Patient examination

Question 1

Why do we examine patients

Answer 1

To determine any issues/problems
Reach a diagnosis
Mandatory (oral health assessment 2011)

Question 2

How often should a person receive an oral assessment

Answer 2

Adult patients should receive a comprehensive oral health assessment every 24 months
Children should receive a comprehensive assessment every 12 months

Question 3

What are we assessing

Answer 3

Verbal and non verbal
Appearance of external structures can show what is gong on underneath in underlying structures

EX one side of face drooping (asymmetry) indicates function of nerve controlling movement on that side of face may be damaged

EX flat cheek appearance may indicate broken cheekbone

Question 4

What can we notice at first glance (bringing patient from waiting room to chair)

Answer 4

• Stature and size​ (chairs only hold certain weight)
• General appearance, behaviour and attitude​
• Exposed skin​
• Hands​
• Mental acuity and ability to communicate
• Mobility

Question 5

Checkpoints of examinations

Answer 5

• Be consistently methodical​
• Adopt a regular way of doing things
• Start from top, look down on patient
• Adequate lighting​
• Patient seated in appropriate position​
• Two dental mirrors​
• Insist on removing dentures​ to carry out full soft tissue examination
• Will take 1 minute​
• An ability to describe and record your
  findings

Question 6

Extraoral examination

Answer 6

ALWAYS START BEHIND PATIENT
* General Appraisal
* (History Taking)
* Inspect, Palpate (stand behind patient and feel head and neck), Assess function (IPA)
* More detailed extraoral examination of the head and neck (ask patient to move/clench)
* Asymmetry
* Skin/scalp - colour / continuity /abrasions /textures
* Eyes, nose, lips, ears
* Symmetry and swelling
* Lymph nodes
* Facial bones
* TMJ (Temporomandibular joint)
* Muscles of Mastication
* Mouth Opening

Question 7

As well as examining the oral cavity what else are we expected to observe/examine

Answer 7

Be able to describe where and what extraoral lesions and abnormalities on a patients face neck and scalp/skin to make diagnosis or referrals

Question 8

What are the 5 main groups of lymph nodes

Answer 8

Parotid
Submental
Submandibular
Occipital
Cervical chain

Question 9

Superficial lymph nodes

Answer 9

Occipital
Postauricular
Preauricular
Submandibular
Submental
Posterior cervical
Anterior cervical

Question 10

Examination of TMJ

Answer 10

Use two fingers placed just in front of ear to feel for head of condyte get patient to open and close jaw, listen for cracking ask about pain or discomfort

Question 11

What are the cranial nerves

Answer 11

12 pairs of nerves that emerge directly from the brain and connect brain to different parts of head and neck

-Olfactory
-Optic
-Trochlear
-Abducens
-Vagus
-Hypoglossal
-Cranial accessory
-Oculomotor
-Trigeminal
-Facial
-Vestibulocochlear
-Glossopharyngeal

Question 12

Intraoral examination sites

Answer 12

• Lips​
• Gingivae​
• Labial mucosa​
• Buccal mucosa​
• Tongue- dorsum and lateral borders​
• Floor of mouth and ventral tongue​
• Hard and soft palates​
• Oropharynx (back of throat) including tonsil