Examination of the oral cavity (mouth) may reveal findings pointing to an underlying systemic condition, and allow for early diagnosis and treatment.
Oral examination should include evaluation for:
- mucosal changes
- periodontal inflammation and bleeding
- condition of the teeth
Examples of lesions:
- Oral findings of anemia may include mucosal pallor, atrophic glossitis, and candidiasis.
- Oral ulceration may be found in patients with lupus erythematosus (SLE), pemphigus vulgaris, or Crohn disease. Oral manifestations of lupus erythematosus may include honeycomb plaques (silvery white, scarred plaques); raised keratotic plaques (verrucous lupus erythematosus); erythema, purpura, petechiae, and cheilitis.
Oral findings in patients with Crohn disease may include diffuse mucosal swelling, cobblestone mucosa, and localized mucogingivitis.
- Diffuse melanin pigmentation may be an early manifestation of Addison disease.
- Periodontal inflammation or bleeding should prompt investigation of conditions such as diabetes mellitus, human immunodeficiency virus (HIV) infection, thrombocytopenia, and leukemia.
- In patients with gastroesophageal reflux disease (GERD), bulimia, or anorexia, exposure of tooth enamel to acidic gastric contents may cause irreversible dental erosion. Severe erosion may require dental restoration.
- In patients with pemphigus vulgaris, thrombocytopenia, or Crohn disease, oral changes may be the first sign of disease.