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What Occurs In Your Mouth During A Dental Care Examination

During a dentistry examination, the dentist examines the mouth mucosa (soft tissues) for any abnormalities or pathology (including oral cancer), the teeth for tooth decay (dental caries) or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar (dental calculus), and debris on teeth, as well as the need to replace any missing teeth or dental prostheses.

The dental examination begins with a complete dental care and medical history, including medications the patient currently is taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dental needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine mouth caries risks, microbiological testing of saliva can measure the level of caries-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.

If removable dentures are present, they are checked for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about oral health status is gathered, the dentist will be better able to discuss dental treatment alternatives that are available.

By Denise J. Fedele, DMD, MS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Sterilization of Dental Equipment

The times are trying enough without having to worry about a visit to the dentist. There is much talk about the transmission of disease in any given medical environment. Well, we're here to say dentistry in our practice still is a safe and healthful experience. And it's not just a matter of trust.

It took the AIDS epidemic to bring it to the public eye. But we've been guarding against it at our dental office since the day we opened our doors.

I'm talking about communicable disease. AIDS is the one you hear most about, but there are others. A quiet new killer (HCV, hepatitis C virus) currently infects about four million Americans who will never be able to rid themselves of it. Here at the office we're also aware that hepatitis B, tuberculosis, influenza-even the common cold-are communicable. The good news is that the same strict standards of asepsis (cleanliness) we use against one disease also defend us against all the others.

You may not be aware of all we do to ensure your protection from cross-communicated viruses during your dental care. In fact, it's a large part of our day, and we're committed to the task.

We use disposable items wherever we can. Every surface in the operatory is secured against airborne bacteria with physical barriers. Our sterilization procedures are complex, monitored by an outside agency, and, not incidentally, much more than OSHA, the American Dental Association, the Centers for Disease Control, and local agencies require.

Metal instruments are cleansed in an ultrasonic bath before autoclaving in chemical pressurized heat. Hand pieces, for instance (you know them as drills), take an hour's preparation-heat-treated then cooled-for each patient. We disinfect everything in sight.

All this costs, but it's worth it.

We wouldn't be here if we didn't care about you, your health, and your good looks. We want you to feel comfortable, all the time. Please ask about our sterilization program and we'll be more than happy to show you what we're doing.

You know we care about open communication in our dental office. This letter is another way we hope to show it.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.