It is well known that FBI agents entering the counterfeit currency division spend a lot of time studying bills. At first, you might think they would study all the various ways that currency could be faked, but, instead, they first learn to be experts at the real thing. Then, it is easy to spot the phony bills.

What does this have to do with correctional nursing? As you strive to develop skill in the unfamiliar area of dental conditions, it is helpful to know what normal looks like in order to spot a problem when you see it. Certainly knowing what the teeth of individuals using methamphetamine look like and knowing the difference between a partial and a bridge is helpful, but do you know what a normal mouth looks like?

Have an Assessment System

Having a system makes you speedy and thorough, whether it is getting out the door in the morning or assessing a patient’s mouth for issues that need attention. For mouth and dental assessment, try this standard format:

• Outside to inside – Start with the lips and move inward until you get to the throat.
• Front to back – Same principle start closest to you and move deeper into the mouth area.
• Left to right – this is the direction we read and can be a standard way to check mouth structures.

Practice, Practice, Practice

When first learning a new skill, it is important that your practice sessions are frequent and close together. Consider ways to get extra dental assessment exposure, like working in Intake and completing the Receiving Screenings or asking to work with the facility dentist when they are holding clinic. Once you have your system in place, dental assessment sessions can be less frequent but need to happen regularly enough to keep up your system and skill.

What is Normal?

So, what is normal when you are assessing those pearly whites (OK, so maybe only a few of your patients will actually have nice looking teeth!)? Here is what a normal mouth should look like.

• Lips and buccal mucosa should be pink, soft, moist and smooth. Note any pallor, cyanosis or blistering.
• Teeth should be white and smooth. Note any missing teeth or ill-fitting dentures.
• Gums should be moist and firm without retraction. Note any receding or bleeding gums.
• Tongue should be pink, move freely, and without tenderness.
• Floor of mouth should be smooth and without mass or lesion.
• Palate and oropharynx should be pink and smooth. Note any discolorations, swelling, or boney growths.

Don’t Forget to Ask!

A person’s medical and dental history may indicate potential dental issues that need attention. The following questions can reveal pertinent background for a complete dental profile.

• Are you currently undergoing a dental procedure or receiving dental treatment?
• Have you been hospitalized recently?
• What medications are you currently taking?
• Do you have any dental concerns?
• Do you have any removable dental appliances such as dentures, partial dentures, or bridges?

Dental assessment is a new skill requirement for most novice correctional nurses. By having a system, practicing regularly, and knowing what is normal, you, too, can become an expert.

How did you learn to assess dental conditions when you started in corrections? Share your experience in the comments section of this post.