A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists. Your cleaning appointment will include a dental exam and the following:
A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.
Periodontal disease and gingivitis occur when bacteria from plaque colonize on the gingival (gum) tissue, either above or below the gum line. These bacteria colonies cause serious inflammation and irritation which in turn produce a chronic inflammatory response in the body. As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out. The pockets between the gums and teeth become deeper and house more bacteria which may travel via the bloodstream and infect other parts of the body.
Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease.
Here are some of the benefits of prophylaxis:
Identification of health issues – Many health problems first present themselves to the dentist. Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis and often spot signs of medical problems like diabetes and kidney problems. Recommendations can also be provided for altering the home care regimen.
Prophylaxis can either be performed in the course of a regular dental visit or, if necessary, under general anesthetic. The latter is particularly common where severe periodontal disease is suspected or has been diagnosed by the dentist. An endotracheal tube is sometimes placed in the throat to protect the lungs from harmful bacteria which will be removed from the mouth.
Prophylaxis is generally performed in several stages:
Prophylaxis is recommended twice annually as a preventative measure, but should be performed every 3-4 months on periodontitis sufferers. Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.
Digital radiography (digital x-ray) is the latest technology used to take dental x-rays. This technique uses an electronic sensor (instead of x-ray film) that captures and stores the digital image on a computer. This image can be instantly viewed and enlarged helping the dentist and dental hygienist detect problems easier. Digital x-rays reduce radiation 80-90% compared to the already low exposure of traditional dental x-rays.
Dental x-rays are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam. Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan. Without x-rays, problem areas may go undetected.
Detecting and treating dental problems at an early stage may save you time, money, unnecessary discomfort, and your teeth!
We are all exposed to natural radiation in our environment. Digital x-rays produce a significantly lower level of radiation compared to traditional dental x-rays. Not only are digital x-rays better for the health and safety of the patient, they are faster and more comfortable to take, which reduces your time in the dental office. Also, since the digital image is captured electronically, there is no need to develop the x-rays, thus eliminating the disposal of harmful waste and chemicals into the environment.
Even though digital x-rays produce a low level of radiation and are considered very safe, dentists still take necessary precautions to limit the patient’s exposure to radiation. These precautions include only taking those x-rays that are necessary, and using lead apron shields to protect the body.
The need for dental x-rays depends on each patient’s individual dental health needs. Your dentist and dental hygienist will recommend necessary x-rays based upon the review of your medical and dental history, a dental exam, signs and symptoms, your age, and risk of disease.
A full mouth series of dental x-rays is recommended for new patients. A full series is usually good for three to five years. Bite-wing x-rays (x-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.
Panoramic X-rays (also known as Panorex® or orthopantomograms) are wrap-around photographs of the face and teeth. They offer a view that would otherwise be invisible to the naked eye. X-rays in general, expose hidden structures, such as wisdom teeth, reveal preliminary signs of cavities, and also show fractures and bone loss.
Panoramic X-rays are extraoral and simple to perform. Usually, dental X-rays involve the film being placed inside the mouth, but panoramic film is hidden inside a mechanism that rotates around the outside of the head.
Unlike bitewing X-rays that need to be taken every few years, panoramic X-rays are generally only taken on an as-needed basis. A panoramic x-ray is not conducted to give a detailed view of each tooth, but rather to provide a better view of the sinus areas, nasal areas and mandibular nerve. Panoramic X-rays are preferable to bitewing X-rays when a patient is in extreme pain, and when a sinus problem is suspected to have caused dental problems.
Panoramic X-rays are extremely versatile in dentistry, and are used to:
The panoramic X-ray provides the dentist with an ear-to-ear two-dimensional view of both the upper and lower jaw. The most common uses for panoramic X-rays are to reveal the positioning of wisdom teeth and to check whether dental implants will affect the mandibular nerve (the nerve extending toward the lower lip).
The Panorex equipment consists of a rotating arm that holds the X-ray generator, and a moving film attachment that holds the pictures. The head is positioned between these two devices. The X-ray generator moves around the head taking pictures as orthogonally as possible. The positioning of the head and body is what determines how sharp, clear and useful the X-rays will be to the dentist. The pictures are magnified by as much as 30% to ensure that even the minutest detail will be noted.
Panoramic X-rays are an important diagnostic tool and are also valuable for planning future treatment. They are safer than other types of X-ray because less radiation enters the body.
The cephalometric X-ray is a unique tool, which enables the dentist to capture a complete radiographic image of the side of the face. X-rays in general offer the dentist a way to view the teeth, jawbone and soft tissues beyond what can be seen with the naked eye. Cephalometric X-rays are extraoral, meaning that no plates or film are inserted inside the mouth. Cephalometric and panoramic X-rays display the nasal and sinus passages, which are missed by intraoral bite-wing X-rays.
Cephalometric X-rays are usually taken with a panoramic X-ray machine. The adapted machine will have a special cephalometric film holder mounted on a mechanical arm. An X-ray image receptor is exposed to ionizing radiation in order to provide the dentist with pictures of the entire oral structure. The advantage of both cephalometric and panoramic X-rays is that the body is exposed to less radiation.
Cephalometric X-rays are not as common as “full sets” or bite-wing X-rays, but they serve several important functions:
Panoramic X-rays are extremely versatile in dentistry, and are used to:
Cephalometric X-rays are completely painless. The head is placed between the mechanical rotating arm and the film holder, which is placed on another arm. The arm rotates around the head capturing images of the face, mouth and teeth. The clarity and sharpness of these images will depend on the positioning of the body. The images are usually magnified up to 30%, so any signs of decay, disease or injury can be seen and treated.
After capturing cephalometric X-rays, the dentist will be able to see a complete side profile of the head. This can assist in orthodontic planning, and allow an immediate evaluation of how braces might impact the facial profile and teeth. Another common use for this type of X-ray is to determine specific measurements prior to the creation and placement of dental implants.
According to research conducted by the American Cancer society, more than 30,000 cases of oral cancer are diagnosed each year. More than 7,000 of these cases result in the death of the patient. The good news is that oral cancer can easily be diagnosed with an annual oral cancer exam, and effectively treated when caught in its earliest stages.
Oral cancer is a pathologic process which begins with an asymptomatic stage during which the usual cancer signs may not be readily noticeable. This makes the oral cancer examinations performed by the dentist critically important. Oral cancers can be of varied histologic types such as teratoma, adenocarcinoma and melanoma. The most common type of oral cancer is the malignant squamous cell carcinoma. This oral cancer type usually originates in lip and mouth tissues.
There are many different places in the oral cavity and maxillofacial region in which oral cancers commonly occur, including:
It is important to note that around 75 percent of oral cancers are linked with modifiable behaviors such as smoking, tobacco use and excessive alcohol consumption. Your dentist can provide literature and education on making lifestyle changes and smoking cessation.
When oral cancer is diagnosed in its earliest stages, treatment is generally very effective. Any noticeable abnormalities in the tongue, gums, mouth or surrounding area should be evaluated by a health professional as quickly as possible. During the oral cancer exam, the dentist and dental hygienist will be scrutinizing the maxillofacial and oral regions carefully for signs of pathologic changes.
The following signs will be investigated during a routine oral cancer exam:
The oral cancer examination is a completely painless process. During the visual part of the examination, the dentist will look for abnormality and feel the face, glands and neck for unusual bumps. Lasers which can highlight pathologic changes are also a wonderful tool for oral cancer checks. The laser can “look” below the surface for abnormal signs and lesions which would be invisible to the naked eye.
If abnormalities, lesions, leukoplakia or lumps are apparent, the dentist will implement a diagnostic impression and treatment plan. In the event that the initial treatment plan is ineffective, a biopsy of the area will be performed. The biopsy includes a clinical evaluation which will identify the precise stage and grade of the oral lesion.
Oral cancer is deemed to be present when the basement membrane of the epithelium has been broken. Malignant types of cancer can readily spread to other places in the oral and maxillofacial regions, posing additional secondary threats. Treatment methods vary according to the precise diagnosis, but may include excision, radiation therapy and chemotherapy.
During bi-annual check-ups, the dentist and hygienist will thoroughly look for changes and lesions in the mouth, but a dedicated comprehensive oral cancer screening should be performed at least once each year.
Oral cancer is often deemed the “forgotten disease,” because it kills more people than testicular cancer, cervical cancer and cancer of the brain each year and receives little publicity in return. Each year, over 30,000 Americans contract oral cancer, and only 57% of these people will live for more than five years without treatment.
Many people believe that if they abstain from tobacco and alcohol use, oral cancer will not affect them. Tobacco and alcohol use does contribute to oral cancer; however, 25% of those diagnosed abstain from both substances.
The best way to stay protected from oral cancer is to get annual oral cancer screenings. Most dentists perform an oral cancer exam during a regular dental checkup. The FDA-approved VELscope® offers dentists another examination tool to help detect oral cancer in its earliest stages. The VELscope® is a blue excitation lamp, which highlights precancerous and cancerous cell changes.
The VELscope® uses Fluorescence Visualization (FV) in an exciting new way. Essentially, bright blue light is shone into the mouth to expose changes and lesions that would otherwise be invisible to the naked eye. One of the biggest difficulties in diagnosing oral cancer is that its symptoms look similar to symptoms of less serious problems. The VELscope® System affords the dentist important insight as to what is happening beneath the surface.
The healthy soft tissue of the mouth naturally absorbs the VELscope® frequency of blue light. Healthy areas beneath the surface of the soft tissue show up green, and the problem areas become much darker.
Here are some of the advantages of using the VELscope® System:
The VELscope® examination literally takes only two or three minutes. It is a painless and noninvasive procedure that saves many lives every single year.
Here is a brief overview of what a VELscope® examination is like:
Initially, the dentist will perform a regular visual examination of the whole lower face. This includes the glands, tongue, cheeks and palate as well as the teeth. Next a pre-rinse solution is swilled around the mouth for slightly less than a minute. The dentist provides special eyewear to protect the integrity of the retinas. The lights in the room are dimmed to allow a clear view of the oral cavity.
The small VELscope® is bent to project blue light inside the mouth. Lesions and other indicators of oral cancer are easily noticeable because they appear much darker under the specialized light.
If symptoms are noted, the dentist may take a biopsy there and then to determine whether or not this is oral cancer. The results of the biopsy dictate the best course of action from there. Otherwise, another oral cancer screening is performed in one year’s time.
