MOUTH ASSESSMENT

• TRUE OR FALSE?

  TRUE: The mouth and oropharynx are composed of the lips, oral mucosa, the tongue and floor of the mouth, teeth and gums, hard and soft palate, uvula, salivary glands, tonsillar pillars, and tonsils.
• There are three pairs of salivary glands empty into the oral cavity:

  • Parotid gland
  • Submandibular gland
  • Sublingual salivary
• Parotid gland is the largest and empties through Stensen’s duct opposite the second molar.
• Submandibular gland empties through Wharton’s duct, which is situated on either side of the frenulum on the floor of the mouth.
• Sublingual salivary gland lies in the floor of the mouth and has numerous openings.
• Inspect the outer lips for symmetry of contour, color, and texture.
• Inspect the outer lips.

  Ask the client to purse the lips as if to whistle.
• Outer Lips Abnormalities.

  Blisters; generalized or localized swelling; fissures, crusts, or scales (may result from excessive moisture, nutritional deficiency, or fluid deficit)
• Inability to purse lips (may indicate facial nerve damage)
• Outer Lips

  Uniform pink color | bluish hue in Mediterranean groups and dark-skinned clients
• Inspect and palpate the inner lips and buccal mucosa for color, moisture, texture, and the presence of lesions.
• Inner lips and Buccal mucosa

  Uniform pink color | freckled brown pigmentation in dark-skinned clients
• Inner Lips and Buccal Mucosa:

  Drier oral mucosa in older clients due to decreased salivation
• TRUE OR FALSE?

  TRUE: Inner lip and Buccal Mucosa should be moist, smooth, soft, glistening, and elastic texture
• Inner Lip and Buccal Mucosa Abnormalities:

  Excessive dryness Mucosal cysts; irritations from dentures; abrasions, ulcerations; nodules
• Inner Lip and Buccal Mucosa:

  Ask the client to relax the mouth, and, for better visualization, pull the lip outward and away from the teeth.
• Inner Lip and Buccal Mucosa:

  Grasp the lip on each side between the thumb and index finger.
• How many teeth does an adult have?

  32
• Brown or black discoloration of the enamel (may indicate staining or the presence of caries)
• Spongy texture; bleeding; tenderness (may indicate periodontal disease)
• Receding, atrophied gums; swelling that partially covers the teeth
• What is the normal color of the gums?

  Pink gums | bluish or brown patches in dark-skinned clients
• What is the equipment that healthcare professional use when examining the mouth?

  Tongue depressor
• View the surface buccal mucosa from top to bottom and back to front.
• A flashlight or penlight will help illuminate the surface.
• For proper vision of the molars, use the index fingers of both hands to retract the cheek.
• Normal Findings of Dentures?

  Smooth, intact dentures
• Inspect the surface of the tongue for position, color, and texture. Ask the client to protrude the tongue.
• Normal or Abnormal? (Tongue Surface)

  Normal: Pink color (some brown pigmentation on tongue borders in dark-skinned clients); moist; slightly rough; thin whitish coating
• Tongue Surface Abnormality:

  Deviated from center (may indicate damage to hypoglossal [12th cranial] nerve); excessive trembling
• Tongue Surface Abnormality:

  Smooth red tongue (may indicate iron, vitamin B12, or vitamin B3 deficiency)
• Tongue Surface Abnormality:

  Dry, furry tongue (associated with fluid deficit), white coating (may be oral yeast infection)
• Inspect tongue movement. Ask the client to roll the tongue upward and move it from side to side.
• Normal or Abnormal? (Tongue Movement)

  Normal: Moves freely; no tenderness
• Normal or Abnormal?

  Abnormal: Restricted mobility
• Normal or Abnormal? (Base of the tongue)

  Normal: Smooth tongue base with prominent veins
• Normal or Abnormal? (Base of the tongue)

  Abnormal: Swelling, ulceration
• Inspecting the ventral surface of the tongue

  
• Inspecting the dorsal surface of the tongue

  
• Fissured tongue