While the vast majority of soft tissue lesions in the oral cavity can represent infectious, traumatic, or reactive processes, the precise etiology can often be determined through a careful history and clinical examination. Many medications have adverse effects that can have a profound effect on oral health. A detailed drug history should be routinely taken. Oral habits, toothpastes, mouth rinses and tobacco all can adversely affect the oral tissues. A professional dental cleaning is more than that, it is about evaluating the patient as a whole. The Oral Evaluation is more of a whole body health exam.
1. The Oral Evaluation
The dental oral evaluation process is a systematic process during which the dentist or dental hygienist will investigate many facets of your overall health in order to identify pathologies or concerns. There are essentially 5 steps to a thorough oral evaluation: Medical history, Oral Cancer Screen, Oral supporting structures, Gum measurements and Radiographs
Medical history intake, the clinician will collect information about you, including:
- List of medications you are currently taking.
- List of vitamins and natural healing remedies you are currently taking.
- Smoking and alcohol consumption.
- Allergy list.
- Previous experience with anesthesia or medications
- Any medical conditions you are currently being treated for.
- Previous surgeries or hospitalizations.
This information allows your dental hygienist and dentist to identify necessary precautions for treatment. It is an integral first step in your treatment planning and the overall Oral Evaluation.
2. The Oral Investigation
The second step of any oral health evaluation involves a thorough examination of your teeth and supporting structures.
- The dental hygienist will complete an oral cancer screening. This is to check for any abnormality, lumps or bumps that should not be present in a healthy individual. The cheek mucosa (inside tissues), tongue, floor of the mouth and a gentle examine under the chin and neck will be completed.
- Your dental hygienist explores every surface of every tooth to uncover new cavities and examine the quality of existing fillings with a dental instrument. Over time, fillings can break down and crowns can decay around the edges and require replacement. They may also be replaced for improved esthetics. The teeth will also be examined for calculus (tartar) deposits above and below the gum line.
- If X-rays are necessary, these will be used to detect abnormalities not visible to the naked eye. Decay, bone loss, cysts and infections without symptoms of pain and swelling are detected using x-rays.
- Periodontal Measurements. Healthy gums adhere tightly to the teeth, just like a brand new turtle neck sweater. If they don't, then periodontal disease may be present or bone loss may be occurring. The dental hygienist performs periodontal probing to measure the circumference of each tooth and the strength of the supporting bone structure. A calibrated probe (this is not a sharp instrument) is inserted between the teeth and gums to measure the depth of gum tissue surrounding the teeth. Healthy measurements should be in the range of one to three millimeters without any bleeding. A number of four or greater with bleeding indicates gum disease and potential bone loss.
Is it time for you to have a thorough Oral Evaluation?
The next time you are in the dental office for 'just a cleaning' you should take into account that there is more going on than a 'polish and shine.' The dental hygienist is not only taking the time to clean your teeth, but they are evaluating your gums and all of the tissues of your mouth as well as your skin and lymph nodes under your jaw.
Has it been a long time since you have had an oral evaluation/exam. The American Dental Association recommends you have an evaluation once a year.