This article provides a guide to performing an examination of the oral cavity in an OSCE setting.

Check out our oral cavity examination OSCE mark scheme here.


Ensure you have the correct equipment available:

  • Gloves
  • Headlight
  • Tongue depressors (x2)


  • Wash hands
  • Introduce yourself to the patient
  • Confirm the patient’s details (name/DOB)
  • Explain the examination
  • Gain verbal consent
  • Ask if the patient currently has any pain
  • Ask the patient if they have any dentures/implants that should be removed
  • Put on headlight (if available)

General inspection

Ask the patient to open their mouth and say “AHHHH”:

  • Perform general inspection of the oral cavity
  • Assess mouth opening for pain and trismus
Oral cavity anatomy OSCE

Anatomy of the oral cavity 1

Closer inspection

Using one tongue depressor to gently depress the tongue, examine the:

  • Lips: colour, ulceration, swelling, angular stomatitis
  • Tongue: candida, glossitis, ulceration, swelling, rarer conditions (black hairy tongue, Kaposi’s sarcoma)
  • Soft palate, hard palate, uvula: swelling, ulceration, papillomas
  • Tonsils and pillars: enlargement, asymmetry, peritonsillar swelling, ulceration, inflammation and tonsillar stones

Using one tongue depressor move the tongue to either side and examine:

  • Buccal mucosa: ulceration, leucoplakia and trauma
  • Stensen’s duct: stones and discharge

Using two tongue depressors examine the:

  • Teeth, gums and alveolar margins
  • Look for missing teeth, nicotine staining, swelling, leucoplakia, tooth decay, gingivitis and periodontal disease


Ask the patient to lift their tongue to the roof of their mouth:

  • Inspect the opening of the submandibular ducts and the floor of mouth
  • Look for ulceration, stones and swellings
Salivary stone in submandibular salivary duct

Salivary stone in submandibular salivary duct 2


If permitted by the patient and examiner, proceed to bimanual palpation of the mouth.

Bimanual palpation of the mouth

Bimanual palpation technique

  • Don gloves
  • With one finger palpating the neck externally and the other gloved finger in the oral cavity, gently palpate any identified lumps from both sides
  • Palpate the lateral wall of the mouth: parotid gland and duct
  • Palpate the floor of the mouth: submandibular gland and sublingual gland
  • Any intraoral swelling should be described according to site, size, thickness, colour, texture, consistency and tenderness

To complete the examination…

  • Thank the patient
  • Dispose of gloves and tongue depressors
  • Wash your hands
  • Summarise your findings to the examiner

Other examinations and investigations to suggest:

  • A full examination of the neck, ears and temporomandibular joint
  • Flexible nasal endoscopy
  • Orthopantomogram if any poor dentition
  • Ultrasound neck +/- fine needle aspiration (FNA) for neck and salivary gland lumps
  • CT and MRI for any suspected oropharyngeal cancer

Example summary

“Today I performed an examination of the oral cavity on Mr Smith, a 30-year-old man who presented with a submandibular swelling. The most obvious finding on inspection was a small, erythematous swelling in the floor of his mouth. On bimanual palpation, the lump was hard, non-tender and immobile. To complete my assessment I would like to do a full examination of the neck and arrange an ultrasound scan of the lesion.”


1. staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. [CC BY 3.0 (], from Wikimedia Commons

2. James Heilman, MD [CC BY-SA 3.0 (, from Wikimedia Commons

3. Klaus D. Peter, Gummersbach, Germany [CC BY 3.0 de (], from Wikimedia Commons

4. Clara Polo Sabat [CC BY-SA 4.0 (], from Wikimedia Commons

5. GalliasM [CC BY-SA 4.0 (], from Wikimedia Commons

6. DRosenbach [CC BY-SA 3.0 (, from Wikimedia Commons

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