Dr Rosalind Ho BDS (S’pore) MFGDP (UK)
Most patients are not aware of their dental condition until they feel some pain and decide to go to the dentist. The half yearly check up is important for a few reasons;
What may a dental check-up reveal ?
1 Most dental lesions like initial decay may not give problems. When treated early, it is fast, economical and painless. Digital technology such as digital xrays that are of negligible dosage and instant result and the use of oral camera can enlighten the patient to the existence of decay.
2 Screening for wisdom teeth. If the wisdom tooth is impacted, it is not uncommon to discover decay on the distal surface of the second molar which is in front of the wisdom tooth. Once decayed, this surface is extremely difficult to fill and often results in redo over the years. The final result may be the loss of the second molar in which case the upper opposing second molar also becomes non functional.
3 Gum disease is silent. The patient may feel no pain at all . Meanwhile, the supporting bone around teeth may be resorbing because of the inflammation of the gums. The only sign would be bleeding. With time, the teeth feels weak to biting and cannot be salvaged.
4 Initial pocketing of the gums , that is the space between the gums and the tooth has an acceptable depth of up to 3 mm. If it becomes pathological, urgent treatment is necessary or the pocket becomes too deep to be treated by a simple gum treatment called curettage. In which case, gum surgery may be necessary.
5 Existing dental infection in the mouth. For instance, teeth that are undergoing necrosis or non-vital(dead teeth) may discharge into the mouth. To prevent further destruction of the roots, they should be treated as early as possible.
6 Dental conditions like tooth wear due to wrong tooth brushing or night grinding may be diagnosed during the check up. Correct tooth brushing techniques would be taught and a night guard is necessary to prevent severe tooth wear and resulting symptoms. Treating them early can prevent further teeth loss and increased costs.
7 Discovering non related medical condition. It is not uncommon for the dentist to find out that the patients may have underlying medical condition during a dental check-up. For eg, the dentist can suspect diabetes, osteoporosis, anaemia etc.
8 Oral cancer screening. The dentist is in the front line where detection of oral cancer is concerned. Oral cancer can occur in the mouth and early detection is very important. This is part of routine dental screening.
9 Patient should see the dentist to find out options to replace missing teeth. With advances in dental sciences, better materials are available and a more suitable option can be discussed. Missing teeth have dire consequences on the resulting occlusion or bite as other teeth now bear the brunt of the forces of mastication.
10 Your dentist can show you the effects of missing teeth such as drifting , tilting and over-eruption of neighbouring teeth. When one tooth is gone, the opposing tooth also loses its function. Hence it is tantamount to losing two teeth.
What is done during the check-up
1 Medical and dental history is taken.
2. Patient’s complaint and concern is noted
3 Dental chart is updated
4 Extra oral examination like the joints, lips and jaws.
5 Intra-oral examination of all teeth, gums, tongue, palate and soft tissues. Any abnormalities highlighted to patient. The use of oral camera may be necessary to show patients.
6 Xrays where necessary. Today, we have clear digital scan that can diagnose any dental lesions . For some treatment such as implants, a 3 D scan is also available.
7 Scaling and Polishing or prophylaxis should be done after the check-up followed by fluoride application if necessary.
8 Discussion about any dental problems, treatment options and cost and verbal consent.
The importance of healthy teeth and gums cannot be over emphasized. The restoration and rehabilitatiom of the dentition and gums are costly and time consuming. Today, it is possible to have teeth for life. But the onus is on the patient to be aware of its care and maintenance and start seeing your dentist regularly.