A dental examination is the process where your dentist will examine your teeth and gums to check how healthy they are and also assess if there are any problem areas within your mouth. If any problems are identified, your dentist will advise the most suitable course of treatment available to you.
What does the examination process involve?
During the dental examination your dentist will:
- Check your jaw and face to see that all appear healthy
- Look at other places in and around the mouth i.e. no just the teeth and gums to ensure that they are in a healthy condition. He will typically check the back of your throat, roof of the mouth and your tongue
- Check your teeth and gums for signs of decay, disease, wear, damage and correct alignment.
- Compare the condition of your teeth and gums to the last visit by examining patient notes and possibly x-rays. This is to assess if any additional treatment is necessary and to check progress of any treatment programme you may be undergoing.
The importance of regular dental examinations:
It is important to undergo regular dental examinations, typically every 6 months to ensure that your teeth, gums and mouth remain healthy. If any problem is identified it can be addressed quickly before it becomes more complex and requiring prolonged treatment.
X-rays show any decay, any possible infections in the roots or bone loss around the tooth. They can help us to see between your teeth or under the edge of your fillings.
In children, X-rays can be used to show where the second teeth are and when they will come through, how the jaw is growing too.
The dentist, as well trained members of the dentist’s staff can take x-rays.
- With modern techniques and equipment, risks received from the amount of radiation received are extremely small
- However, we will only take x-rays if they are needed; after that, x-rays are usually recommended every 6 to 24 months depending on the person, their history of decay, age and the condition of their mouth
- We may still ask you whether you are pregnant or whether you might be, and whether you would rather not have an x-ray
When the x-ray is taken:
- You will need to keep very still for a few seconds to give a clear picture
- We usually compare a new x-ray with one taken some time ago
- According to the law we will keep old x-rays in your file for at least two years from the date of your last course of treatment
Scaling and polishing
Every day, a sticky film of bacteria called plaque builds up on the surface your teeth. The bacteria within the plaque can cause gum disease and promote tooth decay. If not removed, the plaque hardens into calculus (or tartar) which can only be removed by the dentist.
The tartar is removed by ‘scaling’ using ultrasonic and hand scalers. Hand scalers come in a variety of shapes and sizes to reach all areas within your mouth – ultrasonic scalers use water and vibrate very quickly to shake free the tartar and plaque from the surface of the teeth. Following scaling, the teeth are polished to make them smooth and easier to keep clean at home. Scaling and polishing is usually recommended according to the needs of the patient.
Fissure sealants are white plastic coatings that are painted onto the biting surface of the back teeth. They help to stop the chewing surface from getting decayed.
Sugar from food and drink collects in the fissure or groove on the biting surface of the back teeth. These sugary deposits promote tooth decay and are difficult to remove by regular brushing because the toothbrush bristle is too wide to reach the base of the fissure. The fissure sealant resists the decay by providing a protective coating for the surface of the tooth.
Before the sealant is applied, the tooth will be cleaned and dried in readiness. Following application, the sealant is hardened by the application of a special light for approximately 30 seconds. The process is painless and correctly applied sealants can last for 2 – 5 years.
When decay has dissolved the tooth substance, i.e. enamel and dentine, the softened structure may break and create a hole. The dentist needs to fill this hole produced by the decay and thus a filling is placed.
There are two types of filling, 'silver' fillings and 'white' fillings. In our time fillings are not only functional, but can be natural looking as well. Many people don’t want silver fillings that show when they laugh or smile because they are more conscious about the way they look.
Patients often attend the dentist at short notice or without appointments. If a patient has lost a filling or in pain, a temporary filling material allows the dentist to rapidly place a restoration, which will protect the tooth from hot drinks, cold air and bacterial invasion.
It is usually best to change fillings only when your dentist decides that an old filling needs replacing. You can ask to have it replaced in a tooth-coloured material.
An extraction is the removal of a tooth from the mouth. Extractions are performed for a very damaged tooth, or loose because of severe gum diseases, which may affect the supporting tissues and bone structures of teeth.
Extractions of problematic wisdom teeth are routinely performed. Also, some permanent teeth are extracted in order to make space for orthodontic treatment.
Types of extractions
Simple extractions are performed on teeth that are visible in the mouth, usually under local anaesthetic.
Surgical extractions involve the removal of teeth that cannot be easily accessed, either because they have broken under the gum line line or because they have not erupted fully.
- We will make sure you are properly numb during the procedure!
- Infection does occur on rare occasions. The dentist may opt to prescribe antibiotics pre- operatively and/or post-operatively if he determines you are at risk
- You will receive advice on how to look after the space where the tooth was while it is healing
- You will receive advice on how to use painkillers so you are not in any discomfort when the anaesthetic wears off
Adults can have up to 32 teeth. The wisdom teeth are the large molars at the end of each line of teeth (there is one wisdom tooth at the end of each row, 4 in total).
Wisdom teeth are the last permanent teeth to develop. They appear in the mouth between the ages of 18-24 years and may develop in the jaw but never erupt or appear in the mouth. Sometimes they appear many years later.
The most common problem associated with wisdom teeth is called Pericoronitis . The way pericoronitis develops is as follows:
If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and swollen. Food particles and bacteria can collect under the gum edge, and it will be difficult to clean the area effectively. This is only a temporary problem that can be dealt with by using mouthwashes and special cleaning methods and possibly antibiotics. If the problem keeps coming back, it may be better to have the tooth removed.
Common symptoms associated with pericoronitis and half-impacted wisdom teeth are:
- Vague ill-defined pain around the back of the mouth and cheek on the affected side
- Pain and swelling overlying the wisdom tooth, sometimes associated with a
- bad taste or an unpleasant taste in the mouth or
- discharge of liquid or pus
- Limited mouth opening
If the pain does not go away or if you find it difficult to open your mouth, you should come and see a dentist. The dentist will usually take x-rays to see the position of the root, and to assess whether there is room for the tooth to come through into a useful position.
Everything depends on the position and the shape of the roots. Your dentist will tell you how easy or difficult each tooth will be to remove after looking at the x-rays. Upper wisdom teeth are often easier to remove than lower ones, which are more likely to be impacted. Your dentist will say whether the tooth should be taken out at the dental practice, or whether you should be referred to an oral surgeon at a hospital.
Reasons for wisdom teeth to be removed:
- Pericoronitis as described above
- Tooth decay (the classic hole in the tooth, rotten teeth) also called caries
- Food impaction between the wisdom tooth and the tooth in front causing decay in either the wisdom tooth itself or the tooth in front (usually this would be the lower 7 -meaning the lower 7th tooth in the jaw on either the left or right side-, also called the lower second molar)
- Damage – root resorption- to the tooth in front (Lower 7) when the wisdom tooth has erupted in a forward position and is pushing on the roots or crown of the tooth in front.
- Damage to the bone or soft tissue due to cysts or tumours associated with the wisdom tooth or nearby structures or tissues.