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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

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Self Dental Care Tips For Special Needs

Maintaining good oral hygiene can be a challenge, especially if you have developed a health condition that makes brushing and flossing more difficult, or have been in an accident that created new limitations. Dentists want to help all dental patients keep their mouths healthy, and they offer these suggestions about performing oral hygiene and home dental care .

Brushing Tips

Problems in hands, wrists, arms, and shoulders can hinder a person's ability to brush, floss, and perform oral hygiene. While each situation is different, there are some suggestions that have been effective in making dental care easier:

• Use a wide elastic band to attach the toothbrush to your hand for extra gripping power.
• Attach a small rubber ball, a sponge, or a rubber grip to the toothbrush handle with strong tape. This enhances gripping power and is often useful when hand or arm movement is weakened or limited.
• Use a longer wooden dowel, a ruler, or plastic rod to lengthen the toothbrush handle, wrapping it securely with strong tape. This longer length may help in more easily reaching your mouth.
• Use an electric or sonic toothbrush.

Flossing Tips

If limitations make brushing harder, flossing may be an even bigger challenge. Depending on your limitations, try these techniques:

• Use a piece of floss, about 18" long, and wind one end of floss around each finger instead of holding it. This will increase your grip and prevent the floss from dropping out of your fingers with each tooth you floss.
• Hold the floss tightly and seesaw it back and forth between the teeth, instead of pushing the floss right through.
• Tie the floss into a long circle instead of using one long piece, which may make it easier to hold and less likely to drop from your hands.
• Try using a floss holder, available wherever oral hygiene products are sold.

By Danine M. Fresch, DDS