Assessment Step 4: The Oral Exam
The extent of an examination on a cat or dog that is awake depends on patient cooperation. Most pets will allow a brief look at their teeth and oral cavity if approached slowly and gently. Unfortunately some patients with oral disease may be in too much pain for examination without sedation or general Anaesthesia.
Inspecting the Mouth
Hold the head steady in one hand and pull the lips backward to examine how the teeth meet.
Periodontal disease noted on the oral exam
Open and close the mouth several times to evaluate the temporomandibular joints. Note any pain or decreased ability to open or close the mouth on the medical record.
Head types dictate how jaws line up. Generally a scissors bite with the upper incisors touching and located in front of the lower incisors is considered normal in most dogs, including retrievers, beagles, terriers and poodles, as well as domestic short hairs and a majority of cat breeds. In short-muzzled breeds (Pug, Bulldog Burmese, Himalayan and Persians), the upper incisors are positioned behind the lower incisors. Mandibular distoclusion, when the upper jaw extends far in front of the lower jaw, is NEVER considered normal in any breed.
View the hard palate either directly or by using a dental mirror. The front portion has prominent, firm folds called rugae that can be large in some patients. Posteriorly, the hard palate is whitish.
Examine the floor of the mouth. In the front, there is a normal raised nodule with an opening to the mandibular gland (Wharton duct).
Inspect the top surface of the tongue for symmetry and ulceration. Check the area under the tongue for inflammation, swelling, oral masses and foreign material. Healthy gum tissue appears light pink and comes to a thin, sharp margin where it lies against the tooth. Inflammation of the gingiva appears as reddened rounding of the gingival margins, and in cases of advanced gingival bleeding, periodontal pocket formation, recession and/or root exposure.