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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.

Dental Waterlines

Have you heard about biofilm? Our dental office monitors it daily. Possibly you'll catch something on TV about biofilm as some sort of newly discovered health threat. It's neither, really. Here are the facts:

Most of our dental equipment is connected to long, flexible tubes that deliver water to your mouth. We call these tubes dental waterlines. Every day, fresh water rushes through them. But overnight or over the weekend, water trapped in these long tubes has the potential of being colonized by a thin layer of microorganisms.

Those microorganisms are biofilm. It's just as important we keep our waterlines free of biofilm as it is you keep your teeth free of plaque through regular brushing.

We've known about biofilm for years. Every morning, all our waterlines are cleared before the first patient arrives. Our dental chairs are equipped with check valves that make sure waterline delivery goes only one way-into the mouth and down the drain.

All this to combat a health hazard that is so far only theoretical-we have no evidence of illness related to water from a dental waterline. Even if it existed, the marginally higher bacteria counts wouldn't necessarily pose a hazard to healthy patients. Bacteria is everywhere-in drinking water, the air we breathe. Getting rid of it is the job of our immune systems.

News organizations love to discover what they believe to be health threats, because it keeps viewers tuned in. But biofilm (if it exists at all) is something we've known about and protected patients against for years.

+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.