Things to consider while charting I/E oral exam
Here are some things that a dental hygienist student is required to chart before periodontal debridement. The purpose of an I/E oral examination is :
- To detect any malignant lesions in neck and head, and intra/extra oral area.
- To determine an effective treatment planning and human needs for the patient.
- To bind with requirements and obligations of ADA, CDHA ( chart all the findings)
EXTRA ORAL
FACE
Color: Uniform Redness lesions scars, hair distribution.
NODES
- Surface : Smooth-rough, flat -raised, swelling, lump
- Shape: Irregular, round, oval
- Consistency: firm, hard, spongy
- Mobility: Mobile-fixed
- Tenderness: If any pain experienced by patient during palpation
TMJ
- Movement: Shifted left-right, asymmetric, abnormal range of motion, can’t open the mouth wide (Place three middle fingers in the P mouth)
- Crepitus : Crackling or popping
- Tenderness: Pain reported by patient when palpating
INTRA ORAL
Lips: Dry, cracks, lesions, herpes, irregular vermilion border angular cheilitis, asymmetric lips(upper shifted left)
Buccal mucosa: Changes in color texture, lesions, trauma or tenderness upon palpation, swelling, pale, reddened, dry, linea alba, leukoplakia, Lichen planus, Halitosis.
Floor of the mouth : color tecture,lesions, swelling, mucolele ( fluid filled swelling, trauma of ducts) hard areas of discomfort (palpate) glands, tori (mand)
Tongue : Moist/dry, papillae absent, asymmetrical appearance, lingual varicosities (with aging), fissured tongue (deep groves, harmless). geographic tongue (white-red patches papillae missing, macroglossia (enlargement), ankyloglossia (short lingual frenum), hairy tongue
Tonsils: Inflamed, enlarged, areas of exudates ( pus)
Oropharynx : Inflamed, sore throat, discomfort when swallowing
Uvula: Deviates from midline (how many mm)?
