Fig. 1. From left to right; oral endoscope with Clearscope® tachment and oral mirror.
at-
mouth clean. A high-quality head lamp or specu- lum light is a must to facilitate the complete oral exam. Anywhere that feed or organic debris is col- lected must be fully cleaned; this can be achieved with a water source or hand tools.10,11 Once the mouth is open and clean, the entire oral
cavity is examined using a mirror or endoscope. This includes every surface of and the periodontia of each tooth. Areas with continued food packing, gingival hyperplasia, gingival recession, and gingi-
val inflammation are noted for further examina- tion.9,10 (Fig. 4) If an area of concern is identified, it is completely cleaned of organic debris and the mirror or endo- scope, along with the periodontal probe, are used to quantify the extent of the periodontal lesion as closely as possible. This is, again, often painful for the patient and local anesthesia distal (caudal) to the area in question can be used to facilitate ease of cleaning and examination, if the patient is reac- tive.13 The author places local anesthesia in the palatal ridges or the buccal/lingual gingival reflec- tion by using a 23-ga butterfly catheter attached to a 3-mL syringe and by placing 20 mg of mepivacaine in two to three locations, again, distal to the lesion.14
