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Visiting Your Dentist And Physical Evaluation

By Stanley F. Malamed, DDS

That first visit to a dental office often causes a degree of anxiety. What will happen at this first visit to the dentist?

In addition to welcoming the new patient to their dental practice and getting information about their oral health needs, the doctor and his/her staff will need to obtain some very important information from that person regarding their health history in order to make their future dental visits as pleasant and as safe as is possible.

It is important that the patient be honest with their doctor in answering these questions about about your mouth and your dental health. Though there is usually no direct correlation between an existing medical condition and the dental care they are about to receive, there are specific instances where the planned dental treatment may require modification or even be postponed due to a pre-existing medical problem, such as bad breath.

In order to obtain this information, the doctor will do the following:

  1. Medical history questionnaire: The medical history questionnaire is a form that usually is filled in by the patient. It will ask questions regarding the status of their past and present health. The patient reads this form carefully and then answers each question to the best of their ability. Most forms will ask for a list of any drugs or medications the patient is currently taking. It is very important that they give a complete list of ALL medicines, including over-the-counter and herbal remedies, as well as any prescription drugs they may be taking.

    In the list of medical problems, the patient should not hesitate to check the appropriate box, yes or no, for each problem listed.

    Any medical information obtained from the patient during this physical evaluation is considered to be confidential.

    The Medical History Questionnaire must be signed by the patient or by a legal guardian, if they are legally a minor.

    It is important for the patient to notify their doctor prior to the start of dental treatment if there is ever any change in their medical condition.
     

  2. Record vital signs: The doctor or a dental auxiliary (dental hygienist or dental assistant) will record blood pressure and take a reading of a patient's heart rate (pulse) and breathing rate. In addition, in some situations, body temperature may be recorded.
     

  3. Dialogue history: The doctor or dental hygienist then will review with the patient all of the findings obtained from the Medical History Questionnaire and the recording of their vital signs. In response to any positive answer (such as diabetes or high blood pressure), additional questions will be asked to determine the significance, if any, of this medical condition to the individual's planned dental treatment.

    Bad breath, or halitosis, is a signal that something is not right inside your mouth. It may be as simple as the need to pay more attention to your daily oral hygiene, or it may indicate tooth decay, gum disease, or another medical problem. Whichever it is, bad breath is a red flag: take another look at your mouth!

    Halitosis is a social problem; if you have bad breath, you may notice that people actually back away as you talk to them. Mouth odors are embarrassing, and they tell other people that you aren't taking care of yourself. Sometimes people are not aware that their breath smells bad; be alert to how other people react when they're close to you, and be grateful if a friend or family member lets you know about the problem.

    Commercial products claim they will make your breath fresher, but the only way to make sure your breath permanently fresh is to practice good oral hygiene. In fact, too many breath mints and hard candies with sugar will lead to tooth decay. If you are constantly using breath mints, breath sprays, or mouthrinses in an effort to cover up your bad breath, realize that you may have a dental or medical problem that needs addressing.

    There are a number of reasons you may experience a bad taste in your mouth, and even be able to smell your own breath. Food may be lodged between your teeth if you are not brushing at least twice daily and flossing regularly. Food particles can be very tiny and can wedge themselves between teeth and below the gum line; brushing after meals is important and flossing is imperative to get at the particles that the brush can't reach. Brush your tongue or use a tongue scraper. As odd as it will feel at first, bacteria collects on the tongue and can contribute to bad breath. If you wear removable dentures, take them out at night and clean them thoroughly before you wear them again.

    If you neglect your daily hygiene over time, halitosis can become a symptom of more serious dental problems. Teeth that are not cleaned properly become a place for bacteria to reside as food particles stay in your mouth and decay. Bacteria attack your teeth and gums and cause cavities and gum disease. If this is happening, gum disease will cause an unpleasant odor.

    Perhaps you believe that you are brushing and flossing on a regular basis, but are still experiencing bad breath. If you have teeth that are crooked or crowded, it may be hard for you to clean between them. If you wear dentures that are not fit properly, they may be trapping food or irritating your mouth. Or perhaps your bad breath is caused by another medical problem: drainage from your sinuses, gastrointestinal problems, kidney or liver problems, or other medical conditions.

    Here's what you can do to "investigate" on your own. Write down what you're eating and notice whether your breath smells bad because of certain foods. Garlic and onions actually cause odor, but the odor is coming from your lungs as you breathe, not from your mouth itself. The odor from these foods is temporary, and will be gone once the food is out of your bloodstream.

    Are you dieting? Hunger can contribute to bad breath, because of the chemical changes as your body turns fat and protein into the energy it needs. Taking prescription or over-the-counter medications? Add these to the record of what you're eating to see whether there's a relationship between your medications and your bad breath. And don't forget to tell your dentist if there's been a change in your overall health since your last visit.

    Suffering from dry mouth? Saliva provides constant rinsing in our mouths and washes away food particles. Your dentist may recommend more liquids, sugarless candy to stimulate natural saliva, and perhaps some of the commercial products that are available to combat dry mouth.

    If halitosis continues after you have done your best job of regular brushing and flossing, start with your dentist. He or she can tell you whether the odor is caused by an oral problem; if it is not, then your dentist will suggest you see your doctor for a physical check-up.

    Regular dental check-ups will help keep your mouth healthy and working well. Your dentist can spot problems before they cause trouble, including problems that cause bad breath.

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