The Oral Cavity

The physical examination of the oral cavity includes inspection and palpation of the following structures:

Lips

Buccal mucosa Gingivae Teeth Tongue

Floor of the mouth Hard and soft palates Salivary glands Twelfth cranial nerve

Sit or stand directly in front of the patient, who should be seated. The patient's face should be well illuminated. Work systematically from front to back so that no areas are omitted. Put on a pair of gloves when palpating any structure in the mouth. When any lesion is found, note its consistency and tenderness. If the patient is wearing dentures, ask him or her to remove them. Inspect the face and mouth for asymmetries and abnormalities.

Evaluate the patient's breath. Is there any distinctive odor to the patient's breath? This may suggest poor oral hygiene or systemic disease. A fetid odor may be caused by extensive caries or periodontal disease.

Have the patient open his or her mouth. If the mouth can be opened much beyond 35 mm, subluxation of the jaw may be present. Deviation of the jaw is suggestive of a neuromuscular or temporomandibular joint problem.

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