The lips, tongue, and oral mucosa (the tissue covering the inside of the cheeks almost to the teeth) are the first soft tissues the health professional will see when performing the oral screening. The lips and tongue should be soft, pink, and moist. The oral mucosa may be pink or brown, depending on the infant’s or child’s skin color. It should be smooth and moist.

In infants and children it is common to observe strips of tissue extending from the oral mucosa to the tissues near the teeth. These are called frena and are located in the upper jaw, midway between the two front teeth. They should be pink, thin, and firm, with smooth borders.

The tissue next to the teeth, called the gingiva, should be pink and should form a tight, smooth collar around each tooth. It should be moist and not spongy. If pressed, it should not bleed. During the transition from primary to permanent teeth, the gingiva may have rolled edges.

To observe the palate, the health professional must gently bend the infant’s or child’s head back. Directing the light onto the surface of the palate, the health professional should observe pink, moist surfaces. Toward the anterior teeth, rows of tissue varying in height will be present. About two-thirds of the way back on the palate will be an area dividing the soft palate from the hard palate. The tissue should be pink, smooth, and soft. The soft, fleshy mass that hangs from the rear of the soft palate is the uvula. If the uvula is “Y” shaped, it is called a bifid uvula.

The major salivary glands are located in the cheeks and on the floor of the mouth. The ducts should be raised and pink. The health professional needs first to look at them and then to press them lightly. It is common to observe clear secretions from the glands. Pressing the glands should not cause discomfort.