t/f for an intraoral exam a checklist is best to be used for keeping record?
why can't you use a checklist for record keeping on an intraoral exam?
need space to write and take notes and describe
what must be kept in the records of an intraoral exam?
- complete description
- follow-up exam
in obtaining the history about a lesion what things must you ask the patient (5)
- lesion known or unknown
- first noticed
- duration, changes
what five things must you not when charting the location and extent?
- location in relation to other structures
- single lesion
what two things must be charted when documenting shape and size?
how is the shape and size measured?
mm with the probe
what colors are common for a lesion?
red, pink, white, red/white
what colors are rare with a lesion
purple, blue, gray, yellow, black and brown
how do you describe the surface texture of a lesion?
smooth or irregular
what three things describe the consistancy
- soft, spongy, resillient
what are the three types of blisterform? describe each
- vesicle-white small 1 cm or less contains cirum
- pustule-yellow fluid-medium more than 1 cm or less
- bulla-large filled with fluid more than 1 cm, can contain blood
what are the four types of nonblisterform? describe each
- papule-less than 5mm (pinhead) solid pointed round or flat
- nodule-bigger 1-5mm white or pink
- tumor-2 cm or greater can be benign or malignant
- plaque-large generalized white area, raised lesion broad flat top larger than 5 mm
what are the two types of depressed lesions?
- ulcer-concave, loss of continuity of epithelium, center gray or yellow with red border results from rupture of raised lesion. Usually means healing stage
- erosion-bigger than plaque, shallow and doesn't go into epithelium
what are the characteristics of a flat lesion?
- single or multiple
- regular or irregular
- macule-flat lesion
what is the number one defense for oral cancer?
what is the main objective of the IO exam?
detect oral cancer early
where is the most common location for oral cancer?
floor of mouth and lateral borders of the tongue
what is the job of the dental hygienist in the oral cancer screening?
identify abnormalities and bring to the attention of doctor, not our job to diagnose
who can perform an oral cancer screening?
- the patient (teach them)
- dental team
what do whiter areas of oral cancer look like?
- filmy to thick
- fissures, ulcers, indurations
what kind of cancer is white?
- white patch or plaque
- buccal mucosa
- cannot be scraped off with gaze
- fungus (antibiotics)
t/f if a white patch scrapes off and is red underneath you note it and bring it to the attention of the doctor
describe a read area of oral cancer
- small ulcers
red patch or plaque
t/f palpation of an ulcer reveals induration
true-hard nodule or is hard underneath
t/f masses are below normal mucosa and can be palpated
true-usually fixed not movable
what is the pigmentation of early cancer?
brown or black
what are two diagnostic aids for detecting oral cancer
- toluidine blue-stain tissues with a biopsy
- chemiluminescence- a light used to show different tissues
what is an excisional biopsy?
entire lesion is removed
what is an incisional biopsy
sample of lesion is taken
what are some indications to take a biopsy?
- unusual lesions
- 2 weeks without healing
- mass-doesn't break the surface of epithelium
who makes the decision to take a biopsy?
what are the limitations of a cytologic smear
- inefficient-when lesion is clearly pathologic
- surface lesions-only
- heavily keratinized lesions-can't get enough tissue
- not exclusively diagnostic
- false negatives
what is a cytologic smear
sample taken and put on slide
what are the six results possible for a lab report?
- unsatifactory-cells on slide not good enough
- class I-normal
- class II-atypical
- class III-uncertain
- class IV-probably for cancer
- class V-positive for cancer
with what results on the lab report would you refer the pt for a biopsy?
class IV or V
which result on a lab report would you reevaluate?
what would you do if the results on the lab report were a class I or II
monitor and take notes
what would you do with a lab report that comes back negative?
follow up and recheck if lesion is still there (can be a false negative)
what are the four physical characteristics of a lesion to be noted?
- size and shape
- surface texture
new growth of abnormal cells