YOUR DENTAL VISIT: WHAT TO EXPECT

TYPES OF DENTAL VISITS

Most people are familiar with the typical dental checkup visit. If the office has a dental hygienist, he or she will clean your teeth, do an evaluation and sometimes take X-rays. Then the dentist will check the X-rays and your teeth for signs of decay, check your gums for changes, and check for signs of oral cancer or other diseases.

From time to time, however, your dentist should do a more thorough exam. This is called a comprehensive examination. It includes a thorough look at your entire mouth, head and neck area. The dentist also will ask about your medical history, and you will get X-rays if indicated.

THE CHECKUP VISIT

During a checkup visit, in addition to the dentist, you may see the dental hygienist. The hygienist typically will check your gums and teeth, clean and polish your teeth, and talk to you about caring for your teeth and gums properly at home. Your dentist also may do a clinical examination, diagnose problems and recommend treatments. Here's what to expect:

Cleaning — A professional dental cleaning removes the hard calculus (also called tartar) from above and just below the gum line. Brushing and flossing at home removes plaque. Only dental instruments can remove calculus. Some dental hygienists use ultrasonic instruments to blast away the larger chunks of tartar. They follow up with hand instruments to thoroughly clean the teeth. Other hygienists use only hand instruments.

Polishing — After the calculus is removed, the crowns of your teeth (the parts that show) may be polished to remove plaque and surface stains. Typically, but not always, an abrasive substance is applied to the teeth with a small rotating rubber cup or brush. This helps to scrub away stains. You will rinse your mouth to wash away the gritty polishing substance.

Prevention — The hygienist may offer instructions for oral care at home based on the results of the exam. He or she may demonstrate how to brush and floss properly.

X-rays — The U.S. Food and Drug Administration (FDA) says X-rays should be limited because the effects of radiation add up over time. Your dentist will decide if you need X-rays during your check-up visit.

Scans — Using new technology, the dentist may take a scan of your upper and lower teeth and your bite to have as part of your patient record. The scans are then stored in the computer inside an electronic health record. This aids in diagnosis and treatment planning.

Treatment advice — If your dentist finds any problems, he or she will recommend steps to fix them. These may include a referral to a specialist (such as a periodontist or orthodontist). You also may need further tests for diagnosis. You may have to return to the dentist for a filling or more intensive periodontal treatment.

THE COMPREHENSIVE EXAMINATION

A comprehensive examination likely will be done the first time you visit a dental office. Even if you have had regular care under another dentist, your new dentist will want to become familiar with your health. This will allow him or her to notice changes or problems more easily during future visits. During a comprehensive examination, your dentist will look at much more than just your teeth.

Head and neck — Your dentist will look at your face, neck and lips to make sure there are no unusual swellings, lip dryness, bleeding or other abnormalities that need to be checked further.

Your dentist will examine your temporomandibular joint to check for problems. The joint guides your lower jaw when you open your mouth. It's often called the TMJ. Tell the dentist if you have had any pain or soreness in the joint. Your dentist also will touch salivary glands and lymph nodes in your neck area. Swelling or tenderness there may indicate infection or disease.

Soft tissue — The soft tissues of the mouth include the tongue, the inside of the lips and cheeks, and the floor and roof of the mouth. Your dentist will check for spots, cuts, swellings, growths or other abnormal areas.

Periodontal — Your dentist will look at the gums for signs of redness or inflammation (puffiness). He or she may poke them gently to see how easily they bleed. These symptoms may indicate gum disease. Your dentist may use a special probe to measure the depth of the pockets between your teeth and your gums. Pockets deeper than 3 millimeters often indicate periodontal disease. If you have periodontal disease, your dentist may recommend treatment or refer you to a periodontist. This is a specialist who treats diseases of the gums.

Occlusion — Your dentist may check how well your teeth fit together by examining your bite. If the teeth don't seem to fit together properly, your dentist may have you bite down on special wax or paper. The paper makes temporary marks on your teeth that show where your teeth come together.

Clinical examination of teeth — Your dentist will check for decay by looking at every tooth surface (using a mirror to see the back sides of teeth). He or she often will examine your teeth with a tool called an explorer to detect cavities. If you have fillings, permanent bridges, crowns ,implants or other restorations, your dentist will check that they are in good condition, and that the teeth around them have no sign of decay.

X-rays — If you are seeing a new dentist for the first time, ask for a copy of your X-rays from your former dentist. This will help you to possibly avoid repeating X-rays. If you have not had recent X-rays, they will be done to help your dentist look for decay (cavities) or other problems that cannot be seen during the clinical exam. X-rays also provide the best way for the dentist to see a need for root canal treatment, or bone loss that may indicate advanced gum disease.

WHAT TO TELL YOUR DENTIST

Your dentist needs to know everything that may help him or her diagnose problems or treat you appropriately. Tell your dentist about:

Your fears — Many people have fears of the dentist that go back to childhood. Pain control and treatment techniques change constantly. The things you fear most may not exist any longer, or there may be new and improved ways of dealing with them. Often, just talking about your fears will take some of the edge off. Your dentist should be open to advising you and allaying your fears.
Changes to your overall health — Tell your dentist if you've been diagnosed with any diseases. Many diseases can affect your mouth and teeth. Researchers continue to discover ways in which oral health is related to overall health. Even diseases that seem to be unrelated to the mouth may require a different approach to dental treatments or prevention.
Medications you take — This includes prescriptions and over-the-counter medicines. Some medicines cause dry mouth, which can increase the risk of cavities. Your dentist also will want to check that any drug he or she prescribes doesn't interact with drugs you are already taking.
Your dental health — Before the examination starts, tell your dentist if:

You think you have a new cavity
Your teeth have become sensitive
You feel lumps inside your mouth

By telling your dentist your symptoms, you may help him or her make an early diagnosis.

Whether you gag easily — If you have a sensitive gag reflex, going to the dentist can be very difficult. This reflex is located on the back wall of the throat. It helps keep objects from going down your windpipe. If a finger or object gets too far back in your mouth, you may gag or fell like throwing up. Talk with your dentist and hygienist about your concerns. There are methods available to deal with this issue.

CHOOSING A DENTIST

If you need to choose a dentist, take your time researching your options. Don't wait for an emergency! There are several things to consider when looking for a dentist.

Location and office hours — A dentist close to home or work will make it easier to schedule visits and to arrive on time.

Cost — Does the dentist accept your insurance? Does the dentist offer multiple payment options (credit cards, personal checks, payment plans)? If your insurance plan requires referrals to specialists, can this dentist provide them?

Also, be aware that costs vary by practice. If you can, get estimates of what your dentist might charge for common procedures such as fillings, crowns or root canal therapy. Even if you have dental insurance, you may be paying part of the costs yourself.

Personal comfort — Do you feel comfortable asking questions? Do you feel like the dentist hears and understands your concerns? Would you feel comfortable asking for pain medicine or expressing your fear or anxiety?

Recommendations — Friends or family that are satisfied with their dentist often make excellent sources for a referral.

Professional qualifications — The dentist's office should be able to tell you about the dentist's training. The office also should have policies on infection control. If the staff seems uncomfortable answering your questions, or you are uncomfortable with their answers, consider finding another dentist. You can also obtain information about a dentist's qualifications from the local dental society or your insurance carrier. Most organizations of specialty dentists also list their members and qualifications.

Emergency care —Find out what happens if you have an emergency, either during normal office hours, or at night or on a weekend. You should be able to contact your dentist (or a suitable substitute) at any time by calling an answering service, cell phone or pager.

Telehealth —The availability of video dental visits using a cell phone or computer for dental consultations and follow up care can enhance the dental experience. This is particularly important for patients who have limited access to dental services. The oral assessment can be conducted and problems identified utilizing this remote technique.

State licensing boards —Most state dental boards have a website where you can verify if your dentist is licensed. The website also should tell you whether there have been any disciplinary actions taken against him or her.

Here are some resources for finding a dentist:

Friends and family members - They can tell you about the personality of the dentist, waiting times and office staff.
Your current dentist — If you are moving, ask your current dentist if he or she knows of someone to recommend near your new home.
Your dental insurance company — Your insurer will provide names and contact information for dentists in your area who are in your dental plan's network. Usually you will have to pay a lower fee if you use these dentists, and you have the added assurance that they underwent a rigorous credentialing process before joining the plan.
Your state's dental association — Each state has a dental association that can provide names of dentists who are members of the American Dental Association (ADA). However, ADA membership does not mean a higher quality of care.
Your local hospital — Some hospitals have their own dental clinics, or can recommend local dentists.
The nearest dental school — Most dental schools have clinics that accept new patients. The care given at these clinics is excellent. The cost is often lower than visiting a private-practice dentist. Usually, routine care at a dental school clinic is provided by dental students and residents (dentists who are completing advanced training). They are supervised by dentists who teach at the dental school. For complicated and newer procedures, these clinics offer state-of-the-art care.
Online reviews — There are reviews of dentists available online, but these are not always reliable because they can be rather easily manipulated positively or negatively.

Last updated March 31, 2021

References:

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