The Intraoral and Extraoral Exam
Conclusion

This course has been presented to enhance the skills of practicing dentists and hygienists. We learn to perform a complete exam during our educational programs, but the ideal clinical environment and expectations sometimes change the further away we get from those formative years. The sequence may change, how we remember key points may become vague and the pressure to keep a schedule makes the oral cancer examination less likely to be performed in its entirety. This CE course has been presented in a logical sequence with key points related to normal and abnormal findings.

We have also included some documents that may be used in an office to make the patient aware that a complete oral cancer examination has been performed:

• Appendix A. Your Oral Cancer Examination – A form that may be used stating that the dental professional has just performed an oral cancer examination as part of the dental office visit. Check off the appropriate boxes on the form and fill in the required information. Inform the patient what changes to watch for if the “Watch area for changes” box is checked and tell them what to do if changes are noted. If the “Follow-up dental appointment required” box is checked write in when the appointment should be scheduled, 2 weeks, 2 months, 3 months etc. Describe changes the patient might see if the area being watched begins to progress and tell them to contact the office immediately if these changes are seen. Inform the patient that if they think the area has returned to normal they should still return for the follow-up appointment to confirm the status of the previous lesion. If a “referral required” box is checked briefly describe the condition the patient is being referred for and to whom they are being referred. Inform them that additional forms containing detailed information about the condition for which they are being referred will be sent to the healthcare provider of their choice.
• Appendix B. Oral Cancer Examination Physician Referral – A form that may be used when a condition requires further evaluation by a physician.
• Appendix C. Oral Pathologist/Oral Surgeon/Oral Medicine Referral Form– A form that may be used when a condition requires further evaluation by an oral pathologist, oral medicine practitioner or an oral surgeon.

Everyone will have their own techniques and approaches to an oral cancer examination; however, telling the patient what is being performed is a key element of the total exam. Since many patients do not know they are receiving an oral cancer examination, we believe that this point should be emphasized. Some offices give patients a button/brochure stating that they have had an oral cancer examination; thereby, calling attention to the fact that the examination is vitally important. The Oral Cancer Foundation provides a lighted tongue blade and instruction on examining the mouth for patients and also buttons that can be given to patients indicating that they have had an oral cancer exam. The buttons can be obtained from the Oral Cancer Foundation at (http://www.oralcancer.org).⁴²