What Is a Comprehensive Dental Exam?
Have you ever wondered how thorough your routine dental exams are?
A dentist that I shadowed prior to dental school told me that he used to rush through patient exams trying to get as much done as he could. Eventually, he got tired of this because he really wanted to spend more time with his patients. He doubled the price of his exams and spent twice as much time with each patient, being as thorough as he could. Rather than losing patients, he said that he gained many more patients because his exams were complete and his patients felt they were getting a quality exam at each visit.
At my dental school, we do our exams by-the-book — we're pretty thorough! We examine just about every possible thing that a dentist can. I thought I'd write a post about what our comprehensive dental examination includes, so you can gauge thorough your dentist's exams are.
What Is a Dental Exam?
A dental exam consists of several different parts. Each part helps to ensure that you and your dentist understand what is going on with your oral health. In order to better describe a routine dental exam, I've simply written what I do when I see a new patient at the dental school.
I've divided it into 10 parts. You can read over them all to see what we do, or simply jump to the sections that interest you. If you have any questions when you're done, scroll to the bottom to leave a comment, and I'll get back with you.
1 - Introduction
I meet the patient in the waiting area, introduce myself and then ask them a little bit about themselves to get to know them better and put them at ease with me as their student-dentist.
2 - What Does the Patient Want?
I ask the patient why they came to the school for treatment. I also ask what they expect from their treatment and what kind of dental work they want to have done.
3 - Medical History
I next obtain a very detailed health history, including which medications they are taking and any past or current medical conditions. I then take a blood pressure and pulse. It's important to get the patient's health history because certain things, like joint replacements and certain heart conditions can affect your dental treatment. Also, there are over 300 medications that can cause dry mouth, affecting dental health. Finally, an accurate health history is important because the dentist needs to ensure that there are no systemic problems that will affect the dental treatment that will be provided.
4 - Dietary Survey
We then complete a dietary form that indicates whether their diet places them at a high risk of getting cavities. Although there are many things that can influence your risk of getting cavities, (here's 25 things that increase your risk of cavities), diet is one of the most important factors.
5 - Risk Factors
We complete a "risk factors" form that tells us the patient's risk for developing certain diseases, such as periodontal disease and oral cancer. This form also gives us a general idea about the patient's risk for fracturing or knocking out a tooth.
Another part of the form discusses the patient's dental phobia. We ask what kinds of things make the patient anxious about their dental treatment. If you want to pinpoint your dental phobia, take a look at 15 common reasons why people are scared of the dentist.
The "risk factors" form also discusses other risk factors. For example, this is the form I talked about in a previous article about how wearing your seat belt affects your dental health.
6 - Head and Neck Exam
6 - After that, we perform what we call a head and neck exam. We feel the neck to note any enlarged lymph nodes or any suspicious lumps or bumps that could be cancerous. We also feel the TMJ to evaluate whether or not the patient has any joint problems. We note any popping or clicking in the jaw, which is fairly normal but which can cause problems.
7 - Oral Soft Tissue Exam
Next, we move on to the intraoral soft tissue exam. The soft tissue exam consists of looking at every area in your mouth. We look at the lips, the cheeks, the gums, the roof of the mouth, every side of the tongue, under the tongue, in the back of the mouth, the throat and the tonsil area. Your tonsils can tell us if your body is fighting off a disease and sometimes your tonsils can cause bad breath if there is a tonsillolith present.
It is necessary to perform a very thorough soft tissue exam because this is where dentists check for oral cancer. If your dentist isn't very attentive during the soft tissue exam, he or she may miss the beginning stages of oral cancer. It is important to catch cancer early because it improves your chances of beating it. If something looks suspicious, your dentist may biopsy the area and/or refer you to an oral pathologist, one of the nine types of dental specialists.
8 - Periodontal (Gum) Health
Another part of the dental exam is periodontal probing. This consists of sticking a little instrument between your teeth and your gums to see how healthy your gums are. We measure the space between the top of the gums and where your gums attach to your teeth. If it's too deep, you won't be able to clean it out well and it could indicate that you have periodontal disease, which is a leading cause of tooth loss in people over age 30. If you do have periodontal disease, your dentist may recommend getting a deep dental cleaning, which is technically known as scaling and root planing.
9 - Hard Tissue Exam: We Finally Check Your Teeth
Next we perform a hard tissue (teeth) exam where we look at every side of your teeth and note any existing fillings, crowns, implants, root canals, cavities, fractures, or if there are any problems with your bite. We also look at all of your dental work to make sure that it is still in good shape. Depending on the health of your teeth, we may order x-rays to better diagnose any problems with the teeth and the area around the tooth. Want to know if you need x-rays? Read the article How Often Should You Get Dental X-Rays Taken?
During the hard tissue exam, we will also evaluate the patient's bite. If we will be making any crowns or dentures for the patient, we usually take dental impressions as part of the dental exam so that we can evaluate the patient's bite and make sure we don't cause any problems with the way that their teeth come together when we place crowns.
10 - Treatment Planning
After gathering all of the above information, we create a treatment plan with all of the dental work that we recommend having done. Sometimes this is as simple as getting a regular cleaning and providing instructions on how to maintain better oral hygiene or it can be as complex as getting dentures, crowns, bridges, root canals, implants, veneers, braces, and other dental treatment.
This is the comprehensive dental exam that each patient receives initially at my dental school. Your dentist may choose to do things differently. For example, some patients hate the "risk assessment" form and the dietary questionnaire. At my dental school, we are required to complete these forms with the patient. If you don't seem interested in those things, then your dentist may choose to omit those parts of the exam.
Remember, all dentists are different, and most dentists want what's best for their patients and will try to provide you with optimal dental treatment. However, some dentists aren't thorough, and hopefully this list will help you evaluate what you want your dentist to address during a dental exam.
If you have any questions, comments, or concerns about your dental exams, feel free to leave a comment below. Thanks for reading!
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