Intraoral examination Flashcards
Types of examinations
Complete Screening Limited examination Follow up Continuing care/reevaluation
Types of oral mucosa
Masticatory
Lining
Specialized
Masticatory mucosa
Covers the gingiva and hard palate, the areas most used during the mastication of food
Firmly attached to underlying tissues except for the free margin of the gingiva
Lining mucosa
Non-keratinized
Covers the inner surfaces of the lips and cheeks, floor of mouth, underside of tongue, soft palate and alveolar mucosa

Not firmly attached to underlying tissue
Specialized mucosa
Covers the dorsum of the tongue. Composed of many papilla, some contain taste buds.
Filiform papilla
Threadlike keratinized elevations that cover the dorsal surface of the tongue. No function in taste
Fungiform papilla
Mushroom shaped papilla interspersed among the filiform papilla on the tip and sides of the tongue. Contain taste buds
Circumvallate papilla
10 to 14 large round papilla arranged in a V shape between the body of the tongue and the base. Lined with taste buds
Foliate papillae
Vertical grooves on the lateral posterior sides of the tongue, also contain taste buds
Steps in the intra oral examination
- inspect lips and intra oral mucosa using mirror for retraction
- Brief visual exam of intraoral structures using mouth mirror
- inspect the mucolabial fold, labial mucosa, then palpate
- Inspect mucobuccal fold and buccal mucosa then palpate
- inspect ventral surface of tongue and floor of mouth then palpate
- inspect hard palate and palpate
- inspect soft palate, anterior/posterior pillars and pharyngeal area
- examined tongue; dorsal surface and lateral borders using gauze and mirror. Palpate tongue
- inspect retromolar, tuberosity and alveolar ridges then palpate structures
What position should you place the patient in for the intra oral examination
Supine position
What do you do if you find a herpetic Lesion?
Stop treatment and get opinion of dentist or instructors on whether to dismiss the patient
Notable findings on the lips
Changes in shape or texture Chapped or cracked lips Pigment changes Lip pits Irregular Vermilion border Lips that do not meet Cheilosis at commissures Herpetic lesions Soft tissue lesions Swelling of lips Asymmetrical mouth
What is angioedema
Swelling of lower lip caused by allergy to latex gloves
Notable findings on mucosal surfaces
Changes in color or texture Swelling Trauma Lesions Pale or reddend mucosa Dry mucosa Linea alba Leukoplakia Lichen planus Halitosis
Wharton duct
Drains saliva from each bilateral submandibular gland and sublingual gland
Located at the base of the tongue near the sub lingual caruncle
Notable findings on the floor of the mouth
Changes in color or texture Lesions or other abnormalities Swelling, especially unilateral Mucocele or ranula Salivary calculi or stones that obscure saliva flow Leukoplakia on floor of mouth Hard areas or discomfort
Notable findings on the palate/oropharynx
Swelling Lesions Tumors Cleft palate Changes in color/texture Petechiae Ulcerations Inflamed or enlarged tonsils Pus balls on tonsils Red and sore throat Deviated uvula
Notable findings on the tongue
Ulcerations and lesions Swelling Variation in color or texture Black, hairy Asymmetrical shape Dry mouth Denuded Fissured Geographic Macroglossia Ankyloglossia
What information do we collect when documenting findings?
History
Location and extent
Physical characteristics
History in documentation of findings
do they know about it? When was it first noticed. Durations, symptoms, changes in size and appearance
Location and extent in documentation of findings
location related to adjacent structures. size, color, surface texture or configurations, consistency, morphology
Descriptive words: localized, generalized, single lesion, multiple lesions, separate, coalescing
Physical characteristics in documentation of findings
Size and shape. Record length and width in millimeters
Color
Surface texture
Procedures for determining when I suspicious lesions needs biopsy
Brush cytology
Toluidine blue
Diffuse tissue reflectance
Laser induced autofluorescence
