# Mallampati score

> The Mallampati score grades how much of the oropharynx is visible when a seated patient opens their mouth and protrudes the tongue, on a four-class scale. Higher classes suggest a potentially more difficult intubation. It is one input to airway assessment rather than a test in itself, and is always read alongside other airway findings.

*Source: https://getpathways.ai/glossary/mallampati-score*

Also known as: Mallampati classification, modified Mallampati score

- **Assesses**: Visibility of oropharyngeal structures on mouth opening
- **Classes**: I to IV
- **Direction**: Higher class suggests a potentially more difficult airway
- **Limitation**: Modest predictive value alone; always combined with other airway findings

## The four classes

Assessed with the patient seated, mouth open and tongue protruded:

| Class | What is visible |
| --- | --- |
| I | Soft palate, fauces, uvula and tonsillar pillars |
| II | Soft palate, fauces and uvula |
| III | Soft palate and base of the uvula |
| IV | Soft palate not visible |

## Why it is never used alone

A high Mallampati class raises the index of suspicion; it does not predict a
difficult airway reliably by itself. It is read together with the rest of the
airway history — previous difficult intubation, mouth opening, neck movement,
dentition, and body habitus — and it is the combination that changes a plan.

This is the general shape of perioperative risk assessment, and the reason
screening on single scores in isolation tends to disappoint. The value of any
one measure is that it contributes to a profile.

## In a remote assessment

Mallampati grading requires someone to look, so it is not something a voice
interview can score. What structured pre-operative interviewing contributes is
everything around it: previous anaesthetic difficulties, family history of
anaesthetic problems, dentition, and the other airway history that determines
whether a physical airway assessment needs to happen early rather than on the
day. Airway assessment is one of the twelve domains the interview covers for
exactly that reason.