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ORAL DIAGNOSIS M5

INTRAORAL EXAM

1. EXAM OF ORAL SOFT TISSUES

2. EXAM OF THE TEETH AND PERIODONTIUM

GUIDELINES/PROTOCOL:

1. Perform the intraoral exam in a

systematic/procedural manner/routine

2. Proper positioning of the patient, proper

illumination/lighting and proper use of clean basic

instruments

3. Practice proper infection control

4. Whatever findings seen in intraoral exam must be

checked with the other findings

a. Must be analyzed, checked and examined

all together

EXAMINATION OF THE ORAL SOFT TISSUES

1. LIPS

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. Ulcers

ii. Rough surface texture

iii. Patchy homogenous thickening

SOLAR/ACTINIC CHELOSIS

i. Patchy homogenous thickening due

to too much exposure to the sun

2. BUCCAL MUCOSA AND VESTIBULE

Get a mouth mirror, place it on the inner

cheek

i. The patients mouth should beslightly closed

LINEA ALBA

i. White line should be bilateral for it

to be normal (anatomic variation)

ii. Due to the physiologic thickening

of the buccal mucosa due to some

habits

iii. Aka. TORUS BUCCALIS

PAROTID PAPILLA

i. Elevation at the opening of the

Stensens duct

FORDYCE GRANULES

i. Sometimes there are yellowish

granules (normal anatomic

variations

ii. Brought about by ectopic

sebaceous glands

Inspection and/or bidigital palpation

3. 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. Reaction of bone to stress

ii. Bony exostosis

iii. Not pathologic because it stops

growing after it reaches its

saturation point

iv. Removed under 3 circumstances:

1. If it interferes with speech

2. If it interferes with

mastication

3. If it interferes with

placement of prosthesis

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

Palpation not routinely performed unless an

abnormality is visually apparent

5. TONGUE

DORSAL

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i. Muscular upon bidigital palpation

ii. Ant. 2/3 must be rough (should

not be smooth nor coated) due to

the presence of the papilla

1. Filiform

2. Fungiform

3. Foliate

4. Circumvallate

VENTRAL

i. Raise tongue (put the tip of the

tongue on the lingual surface of the

maxillary incisors)

ANKYLOGLOSSIA

i . Tongue-tied

ii. Short or no lingual frenum

ANKYLOTOMY

i. Surgical procedure done to

lengthen the lingual frenum

LINGUAL VARICOSITIES dilated veins

6. FLOOR OF THE MOUTH

SUBLINGUAL CARUNCLE

i. Small elevations found on either

side of the lingual frenum at the

floor of the mouth

ii. Marks the opening of the Whartons

duct

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. Number of teeth present

b. Quality of oral hygiene

c. General extent of calcular deposits

d. Presence of extensive decay

e. Dental developmental malformations and

malalignment

f. Dental discolorations

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

-Rosette Go 081810