What to expect at a dental exam

  • Published
  • By Capt. Bryan Katz
  • 66th Medical Squadron Dental Flight
HANSCOM AIR FORCE BASE, Mass. --  People visit the dentist at least once a year, but are they fully aware of what is being evaluated during the exam?

Of course, the dentist is checking for cavities, but that is only a small portion of the examination. A thorough dentist will not only check for the presence of tooth decay, but will also evaluate them for the presence of conditions such as gingivitis, periodontitis, abscesses and oral cancer. All of these diseases can be present without the patient even being aware that they exist. Below are the steps of a typical exam and why the dentist performs each step.

Take a set of radiographs. It is important that each patient receives a new set of radiographs every one to two years. These images allow the doctor to detect for the presence of interproximal tooth decay, which are cavities between the teeth that cannot be seen.

Complete a thorough head and neck exam. The dentist can determine the presence of skin and neck and palpate the major muscles. They can determine the presence of skin lesions, muscle tenderness, a localized swelling that may be indicative of TMJ problems or other pathological processes. The dentist will also inspect the gingiva, tongue and palate. Certain systemic diseases such as leukemia, herpes, HIV/AIDS, in addition to oral cancer, can present as oral lesions.

Conduct a periodontal evaluation. The periodontium is an all-encompassing term used to describe the tooth supporting tissues. It is vital that these tissues are healthy or over time the teeth can become mobile and potentially require extraction. The easiest way for a dentist to evaluate overall periodontal health is to evaluate the depth of the gingival pockets. In simplest terms, the gingiva forms a sleeve around the tooth. If the depth of this sleeve is greater than 3.5 millimeters and bleeding or hardened plaque is present, this might indicate the initial signs of periodontal disease.

Check for the presence of tooth decay/failing restorations. The dentist will inspect for the presence of tooth decay and evaluate existing restorations in the mouth. If they detect the presence of caries, or tooth decay, or a failing restoration, then they will recommend the placement of a new filling or crown.

Ask the patient if they have any concerns with their mouth. It is important the patient tells the dentist about any concerns they may have with their oral health. Sometimes tooth problems present in ways that dentists cannot easily detect in a routine exam.

A thorough dental exam is much more than simply checking for cavities. It is a full evaluation of a person's oral health. In addition, oral health can also serve as a primary indicatory of systemic health. Therefore, it is vital to maintain excellent home care and see a dentist at least once a year.