The Check Up

Regular dental check ups are the best way to make sure your gums and teeth stay healthy. The check up allows your dentist to diagnose any problems, and to take preventive action to stop problems before they develop.

Your dentist is trained to look for anything unusual in your mouth, throat and neck, including the oral manifestations of diseases, oral cancer, infections, the early signs of gum disease, eroded fillings and dental decay.

Your dentist understands the treatment alternatives available to you, and can help you make informed decisions about your dental care. But you have a role to play too in preventing many of the common dental problems associated with growing older.

Brush and floss your teeth properly, visit your dentist regularly for a professional cleaning, check up and necessary treatment, and update your dentist on your medical history, including any new medication you are taking.

Do I Need a Dental Check Up?

Yes. Everyone needs regular preventive check ups. Even if you are diligent about brushing and flossing, your teeth and gums still need regular care from a dental professional. Check ups are equally important if you wear dentures, have dental implants, or are taking medication that affects your mouth in some way, such as causing dry mouth or overgrown gums.

How often you go for a check up depends on your oral health needs. The goal is to catch small problems early. For many people, this means a check up every six months. Your dentist may suggest that you visit more or less often depending on how well you care for your teeth and gums, problems you have that need to be checked or treated, how fast tartar builds up on your teeth, and so on.

No matter how carefully you take care of your teeth and gums, or how carefully you look for signs of problems, there are a number of oral health conditions that only your dentist can see. Various medical conditions can also be detected during your dental checkup, often in their early stages. Your dentist has been trained to identify the oral manifestations of these conditions, and can refer you to other health professionals for treatment.

Ten oral health problems your dentist can see that you can't:

1. Deterioration in fillings, crowns and other restorations.
2. Root cavities — decay on roots of teeth exposed by receding gums.
3. Periodontal pockets caused by gum disease.
4. New decay under the gumline.
5. Cavities under existing fillings.
6. Hairline tooth fractures.
7. Impacted wisdom teeth.
8. Early signs of gum disease.
9. Early signs of oral cancer.
10. Signs of other problems that could affect your general health

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Parts of the Check Up

During your check up, your dentist will look for early signs of oral cancer and many other diseases. Your dentist will also look for gum disease, cavities, eroded fillings, tooth fractures, and oral infections. He or she is trained to catch small problems before they become big ones, and can often treat a problem right away.

A check up can include some or all of the following procedures:

1. Dental and medical history update — your dentist will ask you about any oral or general health problems you have (e.g. changes in your teeth, sensitive gums, allergies, medical conditions)

2. Examination and treatment — your dentist looks for anything unusual and catches small problems before they become big ones (e.g. early signs of gum disease, eroded fillings, infections, oral cancer). Many small problems can be caught before they get big and can often be treated right away.

3. Cleaning — a cleaning makes your teeth and fillings smooth, so it's harder for plaque to build up on your teeth. Plaque is clear and sticky. It forms on your teeth every day. If plaque is left on your teeth, it hardens into tartar (also called calculus). A cleaning is the only way to remove tartar. It cannot be removed with your toothbrush. If tartar is not removed, it can help cause gum disease. A cleaning also removes some stains, so your teeth look better.

Here are the main steps in a cleaning. Your dentist or dental hygienist may do these steps in a different order, because your teeth are unique.

• Flossing removes plaque from under the gumline and between teeth. It also removes bits of food from between teeth.



• Scaling removes tartar from teeth. "Gross scaling" removes bigger pieces of tartar. "Fine scaling" gets much smaller pieces of tartar, mostly from back teeth and other hard-to-reach places.



• Polishing smooths and cleans the surfaces of the teeth.

Why do I need my teeth cleaned?

Professional cleaning is the only way to remove hardened deposits of tartar from your teeth. If tartar is not removed, it can cause gum disease, the leading cause of tooth loss in adults.

Cleaning also smoothes and polishes the surfaces of your teeth and your fillings so they are less likely to accumulate plaque (the invisible bacterial film that builds up on teeth every day). Finally, cleaning removes stains and mild discolourations, so your teeth look better.

A good cleaning can take some time, but it's time well spent. A cleaning by your dentist or dental hygienist helps to prevent gum disease, one of the most common adult dental problems.

4. Fluoride treatment — a member of your dental team may apply fluoride to your teeth during a check up. It may be a gel, a foam or a liquid. Fluoride helps prevent cavities by fixing the first, tiny stages of tooth decay, and by slowing down the germs (or bacteria) growing on your teeth. Your dentist will talk to you about your total exposure to fluoride to determine if you need a fluoride treatment.

5. Advice — your dentist can give advice and answer your questions based on the results of your checkup.

You can help your dentist understand more about your teeth by telling your dentist about any changes in your mouth or with your overall health. Ask your dentist questions about your check up results and how to take better care of your teeth and gums. And make sure your dentist has your updated medical history.

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Will the Dentist Take X-rays?

X-rays may or may not be a regular part of your checkup. X-rays help your dentist see problems long before they get too serious. Your dentist will only take x-rays if there is a need for them.

X-rays can show:

• Cavities between teeth, under the gums and around old fillings
• Bone loss caused by gum disease
• Teeth that are trapped (or impacted) in the gums, such as wisdom teeth
• Long or crooked tooth roots that will need special care if you have treatment such as a root canal
• Infections at the roots of teeth with deep cavities
• Cracks in teeth
• Problems with the bone holding the tooth in place
  

Are X-rays Safe?

X-rays are safe. People are exposed to very low levels of radiation as part of their daily lives. When you have a dental X-ray, you are protected in three ways:

1. Targeting — The machine directs the X-ray only to the area where you need it. High-speed film and precise timers shorten the amount of time you are exposed to radiation. Equipment is checked on a regular basis to make sure it is working the way it should.
2. Covering — A lead apron and collar give you added protection.
3. Staff training — Members of the dental team are well trained in giving X-rays.

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Is There Anything I Need to Do?

Yes. Be sure to tell your dentist about any changes in your general health, any medication you are taking, or whether your medication has changed since your last visit. Talk to your dentist about any specific dental problems or concerns you have. You should also mention any stress-producing factors in your life, since stress affects the condition of your mouth.

Be sure to tell your dentist about discomfort, pain or other oral symptoms that you are experiencing. Your dentist will be able to determine what's wrong, or refer you to an appropriate health care professional for further consultation.

Some adults suffer from dry mouth, which may be a side effect of medication. In addition to being uncomfortable, this condition can aggravate other dental problems and increase the risk of decay. Mention it to your dentist.

Tell your dentist:

• about any changes in your teeth such as changes in colour, looseness or position
• if your teeth or gums are more sensitive to heat, cold or sweets
• about any changes in your gums like changes in colour, tenderness or bleeding when you brush or floss
• if your floss catches on rough edges of teeth and shreds
• about any changes in the skin on the inside of your mouth, such as changes in colour
• if you clench or grind your teeth, or if your neck and jaw muscles are tense

It's just as important to let your dentist know about your general health. Tell your dentist:

• if you smoke (smoking can lead to serious problems like oral cancer)
• about any allergies you have
• if you are pregnant
• about any medicine you are taking
• if your medicine has changed since your last check up
• about any health problem or medical condition you are being treated for
• about any other changes in your general health

You should also tell your dentist if you are nervous about dental visits. This feeling is called dental anxiety. Even people who visit the dentist on a regular basis sometimes get "butterflies in the stomach." In severe cases, fear can be so bad that it keeps people away from the dentist and puts their dental health at risk.

Often, it's fear of pain that keeps people out of the dental chair. But new ways of doing things have made modern dentistry almost painless. If you are afraid of going to the dentist for any reason, don't be shy to talk to your dentist about it. Your dentist is trained to help you relax.

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Questions to Ask Your Dentist

A check up is also an opportunity to talk to your dentist about your oral health and to ask questions.

1. What type of toothbrush and floss are best for me?
2. Am I brushing and flossing effectively?
3. Am I missing any spots when brushing or flossing?
4. Where does plaque accumulate in my mouth?
5. How fast does plaque accumulate in my mouth?
6. How does my mouth look?

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For more information on how to keep your teeth good for life, talk to your dentist.

Photos provided courtesy of the American Association of Dental Editors. www.dentaleditors.org