Dental Oral Exam

The dental examination is a process during which the dentist will investigate the oral and systemic health of a patient in order to identify pathologies or concerns. Then, a uniquely customized treatment plan is developed, catered towards maximizing the patient’s oral health, while meeting their goals and expectations. Below is an outline of a typical dental exam.

Medical History

This important information allows the dental hygienist and dentist to identify necessary precautions for treatment.

• List of medications the patient is currently taking, including vitamins and natural healing remedies.
• Smoking and alcohol consumption.
• Known drug allergies.
• Previous experience with anesthesia.
• Adverse reactions to anesthesia.
• Family member reactions to anesthesia.
• Any medical conditions you are currently being treated for.
• Previous surgeries or hospitalizations.

Investigation

• The dental hygienist explores every surface of every tooth to uncover new cavities and examine the quality of existing fillings. Over time, fillings can break down and require replacement. They may also be replaced for improved esthetics. In fact, some people opt to electively remove their older silver amalgam fillings and replace them with natural-looking composite fillings or ceramic inlays/onlays.
• The hygienist uses a probe to check for calculus deposits.
• If X-rays (radiographs) are necessary, the hygienist or assistant takes full-mouth X-rays or bitewings (molars and premolars) to detect abnormalities not visible to the naked eye.
• The dental hygienist typically performs periodontal probing to measure the relationship of the supporting bone structure and the gingiva. A calibrated probe is inserted between the teeth and gums to measure (in millimeters) the level of "gum adherence" to the teeth. The hygienist then records a millimeter number for every tooth. The goal is to record a number of one, two or three. A number of four or more indicates periodontal disease and potential bone loss. Scaling and root planning will be treatment planned if the patient has been diagnosed with periodontal disease. For more severe cases, a referral to a periodontist for additional treatment may be necessary.

Education

• The dentist and hygienist will spend some time with you talking about their findings, concerns and any problematic issues. A treatment plan with the appropriate risks, benefits, and alternatives is discussed and formulated.
• Professional cleaning is recommended every six months or as often as every three months should the patient be at risk for periodontal disease, smoker or a diabetic.
• It is important to brush teeth after every meal. Improper brushing such as brushing too hard can lead to enamel erosion and gum recession. Flossing, at least once a day, between teeth is done to remove debris that can cause bacteria to form. The hygienist reviews brushing and flossing habits to ensure the patient knows how to perform them properly.
• Nutritional habits also play a role in dental hygiene. The hygienist reviews nutritional habits that support the teeth, gums and bone structure in the mouth. Special attention is given to people who suffer from bad breath (halitosis), dry mouth, and tooth sensitivity.
• The dental hygienist provides advice based on the patient’s individual needs. For example, smokers and smokeless tobacco users are informed that they face an increased risk for periodontal disease, which leads to tooth loss. Nail biters can be risking injury to the enamel on their teeth. Teeth clenchers/grinders are informed that the dentist will speak to them about a night guard. The dental hygienist also has special treatment considerations for expecting mothers, babies, youths and senior citizens.

Prophylaxis (Cleaning) or Scaling/Root Planing

• The dental cleaning is usually done at a separate appointment, after the initial exam and treatment plan have been performed, discussed, understood and agreed upon by the patient.
• Using scalers (scraping instruments), curets (scoop-shaped instruments) and sometimes additional high-frequency ultrasonic scalers, the hygienist cleans each tooth and root surface. Cleaning is performed below the gum and between the teeth.
• The hygienist gently polishes the teeth with a mild pumice.
• Fluoride treatment is the last step.
• If periodontal disease exists, the “treatment” cleanings are scheduled in two to four visits. See the discussion about gum disease treatment.

Take-Home Goods

• New toothbrush or interdental brush
• Floss with threaders if necessary
• Tongue cleaner
• Next appointment card

Promoting at-home oral health practices is the goal. There is nothing better than proper dental hygiene to preserve your teeth for all the years to come. By keeping a healthy mouth, many potential dental and health problems will be ultimately avoided. We want the patient to keep their smile bright, and avoid major financial investments at the dental office.