Warnakulasuriya used a semi-quantitative clinical examination to monitor patients with oral submucous fibrosis. The author is from the University Dental School in Peradeniya, Sri Lanka.
Parameters:
(1) opening of the jaws, as determined by the degree of mouth opening
(2) fibrous banding of lips, cheek and soft palate
(3) tongue fixation
(4) atrophy of tongue papillae
(5) associated symptoms (burning sensation to spicy food, alteration in salivation)
(6) associated signs (blanching of oral tissue, ulceration, keratotic patches, overt carcinoma)
degree of mouth opening =
= (maximum inter-incisal distance in mm)
If the incisor teeth are lacking, then inter-arch clearance is measured and the inter-incisal distance is estimated.
The degree of mouth opening can be monitored over time, and the percent of the original distance can be calculated.
|
Parameter |
Finding |
Points |
|
tongue fixation |
none |
0 |
|
|
able to protrude beyond muco-cutaneous junction of the lower lip |
1 |
|
|
able to protrude beyond the lower incisors but unable to touch the muco-cutaneous junction of the lower lip |
2 |
|
|
able to protrude up to the lower incisor edge only |
3 |
|
atrophy of the tongue papillae |
none |
0 |
|
|
minimal |
1 |
|
|
partial, moderate |
2 |
|
|
total |
3 |
where:
• The article mentions only 3 measures of atrophy in the papillae - none, partial and total. I added an additional level to conform with the other measures.
|
Fibrous Banding |
Finding |
Points |
|
upper lip |
none |
0 |
|
|
single band |
1 |
|
|
multiple bands |
2 |
|
|
broad band > 2 cm |
3 |
|
lower lip |
none |
0 |
|
|
single band |
1 |
|
|
multiple bands |
2 |
|
|
broad band > 2 cm |
3 |
|
right buccal mucosa |
none |
0 |
|
|
single band |
1 |
|
|
multiple bands |
2 |
|
|
broad band > 2 cm |
3 |
|
left buccal mucosa |
none |
0 |
|
|
single band |
1 |
|
|
multiple bands |
2 |
|
|
broad band > 2 cm |
3 |
|
soft palate |
none |
0 |
|
|
single band |
1 |
|
|
multiple bands |
2 |
|
|
broad band > 2 cm |
3 |
where:
• The percent of each region affected by fibrosis can also be recorded.
|
Associated Symptoms |
Findings |
Points |
|
burning sensation on spicy foods |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
change in salivation |
no change |
0 |
|
|
mild increase or decrease |
1 |
|
|
moderate increase or decrease |
2 |
|
|
severe increase or decrease |
3 |
|
Associated Signs |
Findings |
Points |
|
blanching of the oral tissues |
none |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
Specialty: Otolaryngology, Pharmacology, clinical ICD-10: , |
