Clinical examination

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					        ‫بسم هللا الرحمن الرحيم‬


                     ‫ُ ُ‬
‫”و َمآَ أوتيتم من ِ ِ إال قليلا“‬
   ‫ِ‬
     ‫َ العلم ِ َ َ‬ ‫ِ ِ‬
‫صدق هللا العظيم‬
   Clinical
examination II
                By
       Dr/Maha Mahmoud
    Assistant professor of Oral
            Medicine
       Peri/Intraoral
       Examination
Good   illumination   is   essential   for   the
examination of the mouth.

The patient should be seated properly and
comfortably for proper examination of all
areas of the mouth.
            Peri/Intraoral
            Examination
     The perioral and intraoral examination
     procedure follows an eight –steps
     systematic assessment of the:
1.   Lips
2.   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.
                     Lips
• Begin examination by observing the lips with the
  patients 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 Examination
• The size of the lip should be considered:
• Swelling of lip may be due to:
  1- Infection         2- Malignancy
  3- Angioneurotic edema.
       Buccal Mucosa
• Retract the Buccal mucosa.
• Examine first the right then the
  left Buccal mucosa extending
  from the labial commissure
  and back to the anterior
  tonsillar pillar.
• Note any change in
  pigmentation,color,texture and
  other abnormalities of the
  mucosa.
• Make sure that the
  commissures are examined
  and are not covered by the
  retractors during the retraction
  of the cheek.            Intraoral Examination
    Gingiva and Alveolar
          Mucosa
• Examine the buccal and labial aspect of the
  gingiva and alveolar mucosa by starting with the
  right maxillary posterior gingiva and alveolar
  mucosa and then move around the arch to the
  left posterior area.

• Drop to the left mandibular posterior area and
  move around the arch to the right mandibular
  posterior area.
• Second examine the palatal and lingual aspects,
  from right to left on the palatal maxilla and left to
  right on the lingual surface of the mandibular
  arch.
                           Intraoral Examination
Gingiva and Alveolar
      Mucosa




          Intraoral Examination
Tongue dorsumTongue
• Inspect the dorsum of the tongue for any
  swellings ,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 it
   is examined for
   any changes in
   mobility or
                         Intraoral Examination
   position.
Tongue




   Intraoral Examination
Tongue




   Intraoral Examination
Tongue Margins
• With the aid of mouth mirrors, inspect the right
  and left lateral margins of the tongue.
• Grasping the tip of the tongue with a piece of
  gauze will assist full protrusion and will aid
  examination of the posterior aspect of the
  tongue lateral borders.




                            Intraoral Examination
Tongue Ventral Surface:
Examine the tongue ventral surface ,observe any
changes in the blood vessels or in the lingual frenum.




                          Intraoral Examination
             Hard Palate

• The hard palate can be
  inspected visually both
  directly and indirectly
  through the use of the
  mouth mirror.




                            Intraoral Examination
Hard Palate




     Intraoral Examination
            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.




                        Intraoral Examination
Oropharynx




     Intraoral Examination
  Floor of the Mouth
With the tongue still
elevated ,inspect the
floor of the mouth for
 the presence of any
     pathological
      changes..




                         Intraoral Examination
Floor of the Mouth




         Intraoral Examination
Palpation




    Intraoral Examination
                     Teeth
• Primary examination techniques for evaluating
  the teeth include visual inspection
  Transillumination, 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.




                            Intraoral Examination
Teeth




  Intraoral Examination
Thank You

				
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posted:7/30/2012
language:Arabic
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