Inspect the Teeth

There are 32 teeth in the full adult dentition. Is the dentition appropriate for the patient's age? The teeth should be inspected for caries and malocclusion. Are the teeth clean, especially around the gum line? Is there discoloration of the teeth? Is there tooth loss? Inspection of the teeth often provides insight into the patient's attitude toward general hygiene.

Are the teeth aligned properly? Ask the patient to bite normally while you retract the buccal mucosa with a tongue depressor. How many teeth bear force on mastication? Repeat this inspection on the other side. Do the maxillary teeth overlap the mandibular ones, and are they in contact with them? If so, the bite is probably normal.

If the patient is wearing dental appliances such as dentures or bridges, he or she should remove them for a complete evaluation.

Figure 12-21 Gingival hypertrophy in a patient taking phenytoin (Dilantin).

Figure 12-21 Gingival hypertrophy in a patient taking phenytoin (Dilantin).

Figure 12-22 Gingival hypertrophy in a patient with acute monomyelocytic leukemia. Note the bleeding gingivae.

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