clinical examination ii

8/12/2019 Clinical Examination II

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Clinical

examination II

By

Dr/Maha Mahmoud

Assistant professor of Oral

Medicine


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Peri/Intraoral

Examination

Good illumination is essential for the

examination of the mouth.

The patient should be seated properly andcomfortably for proper examination of all

areas of the mouth.


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Peri/Intraoral

ExaminationThe perioral and intraoral examination

procedure follows an eightstepssystematic assessment of the:

1. Lips2. Labial mucosa,sulcus and commisures.

3. Buccal mucosa and sulcus.

4. Gingiva and alveolar ridge.

5. Tongue.

6. Floor of the mouth.

7. Hard and soft palate.

8. Teeth.


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Lips

Begin examination by observing the lips with thepatients mouth both closed and opened .

Apart lips indicate, mouth breathing ,tongue

thrusting, or nasal obstruction

Note the color, texture, fissuring and any surface

abnormality of the upper and lower vermillion

border.

Perioral Examinatio


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The size of the lip should be considered:

Swelling of lip may be due to:

1- Infection 2- Malignancy

3- Angioneurotic edema.


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Buccal Mucosa Retract the Buccal mucosa.

Examine first the right then theleft Buccal mucosa extendingfrom the labial commissureand back to the anterior

tonsillar pillar. Note any change in

pigmentation,color,texture andother abnormalities of themucosa.

Make sure that thecommissures are examinedand are not covered by theretractors during the retraction

of the cheek. Intraoral Examination


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Gingiva and Alveolar

Mucosa Examine the buccal and labial aspect of thegingiva and alveolar mucosa by starting with theright maxillary posterior gingiva and alveolarmucosa and then move around the arch to the

left posterior area.

Drop to the left mandibular posterior area andmove around the arch to the right mandibularposterior area.

Second examine the palatal and lingual aspects,from right to left on the palatal maxilla and left toright on the lingual surface of the mandibulararch.

Intraoral Examination


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Gingiva and Alveolar

Mucosa



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TongueTongue dorsum

Inspect the dorsum of the tongue for anyswellings ,ulceration, coating or variation

in size, color or texture.

Note any changes in the tongue coating .


The patient is

asked to protrude

the tongue and itis examined for

any changes in

mobility or

osition.


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Tongue



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Hard Palate

The hard palate can be

inspected visually both

directly and indirectlythrough the use of the

mouth mirror.



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Hard Palate



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Soft Palate The soft palate can be seen by use of a mouth

mirror and reflected light as well as by

depressing the tongue and having the patient

elevate it by saying ahh.



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Oropharynx



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Floor of the MouthWith the tongue still

elevated ,inspect the

floor of the mouth for

the presence of anypathological

changes..



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Floor of the Mouth



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Palpation



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Teeth Primary examination techniques for evaluating

the teeth include visual inspectionTransillumination, probing, palpation,

percussion and evaluation of function.

Teeth are examined for the detection of caries,mobility, local factors, stains ,vitality , occlusion,

and condition of restorations.



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Teeth



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Thank You

clinical examination ii

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