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Clinical Evaluation, continued

The Examination
Examine both the hard and soft tissues, including the lips, gums, teeth, tongue, cheeks, and palate.

Examine closely along the gum line for plaque and dental caries at any stage of progression, such as a white spot lesions or cavitation.

What to Look For
A thorough examination requires lifting the upper lip and lowering the bottom lip to check along the gum line. Look for the following:

 
Inflammation of the gums (
Gingivitis: Inflammation of the gums.
gingivitis)
 
Ulcers or abscesses
 
Caries
 
Bullet
Masses
 
Enamel defects
 
Pattern of tooth eruption
 
Malocclusion: An abnormality in the coming together of teeth.
Malocclusion or misalignment
 
Evidence of trauma; chipped, broken or missing teeth

Documentation
Document all findings and refer children with abnormalities to a dental provider.

 
 
A complete oral examination should be part of every routine visit, starting at 6 months of age.
 
The most important tools include a good light source and a tongue depressor.
 
The knee-to-knee exam is often best for young children.
 
It is important to examine the gum line for plaque and all stages of dental caries, as caries usually begin along the gum line.
 
It is important to document all findings and refer any abnormalities to a dental provider.
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