Q2g1d_OSOP specify other oropharynx
Manually palpate the pharyngeal tonsils areas
hold the tongue with a gauze and pull to examine as far back as possible.
Pull tongue out with a gauze to visually inspect the sides as well
Tongue at rest and patient saying "ahhhh".
hold tongue with 2x2 gauze and move around to view areas
DDS does all oral cancer screening exams
Look in the back of the mouth, and attempt to get the patient to move tongue, or try myself, often cannot visualize, thus the low %. Low Success
grasp tongue in order to evaluate the lateral borders a-p have the patient say ahhh with tongue sticking out and press down tongue with mirror
Wrap the tongue with gauze and gently pull forward and out, then have patient say “ahh”
sometimes cannot see well and simply try just to look back there if malampati class 3 or 4
Have them tilt their head left and right
Examine lateral sides of tongue and palpate apex
check for Mallampatie score and tonsil grade, Depending on patient, an instrument maybe used to depress tongue
Have them protrude tongue when necessary
hold tongue c gauze and have patient say ahhh
grab tongue with gauze to look at lateral borders and palpate hard palate for sponginess
I use a 2x2 and grab the tongue, pull it out and look under and on sides and in back of throat
ask pt to open and relax tongue and depress with mirror. only ask to say "aaahhh" if can't visualize that way first
Pull tongue anteriorly with 2X2 gauze and examine lateral margins of tongue and oropharynx
grab tongue with cotton 2X2 and gently manipulate and position
Only while just looking around while cleaning. My doctor does all the intraoral and extraoral exams. If I see anything different I let dr. Know.
Stick out their tongue and take a deep breath through their mouth
Have pt stick tongue all way out checking bilaterally for striations or anomaly
I also have them stick their tongue out so that all surfaces can be examined and palpated.
Hold tongue with piece of guaze and pull and lift from side to side
Grasp tongue pull it forward, and side to side as well as lift it
I have patients first just say aaahhh WITHOUT sticking out tongue, in no or part visibility then will ask for tongue to be stuck out and aaahhh
hold the tongue with gauze and pull gently while the pt says aaahhh
some times they open enough were you can see everything
Have patient move tongue to one side and then the other
I just push down on back of tongue and have them say ahh. I do not have them stick their tongue out or it will block my view
engage tip of tongue with 2x2 and depress back of tongue with mouth mirror
sometimes you don't need either of the above, and some patients you just can't see
most often pull the tongue forward with a two x two gauze as I look with mirror
Lateral displacement of the tongue is also used.
Also use guaze to pull the tongue forward and sideways
Ask them to sing & observe in native state
use a large mouth mirror to reflect down
Do not press down tongue if all is visible
I grab the tongue with gauze and examine lateral borders of tongue and palpate tonge between thumb and first finger
pull on tongue w/2x2 to retract tongue and inspect bilaterally oropharyngeal fauces
Retract the tongue to the L and R w/ gauze placed on the anterior tongue.
2x2 tug on tongue laterally and outward while visually looking.
grab tongue with gauze square and physically move tongue and look at same time
Have patient open and gasp in air to view easily.
have patient take a deep breath in through their mouth while being wide opened
look in back and press tongue down with mirror if necessary to see better
Hold tongue with gauze, this allows me to also check the lateral borders of the tongue
I found that I can see the best without the tongue stuck out, but depressed and the patient saying aahh.
Please note: in our office the Dr performs the NPE
I have the pt say ahh keeping his tongue inside his mouth bc sticking out the tongue + pressing it usually makes the tongue rise up gagging the pt
pull the tongue out and visually examine posterior and lateral to the tongue
Put my finger on the tongue, it works better
Combination of all of the above, also using a Velscope. Some patients I cannot visualize the oropharynx with any method, airway too narrow, gag, etc.
Ask about history of tonsils/adenoids/ ENT visits
Grab the tongue with guze and gently pull it forward
pull tongue to side with gauge and visually see the oropharynx area with overhead light
wrap anterior of tongue in 2X2 gauze and ask patient to stick out tongue and say "aaahhh"
I have patient say ha ha ha.....this allows better vision and you see muscle retract to see any abnormalities
Hold tip tongue out with guaze while doing above.
use cotton gauze to grab and manipulate tongue
grab the tongue with a gauze and manipulate tongue left and right
move tongue side to side with cotton gauze
ask them to "raise thier palate" and just try to see anything at all- mallampati cases there's usually nothing I can see of soft palate or pharynx
We use Velscope technology to perform Cancer screenings on all of our patients.
For gaggers, I hand them mouth mirror and walk them through opening and breathing in a way to “see their tonsils(area).
Grab the tongue with a gauze and manipulate as needed
The above, as well as holding the tongue with a 2x2 to retract the tongue to get a better visual view
as I am doing the cleaning I usually get a good view with patient's movements
As I feel the tongue / have them stick it out ,for the oral cancer exam i can usually see the throat really well
With velscope as above in addition to visual with light

Q2h1d_OS_lat text of exam tong lat border
lifting tongue toward the back of the mouth
Holding the tongue with a gauze, moving it to the sides, use a dental mirror to view the back sides, palpate.
palpate the lateral borders of the tongue
Palpate lateral borders of tongue while holding with gauze, and using mirror to examine lingual tonsil area
have pt lift his tongue and touch the roof of his mouth
Have patient lift tongue to touch the hard palate
Have the patient stick out their tongue and I hold the tongue with a guaze and move it from side to side so I can see the lateral borders.
grasp pts toungue if they have difficulty "sticking out" their tongue
I do not do the oral exam the dentist does
stick the tongue to the cheek on either side.
Holding and palpating tongue without guaze
Have patient touch tip of tongue to opposite internal cheek area
feel the tongue and floor of mouth with finger
hold tongue with 2x2 gauze and retract borders of tongue with mouth mirror
I hold the tongue with a gauze and also feel along the lateral borders with my hand while moving the tongue from side to side.
Holding the tongue with a gauze and palpating with fingers
gently pulling the patients toung out and from side to side
My doctor holds tongue and examines side to side
Look at the tongue as I'm scaling lingual surfaces
Rotate tongue to opposite buccal mucosa and palpate lateral boders
Have PT stick tongue out.pull from side to side and palpate each side.
I only hold the tongue with gauze if the pt has minimal control of his tongue muscle
All of the above with white light exam and Velscope exam. I also palpate tongue, patient permitting.
Have patient touch tip of tongue to maxillary 2nd molar on both sides
moving the tongue side to side, up and down; I also use bidigital palpation to feel the border.
Palpate the tissue of the tongue for nodules
The Dr does the oral cancer screening in my office
Don’t do thorough intraoral exam, dentist does it
I also have the patient move their tongue from side to side during a cancer screening.
ask patient to put tongue on right and left side
Lift the tongue to the palate as well. I’m always checking visually when cleaning as well

Q7b_HPVVerbalOS text
since participatiing in the study more often, now approx 75%. I usually have to explain what it is.
Check on the Medical Record (not the dental record); it's a more valid source for medical information.
While performing the OCE I explain the statistics on HPV and oral pharyngeal cancer, most do not know if they have had a prior HPV infection
Yes, most adults when a lesion is present or to explain why screenings are necessary
Our health questionnaire asks about STDs, if this is "yes", then I ask more questions
pt complete medical hx is available. lab result review at each visit.
I am in pediatric practice. Only see special needs adults
I assume that as an adult, everyone has had exposure to HPV and so I don't worry about asking.
Herpes is listed, and if patient responds positively then HPV is questioned
It's part of the history & we "preach" #hpv, epidemic, ca vaccine
Gov't agency using electronic health record therefore no separate health hx form
not unless there is anything related to open the conversation
we are working this into our exams about 50% of time or less
Yes, but it is grouped in with Sexually transmitted diseases
I work in pediatrics. Honestly, we never ask on paper or verbally.
Discuss with all patients correlation with HPV and cancer.
Yes, but I have been discouraged to do so because patients become very defensive when doing this, and not sure I get a truthful answer
Only if they tell us when we ask if they have had any medical or medication changes since their last visit.

Q7d_HPVBehavVerbalOS text
Most patients are 50 years or older and have no idea of what HPV infection is.
if patient say yes and if there is a doubt
Only when it is related to their chief complaint or abnormal finding of a OCE
No, I assume that everyone may have been involved with behaviors that are associated with HPV, so I don't worry about asking
we talk to patients under 25 about it in a general way.
If when taking a medical there is reason to persue that area of questioning
The vaccine is to new... my child will not be getting it and my mom died from ovarian cancer
I often talk of the rise of oral cancer especially in young people and a conversation of HPV follows
I would like to; again, people are generally VERY defensive with this, and given we live in a letigious society, I don't want to get sued.
only if oral lesion is present, then we refer to oral surgeon
Rarely, I will ask young, single adults (18-25) if they have been vaccinated against HPV