Oral examination

Examination of the oral cavity includes examination of the lips, teeth, gums, tongue, palate, tonsils, mucous membranes of the cheeks and pharynx.

Teeth and gums

The number of teeth in many ways determines the effectiveness of the chewing process, which may not be thorough enough in the absence of molars. Changing the color of the teeth is often associated with smoking and poor hygiene practices. Dental caries are often found, which requires treatment by a dentist.

Sometimes progressive tooth caries is combined with other symptoms of so-called dry syndrome. A characteristic manifestation of gum disease is pyorrhea ( periodontal disease ), accompanied by bleeding and the appearance of a narrow band of inflammation of the free edge of the gums. When the process progresses between the teeth and along the edge of the gums, pus accumulates, creating conditions for the emergence of transient bacteremia (green streptococcus), which must be taken into account in patients with rheumatism.

Language

The movements of the tongue are important for the evaluation of certain disorders of the central nervous system. At the same time pay attention to the symmetry and size of the language, its mobility. An increase in the tongue (c) occurs with certain diseases, for example amyloidosis. The color of the tongue sometimes depends on the characteristics of the food. Usually it is pink or red with papillae on its surface. The tongue is covered with plaque with digestive disorders. Especially should pay attention to the appearance of a bright red color ( "raspberry" tongue) and the smoothness of the mucous membranes of language ( "lacquered" language) - "gyunterovsky language", which is very typical for a number of deficiency diseases, but especially for the deficiency of vitamin B ₁₂.

Tonsils

Tonsils are the lymphoid formations, located between the anterior and posterior arch in the mouth to the pharynx. They reach a maximum value at the age of 8 to 12 years, and then undergo involution. They are possible to increase and inflammation with exacerbation of streptococcal infection, infectious mononucleosis, diphtheria.

The condition of salivary glands is often judged by the sensation of dryness in the mouth (xerostomia), which indicates their hypofunction. Xerostomia in combination with xerophthalmia and dry keratoconjunctivitis (the result of disturbed tear production) is the so-called dry syndrome, in which joints, lungs, pancreas and other organs can be affected. Occasionally, the parotid gland is enlarged. Parotitis is observed in sarcoidosis, tumor damage, alcoholism, and most often it has an infectious origin ("mumps").

Change (ulceration) of the oral mucosa occurs with aphthous stomatitis, and patients have very unpleasant sensations. Stomatitis with ulceration can also occur in chronic tumorous diseases, such as acute leukemia, as well as agranulocytosis. A characteristic form is candidal stomatitis, which is observed with prolonged intensive treatment with antibiotics and immunosuppressive agents. A number of acute infections is accompanied by the appearance on the mucous membrane of the oral cavity of peculiar rashes, which can be guided by the diagnosis (for example, the spots of Velsky-Filatov-Koplik in patients with measles). Perhaps icteric staining of the mucosa, especially the tongue (hyperbilirubinemia), in addition, there are telangiectasias ( Randu-Osler's disease ).