Common techniques for Oral Diagnosis

1. "Techniques of Clinical Examination"

2. Techniques of Clincal Examination :-
I. Inspection
II. Palpation
III. Percussion
IV. Probing
V. Auscaltation
VI. Olfaction
I. Inspection
It is the method of see overall of orofacial region
of the patient intraorally and extraorally by eyes
only, with proper illumiation.
It has 2 types :-
1): Passive Inspection
2): ActiveInspection .
*1): PassiveInspection, it is the type which done in
resting state & as _ ( Eyes, Nose , Head , Hair, Ears ).
*2): ActiveInspection, it is the type which done in
movement state & as _ ( Tongue , T.M.J , Hard palate,
Soft palate , Lips , Cheeks , Floorof the mouth ).

3. Requirements for properinspection :-
*1):Proper position of the patient on the dental chair.
*2):Adeuate light source of the dental unit and the
examination room itself .
*3):complete drynesss by cotton rolls or suction tip or
compressed air.
*4):Proper Retraction of the tongue and cheeks by
mirror, cheek retraction , examiner finger , wooden
tongue depresor .
Aims of Inspection :-
*To know about ( color , contour, surface texture ,
functional movement ,Obvious Lesions ).
 Abnormalities may be found by Inspection :-
#(Head) as Frontal Bones are prominent and the height
and breadth of forehead are exaggerated in
“Congenital Syphilis”.
#(Face)as Moon Face in “Cushing Disease”.
#(Eye) as Blue Sclera in “Osteo/Odonto–genesis
Imperfecta”.
#(Tongue) as Hairy Leukoplakia in “H.I.V”.
#(Buccal Mucosa)as “TraumaticUlcer”.
#(Lips)as “AngularCheilitis”.

4. II. Palpation
It`s the method of clinical examination that depends
on sense of touch .
Techniques of Palpation:-
*1):(Bilateral Palpation)_ by using the middle finger and
index finger to examin the structural symmetry as “ T.M.J
, Lymph Nodes and Parotid Gland “.
*2):(Bimanual Palpation )_ by using two hands or two
fingers of both hands to examin “ Cheeks , Floor of the
mouth and if presence of salivary gland stone “.
*3):(BidigitalPalpation)_ by using of two fingers of one
hand to examin thin tissues as “ Lips “.
*4):(Digital)_ by using the index finger to examin “The
soft palate“ , but it is uncommon type of palpationand
done only if necessary as it is uncomfortable.
Aim of Palpation :- check the consistency of the
underlyingtissues as it may be “ Soft , Bony Hard ,
Indyrated , Firm masses , Compressible , Doughy ,
Spongy , Pitting , collapsing”.
Abnormalities may be found by Palpation :-
Fibrosis of minor salivary glands of lips,stones in parotid.

5. III. Percussion
It`s the stricking of the tissues “ soft or hard ” with
instrument or examiner finger and then the examiner
listen to the resulting sound or watches the patient`s
reaction.
It`s 2 Types :-
*1):(Hard TissuePercussion),
# It`s performed by stricking the cusp tip or incisal edge
of each tooth with agentle but firm blow with the blunt
end of mo.17 explorer or the tip of mouth mirror handle,
the blow direction should be in the long axis of the tooth.
#The examiner should be aware of “ The feel of the blow ,
The soundproduced, The reactionof the Patient ” to
check the pulp reaction.
*2):(Soft TissuePercussion),
# This techniqueof percussion of muscles and bone
consists of sharply tapping the area to be tested with the
tips of two or three fingers.
# This method of percussion is of value in observing
muscle reflex mechanisim, muscle tenderness,
hypertonicittyoth muscle of mastication and
demonstration of “ ChvostekSign ”, in latent tetany
tapping over the facial nerve in front of ear causes
twitching of the facial muscles.

6. IV. Probing
It`s the use of a slender device to identify or
determine the extent of a narrow tract or cavity.
It`s done by :-
*1):Explorer which is sharp ended,curveor angulated,
used for :-
-Detection of carious cavity whether occlusal, cervical or
proximal.
-Explorationof deposits on tooth surface.
-Testing local anesthesia.
-Explorationof sinus tract or major salivary gland duct.
*2):Graduated Periodontal Probe, used for :-
-Pocket measurement.
-Caries detection.
-Bleeding points in gingivectomy.
-Testing of local anesthesia.
-Exploringof deposits on toothsurface.

7. V. Auscaltation
It`s process of listening to the sounds made by various
body structures.
It`s done by use of “ Stehoscope”.
For detection of :-
1):T.M.J troubles as clicking .
2):Thyroid Thrill , in thyroid gland enlargement.
VI. Olfaction
It`s sense of smell occasionallyto get diagnostic
information. As:-
#(FoeticOdour) of “ ANUG ”.
#(Garlicor Bad Odour) of “ ChronicPeriodontitis ”.
#(Acetone Odour) of “ Diabetes ”.
#(UrineSmell) of “ Renal Failure”.
#(Amine-likeOdour) as freshly open corpse in
“ advancedliver disease”.