Intra Oral Examination PDF

Intra Oral Examination Module: Foundations for Clinical Skills and Practice Tutor: Rhona Mann Aim: Deliver the required information in order to gain an understanding of the relevance of the Intra Oral examination in clinical Practice. Intended learning outcomes By the...

Intra Oral Examination Module: Foundations for Clinical Skills and Practice Tutor: Rhona Mann Aim: Deliver the required information in order to gain an understanding of the relevance of the Intra Oral examination in clinical Practice. Intended learning outcomes By the end of the session students should be able to: Explain the relevance and importance of the Intra oral examination of the patient. Identify areas of particular significance in relation to the Intra oral examination. Explore the techniques and observations and assessments required in order to carry out a thorough and effective Intra oral examination. Recognise signs of disease and abnormalities in the hard and soft tissues. What do we mean by Intra oral examination? This examination forms part of the general initial assessment of the patient. The Intra Oral examination is carried out to identify signs of health and disease in both the hard and soft tissues of the oral cavity. To assess treatment needs in the patient as well as identifying any worrying signs and symptoms the patient may present with, and act accordingly. What is normal? To know what is abnormal you need to know what is normal for the patient Intra Oral Examination Lips Mucosa Hard & soft palates Floor of the mouth The tongue including the dorsum & lateral borders The vestibules The fauces The lips: What are we looking for? Intact mucosa? Any trauma? Any swelling? Lumps? Colour? Pigmentation? Texture? Anything else? Examination 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 Traumatic Accessed from Google January 2021 10 Apthous Ulcers: Commonly seen on the mucous membrane. Usually sore and painful. Vary in size. Usually heal completely within 14 days. May make oral examination/dental treatment challenging due to discomfort. What do you think are the possible causes of this type of ulceration 11  Fordyce spots Mucocele 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 Traumatic ulcerative Lichen Planus granuloma Aspirin burn Linea alba Hard & Soft 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 Soft Palates Nicotinus Thrush Ulceration Stomatitis Tori Accessed from Google images January 2021 Tongue Refer to Tongue Lecture 20 Tongue: What should it look like? Accessed from Google images January 2021 21 Examining the tongue Images from Dentalcare website Feb 2021 With gauze and pull tongue out Then left The right Tongue to roof of mouth for underside Why use the gauze? 22 Black hairy Tongue Piercings tongue Split tongues Accessed from Google images January 2021 23  Geographic Fissured tongue tongue Squamous Cell Carcinoma Glossitis 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 Vestibules Space between cheeks and gingiva Lateral wall is formed by the cheek Images from Google Feb 2021 28 Vestibules 29 Fauces Represents the space between the cavity of the mouth and the pharynx 30 https://www.youtube.com/watch? v=hUG2veJhinI Intra Oral Exam - YouTube 31 Other Intra-Oral Assessment to consider Please see each lecture independently to gain sufficient knowledge on each subject 32 More intra- oral assessments 33 Periodontal Assessment Gingival condition? Bleeding on Probing? Probing depths/ BPE/ 6 Point pocket charting? Classification of Periodontal Disease? Suppuration? Mobilities? 34 Images from Google Feb 2021 35  Further Assessment: Plaque and Calculus deposits Assess, Disclose, Indices, Observe and Document. 36 What differences can you observe in these 2 pictures? 37  Hard Tissues Caries Staining…… Intrinsic? Extrinsic? Tooth Surface Loss? Erosion Abrasion Attrition Anything else? 38 Radiographic Assessment for Caries  Tooth  Surface  Enamel / dentine  Primary / secondary S  Restorations margins / leakage  Pulpal distance / response  Pathology 39 Radiographic Assessment: Periodontal Looking for … Degree of bone loss Type of bone loss…..horizontal, vertical? Distribution…..generalized of localized? What else? Furcation involvement? Radiolucency at apices? 40 Treatment Planning: Consider: Order of treatment: Pian/emergency addressed as a priority Prevention: What is included? NSPT/ Restorative as required Refer as necessary Assess Risk Review Monitor 41 Summary Image from ETF Trends Feb 2021  All patient assessments are considered collectively and not in isolation.  Assessments comprise of a physical examination and verbal discussion.  All assessments must be documented. 42 Thank you for your attention! Any questions? [email protected] 43