TMJ Disorders and Orofacial.pdf - E-Lib FK UWKS

8 Primary Dental Evaluation
Findings in the Teeth and Mucous Membrane
The intraoral evaluation includes in particular:
• careful evaluation of the mucous membranes
• determination of the status of the teeth, including detec
tion of caries and periodontal disease
• a search for signs of occlusal disturbances and parafunc-
tion (abrasion, wedge-shaped defects, enamel cracks and
fractures, and increased tooth mobility) and
• evaluation of the function of fixed and removable partial
dentures and orthodontic appliances.
11 Intraoral inspection
Dentition of a 35-year-old patient
exhibiting severe damage from
caries and periodontal disease.
There is diffuse radiating pain in the
right half of the face.
12 Diagnosis of caries
Transillumination by placing a co!J
light probe (by EC Lercher) interproximally
reveals caries extending
into the dentin of the second premolar
as evidenced by the increased
opacity of the carious toot!
structure.
Right: The same region as in the left
photograph under regular lighting.
The proximal caries on the mesial of
the second premolar cannot be
seen without the help of a diagnostic
aid.
Contributed by K. Pieper
13 Fractured filling and
fractured dentin
A functionally inadequate filling
with poor marginal integrity is the
cause of dentinal pain.
Right: The dentinal fracture on this
first premolar was detected only
after the occlusal base under the
filling was removed. The patient
had been experiencing paroxysmal
pain in this area upon occlusal loading.
Numerous diseases, both local and systemic, reveal themselves
through changes in the oral mucosa. Therefore the
lips, entire vestibule, alveolar ridge, hard and soft palate,
tonsils, pillars of the fauces, oropharynx, floor of the mouth,
and tongue, including its ventral surface, must be carefully
examined for any rashes, discolorations, coatings, or indurations
(Veltman 1984). Inflammation localized within the
pulp, periodontium, or mucosa can cause pain, varying in
degree from light to excruciating, to radiate to the jaws,
cheeks, eyes, or ears. The pain can be accompanied secon-