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during a Dental Visit?
On your first visit to a dentist, they
will take a full health history. Most dental visits are checkups.
Regular checkups (ideally every 6 months) will help your teeth stay
cleaner, last longer and can prevent painful problems from
developing. Your dentist will perform a thorough intra and
of your teeth, gums and mouth,
looking for signs of disease or other problems. His or her goal is
to help maintain your good oral health and to prevent problems from
becoming serious, by identifying and treating them as soon as
examination consists of an inspection of the soft
(including the gingiva), the teeth, the occlusion,
and the temporomandibular joint. Full-mouth roentgenograms should
be taken. In addition, study models and Kodachrome photographs of
the dentition may be helpful. It may be necessary to test the
vitality of the teeth. The date of the examination should be noted.
All data should be carefully charted because they become a part of
the patient's record.
A proper dental examination pays attention
to the soft tissues as well as the teeth. The condition of the
following should be observed: tongue, buccal mucosa, floor of the
mouth, palate, frena, throat, and oral mucosa. Do the amount and
consistency of saliva appear normal? Are there variations in the
color, contour, or firmness of the gingiva? Is the form of the
gingiva physiologic? Is the gingiva firm or is it retractable and
does it bleed easily? Is the vestibule shallow or deep? Is the zone
of gingiva narrow or broad? Does the patient have pain? Are there
areas of food impaction? Are any other possible local causes
evident? Does the patient relate a history of trench mouth or
pyorrhea, recurrent cold sores, cankers or mouth blisters, dental
abscesses, sinus trouble, swellings or pain? Is there evidence of
these in the mouth?
In examining the gingiva
the clinician must keep the picture of the "normal" gingiva in
mind: With this as a guide, he/she can more readily observe the
extent and state of inflammation and the distribution of the
lesions. The size of the teeth should be noted, and the degree of
caries susceptibility should be gauged by the number of
restorations and cavities. The type and quality of restorations
should be evaluated. In addition, erosions should be noted. The
biting surfaces should be examined for excessive occlusal wear.
When this is evident, the patient should be questioned as to
whether he/she grinds the teeth or chews on one side only.
he/she chew tobacco? Is he/she unhappy with the appearance of the
mouth? Diastemata should be noted, and proximal contacts tested
with dental Hoss. Conditions such as toothbrush abrasion, tooth
mobility, tooth malpositions, hypoplastic enamel, supernumerary
teeth, nonvital teeth, and tooth sensitivity should be recorded.
For tooth sensitivity, questions may be asked conceming the effects
of temperature extremes and sweets. The teeth may be
assessment includes an inspection of the face, head, and neck. The
face, ears, and neck are observed, noting any asymmetry or changes
on the skin such as crusts, fissuring, growths, and/or color
change. The regional lymph node areas are bilaterally palpated to
detect any enlarged nodes, and if detected, their mobility and
consistency. A recommended order of examination includes these
regions: Preauricular Submandibular Anterior Cervical
Posterior Auricular Posterior Cervical
status of oral hygiene
The general status of oral
should be ascertained. Note the presence of
plaque, stain, and calculus. A disclosing solution may be used to
show the patient the presence of plaque. In addition, the patient
may be questioned concerning the date of the last prophylaxis, the
method and frequency of toothbrushing, and cleaning aids used in an
attempts to gauge the rate of calculus deposition. At this time
some practitioners take a plaque survey. The score indicates the
status of the patient's oral hygiene as shown by the stained
plaque. During treatment complete indices can be taken and compared
with earlier indices to note improvement or lack of improvement in
Disclosing solutions and tablets may be used to
make plaque visible. Disclosing solutions impart a bright red color
to the plaque, stains, and calcified deposits. Two-toned disclosing
solutions may be applied to distinguish between old and new plaque.
The solutions also stain the imperfect margins of plastic fillings
and the mucosa of the lips, cheeks, tongue, and floor of the mouth.
Because these stains tend to last on mucosal surfaces for several
hours, some patients object to the regular use of disclosing
solutions. The stain of disclosing tablets, on the other hand, does
not last as long nor is it as intense.
When disclosing tablets
are used, the patient is instructed to chew the wafer thoroughly,
working it into the saliva, and then to swish the fluid vigorously
about the mouth for a minute. Care must be taken that the solution
reaches all parts of the mouth. If it does not, surfaces of some
teeth may not be stained, even when plaque is present. Proper
staining can be attained by a vigorous pumping action of the cheeks
to force the solution between the teeth. After about a minute the
mouth may be emptied and rinsed gently with water. Examination
should be made immediately. The patient should observe the
procedure with a mirror.
Obviously the use of stains such as
basic fuchsin, Bismark brown, or erythrosin can facilitate the
patient's efforts at plaque removal. Stains facilitate the
patient's objective: the complete removal of plaque from the tooth
surfaces. They provide an effective means of determining whether
this objective has been reach ed by the absence of a stain on
exposed tooth surfaces.
See also About
the importance of oral examination
Further information on the
oral examination, dental hygiene AGD - Academy
of General Dentistry
Dental Visit Tips