The Intraoral and Extraoral Exam
Radiographs and Oral Photography

Radiographs and oral photography are important adjuncts which can be utilized to compare changes in tissue. Photography is especially beneficial in cases where severe inflammation is present. Some of the adjunct devices can identify inflammation in the soft tissues but they cannot differentiate between inflammation caused by, for example, cheek biting or lichen planus. At the same time, because inflammation is a constant in some cases, frequent biopsy may not be appropriate since constant biopsies are not the optimal form of patient management. Often tissue specimens return with a “non-specific ulcerative tissue” diagnosis and crucial areas may be missed due to excessive inflammation. Being able to compare digital images of the lesion provides the practitioner the added benefit of actually seeing the progression or extension of the lesion. An added benefit is being able to show the patient how the lesion has progressed over time when suggesting they need to have a biopsy. Oral photography is highly beneficial as a key part of the patient’s permanent record as well. Radiographs can be used to determine if a lesion seen on the surface of the oral tissues actually extends into the bone or other hard structures adding another dimension to the diagnostic process. Radiographs are also important in assessing both hard and soft tissue lesions within the oral cavity that may not be visible during the standard oral cancer exam. Periodic radiographs may find pathology and lesions at a much earlier existence when treatment may be far less invasive for a patient.