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Extra-Oral Observation Paper

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The extra-oral exam includes an observation of Rangi’s demeanor and general state of health. As mentioned before, observation should commence as soon as the patient enters the clinic and this should be continued while taking the history as already discussed above. Careful observation aids identifying risk factors for disease. For example, I will note changes in the skin, lips and general appearance as this will give me clues about nutrition and general health. I will observe if Rangi is breathing through his mouth or nose as a study by Nascimento-Filho, Mayer, Pontes, Pignatari, and Weckx (2004) have shown that mouth breathing may increase the risk for caries not only of the anterior teeth but also of the posterior teeth since desiccation of oral hard and soft tissues increases the numbers of Streptococcus mutans, a known pathogen for dental caries. …show more content…
According to Wilkins (2013), asking permission to touch a patient would reduce miscommunications about the violation of personal space during the extra-oral and intra-oral examination as there are cultural differences to consider. For example, when examining his lymph nodes for signs of infections, I will tell him I will touch his skin around his head and neck to feel for “lumps” as this could be a sign that the body is trying to fight infection (McKinley, O'Loughlin, & Bidle, 2013). This tells him what I am going to do and why it is important to do it. I will also palpate his temporomandibular joint (TMJ) by placing my fingers gently over the skin in front of his ears then ask him to open and close his mouth. This will allow me to detect sign of TMJ disorders such as pain in the preauricular area, deviations in jaw movemenent, clicking sounds during jaw movement (Wilkins, 2013). I will also look for signs of cellulitis such as swelling, facial asymmetry, trismus and pain (Robertson, Keys, Rautemaa-Richardson, Burns, & Smith,

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