Assessment of the mouth

• Asymmetry of placement - Congenital deformity, trauma, paralysis, or surgical alteration.
• Pallor - Anemia
• Redness - Inflammatory or infectious disorder.
• Cyanosis - Vasoconstriction or hypoxia
• Cheilitis - inflammation of lips, drying, and cracking: Dehydration, allergy, lip licking.
• Cheilosis - fissures at corners of lips, Deficiency of B vitamins or maceration related to overclosure.
• Angioedema - Allergic response
• Herpes simplex - clustered area of fullness/nodularity that forms vesicles, then ulceration: Herpes viral infection.
• red “beefy” tongue is seen with pernicious anemia.
• Hypertrophy and discoloration of papillae - Antibiotic use.
• glossitis - Anemia, chemical irritants, medications.
• adherent white patches - Candida albicans.
• Black, hairy tongue - Fungal infections
• Small, painful vesicles that often have a reddened periphery and a white or pale yellowish base, believed to be caused by viral infection, stress, or trauma - Aphthous ulcer
• Nodular, macular, or papular lesions widely involving the integument and often evident on the oral mucosa - Kaposi’s sarcoma. Incidence has increased with the development of acquired immunodeficiency syndrome (AIDS).
• chronic gray, lacy patches with or without ulceration: Lichen planus. May progress to neoplasm.
• Reddened mucosal change that may progress to form cancer: Erythroplakia
• Gingivitis: Pale or gray gingivae: Chronic gingivitis.
• Recession of gums: inflammatory gum changes (gingivitis/periodontal disease): Poor dental hygiene or vitamin deficiency.
• Gum hyperplasia: Side effect of medications, such as dilantin or calcium channel blockers.
• Leukoplakia: White, adherent mucosal thickening, May progress to cancer.
• Fordyce granules: Enlarged sebaceous glands on buccal mucosa, white/yellow raised lesions.
• adults have 28 teeth, or 32 if the four third molars, or wisdom teeth, are erupted
• Tetracycline staining: Discoloration of teeth: may discolor teeth gray if administered before puberty.
• Fluorosis: Mottled enamel: excessive fluoride.
• Perforation: Congenital or from trauma or drug use
• Yellowish or green streaks of drainage on the posterior wall: Postnasal drainage.
• Gray membrane/adherent material: Diphtheria.
• Erythema: Inflammatory response, typically associated

  with infectious pharyngitis; also common in smokers.
• Scattered vesicles/ulcerations: Herpangioma.
• Bulges adjacent to the tonsilar pillars: peritonsillar abscess
• Reddened, hypertrophic tonsil, with or without exudates: Acute infection or tonsillitis.
• Stensen’s duct: Inspect inner aspect of cheek (buccal mucosa) opposite the second upper molar.
• Wharton’s duct: Have patient lift tongue and inspect the floor of mouth
• Parotitis: Fullness or inflammatory changes of glands: Blockage of duct by calculi, infection, malignancy. inflammation of parotid glands
• Cleft palate – Bifid Uvula
• Hard palate – made out of bone (whitish color)
• Soft palate – made out of muscle (more pink in color)
• Uvula – hangs from middle of soft palate
• Tongue – striated muscle assist with mastication and swallowing