In the examination process, every patient should have a complete exam to assess where they are at, how they got there, and what are the future risks. There are three major areas that should be addressed during a good examination: the structure of the teeth (looking for cavities and fractures), the conditions of current restorations, and structurally, if the tooth is strong enough with that restoration over a long period of time. We also examine the aesthetics of the teeth.
During examination it is also important to determine the health of the gums. We spend a lot of time with our patients education them about their responsibility, because there is not anything we can do that will make up for the patient not taking care of their teeth and gums on a regular basis. When examining the gums, we evaluate the bone support (do the teeth have good support?), checking gums for inflammation and pockets (Are there areas that can not be reached during brushing causing plaque and tooth decay), and looking for bleeding of the gums. We conduct a dental fitness program that measures these in graphs for our patients so they know what percentage is free from plaque and bleeding. We also provide a score card so our patients can compare their progress and we know our patients are getting healthy.
Lastly, we determine if the jaw joints are healthy, if the bite is in harmony with the jaw joints, and if the muscles are able to relax. This aspect is often overlooked in dentistry, but is a priority for our patients because functioning out of harmony can lead to headaches, TMJ problems, and worn teeth.
To properly educate our patients, part of the examination process includes a photographic series so they can see what we see and so we can explain to them what is going on with the individual teeth, the bite, and wear. Examination has to be more involved than just taking x rays between the teeth to check for decay or to see if there are cavities on the biting surfaces.