A Dental Examination, more than a checkup.
Most people are familiar with a dental check up, either having had one themselves or knowing someone who has had one. While almost everyone is aware that the dentist is looking for cavities in the teeth, there is more to a dental examination than merely looking for holes.
Today, I would like to walk you through a typical complete dental examination. Hopefully, this will help you to understand what is going on at your next dental check up.
The first part of the examination involves an interview with the patient, either by the doctor or one of the staff members. In this interview, we hope to discover what your long term plans are regarding your teeth. What do you want your teeth to be like in the future, are there any changes you want to make regarding the appearance or function? Are you currently having any dental problems, and if not, what brought you to the dental office today? What are your concerns regarding dental treatment? These are the types of questions that help your dentist establish a treatment plan that custom fits your desires.
As part of the interview, a medical history is taken to ensure that you have no underlying medical problems that would affect your teeth or dental care.
Once the interview is completed, the dentist will take a quick look in your mouth to determine what type of dental records would be required to establish your oral situation. These may include x-rays, photographs, plaster models of your teeth, etc. In most cases, a large x-ray that shows all your teeth, and bone (called a panorex) and small individual x-rays of your teeth (bite wings and P.A’s) are taken.
The x-rays or radiographs show bone levels, cavities, wisdom teeth, abscesses, and many other things that cannot be seen by looking in the mouth.
The clinical examination will have many components. First the dentist will perform a general survey of the head, face, neck and jaw to see confirm that everything is healthy. Then the dentist checks the lips, tongue, palate, throat, floor of the mouth and all the other soft tissues in the mouth. This is done to ensure that there are no lesions, or areas of concern as some nasty oral conditions such as oral cancer can be present without any symptoms.
After the soft tissue screening, the dentist will check the muscles that you use to chew. These muscles are in the temples, cheeks, neck, and at the back of the mouth. The dentist will press on the skin over the muscles to see if there is any pain to this pressure. Painful muscles and a history of headaches or neck aches may indicate a bite problem.
The jaw joint is next in line for examination. You will be asked if you have a history of jaw clicking or pain. The dentist will then check around the joint for tenderness and listen for clicking or popping. You will be asked to open wide and close while the dentist observes if the jaw opens straight or if there is a deviation to the sides. Measurements of your overbite (how much your teeth overlap), overjet (how much they stick out) and maximum opening are then recorded. At this time they will also record any crowding or spacing and your orthodontic classification (Class one is normal, Class two, the upper teeth are excessively forward and Class three, the lower teeth are excessively forward).
The next step is to examine how the teeth come together. The dentist will check how the top teeth hit the bottom teeth. He will compare where most of the teeth touch normally with where they touch when the jaw is gently coaxed into an ideal position in the socket. Any differences between these two positions will be noted. He will also check how the teeth contact when you move your jaw from side to side and forwards and back. The bite plane will also be examined. Often, missing teeth or wear can cause other teeth to move creating a problematic bite plane.
The periodontal examination or gum examination is next. Any signs of inflammation, bleeding or recession are noted. At this time your gums are measured with a thing called a periodontal probe. This probe measures the distance from the tip of the gum to the base of the gum where it attaches to the tooth. The pocket depths are an indication of gum health. Healthy gums have a measurement of 3mm or less. Periodontal probing is painless in healthy gums.
Now that all the other stuff is done, the dentist will check your teeth. The dentist will be looking for areas of decay, wear, fracture, and cracking in both your natural teeth and any dental restorations. Any existing problems or future problematic areas will be recorded.
Now that your dentist has completed the comprehensive examination, he or she will be able to help you in determining what if any dental treatment would be best to help you achieve your long-term dental goals.
