There is a critical time, however, when dentists often don't have adequate time to bridge this information gap with our patients -- this is when we give exams during your routine cleaning appointments. The purpose of these exams often baffles patients, as our visit is usually short, and some patients even go as far as declining the dental exam because they just don't see any value in it. For that reason, I have decided to reveal exactly what your dentist is doing during that three minute exam and why it is important.
You may not realize this, but often your dental exam begins before the dentist even sees you. When your hygienist has completed your cleaning and comes to get me in my office, I will receive an overview of your oral health condition. I will review your digital x-rays on my computer and evaluate them for any decay, periodontal disease, compromised crowns or fillings, and other pathology. After I have completed this review, I will then walk over to greet you in the hygiene room (and am often greeted with an anxious expression from someone uncomfortably reclined in the dental chair). I realize this reclining position is an odd way to greet someone, so I always try my best to put you at ease.
I'll then proceed to examine your entire mouth visually with my instruments and explorer. The explorer is the "Captain Hook" instrument which basically allows me to feel for any decay in the various crevices of your teeth. Specifically, I'm looking for areas of new decay on the tops and sides of your teeth, as well as checking the integrity of any fillings/crowns you have by feeling how they integrate with your tooth. If a gap has appeared between a filling/crown and your tooth, there's probably decay there.
Next, I'll examine any problem area of your gums and determine if additional periodontal treatment is necessary. I'll then compare my findings to x-rays to validate what I see in your mouth. I'll also use this time to reinforce any instruction concerning diet or oral hygiene the hygienist may have shared with you.
At this point I should have a pretty good determination of what, if anything, needs to be done and will discuss the options with you. The hygienist will then schedule any follow-up appointments. Sometimes the necessary work is extensive enough that I don't have adequate time to discuss everything with you during this cleaning appointment. If that is the case, we will schedule a consultation appointment for a later date to discuss the necessary treatment in detail. During this consultation appointment I will make sure you have all the information you need and all your questions are answered to your satisfaction.
While this entire dental examination process only takes a few minutes and can feel like just a bunch of poking and prodding, a lot of things are actually happening. It is important to keep in mind that dentists are trained to find, diagnose, and treat all the ailments of the mouth. Though skilled hygienists can spot many of these issues too, they will be the first to tell you a dentist needs to examine your mouth to catch all the areas of concern.
Whenever a patient refuses the dentist's exam, we make it a point to note his/her chart that the suggestion for this exam was made but declined by the patient. Why do we do this? If, down the road, this same patient comes in with a dental problem and asks why it was not caught sooner, we will be able to respectfully discuss his/her decision to forgo the dental exam during previous cleaning appointments.
So - that's whats going on in that whirlwind of an encounter you sometimes have with your dentist during a cleaning appointment. Now you know -- and you can consider that dental information gap just a little smaller!
Next blog topic: Six month checkups: Why they can save you considerable pain and money in the long-run.
Have a good one!
-DRS
