Chapter 9 Consequences of Poor Oral Health

Figure 9.1 cont. How to Conduct a Nutrition-Focused Physical Examination of the Head, Neck, and Oral Cavity

STEP 5: LOOK FOR SIGNS AND SYMPTOMS OF MICRONUTRIENT DEFICIENCIES: -

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Clinical Manifestation

Gingiva Tongue

Teeth Salivary glands Spongy, bleeding, redness, lesions, ulcerations

Glossitis; pale, atrophic, smooth/slick Decreased taste

Missing, broken, lack of occlusion Enlarged, tender to palpation

- Risk for Deficit/Altered Function Vitamin C, vitamin K; systemic disease; impaired eating

Folate, B-6, B-12, iron, riboflavin Iron, folate, zinc, vitamin A

Ability to bite and chew food Bulimia, sialolithiasis (salivary calculi)

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STEP 6: ASSESS FOR DIFFICULTY SWALLOWING :

Dysphagia screen: cognition (alert and oriented), position (able to maintain upright position during meal), cranial nerve exam (V, VI, IX, X, XII), swallow, cough reflex Is the patient pocketing food? Does the patient have a wet cough or a hoarse voice?

Source: Stepwise Approach to the Conduct of the Nutrition Focused Physical Exam: Head, Neck, and Oral Screen. Department of Nutritional Sciences. Rutgers—SHRP Graduate Programs in Clinical Nutrition © 2014.