 To be aware of elements examined during

clinical assessment and role of the dental

nurse

 To know the purpose of carrying out a clinical

assessment & be familiar areas checked during
intra & extra oral assessment
 To distinguish between BPE scores and & 6 point
charting
 To identify the different patient records and their
uses
 Know the legislation related to patient records

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 Clinical assessment of a patients oral health
is an examination of the condition of the:-

 Extra oral and intra oral tissues

 Soft tissues
 Dentition
 Periodontal tissues

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 Visual inspection to detect visible problems
 Manual inspection to feel abnormalities
 Use of mouth mirrors for intra oral and tooth
assessments
 Uses of probes for tooth inspection (briault & right
angled)
 Uses of periodontal probes for periodontal tissue
inspection
 Use of caries dye and trans-illumination

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 To identify any problems

 Carry out further investigation

 Formulate an agreed treatment plan

 Promote the prevention of cavities and

periodontal disease

 Early detection of any problems can prevent the

condition becoming worse

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 Skin colour – nervous
patients appear pale and
clammy as they are about
to faint

 Lips – examined for

blemishes, cold sores,
minor salivary glands cysts

 Lips tinged bluish- purple

indicate some degree of
chronic heart failure which
needs noting before LA is
given and traumatic dental
procedure is carried out
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Lymph nodes Facial symmetry

are part of the bodies  Where one side of the

immune system and face is shaped
any enlargement of differently, this could
these indicates that the indicate the presence
body is fighting of
infection or some  Swelling
disease process.  Muscular control
Further investigation is  Problems with nerve
required supply

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 Medical History
 Intra oral exam
◦ Check on condition of
teeth noted onto chart
using Palmers Notation as
seen on an NHS Record
card
◦ Teeth
 Caries using indirect and
direct methods
 Fractures
 Gingivae
 Genetical or structural
abnormalities e.g.
Amelogenesis imperfecta
 Staining – intrinsic and
extrinsic, tetracycline
 Non vital teeth
 Oral Mucosa
◦ Tongue
◦ Sulcus
◦ Palate
◦ Lips for ulceration
◦ Possible malignant sites
(important for people at
risk from oral cancer
◦ Condition of gums using
either BPE or full
periodontal charting (6
pocket charting)
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 There are a number of systems available which
include:-
 The Zsigmody Palmer chevron or set square system
 Mouth divided into quadrants and adult teeth
identified by numbers whereas deciduous teeth are
identified by letters

 The FDI (2 digit system)

 Each quadrant is given a number and each tooth is
identified by the quadrant number as well as tooth
number

 The European system

 The American system

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 0 1 2
BPE Scores
2 3 4

BPE probe/CPITN used

 Code 0 -healthy gums, no bleeding
 Code1-bleeding on probing, pocket <3.5mm
 Code2 plaque retention factors pocket < 3.5mm
 Code3 – pocket up to 5.5mm
 Code4 – pocket >5.5mm
 Code * - furcation involvement, or recession &
pocket depth 7mm or more

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 Higher BPE codes indicate more serious
periodontal problems

 Any patients with scores of code 3,4 or * require

individual pocket depths recorded on a
periodontal chart

 6 measurements are taken on each tooth using a

CPITN probe also called william’s probe or
graded probe
 Other factors recorded include bleeding on
probing, calculus, recession, mobility(grade 1-3)
 Nabers furcation probe
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 Research and write short notes on the
caldicott principles

 What is Gillick competence?

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