(BQ) Part 2 book “History taking and clinical examination in dentistry“ has contents: Intraoral examination, establishing the diagnosis, investigations, final diagnosis, formulating a comprehensive treatment plan, levels of prevention. | C H A P T E R 11 Intraoral Examination SOFT TISSUE EXAMINATION Examination of Lips and Labial Mucosa Logically, the intraoral examination begins with the examination of the lips. The exposed red portion of the lips, or the vermillion border, forms a transition between the external skin and the moist mucous membrane of the oral mucosa. Because the overlying epithelium is thin, a normal lip shows the characteristic reddish color. Several folds and sulci over the epithelium of the lip may crease the skin. The thick, pink labial mucosa that line the internal surfaces of the lips may appear mildly lumpy or nodular on visual inspection. This is due to the presence of accessory salivary glands found just beneath the mucosal surface. Both the upper and lower lips have a flap of tissue called a frenum or frenulum, which attaches to the midline mucosa of the maxillary and mandibular alveolar processes. The clinical features of normal lips and labial mucosa are: •• Reddish color over the area •• Folds and sulci over the surface of lips •• Absence of any plaque or patchy area •• Absence of any erosive areas. The lips and the labial mucosa are examined by the observation of the patient at rest. The lips are normally in contact or slightly apart. The lip line, the level of the edge of the lip should be noted, both at rest and when the patient smiles. Any abnormalities should be carefully noted and recorded. A careful evaluation of the lip by bidigital palpation is done 166 History Taking and Clinical Examination in Dentistry using the index finger and the thumb to gently squeeze the lip mass. Any abnormalities to sight or feel are carefully recorded. The lips are thus recorded for: •• Competency •• Color •• Texture •• Fissuring •• Shape •• Presence of any lump or hard tissue. Some of the common conditions that manifest as lip abnormalities are: 1. Lip pits and commissural pits: These are congenital defects of lip and labial mucosa that result in unilateral or .
