ORAL EXAMINATION
Before performing an oral examination, you should review the patient's medical and dental histories. Note the medications the patient is currently taking. The dental health questionnaire should be updated if any significant changes in the patient's health status have occurred since the form was last updated by the patient.

When you examine the oral cavity, use a thorough and systematic approach. You must have a knowledge of the normal dental anatomy and histology to recognize oral diseases and injuries. The chief complaint that brought the patient to seek treatment will fall into the category of either an oral disease or condition or an oral injury.

The following are brief descriptions of the major oral diseases or conditions and oral injuries that may be seen during an oral examination.

· Dental caries are the result of localized decay of the calcified tissues of teeth. Bacterial plaque is the most common cause of dental caries. Bacteria release acids and other toxins that attack tooth enamel and produce carious lesions called cavities.

· Acute pulpitis is a severe inflammation of the tooth pulp. Usually, it is the result of dental caries.
· A periapical abscess usually results from an infection of the tooth pulp, often developing as a result of unchecked pulpitis.
· Gingivitis is an inflammation of the gingival tissue. The most frequent cause of marginal gingivitis is poor oral hygiene.
· Necrotizing ulcerative gingivitis (NUG) is a severe inflammation of the gingival tissue. NUG may be also referred to as trench mouth. NUG is not contagious.

· Periodontitis is an inflammatory condition that involves the gingivae, the crest of the alveolar bone, and the periodontal membrane above the alveolar crest.

· Aperiodontal abscess is caused by an infection in the periodontal tissues.

· Pericoronitis is an inflammation of the gingiva around a partially erupted tooth. It may also result from constant contact between the tissue flap and a tooth in the opposing arch.

· Stomatitis is an inflammation of the oral mucosa.

· Recurrent labial herpes is an infection that produces a fever blister or cold sore. Such a lesion is usually found on the lip.
· Postoperative hemorrhage may occur any time from a few hours to several days after a tooth extraction. The bleeding from the extraction site may be light or heavy. Treat all abnormal postextraction bleeding as serious.

· Alveolar osteitis, also known as dry socket, results when a normal clot fails to form in the socket of a recently extracted tooth. Since this condition is usually very painful, always consider it a serious emergency.

· Pain in fractured teeth usually results from the irritation of the pulp tissue. Additional information concerning the types of fractures is contained in chapter 6 of the Dental Technician Training Manual, Volume 1, NAVEDTRA 12572.

DENTAL RECORD
Each service member's military dental treatment record consists of a Dental Record Jacket, NAVMED 6150/21-30, containing dental treatment forms. The form used to record dental treatment is EZ603A. It is imperative that all forms documenting patient care contain adequate treatment information. Additional information concerning dental forms is contained in chapter 2 of the Dental Technician Training Manual, Volume 2, NAVEDTRA 12573; and chapter 6 of the Manual of the Medical Department, NAVMEDP-117.

SECTION SUMMARY
When dental emergencies occur and dental facilities are not readily available, medical personnel are expected to perform basic emergency dental care. This section has provided basic information on fundamental dental histology and a variety of dental conditions. We also discussed the importance of dental record maintenance and dental forms used by medical personnel.

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