Intra Oral Examination GN PDF

Intra Oral Examina-on Module: Founda-ons for Clinical Skills and Prac-ce Tutor: Rhona Mann Aim: Deliver the required informa2on in order to gain an understanding of the relevance of the Intra Oral examina2on in clinical Prac2ce. Intended learning outcomes By the end of...

Intra Oral Examina-on Module: Founda-ons for Clinical Skills and Prac-ce Tutor: Rhona Mann Aim: Deliver the required informa2on in order to gain an understanding of the relevance of the Intra Oral examina2on in clinical Prac2ce. Intended learning outcomes By the end of the session students should be able to: Explain the relevance and importance of the Intra oral examina2on of the pa2ent. Iden2fy areas of par2cular signiAcance in rela2on to the Intra oral examina2on. Explore the techniques and observa2ons and assessments required in order to carry out a thorough and eBec2ve Intra oral examina2on. Recognise signs of disease and abnormali2es in the hard and soD 2ssues. What do we mean by Intra oral examina-on? This examina2on forms part of the general ini2al assessment of the pa2ent. The Intra Oral examina2on is carried out to iden2fy signs of health and disease in both the hard and soD 2ssues of the oral cavity. To assess treatment needs in the pa2ent as well as iden2fying any worrying signs and symptoms the pa2ent may present with, and act accordingly. What is normal? To know what is abnormal you need to know what is normal for the pa-ent Intra Oral Examina-on Lips Mucosa Hard & soD palates Floor of the mouth The tongue including the dorsum & lateral borders The ves2bules The fauces The lips: What are we looking for? Intact mucosa? Any trauma? Any swelling? Lumps? Colour? Pigmenta2on? Texture? Anything else? Ulcers, piercings, filler/botox Examina-on Images from Dentalcare website Feb 2021 Wearing gloves Stretch lips upwards and outwards Stretch lips downwards and outwards Colour Breaks / tears Lumps / bumps Vessels 9 Aphthous Ulcers Major Minor Trauma-c Accessed from Google January 2021 10 Apthous Ulcers: Possible causes: Aenemia Vit deficiency Commonly seen on the mucous membrane. Usually sore and painful. Vary in size. Usually heal completely within 14 days. May make oral examina2on/dental treatment challenging due to discomfort. What do you think are the possible causes of this type of ulcera-on 11  Fordyce spots Harmless, painless Mucocele Harmless, painless fluid filled cyst Disruption of saliva flow Images Google January 2021 12 Buccal Mucosa 13  Buccal Mucosa The inside of the mouth: the lining of the cheeks Normally smooth, reddish/ pink /naturally pigmented. Image accessed Google 2021 Moist Flexible: not rigid 14 Examining the Buccal Mucosa Colour Breaks / tears Lumps / bumps Vessels Textures Images from Dentalcare website Feb 2021 15 Buccal Mucosa Accessed from Google images January 2021 Chronic trauma Dermological condition Chronic inflammatory disease White/red, lacy patches Can be painful Burning sensation Increased sensitivity to acid, spicy, coarsely textured and hot foods. Trauma-c ulcera-ve Lichen Planus granuloma Horizontal white line or ridge Thickening of tissue lining from friction or pressure Benign Aspirin burn Linea alba Hard & SoT Palate Refer to Hard & Soft Palate Lecture 17 Moving onto the palate area……… What does a healthy palate look like? Describe what you see. Image accessed from Google 2021 18 Hard and SoT Palates Not painful - caused by heat and nicotine Nico-nus Thrush Ulcera-on Stoma--s Tori Accessed from Google images January 2021 Tongue Refer to Tongue Lecture 20 Tongue: What should it look like? Coated tongue - not abnormal - just needs a good brush Accessed from Google images January 2021 21 Examining the tongue Images from Dentalcare website Feb 2021 With gauze and pull tongue out Then leD The right Tongue to roof of mouth for underside Why use the gauze? 22 Stained and enlarged papillae Black hairy Tongue Piercings tongue Accessed from Google images January 2021 Split tongues 23  Geographic Fissured tongue tongue Squamous Cell Carcinoma Glossi-s Images from Google Feb 2021 24 Floor of the Mouth 25 Floor of the Mouth 26 Floor of the Mouth – not normal Lingual torus Lingual Ranula Floor of mouth cancer Lingual salivary stone 27 Ves-bules Can be quite prominent in some Space between cheeks and patients gingiva Lateral wall is formed by the cheek Images from Google Feb 2021 28 Ves-bules 29 Fauces Represents the space between the cavity of the mouth and the pharynx 30 h]ps://www.youtube.com/watch? v=hUG2veJhinI Intra Oral Exam - YouTube 31 Other Intra-Oral Assessment to consider Please see each lecture independently to gain suacient knowledge on each subject 32  PERIODONTAL ASSESSMENT BPE More intra- BLEEDING/PLAQUE RECCESION oral assessments CAL FURCATIONS MOBILITY 33 Periodontal Assessment Gingival condi2on? Bleeding on Probing? Probing depths/ BPE/ 6 Point pocket char2ng? ClassiAca2on of Periodontal Disease? Suppura2on? Mobili2es? 34  STAINING CARIES DRIFTING RECESSION ABRASION Images from Google Feb 2021 35  Further Assessment: Plaque and Calculus deposits Assess, Disclose, Indices, Observe and Document. 36 What diBerences can you observe in these 2 pictures? 37  Hard Tissues Caries Staining…… Intrinsic? Extrinsic? Tooth Surface Loss? Erosion Abrasion A^ri2on Anything else? 38 Radiographic Assessment for Caries  Tooth  Surface  Enamel / den2ne  Primary / secondary S  Restora2ons margins / leakage  Pulpal distance / response  Pathology 39 Radiographic Assessment: Periodontal Looking for … Degree of bone loss Type of bone loss…..horizontal, ver2cal? Distribu2on…..generalized of localized? What else? Furca2on involvement? Radiolucency at apices? 40 Treatment Planning: Consider: Order of treatment: Pian/emergency addressed as a priority Preven2on: What is included? NSPT/ Restora2ve as required Refer as necessary Assess Risk Review Monitor 41 Summary Image from ETF Trends Feb 2021  All pa2ent assessments are considered collec2vely and not in isola2on.  Assessments comprise of a physical examina2on and verbal discussion.  All assessments must be documented. 42 Thank you for your attention! Any questions? [email protected] 43