Mouth and Oropharynx

Parts:

Mouth and Oropharynx

Are composed of a number of structures:
Lips, inner and buccal mucosa, the tongue
and floor of the mouth, teeth and gums,
hard and soft palate, uvula, salivary
glands, tonsillar pillars, and tonsils.
By age of 25 most of people have all their
permanent teeth.

Assessing the mouth and

oropharynx
PLANNING
Arrange for the client to sit with the head
against a firm surface such as a headrest or
examination table.

Equipment:
Clean Gloves
Tongue Depressor
2x2 gauze pad
penlight

Implementation
Performance
1.Introduce self and verify the clients identity using
agency protocol. Explain the procedure.
2.Hand Hygiene
3.Provide Privacy
4.History of routine pattern of dental care, last visit
to dentist; length of time ulcers or other lesions have
been present; denture discomfort; medication client
is receiving.
5.Position in comfortable position; seated if possible.

Assessment:
Lips and Buccal Mucosa
6. Inspect
Symmetry of contour
Color
Texture
Ask to purse lips as if to
whistle

Normal Findings

Deviation from normal

Uniform pink color

Soft, moist, smooth
texture
Symmetry of contour
Ability to purse lips

Pallor, cyanosis
Blisters, generalized and
localized swelling;
fissures, crusts or scales
Inability to purse lips

Applyand
clean
gloves Uniform pink color
7.Inspect
palpate
Asklips
theand
client
to relaxMoist,
the mouth,
(inner
buccal
smooth,
and for
better visualization,
the
mucosa
for color,
smooth,pull
glistening,
lip outward
from
the teeth
moisture,
textureand
andawayand
elastic
texture
presence
Grasp theoflip
on each side between
the
lesions)
the thumb and index finger
Palpate any lesion for size,
tenderness and consistency
Inspect the front teeth and gums

Pallor; leukoplakia(white
patches, red, bleeding
Excessive dryness
Mucosal cysts; irritations
from
dentures;abrassions,
ulceration; nodules

Teeth and Gums

*Ask the client to open the mouth

Using the tongue depressor, retract the
cheek. View the buccal mucosa from top to
bottom
and back
Use teeth
penlight to
8. Inspect
the teeth
and to front.
32 adult
illuminate
the surface.
Repeat to
the other
gums while
examining
Smooth,
white,
shiny
side
the inner
lips and
tooth enamel
penlight to assist
Pinkvisualization,
buccal*Using
mucosa
gums
move a finger along the
cheek.
Another
Moist,
firm
texture to
finger may be moved outside
gums the cheek.
*Examine the back of No
the retraction
teeth
of
*Inspect the gums around
gumsthe molars.
Check the for bleeding, color and
retraction, edema and lesions.
*assess the texture of the gums.

9. Inspect for dentures

Smooth and intact

dentures

Missing teeth; ill

fitting dentures
Brown or black
discoloration of the
enamel
Excessive red gums
Spongy texture;
bleeding, tenderness
Receding atrophies
gums; swelling that
partially cover the
teeth
Ill-fitting dentures;
irritated and excoriated
area under dentures

Tongue/Floor of the mouth

14. Palpate the

Smooth and
Swelling and
10. Inspect thetongue
surfaceand
of floor
Central
positon

Deviated
palpable nodules
nodules from center
the tongue for of
position,
damage CN VII
the mouthforPink color
color,12.
and
texture.
Moist,
slightly
Inspect
thenodules,
Smooth
tongue
Swelling and (hypoglossal)
any
ask base
the client
to
rough; thin and
of the
ulceration Excessive trembling
lumps,
orbase with
protrude
theand,
tongue.
whitish
coating
Smooth, red tongue
tongue
the prominent
veins
excoriated
areas
(may indicate iron,
mouth floor
anda piece of Smooth, lateral
Use
margins; no lesions
vit B12 or vit B3
the frenulum
gauze and grasp
Raised papillae(taste
deficiency)
Ask the client
towith the
the tip
Dry and furry tongue
place the tip
of hand use buds)
other
the
Nodes, ulceration,
the tongueindex finger
discolorations;
against the
roof the back
palpate
areas of tenderness
of the mouth
of the tongue, its
11.Inspect tongue
Restricted mobility
border andMoves
base freely; no
movement
tenderness
Ask the client to roll
the tongue upward and
move it side to side

Salivary gland
14. Insect salivary duct
openings for any
swelling or redness

Same color of buccal

mucosa and floor
mouth.

Inflammation(redness
and swelling

Palates and Uvula

15. Inspect the hard
and soft palate for
color, shape, texture,
and presence of bony
prominences

16. Inspect the uvula

position and the
mobility while
examining the
palates

Light pink, smooth,

Discoloration
Palate
soft palate
samewide
color
Open
the mouth
and
Lighter pink hard tilt theIrritation
head backward.
Exosomes(bony
palate, more
Then,
depress the tongue
irregular texture
growing
usinggrowth)
tongue depressor.
from thefor
hard palate
Use penlight
appropriate visualization
Positioned in midline Deviation to one side
of soft palate
from tumor or
trauma; immobility
( cn #5 trigeminal or
cn #10 vagus )

Oropharynx and Tonsils

To expose the one side of the oropharynx, press a
17. Inspect the
Pink and
smooth
Reddened
or
tongue depressor
against
the tongue on
the same
oropharynx for
the
posterior wall
edematous; presence
side.
color and texture. One
of lesions, plaque or
side at a time to avoid
drainage
eliciting gag reflex.

20.DOCUMENT
FINDINGS

19. Elicit gag

18. Inspect

reflexesthe
by
tonsils
( behind
pressing
thethe
fauces
) for color,
posterior
tongue
discharge,
and

with tongue
size,depressor

Present
Pink and
smooth
No discharge
Of normal size
or not visible
Grade 1
(normal):
The tonsils are
behind the
tonsillar pillars

Absent may
Inflamed
indicate
Presence
problems
withof
discharge
glossopharynge
Swollen
al (CN#9)
or
Grade
2
Vagus
(CN#10)
Grade 3
nerves
Grade 4