Oral Anatomy Final - Extraoral/Intraoral Exams and Anomalies Flashcards
questions taken from lecture powerpoints
True or false: In general, gloves are worn for the extraoral exam.
FALSE. Gloves are not worn for the extraoral exam unless there is a cut or open sore on patient’s skin or operator’s hand.
What does “WNL” stand for?
Within Normal Limits
What is checked in an extraoral exam?
- general appearance
- head
- skin
- eyes
- TMJ
- neck
- nodes
- salivary glands
- lips
What does “AWNN” stand for?
Apparently Well, Normally Nourished
What is evaluated when checking general appearance?
Look for abnormalities in: posture, gait, breathing, facial symmetry, swelling, nasal discharge
What is evaluated when checking skin?
Look for abnormalities in: color and lesions (if lesions, document location and size)
What is evaluated when checking eyes?
Look for abnormalities in:
- sclera (should be white and clear)
- conjunctiva (should not be red/irritated)
- pupil (should not be excessively dilated or small)
How is the TMJ evaluated?
Palpate TMJ anterior to tragus and have patient slowly open and close. Note any deviations, deflections, or crepitus.
What are the characteristics of an infectious/inflammatory lymph node?
- soft to palpation
- freely movable
- painful
What are the characteristics of a malignant lymph node?
- firm to palpation
- fixed
- generally not tender or painful
What does “NPNT” stand for and when is it used?
Non-Palpable, Non-Tender
describes normal lymph nodes
What is checked in an intraoral exam?
- mucosa (labial and buccal)
- palate
- tonsils/oropharynx
- tongue
- floor of mouth
- salivary glands
- alveolar processes
- gingiva
- teeth/occlusion
What are the four types of papillae on the tongue?
filiform, foliate, circumvallate, and fungiform
What are the top 3 most commonly missing adult teeth? (partial anodontia)
- third molars (especially maxillary)
- maxillary lateral incisors (1-2% of the population)
- mandibular second premolars (1%)
What is the most commonly missing primary teeth?
mandibular central incisors
On which dentition and in which arch is it more common for extra or supernumerary teeth to occur?
permanent dentition in the maxillary arch (90%)
What are the three common areas for extra or supernumerary teeth to occur?
- maxillary incisor area
- third molar area
- mandibular premolar area
A small extra maxillary incisor is located on the midline between the 2 central incisors. What is this tooth called?
mesiodens
What are the 3 terms that can be used to describe an extra molar?
paramolar, distomolar, or fourth molar
If there is an extra mandibular premolar in the arch, is it more likely to erupt facial or lingual to the arch?
If it is not in the arch, an extra mandibular premolar is likely to erupt lingual to the arch.
If there is an extra mandibular canine in the arch, is it more likely to erupt facial or lingual to the arch?
If it is not in the arch, an extra mandibular canine is likely to erupt facial to the arch.
What tooth’s crown is the most variable?
third molars
What tooth is the most likely to be peg-shaped?
maxillary lateral incisors (peg-shaped maxillary central incisors are very rare)
Identify this anomaly.
One crown appears double in width with one root, one pulp chamber, and one canal.
gemination
Identify this anomaly.
One crown appears double in width with two roots, two pulp chambers, and two pulp canals.
fusion (two adjacent crowns fused); most common in primary anterior
Identify this anomaly.
“screwdriver teeth” in which there is a notch missing
Hutchinson’s incisors (congenital syphilis)
What disease are mulberry molars a result of?
syphilis
Identify this anomaly. a third (middle) lingual cusp is present on mandibular molars
tuberculum intermedium
Identify this anomaly.
an additional distal cusp is present on mandibular molars
tuberculum sextum
Identify this anomaly.
similar to an extra lingual cusp; may have its own pulp horn
talon cusp
Identify this anomaly and its two subtypes.
enlarged teeth:
-the entire dentition is enlarged
-only incisors and canines are enlarged
macrodontia
- generalized (occurs in pituitary giants)
- localized
Identify this anomaly.
small teeth; only affects maxillary lateral incisors and third molars
microdontia
Identify this anomaly.
common in those with American Indians, Asian, Mongoloid, and Eskimo heritage; appears as very prominent marginal ridges on maxillary incisors
shovel-shaped incisors
Identify this anomaly.
severe bending of the root at the CEJ
dilaceration
Identify this anomaly.
severe bending of the root at any level other than the CEJ
flexion
Identify this anomaly.
often found near furcations; core of dentin with a cover of enamel; may cause problems because hinders periodontal attachment
enamel pearls
Identify this anomaly.
affects molars; more common in Native Americans, Neanderthals, and Eskimos; has a very large pulp chamber with no constriction at the CEJ
taurodontia (“bull tooth”)
Identify this anomaly.
during development of a tooth, there is an invagination of the enamel
dens in dente (“tooth within a tooth”)
Identify this anomaly.
thickening of the cementum due to trauma or metabolic dysfunction; may cause webbed root
hypercementosis
Identify this anomaly.
joining of cementum of adjacent teeth after eruption; usually occurs in third molar area
concrescence of roots
Identify this anomaly.
very short roots; common in central incisors; usually hereditary or due to early orthodontic movement
dwarfed roots
Which secondary teeth commonly have accessory (extra) roots?
- third molars
- mandibular first and second molars
- mandibular canine and premolar (so that it would have facial and lingual root)
- maxillary first premolar (so it may have 3 roots)
What is the most common primary tooth to have accessory roots? (but this is still very rare)
primary maxillary canine
What two teeth are most commonly impacted?
third molars and maxillary canines
What is the difference between transposition and transmigration?
Transposition is when a tooth switches spots with another tooth.
Transmigration is when a tooth moves into the wrong spot.
Identify this anomaly.
a tooth erupts somewhere other than the arch (like the nose, for example)
ectopic
Identify this anomaly.
failure to complete eruption due to trauma or infection; loss of periodontal ligament; root is fused to the bone
ankylosis
Identify this anomaly.
abnormal enamel formation
enamel dysplasia
Identify this anomaly.
faulty formation of enamel; hereditary; total or partial loss of enamel; affects both primary and secondary dentition; dentin is exposed so prone to decay
amelogenesis imperfecta
Identify this anomaly.
due to too much fluoride during tooth formation; mild form will only have mottled enamel while more severe form has pitted enamel; teeth are strong and will not decay
fluorosis
Identify this anomaly.
pitted enamel due to an infection/disease while the teeth were developing
enamel damage due to high fever
Identify this anomaly.
seen as hypocalcification or a yellow spot on tooth; from local trauma or infection like an abscess on primary tooth
focal hypermaturation (Turner’s tooth)
Identify this anomaly.
abnormal dentin formation
dentin dysplasia
Identify this anomaly.
faulty dentin formation; hereditary; affects primary and secondary dentition; teeth are grayish-blue in color and opalescent; no pulp chamber or pulp canal; teeth chip easily because enamel is brittle
dentinogenesis imperfecta
Identify this anomaly.
teeth appear green in color; blockage in the gall bladder and the bile accumulates
biliary atrisia
Identify this anomaly.
affects the teeth that were forming while the patient was taking drug; if pregnant while taking drug, baby’s primary dentition may be affected
tetracycline stain
What are the 4 reactions to injury after eruption?
- attrition
- abrasion
- abfraction
- erosion
Define attrition.
wear of enamel and dentin due to opposing tooth contact
Define abrasion.
wear of tooth structure by mechanical means like a tooth brush, tooth pick, chewing tobacco, etc.
Define abfraction.
bending of tooth due to heavy occlusion with enamel chipping off at cervical
Define erosion.
wear of tooth structure due to chemical agents like citric acids, carbonated beverages, and vomit
What is bruxism?
- normally teeth are in contact 20 min/day during mastication with a load of 20-40 pounds
- patients with bruxism have 40 min/hr contact during the night with a load of 250 pounds
