Many patients in the past have asked me, “So what’s in a checkup?” I assume they mean what am I and my dental team looking at and looking for in a typical dental exam. I’ll take this opportunity to let you know exactly what comprises one of my dental exams.
First, let me clarify that I’ll be describing the makings of one of my initial exams. A comprehensive initial exam is given by my dental team when it is the patient’s first introduction to our office. After this “initial” exam the patient receives “recall” exams or a condensed version of this initial exam on cleaning appointments.
The first task that is completed by my team is reviewing your medical and dental history. Here, the important point is making sure you are physically healthy and you do not have any contraindications to receiving dental care. Major issues we are looking for is a history of heart problems, high blood pressure, diabetes, siezures, and congenital defects. Although not specific to your mouth, these conditions can affect the timing or type of dental care you receive. An interesting factoid is that most cases of high blood pressure is indirectly or directly diagnosed during a dental check up. So this is a very important step for us and our patients.
At this point, the dental team will proceed to taking dental xrays that are necessary for the initial exam. This is also the time to notify the team if you have an urgency, such as toothache or sensitivity, because certain conditions may require another type of dental xray.
We then proceed to the head and neck exam. During this part of the exam, I am looking for any out of place or noticeable bumps, marks, and swellings. Your TMJ or Temporal Mandibular Joint will also be evaluated at this stage. This also serves as the first part of you oral cancer screening, which is the next step.
During your oral cancer screening, I examine all the tissues in and around your mouth. I’m looking for ulcers, colored marks, bumps, and white patches. Although most of the time these things are not cancerous, they should always be noted, measured, and recorded for specialist referral or future reference.
We then use the xrays and a visual exam to note the existing dental work and conditions of the teeth. Usually, I communicate with my team using dental terminology during this part of the exam, but we always explain our findings to you the patient after the visual exam. We are looking for failing dental work, cavities, loose teeth, staining, missing teeth, and fractured teeth.
The next step is to evaluate your periodontal health, which means the health of your gums and the bone underneath that hold your teeth in place. We do this by taking measurements of the gums itself and noting areas of inflammation and spontaneous bleeding. This is the step where it is determined what type of dental cleaning you will need.
Finally the last and most important step of the initial exam is presenting you our patient with our findings and reccomendations for treatment or maintenance (also known as the treatment plan). Our dental team makes a special effort to educate during this step and feel the exam is complete only when you are comfortable with all the aspects of your personal treatment plan.