Oral Mechanism Examination

What is an Oral Mechanism Examination?

An Oral Mechanism Examination (OME), also known as an oral mech exam, oral peripheral exam, or oral-facial exam, is a comprehensive assessment, often a component of a comprehensive speech evaluation, conducted by medical professionals, particularly speech-language pathologists (SLPs). This exam aims to evaluate the structures and functions of the mouth and related areas that impact speech production. It involves assessing various components such as the lips, tongue, teeth, hard palate and soft palate, throat, jaw, cheeks, and cranial nerves.

During the oral mechanism exam, the SLP doctor or other medical professionals may use tools like tongue depressors to observe the oral cavity, evaluate a range of motion, and assess the presence of any structural abnormalities or functional issues. They may also check for a gag reflex, enlarged tonsils, bifid uvula, or missing teeth, which can impact speech production.

The examination aims to identify any underlying structural or functional issues contributing to speech sound disorders or difficulties in speech production. It provides detailed information to guide therapeutic interventions and speech therapy strategies tailored to the individual's needs.

Both children and adults may undergo an oral speech mechanism and exam, especially if they are experiencing difficulties with articulation, voice quality, or other speech concerns. Assessment is an integral part of the diagnostic process in speech-language pathology, helping doctors and SLPs evaluate and address any oral motor or structural issues that may impact speech and language development.

How does our Oral Mechanism Examination template work?

The Oral Mechanism Examination (OME) template serves as a structured framework for conducting a comprehensive assessment of the structures and functions of the mouth and related areas. Here's how the template typically works:

Step 1: Prepare the template

Download the template provided in this guide. It is designed to help you perform a standardized OME and includes sections for recording patient demographics, medical history, and specific concerns related to speech or swallowing.

Step 2: Follow the template

Conduct the exam following the template for a structured approach to an oral mechanism examination. You can begin with visual observation, physical assessment, functional evaluation, and voice and articulation assessment.

Step 3: Document

While conducting your examination, use the template to record your observations, measurements, and findings. Write the information directly onto the template during the examination.

Step 4: Interpret and analyze

Review the findings recorded in the template following the examination. You may summarize significant findings, analyze speech/swallowing function implications, and identify areas of concern or potential intervention. You can write all of these down in the fields provided.

Step 5: Next steps

With the information you obtained, create a report to share with your fellow healthcare professionals. Track progress and evaluate the effectiveness of interventions so you may adjust the treatment plans as needed.

What can you expect from an Oral Mechanism Examination?

During an Oral Mechanism Examination, individuals can expect a thorough assessment of the structures and functions of the mouth and related areas that impact speech production. Here's what you can typically expect during an OME:

Preparation

Understanding the significance of OME before undergoing one is essential. The preparation phase involves gathering information about specific concerns or symptoms related to speech or swallowing. The SLP or medical professional will explain the process and its importance before the examination begins.

Examination

During an Oral Mechanism Examination, several components are assessed to evaluate the structures and functions of the mouth and related areas impacting speech production. Each aspect of a thorough oral mechanism exam contributes to a comprehensive understanding of oral motor function.

• Observation: The examiner will visually observe the oral cavity, including the lips, tongue, teeth, hard and soft palate, throat, cheeks, and jaw, to assess for any visible abnormalities, asymmetries, or signs of structural issues.
• Physical examination: The SLP may use tools such as tongue depressors or gloves to physically assess the structures inside the mouth. This may involve palpating different areas to check for tenderness, muscle tone, and symmetry.
• Functional assessment: The examiner will evaluate how well the individual can perform various oral motor tasks, such as blowing, sucking, puckering the lips, and moving the tongue in different directions.
• Gag reflex: The presence and strength of the gag reflex may be tested by gently stimulating the back of the throat with a tongue depressor or cotton swab.
• Range of motion: The examiner will evaluate the range of motion of the tongue, lips, and jaw to assess their flexibility and mobility. Limited range of motion in these areas can affect speech production.
• Cranial nerve assessment: The SLP may assess the function of cranial nerves that control movements in the mouth and throat, such as the trigeminal nerve (responsible for jaw movement) and the hypoglossal nerve (responsible for tongue movement).
• Voice and articulation: The examiner may ask the individual to produce specific speech sounds or words to assess their articulation and vocal quality. This helps identify any speech disorders or difficulties in speech production.

Follow-up

Following the examination, documentation of speech evaluation and findings is essential for reference and treatment planning. Recommendations for further evaluation, therapy, or intervention are provided based on the examination results. This may include developing a treatment plan to address any identified speech or swallowing concerns, including speech therapy if necessary.

• Documentation: Throughout the examination, the SLP will take detailed notes and may use diagrams or photographs to document any findings.
• Recommendations: Based on the examination results, the SLP will recommend further evaluation, therapy, or intervention if necessary. This may include speech therapy to address specific speech or swallowing difficulties.

How are the results interpreted, and what are the next steps?

After conducting an Oral Mechanism Examination, the results are interpreted to determine the individual's oral motor function and identify any areas of concern. Here's how the interpretation process works and what the next steps typically entail:

Interpretation of results

When examining a person, the examiner looks at their physical assessments, functional evaluations, and observations. The examiner compares these results to what is generally considered normal for a child of their age and development. If there are any problems or structural abnormalities, the examiner notes them and analyzes how they affect the person's ability to speak or swallow.

Clinical implications

When examining a child's speech and swallowing abilities, the provider determines if functional limitations or structural abnormalities contribute to speech disorders or difficulties. They will carefully evaluate the implications of the results for diagnosis, treatment planning, and prognosis.

Next steps

After examining the results, the healthcare provider may suggest further evaluations or interventions. These may include additional tests or imaging studies for more detailed information about specific functions or structures. 

The provider may also refer the patient to other specialized professionals, such as dentists or otolaryngologists, for further evaluation or treatment of the physical condition. The provider will develop a treatment plan to address any identified concerns, including speech therapy or other therapeutic interventions.

Treatment planning

The healthcare provider will create a personalized treatment plan based on your needs and goals. The plan aims to improve oral motor function, speech articulation, voice quality, and swallowing abilities. To achieve this, they may use therapeutic techniques, exercises, and strategies that address your specific deficits and help you improve your functionality.

Monitoring and follow-up

It's essential to keep track of progress to see how well interventions are working and adjust the treatment plan as needed. Follow-up appointments are scheduled to check progress, address new concerns, and provide ongoing support and guidance. Working with other healthcare professionals, caregivers, and educators may be necessary to ensure that the individual gets comprehensive care and support for their needs.