Oral Examination Techniques

Extra Oral Examination

• The submental lymph node drains the lower lip, lower anterior gingiva, corners of the mouth, and chin tissue.
• The submandibular lymph nodes are associated with the submandibular gland, and three groups of nodes are involved.
• Temporomandibular joints are examined by observing the patient open and close their mouth while examiners observe the motion of the joint.  Crepitus is the sound of popped, clicking, or grinding of the TMJ.
• The sternocleidomastoid muscle is commonly palpated to check for anterior superficial or deep nodes. 
• Supraclavicular lymph nodes are found just above the clavicle.

Intraoral Examination

• Palatine fovea (fovea palatinii) is characterized by two orifices on each side of the midline near the vibrating line.
• These orifices also serve as collecting ducts for minor palatine salivary glands.

Practice Question: General

• The primary step in assessing a patient is a patient interview.
• The O'Leary index is used to assess plaque visibility and oral hygiene motivation.
• The patient in question 19 has a Class II, Division 1 occlusion. 
• Different numbers of succedaneous teeth exist in the permanent dentition.
• Diastema is a hereditary/genetic gap between two teeth.

Practice Question: Specific

• Some tissues are keratinized (hard palate), and other tissues are not (soft palate).
• The earliest sign of gingivitis is bleeding on probing.
• A therapeutic treatment, such as scaling or root planing, does not include coronal polishing.
• The least effective antibiotic for periodontal disease is Povidone-iodine.
• The lamina dura is thinner during periodontal disease. It's a radiopaque line in a healthy radiograph that's present at the root.
• For cold sterilization of instrumentation, 8 hours is the minimum time.
• A fomite is any object that transfers diseases by carrying microorganisms.
• The submental lymph node is the appropriate lymph node to examine when there's an infection in the lower lip, lower anterior gingiva, corners of the mouth, and the chin area.
• In the case of a patient having periodontal maintenance appointment, the possible abscess after scaling is a gingiva abscess.
• The most useful instrument for removing heavy calculus deposits is the ultrasonic scaler.
• For a patient with gingival recession, the Modified Stillman method is one tool that can be used for effective plaque control.
• The most common location for oral cancer is the lateral border of the tongue. 
• Koplik spots associated with measles, not eating disorders.
• Median rhomboid glossitis is a result of a chronic fungal infection, not a bacterial infection (antifungals, not antibiotics, are needed).
• A common lesion of the lateral border of the tongue that is soft, dark purple, and 2mm in diameter is a hemangioma.
• The coxsackie virus does not cause verruca vulgaris.
• Dental fluorosis is a form of enamel hypocalcification caused by excessive fluoride ingestion during enamel formation. 
• In the case that a patient has a periodontal abscess it is considered vital.
• The correct amount for a nasal cannula regarding a flow rate for supplemental oxygen is 1-6 L/m
• The most effective aspect of a periodontal exam involving a probe is the ability to precisely measure the CAL (clinical attachment level).
• Taking a larger dose of an opioid medication can lead to issues like euphoria and a build-up of tolerance.
• The most common side effect of a prescription medication containing heparin is hemorrhage (bleeding).
• A primary aspect to consider when recommending an instrument to use would be to consider the depth of the pocket, and if it is severe or not. 

General Oral Health

•  When air-polishing, the angle for anterior teeth is 90°, for occlusal surfaces is 60°, and for posterior teeth is 80°.
•  The appropriate type of material for root caries restorations is glass ionomer.
•  Warm water will NOT improve impression material setting time.  Borax will reduce working time if mixed with the impression material. 
•  The best type of treatment for xerostomia is determined by the cause.
•  A patient who is hyperventilating is contraindicated for oxygen.
•  The most common side effect of a specific medication containing heparin is hemorrhage.
•  The following are common side effects of steroid use: orthostatic hypotension, excessive bleeding, delayed wound healing.
•  A patient on anti-hypertensive medication is most likely experiencing an orthostatic hypotension when in a dental chair.

This quiz covers key concepts and procedures for extraoral and intraoral examinations. Learn about lymph node drainage, TMJ assessment, palpation techniques, and the significance of oral structures. Test your knowledge and improve your clinical skills in dental examinations.