ORAL DIAGNOSIS M5 INTRAORAL EXAM 1. 2.

EXAM OF ORAL SOFT TISSUES EXAM OF THE TEETH AND PERIODONTIUM

PAROTID PAPILLA i. Elevation at the opening of the Stensens duct

FORDYCE GRANULES i. Sometimes there are yellowish granules (normal anatomic variations Brought about by ectopic sebaceous glands

GUIDELINES/PROTOCOL: 1. Perform the intraoral exam in a systematic/procedural manner/routine Proper positioning of the patient, proper illumination/lighting and proper use of clean basic instruments Practice proper infection control Whatever findings seen in intraoral exam must be checked with the other findings a. Must be analyzed, checked and examined all together Inspection and bidigital palpation Check the intraoral and extraoral surfaces Evert the lups to check the inner surface of the lips and the vestibule Common abnormalities include: i. ii. iii. Ulcers Rough surface texture Patchy homogenous thickening 3.

ii.

2.

Inspection and/or bidigital palpation

3. 4.

HARD/SOFT PALATE Bidigital palpation Direct visualization Submental perspective (without the use of mouth mirror) Indirect visualization uses mouth mirror Rough at the hard palate and smooth at the soft palate TORUS PALATINUS i. ii. iii. Reaction of bone to stress Bony exostosis Not pathologic because it stops growing after it reaches its saturation point Removed under 3 circumstances: 1. 2. If it interferes with speech If it interferes with mastication If it interferes with placement of prosthesis

EXAMINATION OF THE ORAL SOFT TISSUES 1. LIPS

iv.

SOLAR/ACTINIC CHELOSIS i. Patchy homogenous thickening due to too much exposure to the sun

3.

2.

BUCCAL MUCOSA AND VESTIBULE Get a mouth mirror, place it on the inner cheek i. The patients mouth should be slightly closed 4. OROPHARYNX Visualization i. inspection of the oropharynx by depressing the tongue with a mouth mirror while patient responds to the request to say ah

LINEA ALBA i. White line should be bilateral for it to be normal (anatomic variation) Due to the physiologic thickening of the buccal mucosa due to some habits Aka. TORUS BUCCALIS

ii.

Palpation not routinely performed unless an abnormality is visually apparent

5.

TONGUE DORSAL

iii.

i. ii.

Muscular upon bidigital palpation Ant. 2/3 must be rough (should not be smooth nor coated) due to the presence of the papilla 1. 2. 3. 4. Filiform Fungiform Foliate Circumvallate

2.

Comprehensive Examination of each tooth by visualization, probing for carious lesions, palpation and percussion for signs of mobility, tenderness and fracture

PERIODONTIUM Visualization periodontal pocket probing palpation

VENTRAL i. Raise tongue (put the tip of the tongue on the lingual surface of the maxillary incisors) -Rosette Go 081810

ANKYLOGLOSSIA i. ii. Tongue-tied Short or no lingual frenum

ANKYLOTOMY i. Surgical procedure done to lengthen the lingual frenum

6.

LINGUAL VARICOSITIES dilated veins

FLOOR OF THE MOUTH SUBLINGUAL CARUNCLE i. Small elevations found on either side of the lingual frenum at the floor of the mouth Marks the opening of the Whartons duct

ii.

Bimanual palpation and visualization

EXAMINATION OF TEETH 2 stage process: 1. Dental orientation examination of the teeth by visual inspection without specific efforts to remove saliva / food debris Includes: a. b. c. d. e. Number of teeth present Quality of oral hygiene General extent of calcular deposits Presence of extensive decay Dental developmental malformations and malalignment Dental discolorations

f.