A dental examination is complete ONLY if it allows identification of all active factors that are capable of causing or contributing to the deterioration of oral health or function. It is incomplete if it does not provide enough information to develop a total treatment plan aimed at optimum maintainability of the teeth and their supporting structures. Since there is no effective way to achieve maintainable oral health without a harmony of all parts of the masticatory system, the total system must be evaluated. what affects one part of the system will eventually affect the other parts. A careful diagnostician must first be a careful examiner who observes every deleterious effect in the form of signs or symptom and then analyzes for all the possible causes.
It takes time (a considerable amount) to perform an examination correctly and then have opportunity to discuss, and answer questions. A complete exam should take place BEFORE any cleaning appointment is made. The primary reason is that there is NO way to determine if a person has any periodontal (gum) disease problems over the phone. It takes a thorough periodontal screening (as part of the entire exam) in order to detect the presence or nonpresence of periodontal disease. It is after and only after the exam that the correct determination for a cleaning (hygiene) appointment can be made.
The components of a complete exam are:
- Review / discussion of Medical History
- Review / discussion of Dental History
- A complete series of x-rays
- Accurate diagnostic models mounted on an articulator utilizing a facebow and centric relation bite
- Blood pressure taken.
- Video imaging.
- Clinical examination (see below).
The following clinical findings must be evaluated in order for the exam to be complete:
- Head and neck exam - muscles of neck, glands and lymph node areas.
- TMJ (jaw joint) exam - observing opening and joint symptoms if present.
- Soft Tissue (Cancer Exam) - are there any lesions?
- Periodontal (Gum) Disease - evaluated with a periodontal probe and general appearance.
- Occlusion (Bite)
- Interferences • Excessive wear • How the teeth relate to each other and to the jaw joint.
- Visual tooth exam
- Decay (Caries) index
- Mobility of the teeth recession and sensitivity
- Missing teeth - do they need replacement?
- Aesthetics - the cosmetic appearance of the teeth
- Decay present
- Periodontal disease
- Impacted teeth
- General abnormalities
- Any other pertinent information