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116 Cards in this Set
- Front
- Back
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Objectives of the oral exam? |
-note normal deviations -oral cancer screening -determine need for postponement of treatment -early detection of lesions -identify conditions that may require medical -evaluation -identify need for treatment adaptions -baseline comparison -info for legal record |
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What is categories are assessed during exams? |
symmetry color size location shape consistency texture symptomatic mobility |
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What should be asked about lesions? |
is it known duration first noticed changes sign/symptoms reoccurrence |
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why should a systemic sequence be used? |
for accuracy and completion |
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What does a systemic sequence prevent? |
overlooking areas and details of importance |
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What does a systematic sequence increase? |
efficiency patients confidence |
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What does systematic sequence maintain? |
a professional atmosphere |
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complete exam |
thorough summary of all the components of the assessment. EO and IO. Required for routine maintenance of a patient |
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Screening exam |
brief, preliminary exam for a particular purpose (initial patient assessment or triage) Determines priorities |
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What is a limited exam? |
for an emergency situation
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What is a Follow-up exam? |
to check healing following a treatment
can remove dressing or sutures |
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What is maintenance/reevaluation exam? |
complete reassessment from which a new diagnosis is formed
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What are the methods used for conducting an oral exam? |
observation palpation auscultation olfactation instrumentation percussion electrical |
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Types of palpation |
digital bidigital manual bimanual bilateral circular compression |
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digital palpation |
1 finger |
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bidigital palpation |
2 fingers |
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What is manual palpation? |
1 hand |
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bimanual palpation |
2 hands (one intraoral, one extra ie) |
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Bilateral palpation |
both sides of the body at the same time |
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What is included in the occlusal screening/oral habits section? |
angles classification habits occlusal discrepancies |
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What is included in the periodontal exam? |
papilla marginal gingiva attached gingiva |
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what is in the periodontal summary statement? |
AAP case type |
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What is described when documenting size and shape? |
length, width, height margin traits contour of border |
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What are you looking for when describing margin traits? |
smooth/flat raised/elevated or depressed |
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What are you stating when describing the contour of the border? |
regular or irregular |
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What categories are used when describing and documenting significant findings? |
size and shape color location and configuration |
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What are the most common colors used when describing a significant finding? |
red white red and white pink |
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what are the less common colors used when describing a significant finding? |
yellow black brown blue |
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What is stated when describing location and configuration of a significant finding? |
generalized or localized discrete grouped confluent coalescing linear |
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define flat lesion |
lesion on the same level as the normal skin and oral mucosa
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What are the types of flat lesions? |
macule patch |
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macule |
small flat discolored spot that exits no change in skin texture or thickness -less than 1cm in size -color melanotic, black, erythemic, or any change lighter than skin -freckles, petechia, amalgam tattoo |
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define patch |
flat discolored area on the skin or mucosa -greater than 1cm in size -lichen planus, snuff patch, port wine stain, birth mark |
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define elevated lesion - nonblisterform |
lesions where the surface is raised above the normal skin or oral mucosa |
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types of nonblisterform elevated lesions |
papule plaque nodule tumor |
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papule |
solid raised lesion, usually less than 1cm in diameter -mole, skin tag |
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plaque |
superficial raised lesion formed by coalescences of closely grouped papules -greater than 1cm diameter, slightly raised but flattened - leukoplakia, psoriasis |
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nodule |
raised marble-like lesion that is a hard mass -usually 1cm or more - wart, basal cell carcinoma, enlarged lymph node |
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define tumor |
general swelling or enlargement. 2cm + in width |
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blisterform fluid filled lesions |
elevated lesions filled with clear fluid or pus vesicle bulla pustule wheal |
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define vesicle |
smal blister filled with clear fluid -less than 1cm diameter - herpes simplex, herpes zoster, chickenpox |
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define bulla |
large blister filled with clear fluid. Greater than 1cm diameter. -burn blisters |
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define pustule |
small raised lesion filled with pus acne boil abscess |
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define wheal |
raised, irregular area of localized edema. Usually from allergic reaction, Lasts 24 hours. -mosquito bite, hives |
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depressed lesion |
surface of the lesion is below the normal level of the skin or oral mucosa. either superficial or deep -Ulcer, erosion (cracks and fissures) |
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ulcer |
crater-like lesion of the skin or mucosa where the top 2 layers of skin are lost. Superficial=less than 3mm deep |
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erosion |
shallow depressed lesion that does not extend through the epithelium to the underlying tissue (just the top layers) |
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what is a crack? |
long narrow break in the surface of skin or mucosa - found on lips |
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what is a fissure? |
linear crack in the top 2 layers of the skin or mucosa |
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Exophytic |
growing outward |
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Exostosis
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benign bony growth projecting from the surface of bone
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Idiopathic
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of unknown etiology (origin)
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Lymphadenopathy |
disease of lymph nodes
lymph node enlargement |
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Petechiae |
hemorrhagic non raised spot of pinpoint to pinhead size
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Papilla/papillary |
small nipple shaped projection or elevation
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Peudomembrane |
loos membranous layer of exudate that contains microorganisms, fibrin, necrotic cells, and inflammatory cells on the surface of a tissue
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Polyp |
any growth or mass protruding from a mucous membrane
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Punctate |
marked with points or punters differentiated from the surrounding surface by color, texture, or elevation
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Purulent |
containing, forming, or discharging pus
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Sclerosis |
Induration or hardening
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Torus |
bony elevation usually located on hard palate and lingual surface of mandible in the premolar area
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Verrucous |
wart like growth
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What is are the letters used to describe in order? |
DBCTA |
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DBCTA stands for |
Diameter/dimensions Border Color Type Anatomic location |
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When is oral cancer most devastating? |
when detected in later stages |
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What is the survival rate within 5 years after treatment? |
50% |
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What is squamous cell carcinoma? |
a malignant neoplasm in the oral cavity |
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What percentage of all malignant neoplasms is squamous cell carcinoma? |
90% |
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What is squamous cell carcinoma associated with? |
tobacco use alcohol abuse HPV sun |
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Why does a DH have a unique opportunity to detect oral cancer? |
the patient is most likely to see you more than he does his physician |
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what is detectable in the appearance of early cancer? |
white areas red areas red and white areas ulcers masses pigmentation |
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What are the diagnostic aids for cancer? |
toluidine blue chemiluminescence |
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what is toluidine blue used for? |
to identify changes in the mucosa that may be malignant or in patients previously treated for oral cancer |
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What are the steps in using toluidine blue? |
rinse or painted on rinsed with acetic acid spots retaining dye should be biopsied |
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What is chemiluminescence? |
a rinse with 1% acetic acid then uses light to detect abnormal cells |
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Are the diagnostic aids definitive? |
no, isnt always cancer |
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define biopsy |
total or partial removal of the lesion so the tissue can be examined to diagnose |
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Is a biopsy definitive? |
yes! |
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what is exfoliative cytology? |
diagnostic aid where cells are removed from the lesion and slide are fixed and mailed in for results |
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how is exfoliative cytology done? |
with a brush that scrapes cells of and creates wound |
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what is a cytologic smear? |
diagnostic aid in which cells are removed from the lesion for microscopic evaluation |
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what is possible with cytologic smears? |
false positives |
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what are the most common sites for cancer in the oral cavity? |
lateral border of the tongue gingiva soft palate floor of mouth lower lip salivary gland |
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most common cancer site in women? |
lateral border of tongue |
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most common cancer site in men |
lower lip chewing tobacco |
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what questions should the patient be asked about lesions? |
aware of it? when it occurred? changes? symptoms? any testing done? |
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why is careful communication important when talking about lesions? |
to not scare the patient |
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What are the different ways of having careful communication? |
be reassuring
not acting alarmed stress need for follow-up could be normal or treatable referral is to check it out, may be normal or benign |
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What color is healthy gingiva? |
pink |
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What size is healthy gingiva? |
snugly around tooth |
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what is the margin position in healthy gingiva?
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near the cementoenamel junction |
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what is the shape of healthy gingiva? |
meets tooth in tapered or rounded edge flat pointed fills embrasure space |
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What is the texture of healthy gingiva?
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firm
stippled |
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what is the consistency of healthy gingiva? |
firm resilient under compression |
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is there bleeding or exudate in healthy gingiva? |
no |
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What is the color for unhealthy gingiva? |
bright red blueish purple white pale pink |
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What is the size of unhealthy gingiva? |
enlarged |
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What is the shape of unhealthy gingiva? |
meets tooth in rolled, thick, irregular edge papilla is blunted, cratered, bulbous, or missing |
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What is the position of the margin in unhealthy gingiva? |
more than 2mm coronal to CEJ apical to CEJ |
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What is the texture of unhealthy gingiva? |
smooth shiny no stippling nodular and firm |
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What is the consistency of unhealthy gingiva? |
soft flaccid spongy puffy leathery not resilient |
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is there bleeding and exudate in unhealthy gingiva? |
yes |
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name and define |
oral tori - bony growth on lingual mandible or hard palate |
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name and define |
fissured tongue - |
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name and define |
geographic tongue - red pink and white patches that look like a map |
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name and define |
hairy tongue - can be brown. thick layer of dead cells build up |
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name and define |
fordyce spots - yellow small spots. sebaceous glands |
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name and define |
attrition - wearing away by friction |
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name and define |
erosion - loss of tooth substance by chemical process that does not involve known bacterial action |
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name and define |
herpes simplex |
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name and define |
aphthous ulcer (canker sore) - (little white or reddish ulcer) |
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name and define |
cheek chewing - hyperkeratinization (white raised rough lesion) |
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name and define |
tongue chewing |
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name and define |
pigmentation |
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name and define |
linea alba - white line in the middle of cheek |
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Community screening |
A survey of a group of individuals to identify the prevalence of a particular disease or condition within the population |
