Authors: Kristin Greenwood, PT, DPT, MS, GCS, Assistant Clinical Professor of Physical Therapy, and Alycia Markowski, PT, DPT, FAAOMT, OCS, Associate Clinical Professor of Physical Therapy, from the Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Heath Professions, Northeastern University.
Topic | Oral examination and dental referral |
Academic Focus | Clinical skills |
Target IPEC Competencies | Domain: Values and Ethics
Work in cooperation with those who receive care, those who provide care, and others who contribute to or support the delivery of prevention and health services. |
Target HRSA Competencies | Domain: Oral Health Evaluation
Perform oral health evaluations linking patient history, risk assessment, and clinical presentation. Domain: Interprofessional Collaborative Practice Exchange meaningful information among health care providers to identify and implement appropriate, high quality care for patients based on comprehensive evaluations and options available within the local health delivery and referral system. |
Learning Objectives | Describe the health status of the patient’s teeth and gums. Identify abnormal lesions. Provide anticipatory guidance. Communicate appropriate referral, if needed, with appropriate time frame. |
Background information. This simulation was pilot tested with a group of Doctor of Physical Therapy students to integrate oral health evaluation and dental referral into a class session on temporomandibular joint (TMJ) disorders and treatment. Some of the exercises can be adapted for use with students of other health professions.
Overview for instructors. This simulation can be performed in any type of environment necessary (i.e., clinic, bedside, doctor’s office, or classroom). It
will allow students to practice an oral examination, provide patient education and recommendations, and make a dental referral.
Materials provided in this toolkit.
Additional materials.
Instructor preparation.
Student preparation.
Schedule.
This simulation will take each group approximately 40 minutes to complete.
Live demonstration (15 minutes). To best prepare your students, perform a live demonstration of the oral exam before conducting the simulation. If time allows, consider teaching Workshop 1. The Oral Examination, located in Chapter 4. Faculty Development.
Simulation orientation (3 minutes). Review the learning objectives.
Review the simulation process with the students.
Simulation (10 minutes).
The provider should refer to the Critical Items Checklist for Simulation 1 and complete the Provider Notes Worksheet during the clinical encounter.
Debrief (10 – 12 minutes). After each simulation, generate open discussion about the exercise by inviting reactions from both the standardized patient(s) and the students. To begin discussion, review the questions included on the Provider Notes Worksheet.
For further prompting, you can ask the students to consider the patient history and specific clinical findings as they relate to the following questions.
You are a physical therapist. A patient comes to you complaining of headaches and jaw pain.
Patient information.
Name: Alex
Age: 21
Occupation: Student
Reason for visit: Headaches and jaw pain due to previously diagnosed TMJ dysfunction.
As her physical therapist, you decide to perform an oral examination and make several observations.
Alex reports that she has not seen a dentist since starting college because she does not know any local dentists. An oral examination reveals red and swollen gums with moderate to heavy plaque accumulation.
Photo: public domain
Alex should receive a dental referral from the provider before she leaves.
You are a physical therapist. A patient comes to you complaining of headaches and jaw pain.
Patient information.
Name: Alex
Age: 21
Occupation: Student
Reason for visit: Headaches and jaw pain due to previously diagnosed temporomandibular joint (TMJ) dysfunction.
As her physical therapist, you decide to perform an oral examination and make several observations.
Alex is unable to open her mouth completely and has a large red bump on her gums, right under one of her back teeth. The tooth looks like there is a cavity present. Alex reports the area is very painful and won’t stop throbbing.
You are a physical therapist. A patient comes to you complaining of headaches and jaw pain.
Patient information.
Name: Alex
Age: 21
Occupation: Student
Reason for visit: Headaches and jaw pain due to previously diagnosed temporomandibular joint (TMJ) dysfunction.
As her physical therapist, you decide to perform an oral examination and make several observations.
Alex reports that she smokes about a pack of cigarettes a week and has done so for the past four years. During the examination, you find a white and red lesion on the base of Alex’s tongue. Alex says she noticed the lesion about a month ago but didn’t think it was a big deal.
Photo: public domain
First Published: 11/2015
Last updated: 03/2016