as periodontitis is the most likely cause for the tooth mobility, the patient's periodontal assessment should be up deated with pocket depths around as many teeth as possible and a radiographic survey, unless recent films are available. periapical radiographs are the view of choice but may not be possible because of the combination of the tongue and lack of cooperation. a panoramic radiograph is a suitable second choice provided the patient can sit still for the required preiod. alternatively, an obliqud lateral is a good choice; the exposure is very short and the film is held against the patient's face, so that the effects of movement during exposure are minimized.