Dental Examination: Head and Neck

Overview of Examination

• Examination of head and neck is a key part of a patient's first dental visit.
• Aim is to check normalcy of tissues or identify conditions needing further investigation.
• Includes examination of both soft tissues outside (extraoral) and inside the mouth (intraoral).
• Performed thoroughly and systematically to avoid missing any areas.

General Examination

• Begins as patient enters office.
• Observations include:
  • General appearance.
  • Mobility, gait, facial asymmetries, lesions, or scars.

Extraoral Head and Neck Examination

Key Components:

• Asymmetries: Observed from the front; patient questioned about previous surgeries, scars, tumors, infections if asymmetries are present.
• Lymph Node Examination:
  • Palpation for tenderness or enlargement.
  • Normal: Non-palpable or small, non-tender.
  • Abnormal: Larger, tender, indicating possible infection or inflammation.
  • Non-tender enlargement could signal cancer.
• Temporomandibular Joint Examination:
  • Gentle palpation of joints.
  • Observation during mouth opening/closing.
  • Noting any abnormalities for further examination.

Intraoral Soft Tissue Examination

Areas Examined:

• Lips and Labial Mucosa:
  • Check for wetness and shine.
  • Scar presence common from childhood trauma.
• Buccal Mucosa:
  • Examined with mirrors for moisture and shine.
• Palate and Throat:
  • Hard palate (roof of mouth) and soft palate (rear area).
  • Throat examined while patient says "Ah".
• Tongue:
  • Examined top, sides, and underside for abnormalities.
  • Attention to possible cancers (ulcers, masses).
• Floor of the Mouth and Gums (Gingiva):
  • Palpation for abnormalities or salivary stones.
  • Healthy gingiva is pink and regular.
  • Abnormalities include swelling, redness, ulceration.

Normal Oral Structures and Common Conditions

• Normal Structures:
  • Stenson's duct, circumvallate papillae, lingual tonsils, Plica fimbriata.
  • Varicosities (veins) common in older patients.
• Common Conditions:
  • Fissured tongue, Fordyce granules, geographic tongue, Linea Alba, cheek biting.

Importance

• Essential part of initial dental visit and ongoing examinations, including cancer screenings.
• Provides additional insights into patient's medical history.
• Documents normal and abnormal findings for future reference.