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{{Oral cancer}}
{{Oral cancer}}
{{CMG}}{{AE}}{{Simrat}}
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==Overview==
==Overview==
Common physical examination findings of oral cancer include a lump or thickening in the oral soft tissues, soreness, difficulty chewing or [[swallowing]], ear [[pain]], difficulty moving the jaw or [[tongue]], [[hoarseness]], [[numbness]] of the tongue or [[swelling]] of the jaw that causes dentures to fit poorly.
Common [[physical examination]] findings of oral cancer include a lump or thickening in the [[Soft tissue|soft tissues]] of the [[oral cavity]], soreness, difficulty chewing or [[swallowing]], ear [[pain]], difficulty moving the [[jaw]] or [[tongue]], [[hoarseness]], [[numbness]] of the [[tongue]], or [[swelling]] of the [[jaw]] that causes dentures to fit poorly.
==Physical Examination==
==Physical Examination==
A thorough head and neck examination should be a routine part of each patient's dental visit and general medical examination.
* A thorough [[Head and neck anatomy|head and neck]] examination should be a routine part of each patient's dental visit and general medical examination.
===Oral Cavity Examination===
 
The [[extraoral]] and [[perioral]] [[tissues]] are examined first, followed by the [[intraoral]] tissues.
===Appearance of the patient===
====The Extraoral Examination====
* The patient may appear ill and [[cachexic]].
The extraoral assessment includes [[inspection]] of the face, head, and neck.
 
*The face, ears, and neck are observed for any asymmetry or changes on the skin such as crusts, fissuring, growths, or color change.
=== HEENT ===
*[[Lymph nod]]e areas are bilaterally palpated to detect any enlarged nodes. If enlargement is detected, determine the mobility and consistency of the nodes.
* Dental practitioners and dental care professionals should examine the teeth and entire [[oral mucosa]].  
====Perioral and Intraoral Soft Tissue Examination====
* Most common involved sites in the [[oral cavity]] include:
The perioral and intraoral examination procedure follows a seven-step systematic assessment of the [[lips]], [[labial]] mucosa and sulcus, commissures, buccal mucosa, and sulcus; gingiva and [[alveolar]] ridge, tongue, floor of the mouth, and hard and soft [[palate]].
** [[Tongue]]
*[[Observe]] the lips with the patient's mouth both closed and open. Note the color, texture and any surface abnormalities of the upper and lower vermilion borders.
** Lateral and ventrolateral aspects of mouth
*With the patient's mouth partially open, visually examine the labial mucosa and sulcus of the [[maxillary]] vestibule and frenum and the [[mandibular]] vestibule.
** Floor of mouth
*Observe the color, texture, and any [[swelling]] or other abnormalities of the [[vestibular]] mucosa and [[gingiva]].
* Lesions such as [[ulcers]], red or white patches may be visible.
*Retract the buccal mucosa. Observe any change in pigmentation, color, texture, mobility, and other abnormalities of the mucosa.
* Any [[ulcer]] with a duration that persists for more than 3 weeks then it should be [[Biopsy|biopsied]].<ref name="pmid24072273">{{cite journal |vauthors=Scully C |title=Rule for cancer diagnosis |journal=Br Dent J |volume=215 |issue=6 |pages=265–6 |year=2013 |pmid=24072273 |doi=10.1038/sj.bdj.2013.884 |url=}}</ref>  
*Examine the [[buccal]] and [[labial]] aspects of the gingiva and alveolar ridges.
*Examine left mandibular posterior [[gingiva]] and [[alveolar]] ridge and move around the arch to the right posterior area.
*Examine the palatal and lingual aspects as had been done on the facial side, from right to left on the palatal (maxilla) and left to right on the lingual (mandible).
*Inspect the dorsum of the [[tongue]] for any swelling, [[ulceration]], coating, or variation in size, color, or texture.
**Note any change in the pattern of the papillae covering the surface of the tongue and examine the tip of the tongue.
**Note any abnormality of mobility or positioning.
**[[Inspec]]t the right and left lateral margins of the [[tongue]].
**Examine the more posterior aspects of the tongue's lateral borders
**Examine the ventral surface.
**[[Palpate]] the tongue to detect growths.
**[[Inspect]] the floor of the mouth for changes in color, texture, swellings, or other surface abnormalities.
**First inspect the hard and then the soft palate.Examine all soft palate and oropharyngeal tissues.
**Bimanually palpate the floor of the mouth for any abnormalities.
**All mucosal or facial tissues that seem to be abnormal should be palpated.<ref>{{Cite web | title = NIH Oral cancer Physical Examination| url =http://www.nidcr.nih.gov/oralhealth/Topics/OralCancer/DetectingOralCancer.htm }}</ref>


===Appearance of the Patient===
The general appearance of the patient is ill appearing, [[cachectic]].
===Ears===
*Ear [[pain]] may be present.
*Ear [[pain]] may be present.
===Throat===
 
*Soreness of the throat may be present.
*Soreness of the throat may be present.
===Oral Cavity===
 
*Difficulty in moving tongue may be present.
*Difficulty in moving [[tongue]] may be present.
*[[Numbness]] of the tongue may be present.
*[[Numbness]] of the [[tongue]] may be present.
*[[Swelling]] of the jaw may be present.
*[[Swelling]] of the [[jaw]] may be present.


==References==
==References==
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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Otolaryngology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]

Latest revision as of 12:51, 11 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]; Grammar Reviewer: Natalie Harpenau, B.S.[3]

Overview

Common physical examination findings of oral cancer include a lump or thickening in the soft tissues of the oral cavity, soreness, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue, or swelling of the jaw that causes dentures to fit poorly.

Physical Examination

  • A thorough head and neck examination should be a routine part of each patient's dental visit and general medical examination.

Appearance of the patient

  • The patient may appear ill and cachexic.

HEENT

  • Dental practitioners and dental care professionals should examine the teeth and entire oral mucosa.
  • Most common involved sites in the oral cavity include:
    • Tongue
    • Lateral and ventrolateral aspects of mouth
    • Floor of mouth
  • Lesions such as ulcers, red or white patches may be visible.
  • Any ulcer with a duration that persists for more than 3 weeks then it should be biopsied.[1]
  • Ear pain may be present.
  • Soreness of the throat may be present.

References

  1. ↑ Scully C (2013). "Rule for cancer diagnosis". Br Dent J. 215 (6): 265–6. doi:10.1038/sj.bdj.2013.884. PMID 24072273.

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