Examination and important pathological changes of the lips and oral cavity

Inspection of the oral cavity must be performed as a cancer screening.

Lips
We assess:
 * color,
 * swellings,
 * splits,
 * ulcers,
 * blisters.

For example


 * Muave – in cyanosis;
 * pale – anemia;
 * stomatitis angularis – cracked lips in the corners – in Ariboflavinosis, acute Dental caries|;
 * herpes labialis.

Oral Cavity
Bad breath:
 * foetor hepaticus – liver failure,
 * acetone – diabetes mellitus,
 * ammonia – uremia.

Gingiva
We assess firstly by aspection. During the examination we can find signs that could be warning flags of a serious general disease.

Necrosis:
 * leukemia,
 * marrow attenuation,
 * agranulocytosis.

Color stripes:
 * in case of heavy metal poisoning.

Gingival bleeding: Hyperplastic gingiva:
 * gingivitis,
 * parodontitis,
 * disorders of clotting and coagulation,
 * deficiency of vitamin C (scurvy).
 * antiepileptics,
 * pregnancy.

Teeth
Firstly we assess the overall condition of teeth. Color of teeth is important for the diagnosis of diseases.

'Overall condition:
 * dentition complete/incomplete,
 * own/teeth prosthesis.

Tongue
The tongue protrudes in middle line physiologically. Jazyk fyziologicky plazí ve střední čáře. We have to focus mainly on size, position, color, papillae, mobility, impressions and ulcers.

Coating – is always presented – food residues, bacteria, endothelium.

Paralysis:
 * peripheral - glossoplegia,
 * central – always on one side – on steam, radical

Other pathologies, e.g..:
 * bitten – epilepsy,
 * Hunter glossitis – during anemia of deficiency Vitamin B12,
 * macroglossia – acromegaly,
 * xerostomia – dry mouth,
 * tongue ulcers:
 * tumors,
 * syphylis,
 * tuberculosis.

Mucosa of Oral Cavity

 * Candidiasis – Candida albicans – white tufts which are well wiped from the mucosa at the beginning, later they combine to form of a gray coatings which adhere to the mucosa
 * Graphite spots – Addison´s disease

Tonsils
Tonsils are trophic or hypertrophic. There might be coating or stones, sometimes there is visible redness. It is important to assess whether the tonsils are symmetrical.

Pharynx
The pharynx is physiologically smooth and wet, during inflammation the nodules are formed and it si congested.