Key Questions to Ask a Patient with a Mouth Infection
When evaluating a patient with a mouth infection, a thorough assessment focusing on symptoms, risk factors, and oral hygiene practices is essential for proper diagnosis and treatment. 1, 2
Essential History Questions
Symptom Assessment
- When did the symptoms first appear?
- What specific symptoms are you experiencing? (pain, swelling, bleeding, ulceration, white patches)
- How would you rate your pain on a scale of 0-10?
- Have you noticed any changes in taste or difficulty eating/drinking?
- Is there any discharge, bleeding, or unusual taste in your mouth?
- Have you experienced fever, malaise, or swollen lymph nodes?
- Are your symptoms constant or intermittent?
Oral Hygiene and Dental History
- What is your current oral hygiene routine? (frequency of brushing/flossing)
- When was your last dental examination?
- Do you have any known dental problems (cavities, periodontal disease)?
- Have you had any recent dental procedures or trauma to the mouth?
- Do you wear dentures or other oral appliances? How do you clean them?
Risk Factor Assessment
- Are you taking any medications? (particularly antibiotics, steroids, anticholinergics) 2
- Do you have any medical conditions? (diabetes, HIV, immunosuppression)
- Do you smoke or use tobacco products?
- How much alcohol do you consume?
- Have you recently been treated with chemotherapy or radiation therapy? 1
- Have you noticed any dryness in your mouth? 2
Previous Treatment
- Have you tried any treatments for this condition?
- Have you had similar infections in the past? What treatments worked?
- Are you currently using any oral rinses or topical medications?
Physical Examination Focus Points
During examination, pay particular attention to:
- Location, size, and appearance of lesions (ulcers, white patches, redness)
- Presence of dental plaque, calculus, or caries
- Signs of periodontal disease (gingival inflammation, pocketing)
- Salivary flow assessment
- Examination of tongue, palate, and oropharynx
- Assessment of lymph nodes in head and neck region
- Signs of dehydration or systemic illness
Common Types of Oral Infections to Consider
Candidiasis (Thrush)
- Look for white, curd-like patches that can be scraped off leaving red, raw areas
- Risk factors include antibiotic use, immunosuppression, and salivary hypofunction 2
Aphthous Ulcers
- Round or oval painful ulcers with gray-white center and red border
- Ask about nutritional deficiencies (vitamin B12, folic acid, ferritin) 2
- Inquire about possible association with celiac disease or other systemic conditions
Odontogenic Infections
- Assess for dental pain, swelling, and history of dental caries
- Determine if infection has spread beyond tooth to surrounding tissues 3, 4
Periodontal Infections
- Evaluate for gingival bleeding, recession, and mobility of teeth
- Poor oral hygiene is a major risk factor 1
Special Considerations
- For patients with suspected tuberculosis, ask about history of TB exposure and symptoms like cough, night sweats, and weight loss 1
- For patients with potential Stevens-Johnson syndrome, inquire about recent medication changes and presence of skin lesions 1
- For patients with dry mouth, ask about medication use, Sjögren's disease, and radiation therapy history 2
Prevention-Focused Questions
- Are you aware of the importance of regular dental checkups?
- Do you know how to properly clean your teeth and mouth?
- Would you be willing to modify any behaviors that might contribute to oral infections? 1
Remember that poor oral hygiene can increase the risk of both local and systemic infections 5, 6. Thorough assessment is crucial for appropriate diagnosis and treatment of oral infections, which can significantly impact a patient's quality of life and overall health.