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Presentation

Introduction to the Oral Examination

Description

In this session led by Jeanette Moranski during the AAD meeting, she introduces important aspects of performing an effective oral examination. She emphasizes the need for clinicians to start with organized methods, avoiding the common practice of simply asking patients to say 'ah'. Key pointers include ensuring proper lighting, patient comfort, and using gauze to manage moisture during the exam. Moranski highlights the importance of examining salivary glands, as saliva plays crucial roles in oral health, including digestion, cleaning, and antimicrobial functions. She discusses the anatomy of major and minor salivary glands, the implications of various oral conditions, and stresses the need for thorough inspections, including palpation of lymph nodes and visual checks for abnormalities. The presentation covers common oral findings, such as Fordyce spots and geographic tongue, and addresses potential complications like ranulas and xerostomia that can result from oral health issues. Moranski concludes by underscoring the significance of a complete examination and the differential diagnosis of mucosal lesions, ranging from benign to malignant, to improve patient care.

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Conclusions

The oral examination should start with a systematic approach, rather than simply asking the patient to say 'ah'.
Clinicians should be aware of the importance of salivary glands and saliva in maintaining oral mucosal health.
Moisture from saliva can alter the appearance of oral lesions, making adequate drying important during examination.
A thorough oral examination should include both extraoral and intraoral evaluations.
Familiarity with common oral conditions and their variants is crucial for accurate diagnosis.
Regular inspections can help identify benign and malignant lesions effectively.
Collaboration with other healthcare professionals is important in managing conditions related to oral health, especially post-radiation effects.
Early detection of oral cancer is facilitated through comprehensive oral examinations.
Biopsy should be considered when lesions are ambiguous and diagnosis is uncertain.

Leone, C. W., & Oppenheim, F. G. (2001). JDE 65(10): 1054-62. Review of 21 studies, chronically low salivary flow rate was the strongest indicator for increased risk for caries prevalence or incidence.
Wu, A. J. (2008). Rhum Dis Clin North Am, 34: 1001-1010.