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The Oral Exam

If you are unfamiliar with what to expect during a typical oral exam, you may find it extremely helpful to get an idea of the step-by-step process before your visit.

The dental examination is a systematic process during which your dentist will investigate many facets of your oral and systemic health in order to identify pathologies or concerns and develop a uniquely customized treatment plan that is catered towards maximizing your oral health while meeting your goals and expectations.

That said, let’s explore all the facets related to the oral exam at your dentist’s office:

1. The Medical History Intake

During the medical history intake, your provider collects information about you, including:

  • List of medications you are currently taking.
  • List of vitamins and natural healing remedies you are currently taking.
  • Smoking and alcohol consumption.
  • Allergy list.
  • 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.

This information allows your dental hygienist and dentist to identify necessary precautions for treatment. It is an integral first step in treatment planning.

2. The Investigation

The second step of any oral health exam involves a thorough examination of your teeth and supporting structures. While this may seem like a straightforward objective, it is its own process that involves the incorporation of various techniques, technologies and therapies.

  • Your dental hygienist explores every surface of every tooth to uncover new cavities and examine the quality of existing fillings with a crown horn or fishhook, two commonly used dental instruments. Over time, fillings can break down and require replacement. They may also be replaced for improved esthetics. In fact, many people today opt to remove their older silver amalgam fillings and replace them with natural-looking composite fillings.
  • The hygienist uses a pigtail tool to check for calculus deposits.
  • If X-rays are necessary, your hygienist takes full-mouth X-rays or bitewings (molars and premolars) to detect abnormalities not visible to the naked eye.
  • Healthy gums adhere tightly to the teeth. If they don’t, then periodontal disease may be present or bone loss may be occurring. The dental hygienist typically performs periodontal probing to measure the circumference of each tooth and the strength of the supporting bone structure. 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. If the gums do not tighten after the cleaning, you will be scheduled for a scaling or root planing appointment. For more severe cases, you will be referred to a periodontist for additional treatment.
  • Using scalers (scraping tools), curets (scoop-shaped instruments) and sometimes additional high-frequency ultrasonic scalers, the hygienist cleans each tooth. Cleaning is performed below the gum and between the teeth as well.
  • Your hygienist gently polishes the teeth to ensure that the enamel is not disturbed. Toothpaste or a combination of baking soda and water may be used to complete the polishing.
  • Fluoride treatment is the last step.

3. The Education

Following the investigative stage of your oral exam, your dentist will spend some time with you talking about his findings, concerns and any problematic issues. You may be advised to consult with a specialist if more complicated or advanced work is required. A treatment plan is discussed at this point in the visit.

  • Professional cleaning is recommended every six months or as often as every two months should you be at risk for periodontal disease, are a smoker or a diabetic. Even those who require deep cleaning or scaling at the standard six-month interval might be better served by more frequent cleanings to avoid further damage, disease and the more invasive treatment necessities (such as scaling and root planing) that can produce tooth sensitivity.
  • It is important to brush and floss teeth after every meal, at least three times a day. Brushing is done in front of, behind, and on top of every tooth to clean and polish the surface. Improper brushing such as brushing too hard can lead to enamel loss and gum recession. Flossing between teeth is done to remove debris that can cause bacteria to form. Your hygienist reviews brushing and flossing habits to ensure that you know how to perform them properly.
  • Nutritional habits also play a role in dental hygiene. Your 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, tooth sensitivity and the like.
  • Your dental hygienist provides advice based on your individual needs. For example, smokers 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 grinders are informed that the dentist will speak to them about a mouth guard. Dental hygienists also have special treatment considerations for babies, youths and senior citizens.

4. The Take-Home Bag

At the end of your oral health exam, your dentist will provide you with a take-home bag designed to promote at-home oral health practices. Your take-home bag may include:

  • New toothbrush or interdental brush
  • Floss
  • Rubber tip stimulator
  • Tongue cleaner

There’s nothing better than proper dental hygiene to preserve your teeth for all the years to come. By keeping your mouth healthy, you thwart many potential dental problems, keep your smile bright, and ultimately avoid heavy financial investments at the dental office.