| 2) Lips |
( ) Smooth, pink, moist |
( ) Cracked, reddish in the commissures, dry |
( ) Swelling, local lump/lump, white or reddish spot, ulcer, bleeding, inflammation in the commissures (corners of the lips). |
| 3) Tongue |
( ) Normal, moist, wrinkled, pink |
( ) Presence of cracks, covered by coating, reddish, stained |
( ) Ulcerated, swollen, reddish and/or white spots |
| 4) Gums and tissues |
( ) Pink, moist, soft, no bleeding |
( ) Reddish, dry, swollen, shiny, rough/scratchy, stain or ulcer under prostheses |
( ) White or reddish spots, general redness, swollen gums, bleeding, ulcers |
| 5) Saliva |
( ) Wet tissues, aqueous salivation, unimpeded free flow without obstruction |
( ) Dry and sticky tissues, small amount of saliva |
( ) Red and dry tissues, very little or no saliva, very thick saliva |
6) Natural teeth
(yes) (no) |
( ) All teeth intact |
( ) 1 to 3 roots or teeth with cavities or broken, teeth very worn s |
( ) 1 to 3 roots or teeth with caries or broken, teeth very worn |
| 7) Dentures (yes) (no) |
( ) No area or broken teeth, dentures used in both arches continuously during the day |
( ) 1 area or 1 damaged tooth, dentures used for only 1 to 2 hours a day, loose/not fixed dentures, use only one denture (upper or lower) |
( ) More than 1 area or more than 1 damaged tooth, missing denture or unused denture, need for denture adhesive |
| 8) Oral hygiene |
( ) Clean mouth, no food residue, no tartar on teeth or prostheses |
( ) Food residues, tartar or biofilm in 1 to 2 areas of the mouth or small area of the prosthesis, bad breath (halitosis) |
( ) Food scraps, tartar or biofilm in most areas of the mouth or in most prostheses, severe halitosis |
| 9) Toothache |
( ) No behavioral, verbal or physical signs of toothache |
( ) Verbal or behavioral signs of toothache such as grimaces, bites on the lips, lack of appetite, aggressiveness |
( ) Physical signs such as facial swelling, abscess in the gums, broken teeth, ulcerations and verbal or behavioral signs such as grimaces, bites on the lips, lack of appetite, aggressiveness |
| Refer the patient to be examined by a dentist |
ASBTO SCORE |
___/16 |
| The patient or family/guardians refuse dental treatment |
| Next review of the patient's oral health at: ____/____/____ |
