Dr. Urban on Today’s Dentistry/The Oral Exam

What is your dentist observing when performing an oral examination?

As a kid I always thought that my dentist was trying to make holes in my teeth with that little pokey thing. As I later found out that was impossible. My dentist was merely trying to detect small soft decaying spots on the chewing surface of my teeth. (Sorry Dr. Parker.)

Dentistry involves more that checking teeth. Dentists check the health of the supporting structures that keep teeth locked in solid and we look for any soft tissue changes or abnormalities that could lead to serious consequences later on.

Your dentist may require you to update your health history at regular intervals. I recommend annual updates or notification of any change of medications or health status.

The soft tissue exam will start with a visual inspection of the face, skin, lips, cheeks, tongue and floor of the mouth. The dentist or hygienist will gently pull the tongue from side to side and check the floor of the mouth for any lumps. Some dentists have invested in specialized equipment to screen their patients for early invisible cancer growths. If positive signs are noted then more diagnostic tests may be necessary. Why is this important? The death rate in the United States for oral cancer is higher than that of cervical cancer, Hodgkin's disease, cancer of the brain, liver, testes, kidney, or ovary.

The doctor will check the condition of your bite and look for any sign of damage to the TMJ. The TMJ is the hinge joint area that allows your jaw to move. Clicking or even popping may be more than an annoyance and lead to more devastating joint damage. Specialist referral or treatment with a night guard may be the next step. If the bite is off or teeth are crowded you may get a referral to the orthodontist.

The periodontal exam concentrates on the gum area around the teeth. The gums should be firm and pink. They should not bleed or ooze pus. They should not be abraded and receded away from over aggressive brushing or swollen from brushing neglect. The color and texture of the gums, any tooth mobility, gum recession, and bone loss will be noted. The hygienist will measure the gap between your gums and where they attach to the tooth. This is the “pocket” and normal healthy pockets are 2-3 mm deep. Beyond that depth and cleaning becomes difficult. The best tooth brushing and flossing techniques will not go below 3mm.and clean the deeper pockets.

Finally, the oral exam will involve checking the teeth. The list of dental conditions includes decay, white spots, abrasion, erosion, attrition, abnormal wear, fractures, cracked fillings, leaky crowns, bad fitting removable bridges and dentures, and loose bridges. Periodically, x-rays will be taken and examined for decay between the teeth, bone loss around the teeth, abscesses, cysts, and tumors.

Your dentist and hygienist are very sensitive to spotting abnormal signs. However, if you notice anything not right please inform your dental team.

For answers to your dental questions, contact
Douglas Urban, D.D.S.
Cerritos, CA 90703
562 924-1523
DrDouglasUrban.com