Techniques of clinical examination

Visual examination

Visual dental examination includes general inspection of the patient, extra-oral and intra-oral inspection. Inspection is either directly by eyes or by using adjunctive instruments such as dental mirror, special sources of light to transilluminate the area. To have correct results of inspection the dentist should know the normal anatomy, tissue, color, size, etc.:

Healthy lips should be smooth, pink and moist. Look for dryness, lumps, cracked corners, inflammation or abnormal color.

A healthy tongue should be pink and moist. Look for patchy, white coating or any redness or swelling.

Healthy gums and tissues should be pink, moist, smooth and free from bleeding. Look for any ulcers, sores, swelling, redness or bleeding. Remove dentures to inspect the surface of the mouth for any hidden irritations.

Healthy teeth should be clean and free from food debris, plaque and decay. Look for worn down teeth, decay (black or brown spots) or cracks.

Dentures should be clean, well-fitting and intact. Look for any cracks, breaks, worn areas, and overall cleanliness. Inspect the tissues under the dentures for any signs of irritation.

Palpation

Palpation is a diagnostic procedure in which the examiner feels or presses gentle but firm pressure upon tissues and structures of the body for the purpose of determining various characteristics present in the areas examined. The clinical examination of the dental patient should include palpation of the various tissues associated with the masticatory system ( neck, oral and facial areas) to detect areas which may be contributing to abnormal masticatory function and to confirm and evaluate sites which have been described by the patient as being uncomfortable, tender, painful, etc. Palpation gives information about texture, consistency, size, temperature, pulsation, hardness, infiltration and mobility.

Probing

Probing is an important step in dental work since it is done by any dentist to any patient using a dental probe (explorer) which is considered as one of the diagnostic instruments. The dental probes are of different shapes but all have pointing tip to detect dental caries, any sensitive dentin; to measure the depth of the periodontal sulcus and reveal any pocket formation; to examine the orifice of the salivary glands and also to detect a communication with the maxillary sinus; to detect the starting of anaesthesia by checking the soft tissues of skin and gingiva; to cut the periodontal ligament before extraction etc.

Percussion

Percussion is a tapping with the mirror handle on the tooth in a vertical direction to identify the tooth that has inflammation in the ligament and, consequently, hurts the most to tapping. If two teeth together hurt to tapping, immobilize one with your finger while tapping the other and then reverse the process. Often you will find that one hurts significantly more than the other and will be the more suspicious of the two.

Auscultation

It is an act of listening for sounds within the body. This is by using the ears either directly or indirectly by using the stethoscope. The stethoscope is used widely by the physician and the dentist uses it to check blood pressure or to hear the sounds of the temporomandibular joint.

Ex.13. Speak on the techniques of clinical examination

Ex.14. Insert the missing prepositions (of, from, in, with, before, by):

Aspiration is an act to withdraw a fluid ____ its contents _____a body cavity ____aspirating syringe. The aspirated area may be located ___ soft tissue or centrally in the bone. Lesions could be injected ____ saline then aspirated, or other lesions may contain fluid _____ the beginning. The color __ the aspirated fluid is of importance. Local anesthesia is done _____ giving intramuscular aspiration.

Ex.15. Read the following text, ask approximately 7-8 questions and answer them: