t/f for an intraoral exam a checklist is best to be used for keeping record?
false-no checklist
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
recurrence
duration, changes
symptoms
what five things must you not when charting the location and extent?
location in relation to other structures
localized
generalized
single lesion
multiple
what two things must be charted when documenting shape and size?
length and width
height
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
hard
indurated
define indurated
abnormally hard
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?
dental professional
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
leukoplakia
what kind of cancer is white?
leukoplakia
describe leukoplakia
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
true
describe a read area of oral cancer
velvety
small ulcers
erythroplakia
describe erythroplakia
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?
the dentist
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?
class III
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?
