Fig. 3.10 Example of annotated sketch used to record trauma.
3.4.4 Intraoral examination
A systematic approach should be adopted for the intraoral examination. The following
is a suggested order:
- soft tissues
- gingival and periodontal tissues
- teeth
- occlusion.
Soft tissues
An abnormal appearance of the oral soft tissues may be indicative of an underlying
systemic disease or nutritional deficiency. In addition, a variety of oral pathologies
may be seen in children (see Chapter 15). It is therefore important to carefully
examine the tongue, palate, throat, and cheeks, noting any colour changes, ulceration,
swelling, or other pathology (Fig. 3.11).
It is also sensible to check for abnormal frenal attachment or tongue-tie, which may
have functional implications. If a tongue-tie or abnormal tongue function is observed,
some consideration should be given to the child's speech. During examination of the
soft tissues, an overall impression of salivary flow rate and consistency should also be
gained.
Gingival and periodontal tissues
A visual examination of the gingival tissues is usually all that is indicated for young