Mouth[1]

Assessing the Mouth and Oropharynx

Smile your Heart Out

Anatomy of the Mouth • Following areas need to be assessed: – – – – – – – – – –

Lips Mucous Membranes Gums Teeth Tongue Salivary Glands Hard and Soft Palate Tonsils Tonsilar Pillars Posterior Oropharynx

Mouth and Oropharynx • Function – Vocalization – Air Passage – Passage for Food – Initiation of Digestion – Sensory Organ

Mouth Problems • • • • • • • •

Dental caries Periodontal disease (pyorrhea) Plaque Tartar Gingivitis Glossitis Parotitis Sordes

Assessing the Mouth and Oropharynx • Inquire if the client has any history of the following: • Routine pattern of dental care, last visit to dentist • Length of time ulcers or other lesions have been present • Denture discomfort • Medications client is receiving

Lips and Buccal Mucosa • Inspect the outer lips for symmetry of contour, color, and texture • Uniform pink color, soft, moist smooth texture • Ability to purse lips • Symmetry of contour

Inspect and palpate the inner lips and buccal mucosa for color, moisture, texture and presence of lesions

Teeth and Gums • Inspect the teeth and gums while examining the inner lips and buccal mucosa • Inspect the dentures

Tongue/Floor of the Mouth • Inspect the surface of the tongue for position, color and texture • Inspect the tongue movement

Tongue/Floor of the Mouth • Inspect the base of the tongue, the mouth floor, and the frenulum • Palpate the tongue and the floor of the mouth for any lumps, nodules or excoriated areas

Palates and Uvula • Inspect the hard and soft palate for color, shape, texture and the presence of bony prominences • Inspect the uvula for position and mobility while examining the palate. Ask the client to say “ah” so that the soft palate rises

Oropharynx and Tonsils • Inspect the oropharynx for color and texture • Inspect the tonsils for color, discharge, and size • Elicit the gag reflex by pressing the posterior tongue

Lifespan Considerations • Infants: • Inspect the palate and uvula for a cleft • First teeth erupt at about 6 to 7 months of age

CLEFT LIP

CLEFT PALATE

Lifespan Considerations • Children • White spots on the teeth may indicate excessive fluoride ingestion • Drooling is common up to 2 years of age • Tonsils are normally larger in children than adults it may extend beyond the palatine arc until the age of 11 or 12 years old

Lifespan Considerations • Elders • Oral mucosa may be drier than that of younger persons • Taste sensations diminish • Teeth may show signs of staining, erosion and abrasion • Gag reflex may be sluggish