer.\n5. Consider non-extraction vs extraction based on cephalometrics.\n6. Assess growth status, arch development, and airway.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Class I crowding |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 49 years old\nSEX: male\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Fractured bridge\nAGE: 53 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Fractured bridge\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove the failed prosthesis.\n2. Assess abutment teeth.\n3. Plan for new fixed bridge or implant\u2011supported crown.\n4. Manage caries or periodontal issues first.\n5. Provide provisional acrylic splint for protection.\n6. Document abutment mobility and prognosis.\n7. Prescribe NSAIDs for pain control if needed.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n4. Avoid hard foods on affected side; use soft diet if recommended\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology - Dental implant maintenance\n\n"}] | wildstash_dental_instruct | Fractured bridge |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Partial edentulism\nAGE: 31 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Partial edentulism\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Construct a removable partial denture or consider implant\u2011supported prosthesis.\n2. Ensure proper design to distribute forces.\n3. Instruct on denture hygiene.\n4. Re\u2011evaluate periodically.\n5. Assess abutment teeth (C/R ratio, periodontal status).\n6. Discuss occlusal scheme options.\n7. Obtain informed consent for treatment options.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology - Dental implant maintenance\n\n"}] | wildstash_dental_instruct | Partial edentulism |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Traumatic ulcer\nAGE: 41 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Traumatic ulcer\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove or modify irritant (rough restoration, habit)\n2. Analgesia as needed (ibuprofen 600mg q8h)\n3. Topical steroid gel if inflammation present\n4. Review in 10-14 days\n5. Biopsy if not resolved by 3 weeks\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Traumatic ulcer |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Alveolar osteitis\nAGE: 26 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Alveolar osteitis\n**Etiology:** fibrinolytic\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Irrigate socket with saline (avoid aggressive curettage).\n2. Place medicated dressing (eugenol or alvogyl).\n3. Advise smoking avoidance and gentle oral hygiene.\n4. Prescribe NSAIDs for pain control.\n5. Optional: chlorhexidine rinse.\n6. Schedule follow-up in 48-72 hours.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 24-72 hours\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Alveolar osteitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Frictional keratosis\nAGE: 58 years old\nSEX: female\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Frictional keratosis\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Differential Diagnosis\n\n- Frictional keratosis\n- Leukoplakia\n- Lichen planus\n- Squamous cell carcinoma\n- Traumatic ulcer\n\n## Management Plan\n\n1. Remove or modify irritant (rough restoration, habit)\n2. Analgesia as needed (ibuprofen 600mg q8h)\n3. Topical steroid gel if inflammation present\n4. Review in 10-14 days\n5. Biopsy if not resolved by 3 weeks\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Frictional keratosis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Tongue thrust habit causing open bite\nAGE: 55 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Tongue thrust habit causing open bite\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Myofunctional therapy exercises.\n2. Habit-breaking appliance.\n3. Orthodontic consultation within 1-2 months.\n4. Speech therapy evaluation if indicated.\n5. Airway assessment.\n6. Retention phase after correction.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Association of Orthodontists - Clinical practice guidelines for orthodontics\n\n"}] | wildstash_dental_instruct | Tongue thrust habit causing open bite |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Tongue thrust habit causing open bite\nAGE: 65 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Tongue thrust habit causing open bite\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Myofunctional therapy exercises.\n2. Habit-breaking appliance.\n3. Orthodontic consultation within 1-2 months.\n4. Speech therapy evaluation if indicated.\n5. Airway assessment.\n6. Retention phase after correction.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Orthodontists - Clinical practice guidelines for orthodontics\n\n"}] | wildstash_dental_instruct | Tongue thrust habit causing open bite |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Class II division 1 malocclusion\nAGE: 54 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Class II division 1 malocclusion\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Two\u2011phase therapy: functional appliance during growth followed by fixed braces.\n2. Consider premolar extractions if severe.\n3. Provide retention.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 4-6 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n\n## Clinical Guidelines\n\n**Source:** American Association of Orthodontists - Orthodontic treatment planning for adults\n\n"}] | wildstash_dental_instruct | Class II division 1 malocclusion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "How to treat shingles?"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Xerostomia due to Sj\u00f6gren's syndrome\nAGE: 44 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Xerostomia due to Sj\u00f6gren's syndrome\n**Etiology:** autoimmune\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Saliva substitutes and sialogogues (pilocarpine/cevimeline).\n2. Intensive fluoride regimen (brush/gel/rinse).\n3. Caries prevention (SDF where needed, xylitol gum).\n4. Candidiasis management.\n5. Rheumatology co-management.\n6. Sugar-free xylitol products.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** systemic_signs\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n4. Address dry mouth symptoms\n5. Recommend sugar-free chewing gum or saliva substitutes\n6. Review medications for xerostomia side effects\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Xerostomia due to Sjögren's syndrome |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 69 years old\nSEX: male\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Stage II periodontitis\nAGE: 42 years old\nSEX: female\nOCCUPATION: retired\n\nCHIEF COMPLAINT: Patient presenting with Stage II periodontitis\n\nHISTORY: Patient reports persistent gum bleeding and bad breath for over a year, with recent tooth mobility\n\nCLINICAL FINDINGS: Generalized 4-5mm probing depths with localized 6-7mm pockets, 40% bleeding on probing, moderate mobility on #3 and #14\n\nRADIOGRAPHIC FINDINGS: Panoramic radiograph shows moderate horizontal bone loss 15-30% affecting multiple teeth, furcation involvement on #19\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Stage II periodontitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Scaling and root planing.\n2. Consider systemic antibiotics only in specific scenarios (e.\n3. , acute abscess, refractory cases).\n4. Consider localized flap surgery.\n5. Establish 3\u2011month maintenance.\n6. Provide smoking cessation counselling and support.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 4-6 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Focus on interdental cleaning; consider antimicrobial mouthrinse\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology/European Federation of Periodontology - Treatment of periodontal diseases\n\n"}] | wildstash_dental_instruct | Stage II periodontitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Morsicatio buccarum\nAGE: 47 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Morsicatio buccarum\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Identify and eliminate parafunctional habits (cheek/lip biting)\n2. Habit counseling and stress management techniques\n3. Consider occlusal splint if bruxism present\n4. Review in 10-14 days to assess improvement\n5. Biopsy only if atypical features develop (irregular borders, color changes)\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Morsicatio buccarum |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Failed root canal treatment\nAGE: 30 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Tooth pain after root canal\n\nHISTORY: Patient reports pain in tooth #19, root canal completed 1 year ago, symptoms returned 2 weeks ago\n\nCLINICAL FINDINGS: Tooth #19 shows large restoration, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows periapical radiolucency around tooth #19, previous root canal treatment visible\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Failed root canal treatment\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Nonsurgical retreatment of the root canal system (disinfection and re-obturation) and proper coronal seal.\n2. Consider apical microsurgery if retreatment is not feasible.\n3. Radiographic follow-up.\n4. Analgesics as needed.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Retreatment and surgical endodontics\n\n"}] | wildstash_dental_instruct | Failed root canal treatment |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Early childhood caries\nAGE: 25 years old\nSEX: female\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Early childhood caries\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Comprehensive risk assessment (feeding habits, fluoride exposure, salivary flow)\n2. Non-operative control: Silver diamine fluoride (SDF) for active lesions\n3. High-fluoride toothpaste (5000 ppm) and daily application\n4. Interim therapeutic restorations (ITR) for symptomatic teeth\n5. Eliminate bottle/juice at bedtime; consider GA for extensive disease\n6. Strict recall every 3-6 months based on risk\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Reduce sugar frequency; use fluoride products; consider xylitol\n\n## Clinical Guidelines\n\n**Source:** American Academy of Pediatric Dentistry - Management of dental caries in children\n\n"}] | wildstash_dental_instruct | Early childhood caries |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Reversible pulpitis in immature permanent tooth\nAGE: 46 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Reversible pulpitis in immature permanent tooth\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Selective caries removal.\n2. Partial pulpotomy with calcium-silicate cement (MTA/Biodentine) or indirect pulp therapy.\n3. Definitive coronal seal.\n4. NSAIDs as needed for pain.\n5. Avoid antibiotics unless systemic signs are present.\n6. Review to ensure resolution and continued root development.\n5. Consider pulp capping if indicated.\n6. Analgesic plan for post-operative sensitivity.\n7. Cold sensitivity expected to resolve in 1-2 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Reversible pulpitis in immature permanent tooth |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Fractured bridge\nAGE: 47 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Fractured bridge\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove the failed prosthesis.\n2. Assess abutment teeth.\n3. Plan for new fixed bridge or implant\u2011supported crown.\n4. Manage caries or periodontal issues first.\n5. Provide provisional acrylic splint for protection.\n6. Document abutment mobility and prognosis.\n7. Prescribe NSAIDs for pain control if needed.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n4. Avoid hard foods on affected side; use soft diet if recommended\n\n## Clinical Guidelines\n\n**Source:** American Academy of Periodontology - Dental implant maintenance\n\n"}] | wildstash_dental_instruct | Fractured bridge |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Severe occlusal wear\nAGE: 28 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Severe occlusal wear\n**Etiology:** unknown\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Provide occlusal rehabilitation with full\u2011mouth restorations.\n2. Raise the vertical dimension gradually.\n3. Fabricate a night guard.\n4. Monitor temporomandibular joint.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Severe occlusal wear |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Early childhood caries\nAGE: 25 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Early childhood caries\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Apply fluoride varnish every three months.\n2. Consider silver diamine fluoride or interim therapeutic restorations for cavitated lesions.\n3. Provide dietary counseling.\n4. Instruct parents on proper brushing with fluoridated toothpaste.\n5. Schedule recall visits every 3 months.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Reduce sugar frequency; use fluoride products; consider xylitol\n\n## Clinical Guidelines\n\n**Source:** American Academy of Pediatric Dentistry - Management of dental caries in children\n\n"}] | wildstash_dental_instruct | Early childhood caries |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Failed root canal treatment\nAGE: 56 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Tooth pain after root canal\n\nHISTORY: Patient reports pain in tooth #19, root canal completed 1 year ago, symptoms returned 2 weeks ago\n\nCLINICAL FINDINGS: Tooth #19 shows large restoration, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows periapical radiolucency around tooth #19, previous root canal treatment visible\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Failed root canal treatment\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Nonsurgical retreatment of the root canal system (disinfection and re-obturation) and proper coronal seal.\n2. Consider apical microsurgery if retreatment is not feasible.\n3. Radiographic follow-up.\n4. Analgesics as needed.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Retreatment and surgical endodontics\n\n"}] | wildstash_dental_instruct | Failed root canal treatment |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Immunocompromised patient with oral candidiasis\nAGE: 26 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Immunocompromised patient with oral candidiasis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Topical antifungal therapy (nystatin oral suspension or clotrimazole troches).\n2. Evaluate for underlying immunosuppression cause.\n3. Consider systemic fluconazole if severe or refractory.\n4. Optimize denture hygiene if applicable.\n5. Saliva substitutes if xerostomia present.\n6. Follow-up in 1-2 weeks.2. Improve oral hygiene.\n3. Treat underlying immunosuppression.\n4. Monitor response.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n4. Address dry mouth symptoms\n5. Recommend sugar-free chewing gum or saliva substitutes\n6. Review medications for xerostomia side effects\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Immunocompromised patient with oral candidiasis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Solve: x - 5 = 12"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Traumatic ulcer\nAGE: 39 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Traumatic ulcer\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove or modify irritant (rough restoration, habit)\n2. Analgesia as needed (ibuprofen 600mg q8h)\n3. Topical steroid gel if inflammation present\n4. Review in 10-14 days\n5. Biopsy if not resolved by 3 weeks\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Traumatic ulcer |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Morsicatio buccarum\nAGE: 52 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Morsicatio buccarum\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Identify and eliminate parafunctional habits (cheek/lip biting)\n2. Habit counseling and stress management techniques\n3. Consider occlusal splint if bruxism present\n4. Review in 10-14 days to assess improvement\n5. Biopsy only if atypical features develop (irregular borders, color changes)\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Morsicatio buccarum |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Extraction in bisphosphonate therapy\nAGE: 61 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Extraction in bisphosphonate therapy\n**Etiology:** iatrogenic\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Consult the prescribing physician regarding bisphosphonate use.\n2. Consider (case-by-case) a temporary drug holiday recognizing limited evidence.\n3. Use atraumatic technique.\n4. Avoid unnecessary surgery.\n5. Prescribe antimicrobial mouthwash.\n6. Coordinate with physician.\n7. Close follow-up to monitor for MRONJ.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** Conditional\n**Reason:** case-by-case; emphasize atraumatic technique and CHX\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Oral and Maxillofacial Surgeons - Management of impacted teeth\n\n"}] | wildstash_dental_instruct | Extraction in bisphosphonate therapy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Failed root canal treatment\nAGE: 58 years old\nSEX: male\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Tooth pain after root canal\n\nHISTORY: Patient reports pain in tooth #19, root canal completed 1 year ago, symptoms returned 2 weeks ago\n\nCLINICAL FINDINGS: Tooth #19 shows large restoration, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows periapical radiolucency around tooth #19, previous root canal treatment visible\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Failed root canal treatment\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Nonsurgical retreatment of the root canal system (disinfection and re-obturation) and proper coronal seal.\n2. Consider apical microsurgery if retreatment is not feasible.\n3. Radiographic follow-up.\n4. Analgesics as needed.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Retreatment and surgical endodontics\n\n"}] | wildstash_dental_instruct | Failed root canal treatment |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Aphthous ulcer\nAGE: 29 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Aphthous ulcer\n**Etiology:** immune-mediated\n**Rationale:** Recurrent, painful ulcers with typical clinical appearance and immune-mediated pathogenesis\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Provide patient education on avoiding local trauma.\n2. Recommend protective wax or occlusal adjustment if needed.\n3. Prescribe hyaluronic acid gel.\n4. Review in two weeks.\n5. Biopsy only for non\u2011healing lesions.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 3-6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Aphthous ulcer |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Alveolar osteitis\nAGE: 31 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Alveolar osteitis\n**Etiology:** fibrinolytic\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Irrigate socket with saline (avoid aggressive curettage).\n2. Place medicated dressing (eugenol or alvogyl).\n3. Advise smoking avoidance and gentle oral hygiene.\n4. Prescribe NSAIDs for pain control.\n5. Optional: chlorhexidine rinse.\n6. Schedule follow-up in 48-72 hours.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 24-72 hours\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Alveolar osteitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Parafunctional habit affecting occlusion\nAGE: 40 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Parafunctional habit affecting occlusion\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. provide patient education on eliminating the habit.\n2. Use positive reinforcement and reminder therapy.\n3. Consider habit-breaking appliance if the habit persists beyond age 7.\n4. Monitor occlusion changes.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Parafunctional habit affecting occlusion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Physiologic tooth wear\nAGE: 39 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Physiologic tooth wear\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Monitor for progression, no treatment needed unless symptoms develop.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Physiologic tooth wear |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: High caries risk (mixed dentition)\nAGE: 56 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** High caries risk (mixed dentition)\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Apply fluoride varnish every three months.\n2. Place sealants on the permanent molars.\n3. Provide dietary counseling.\n4. Instruct parents on proper brushing.\n5. Schedule recall visits every 3 months.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Reduce sugar frequency; use fluoride products; consider xylitol\n\n## Clinical Guidelines\n\n**Source:** American Dental Association - Caries risk assessment and preventive care\n\n"}] | wildstash_dental_instruct | High caries risk (mixed dentition) |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Treatment for GERD?"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Patient post\u2011radiation therapy\nAGE: 59 years old\nSEX: female\nOCCUPATION: engineer\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Patient post\u2011radiation therapy\n**Etiology:** iatrogenic\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Coordinate with oncology and review radiation dose/fields.\n2. Use atraumatic extraction with primary closure.\n3. Provide custom fluoride trays and chlorhexidine rinses.\n4. Consider hyperbaric oxygen or PENTO protocols for high-risk cases.\n5. Monitor long-term for osteoradionecrosis.\n6. Provide comprehensive caries prevention.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** Conditional\n**Reason:** only if infection present or high-dose radiation to mandible\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Patient post‑radiation therapy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Internal resorption\nAGE: 48 years old\nSEX: male\nOCCUPATION: student\n\nCHIEF COMPLAINT: Patient presenting with Internal resorption\n\nHISTORY: Patient reports mild tooth discoloration noticed 3 weeks ago, with occasional sensitivity to hot/cold\n\nCLINICAL FINDINGS: Tooth #8 shows pinkish discoloration in crown, pulp chamber appears enlarged on transillumination, no mobility or percussion sensitivity\n\nRADIOGRAPHIC FINDINGS: Periapical radiograph shows enlarged pulp chamber with irregular borders, no periapical radiolucency\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Internal resorption\n**Etiology:** inflammatory/idiopathic\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Perform root canal therapy to remove resorptive tissue.\n2. Repair any perforations with mineral trioxide aggregate (MTA).\n3. Obturate with warm gutta-percha.\n4. Monitor healing with follow-up radiographs at 6 and 12 months.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 3-6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Association of Endodontists - Endodontic treatment of apical periodontitis\n\n"}] | wildstash_dental_instruct | Internal resorption |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale\n- Use condition-specific protocols and evidence-based guidelines"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Adult with suspicious oral lesion\nAGE: 58 years old\nSEX: male\nOCCUPATION: retired\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 30 pack-years, heavy alcohol use\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension, hyperlipidemia\n\nCURRENT MEDICATIONS: Atorvastatin 20mg daily, Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 30 years, alcohol 3-4 drinks/day\n\nCLINICAL MEASUREMENTS:\n- Lesion Size: 8mm x 12mm\n- Location: Left lateral tongue\n- Characteristics: White, slightly raised, non-wipeable\n- Duration: 3 weeks\n- Risk Factors: Smoking 30 pack-years, heavy alcohol use\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Suspicious Oral Lesion (Leukoplakia vs. Early SCC)\n**Etiology:** Tobacco and alcohol use, potential malignant transformation\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. **Immediate Action:**\n - Incisional biopsy within 2 weeks\n - Photographic documentation\n - Complete head and neck examination\n\n2. **Definitive Treatment:**\n - Biopsy at indurated edge with normal margin\n - Rush pathology request\n - ENT/Oncology referral if SCC confirmed\n\n3. **Risk Management:**\n - Smoking cessation counseling and referral\n - Alcohol reduction counseling\n - Nutritional assessment\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** No systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread); antibiotics only indicated for systemic involvement\n\n## Follow-up Recommendations\n\n**Next Appointment:** 24-72 hours (urgent)\n**Monitoring:** Biopsy scheduling, risk factor modification\n**Recall Schedule:** 2-week rule for biopsy results\n\n## Patient Counseling\n\n1. Biopsy is essential for definitive diagnosis\n2. Smoking cessation is critical for prevention\n3. Alcohol reduction recommended\n4. Return immediately if lesion changes or new symptoms develop\n5. Understand potential for malignant transformation\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Biopsy Guidelines (2021)\n**Rationale:** Suspicious lesion with high-risk factors requires immediate biopsy to rule out malignancy\n**Success Criteria:** Biopsy completed within 2 weeks, definitive diagnosis obtained, risk factors addressed\n\n"}] | wildstash_dental_instruct | Adult with suspicious oral lesion |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Complete edentulism\nAGE: 68 years old\nSEX: male\nOCCUPATION: retired\n\nCHIEF COMPLAINT: Denture problems\n\nHISTORY: Patient reports ill-fitting complete dentures, sore spots, difficulty eating\n\nCLINICAL FINDINGS: Complete edentulism, ill-fitting dentures, traumatic ulcers on alveolar ridges\n\nRADIOGRAPHIC FINDINGS: Panoramic radiograph shows complete edentulism, adequate bone height\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Complete edentulism\n**Etiology:** unknown\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Fabricate new complete dentures after thorough assessment.\n2. Adjust and reline as needed.\n3. Provide oral hygiene instructions.\n4. Schedule periodic recall.\n5. Review for sore spots at 24-72 hours.\n6. Set realistic outcome expectations.\n7. Consider implant overdentures as option.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American College of Prosthodontists - Complete denture therapy\n\n"}] | wildstash_dental_instruct | Complete edentulism |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Early childhood caries\nAGE: 27 years old\nSEX: male\nOCCUPATION: manager\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Early childhood caries\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Comprehensive risk assessment (feeding habits, fluoride exposure, salivary flow)\n2. Non-operative control: Silver diamine fluoride (SDF) for active lesions\n3. High-fluoride toothpaste (5000 ppm) and daily application\n4. Interim therapeutic restorations (ITR) for symptomatic teeth\n5. Eliminate bottle/juice at bedtime; consider GA for extensive disease\n6. Strict recall every 3-6 months based on risk\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Reduce sugar frequency; use fluoride products; consider xylitol\n\n## Clinical Guidelines\n\n**Source:** American Academy of Pediatric Dentistry - Management of dental caries in children\n\n"}] | wildstash_dental_instruct | Early childhood caries |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nIMPORTANT: Only produce dental patient evaluations. If prompt is not a dental case, output: 'Out of scope: I only handle dental patient evaluations.' Do not answer unrelated requests.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "What is data science?"}, {"role": "assistant", "content": "Out of scope: I only handle dental patient evaluations."}] | wildstash_dental_instruct | unknown |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Necrotizing ulcerative gingivitis\nAGE: 25 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Necrotizing ulcerative gingivitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Debridement under local anesthesia.\n2. Consider metronidazole only if severe disease, systemic signs, or immunocompromised.\n3. Instruct on chlorhexidine rinses.\n4. Address underlying systemic factors.\n5. Schedule close follow\u2011up.\n6. Prescribe antibiotics only if systemic signs (fever, malaise, spreading infection) or immunocompromise.\n4. Pain control with NSAIDs.\n5. Hydration and nutritional support.\n6. Smoking and stress reduction counseling.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** Conditional\n**Reason:** only if systemic signs or immunocompromise\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Necrotizing ulcerative gingivitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Diastema closure\nAGE: 35 years old\nSEX: male\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Diastema closure\n**Etiology:** developmental\n**Urgency:** Elective (0)\n\n## Management Plan\n\n1. Close spacing with clear aligners or fixed braces.\n2. Evaluate for frenum involvement and perform frenectomy if indicated.\n3. Provide retention.\n4. Consider composite bonding for simple cases.\n5. Timing around canine eruption in adolescents.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 6 months\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Brush twice daily with fluoride toothpaste; clean interdentally daily\n2. Limit free sugars and acidic beverages between meals\n3. Return sooner if pain, swelling, ulceration >2 weeks, or other new symptoms\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Diastema closure |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Pulp therapy in primary tooth\nAGE: 9 years old\nSEX: male\nOCCUPATION: student\n\nCHIEF COMPLAINT: Tooth pain\n\nHISTORY: Parent reports child crying from tooth pain, difficulty eating, large cavity visible\n\nCLINICAL FINDINGS: Large carious lesion on tooth A, positive percussion, no mobility, normal periodontal probing depths\n\nRADIOGRAPHIC FINDINGS: Bitewing radiograph shows large carious lesion on tooth A, approaching pulp chamber\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Pulp therapy in primary tooth\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Pulpotomy or pulpectomy based on vital status.\n2. Stainless steel crown placement.\n3. Rubber dam isolation for procedure.\n4. Vital vs non-vital pulp therapy decision.\n5. Follow-up at 1 week and 6-8 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none (unless systemic signs or spreading infection)\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Pulp therapy in primary tooth |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 52 years old\nSEX: female\nOCCUPATION: retired\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Reversible pulpitis\nAGE: 47 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Reversible pulpitis\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove caries and place a protective restoration.\n2. Monitor symptoms.\n3. Use desensitizing agents as needed.\n5. Consider pulp capping if indicated.\n6. Analgesic plan for post-operative sensitivity.\n7. Cold sensitivity expected to resolve in 1-2 weeks.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Reversible pulpitis |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Suspicious oral mucosal lesion requiring biopsy\nAGE: 59 years old\nSEX: female\nOCCUPATION: consultant\n\nCHIEF COMPLAINT: White patch on tongue\n\nHISTORY: Patient reports white patch on lateral tongue for 3 weeks, no pain, smoking history 20 pack-years\n\nCLINICAL FINDINGS: 8mm x 12mm white patch on left lateral tongue, slightly raised, non-wipeable, no ulceration\n\nRADIOGRAPHIC FINDINGS: Not applicable\n\nMEDICAL HISTORY: Hypertension\n\nCURRENT MEDICATIONS: Lisinopril 10mg daily\n\nHABITS: Smoking 1 pack/day for 20 years\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Suspicious oral mucosal lesion requiring biopsy\n**Etiology:** neoplastic_suspicious\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Immediate referral to oral surgeon for incisional biopsy\n2. Biopsy within 2 weeks of presentation\n3. Document with clinical photographs for baseline\n4. Cease tobacco and alcohol use immediately\n5. Remove potential irritants\n6. Follow up biopsy results and plan definitive treatment\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 48-72 hours for biopsy coordination\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Stop smoking and alcohol use immediately\n2. Avoid irritants (spicy foods, alcohol-containing mouthwashes)\n3. Maintain excellent oral hygiene\n4. Return immediately if lesion changes rapidly\n5. Be prepared for possible malignant diagnosis\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral and Maxillofacial Pathology - Benign oral lesions\n\n"}] | wildstash_dental_instruct | Suspicious oral mucosal lesion requiring biopsy |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Irritation fibroma\nAGE: 63 years old\nSEX: male\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n\n\n**Diagnosis:** Irritation fibroma\n**Etiology:** mechanical_trauma\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Remove or modify irritant (rough restoration, habit)\n2. Analgesia as needed (ibuprofen 600mg q8h)\n3. Topical steroid gel if inflammation present\n4. Review in 10-14 days\n5. Biopsy if not resolved by 3 weeks\n\n\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 10-14 days\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Avoid chewing on affected area\n2. Use soft toothbrush with gentle technique\n3. Apply topical anesthetic if needed\n4. Report if lesion persists >2 weeks\n5. Return immediately if lesion enlarges or becomes painful\n\n\n\n## Clinical Guidelines\n\n**Source:** American Academy of Oral Medicine - Oral mucosal lesions\n\n"}] | wildstash_dental_instruct | Irritation fibroma |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: Mandibular fracture\nAGE: 60 years old\nSEX: female\nOCCUPATION: nurse\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** Mandibular fracture\n**Etiology:** mechanical_trauma\n**Urgency:** Urgent (2)\n\n## Management Plan\n\n1. Stabilize with rigid fixation under general anesthesia.\n2. Prescribe antibiotics and analgesics.\n3. Maintain soft diet.\n4. Monitor healing with radiographs.\n5. Assess tetanus status.\n6. Neurosensory assessment.\n7. Consider intermaxillary fixation if indicated.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** Yes\n**Reason:** open_fracture\n\n## Follow-up Recommendations\n\n**Next Appointment:** 24-72 hours\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Follow all postoperative instructions carefully\n2. Take medications as prescribed\n3. Return immediately if symptoms worsen or new concerns arise\n4. Avoid hard foods on affected side; use soft diet if recommended\n\n## Clinical Guidelines\n\n**Source:** American Association of Oral and Maxillofacial Surgeons - Management of facial trauma\n\n"}] | wildstash_dental_instruct | Mandibular fracture |
[{"role": "system", "content": "You are an expert dental clinician providing comprehensive patient care. Always consider the patient's full clinical context, medical history, and provide evidence-based recommendations.\n\nKey principles:\n- Prioritize patient safety and evidence-based dentistry\n- Match urgency levels to follow-up timing (0=elective\u21923-6mo, 1=moderate\u21921-2w, 2=urgent\u219224-72h)\n- Use antibiotics only for systemic signs (fever, malaise, cellulitis, trismus, lymphadenitis, fascial spread)\n- Provide definitive treatment first, then adjuncts\n- Include appropriate referrals and follow-up intervals\n- Document clinical findings and rationale"}, {"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: High caries risk (mixed dentition)\nAGE: 51 years old\nSEX: female\nOCCUPATION: teacher\n\nCHIEF COMPLAINT: Dental problem\n\nHISTORY: Patient reports symptoms for 2 weeks\n\nCLINICAL FINDINGS: Clinical examination reveals findings consistent with the condition\n\nRADIOGRAPHIC FINDINGS: Radiographic examination shows findings consistent with clinical presentation\n\nMEDICAL HISTORY: None significant\n\nCURRENT MEDICATIONS: None\n\nHABITS: None reported\n\nWhat is your diagnosis and treatment plan?"}, {"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** High caries risk (mixed dentition)\n**Etiology:** infectious\n**Urgency:** Moderate (1)\n\n## Management Plan\n\n1. Apply fluoride varnish every three months.\n2. Place sealants on the permanent molars.\n3. Provide dietary counseling.\n4. Instruct parents on proper brushing.\n5. Schedule recall visits every 3 months.\n\n## Antibiotic Considerations\n\n**Antibiotics Indicated:** No\n**Reason:** none\n\n## Follow-up Recommendations\n\n**Next Appointment:** 1-2 weeks\n**Monitoring:** Regular clinical and radiographic assessment as indicated\n\n## Patient Counseling\n\n1. Maintain excellent oral hygiene to prevent complications\n2. Use warm salt water rinses if recommended\n3. Return immediately if symptoms worsen or systemic signs develop\n4. Reduce sugar frequency; use fluoride products; consider xylitol\n\n## Clinical Guidelines\n\n**Source:** American Dental Association - Caries risk assessment and preventive care\n\n"}] | wildstash_dental_instruct | High caries risk (mixed dentition) |
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in Data Studio
DentalGemma Instruct Dataset
A text-only instruction-tuning dataset of 2,494 synthetic dental clinical cases for fine-tuning MedGemma 1.5 4B IT on dental diagnosis and treatment planning.
Dataset Details
- Total samples: 2,494 clinical cases
- Format: Chat-format messages (system/user/assistant)
- Splits: 2,246 Train / 248 Validation
- Conditions covered: 98 unique dental conditions
- Source: Wildstash/dental-2.5k-instruct
Message Format
[
{"role": "system", "content": "You are an expert dental clinician..."},
{"role": "user", "content": "Please evaluate this dental patient:\n\nPATIENT: ..."},
{"role": "assistant", "content": "## Patient Assessment\n\n**Diagnosis:** ..."}
]
Usage with MedGemma
from datasets import load_dataset
dataset = load_dataset("naazimsnh02/dentalgemma-instruct")
Built For
The MedGemma Impact Challenge — fine-tuning Google's MedGemma 1.5 for dental diagnostics.
Case Structure
Each case includes: demographics, chief complaint, clinical findings, radiographic findings, medical history, and a structured assessment containing diagnosis (including etiology and urgency), management plan, antibiotic considerations, follow-up recommendations, patient counseling, and supported clinical guidelines.
License
Apache 2.0
- Downloads last month
- 24
Size of downloaded dataset files:
968 kB
Size of the auto-converted Parquet files:
968 kB
Number of rows:
2,494