What Occurs In Your Mouth During A Dental Care Examination
By Denise J. Fedele, DMD, MS
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.
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