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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.
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History taking with this step will allow the examination
to be history driven.
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- 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.
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- 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.
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- Open the mouth - if this is not possible, consider sedation
at this point as there may be an underlying (painful) reason
for this.
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- 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.
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- 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.
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- Examine the oropharynx and the tonsillar area for pathology
or foreign bodies.
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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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