Preventative dentistry chapter
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Oral Examination Procedure

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Much of the initial examination is performed automatically whilst taking the history, putting the patient on the table and making a fuss to calm it. The information is frequently obtained subliminally with only abnormalities registering as worth following up.

History taking with this step will allow the examination to be history driven.

 

 

  1. Visually inspect the head and neck from afar. Palpate the outer surfaces of the head for pain, heat, sensitivity or swelling. Palpate the mandibular lymph nodes.

      Examination of head visually and digitally (22 seconds)

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  Observe and palpate face and head
     
  1. Externally, inspect the lips and palpate them. Retract the lips and examine the vestibule (i.e. - inner surfaces of the lips, the buccal mucosa, the rostral surfaces of the incisors and the buccal surfaces of the canines, premolars and molars.

      Visual inspection of oral vestibule and buccal surfaces of teeth (21 seconds)
  Examine vestibule and buccal surfaces of teeth
     
  1. Open the mouth - if this is not possible, consider sedation at this point as there may be an underlying (painful) reason for this.
  Sedation may be required
     
  1. Examine the mucous membranes of the floor of the mouth, the tongue (dorsum and ventrum), gingiva and palatal tissues. Check for colour, inflammation, ulceration, hyperplasia, bleeding, unusual swellings, tumours, and foreign bodies.
     
  1. Examine teeth for calculus, gingivitis, malocclusion of bite and, in cats, feline odontoclastic resorptive lesions. Look for retained deciduous teeth, attrition facets, enamel abnormalities, root or furcation exposure, caries and absence of teeth.
  Examine rest of oral cavity and pharynx
     
  1. Examine the oropharynx and the tonsillar area for pathology or foreign bodies.
  Open mouth oral examination of palate, tongue, pharynx and occlusal surfaces of teeth (13 seconds)
 
 

Note that a more detailed oral examination can only be performed under sedation or general anaesthetic. This will incorporate detailed periodontal and dental examination including sulcus depth, periodontal pocketing (if present) and any areas where caries or pulp exposure may be suspected - often seen initially as black spots on incisal edges or occlusal pits.

 

 
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