1. ORAL CAVITY &
OROPHARYNX

7. Palpation of the floor of the mouth

8. Exam: Lips
• Observe the color & its consistency-
intra-orally and externally
• Is the vermillion border distinct?
• Bi-digitally palpate the tissue around
the lips. Check for nodules, bullae,
abnormalities, mucocele, fibroma

9. Exam: Lips

11. Exam: Lips
• Evert the lip and examine the tissue
• Observe frenum attachment/tissue
tension
• Clear mucous filled pockets may be
seen on the inner side of the lip
(mucocele). This is a frequent, non-
pathologic entity which represents a
blocked minor salivary gland

12. Exam: Lips-palpation
• Color, consistency
• Area for blocked minor salivary
glands
• Lesions, ulcers

13. Exam: Lips
• Frenum:
– Attachment
– Level of attached gingiva

14. Exam: Lips-sun exposure

15. Exam: Lips
• Palpate in the vestibule, observe
color

16. Examination: Buccal Mucosa
• Linea alba
• Stensen’s duct

17. Examination: Buccal Mucosa
• Lesions – white, red
• Lichen Planus, Leukedema

18. Gingiva
• Note color, tone,
texture, architecture
& mucogingival
relationships

19. Gingiva

20. Gingiva

21. Exam: Hard palate

23. Exam: Tongue
• The tongue and the floor of the mouth
are the most common places for oral
cancer to occur
• It can occur other places; so visualize
all areas
• You may observe:
– Circumvalate papillae, epiglottis

24. Exam: Tongue
• Have the patient stick out their tongue
• Wrap the tongue in a dry gauze and
gently pull it from side to side to observe
the lateral borders
• Retract the tongue to view the inferior
tissues

25. Exam: Tongue

26. Exam: Tongue
• You may observe
lingual varicosities

27. Exam: Tongue
• You may observe geographic tongue
(erythema migrans)

28. Exam: Tongue
• You may observe drug reaction

29. Exam: Tongue
• Observe signs of nutritional deficiencies,
immune dysfunction

30. Exam: Tongue
• You may observe
oral cancer

32. Palpation of the floor of the mouth

33. Exam: Floor of mouth
• Visualize, palpate - bimanually
• Wharton’s duct
• Must dry to observe
• Does “lesion” wipe off?
• Where are the two most
likely areas for oral cancer?
• lateral border of the tongue
• Floor of mouth

34. Exam: Floor of mouth
• Oral Cancer:
• Red
• White
• Red and White
• Does the patient have important
risk factors for oral cancer?
• Counseling for smoking and alcohol
• Cessation

35. Exam: Floor of mouth

36. Exam: Floor of mouth
• Squamous Cell Carcinoma

37. Exam: Floor of mouth
• Squamous Cell Carcinoma

38. Exam: Leukoplakic area
Edentulous Mandibular Ridge

39. Retromolar trigone
• The small area behind the wisdom teeth.

42. TMJ & OcclusionTMJ & Occlusion

43. Occlusion
• Orthodontic
classification

44. Occlusion

45. Systematic Oral
Examination
• Done at initial exam & at recalls
unless patient history requires
sooner
• You must visualize all areas of the
oral cavity

46. Systematic Oral
Examination
• Oral cancer can occur in other
places than the lateral borders of
the tongue & the floor of the mouth
• Be complete
• Do good, do no harm, do justice,
respect autonomy

47. Visualize all areas

48. Exam: Oropharanyx
• Color, consistency of tissue
• Look to the back, beyond the soft
palate
• Note occasional small globlets of
transparent or pink opaque tissue
which are normal and may include
lymphoid tissue

49. Exam: Soft palate
• How does soft palate raise upon
“aah”?
• Vibrating line, tonsilar pillars, tonsils,
oropharynx

54. ORAL CAVITY &
OROPHARYNX