Family Dentistry

During a dentistry examination, the dentist examines the mouth mucosa (soft tissues) for any abnormalities or pathology (including oral cancer), the teeth for tooth decay (dental caries) or defects, the gum tissues for periodontal (gum) disease, the neck for swollen lymph nodes, the amount of plaque, tartar (dental calculus), and debris on teeth, as well as the need to replace any missing teeth or dental prostheses.

The dental examination begins with a complete dental care and medical history, including medications the patient currently is taking. The skin of the face and neck is examined for any abnormalities, especially pigment changes. The lymph nodes in front and behind the ears, under the floor of the mouth and chin, and the midline of the neck, sides, and back of the neck are palpated to determine if any swelling or tenderness is present.

Inside of the mouth, the lips, cheeks, gums, and roof of the mouth are inspected and palpated. During this process, the tip of the tongue is placed on the roof of the mouth just behind the upper teeth for inspection of the front floor of the mouth and sides of the tongue.

The back floor of the mouth, the area behind the lower wisdom teeth, and the back sides of the tongue are inspected by grasping the tip of the tongue with a small gauze sponge and pulling the tongue forward and toward the opposite side of the mouth.

To inspect the back of the throat, soft palate, and tonsil area (sides of the throat), the tongue is depressed with a dental mirror or tongue blade and then a deep breath is taken by the patient.

To detect swelling on the floor of the mouth, the area inside the mouth is felt with the finger of one hand while a finger of the other hand feels below the chin. Salivary gland enlargement, saliva flow, or xerostomia (dry mouth) are determined by milking the major salivary glands to assess the quantity and consistency of saliva.

Today's dentist has many analytic tools available to pinpoint dental and oral diseases. The basic tools are the dental instruments, lights, and radiographs (X-rays). Depending upon the dentist and the individual's dental needs, additional diagnostic tests are available. Testing for essential proteins and buffering capacity can evaluate the protective ability of saliva.

To determine mouth caries risks, microbiological testing of saliva can measure the level of caries-producing organisms. Periodontal susceptibility tests, which test for the DNA of gum disease-producing organisms, can be performed to assess an individual's risk for gum disease.

If removable dentures are present, they are checked for bite, retention, stability, and overall fit. Dental impressions or models also may be taken to study the mouth and tooth structures to initiate fabrication of prostheses. Photographs may be exposed for a variety of reasons, including before and after treatment comparisons.

The level of oral hygiene and home care practices are assessed and reviewed. Recommendations for home care devices and products may be made. Instruction and methods for maintaining a good oral hygiene regimen can also take place.

Once basic information about oral health status is gathered, the dentist will be better able to discuss dental treatment alternatives that are available.

By Denise J. Fedele, DMD, MS

Technology in dentistry now offers attractive options in dental fillings for cavity restorations in dental care. Called composites, these new tooth-colored dental fillings are excellent choices for front teeth and other repairs that might be visible. Composites duplicate the natural appearance of a tooth in restoring decayed teeth or repairing a defect and giving you a more attractive mouth.

What Dental Care Material Is Used in the Composite Filling?

Dental fillings composites are made from a mixture of microscopic plastic and ceramic resin particles. Another type of tooth-colored dental fillings used in dental care are called a resin ionomer, which releases fluoride useful for preventing tooth decay.

Besides Their Cosmetic Value, What Other Benefits Do Composites Provide in dental care

The bonding process used in restoration provides strength to the tooth, making it more structurally sound. It also seals the tooth, decreasing the chance of sensitivity to hot and cold. Some composites made with materials releasing fluoride are ideal for treating root decay, a condition when gums recede, exposing tooth roots to more cavity-causing plaque. These fluoride-releasing materials also are useful dental fillings for decayed baby teeth.

What Is the Process for Dental Care Treatment?

Following removal of the decayed area, a mild acid solution is used to prepare the tooth's surface for bonding and dental fillings. A bonding agent is then brushed over the surface. Several layers of the composite are applied during the next dental care process. For a natural appearance, the dentist matches the color of the dental fillings composite to the tooth.

Then, it is chemically hardened or cured with a special light and finally polished for a natural-looking finishing touch.

How Durable Are these Dental Fillings?

In a five-year clinical study of dental care, some of the resin materials demonstrated 100% effectiveness for adhesion and retention. Like other types of dental fillings, they may require periodic replacement. While the material is very durable, they may not perform quite as long as silver fillings or amalgams for their resistance to the rigors of grinding and chewing.

Scheduling dental care on a regular basis is an important part of good oral hygiene. Your dentist will check your fillings each time to ensure their performance.

By Brian J. Gray, DDS, MAGD, FICO

A world of opportunities for dental health awaits us in the new dentistry. Using the old dentistry, dentalcare professionals did their best to provide a high quality of service given the state of knowledge and technology at that time.

Through advancements in treatment, research, and the desire of the dental care profession to do more and do it better, the new dentistry has emerged giving you a better smile. It is based on a foundation with specific characteristics that are of great benefit to us as consumers.

• Efficiency: Your time and your resources are valuable to you, and your dentist recognizes this. New dentistry treatment techniques and methods have considerably reduced the amount of time that the dental care now takes. The return on your investment in dental health is excellent.
• Comfort: Not only are the dental chairs and the dentistry office environment more comfortable and pleasant, improvements in the use of local anesthetics and new equipment provide more comfort than ever before.
• Collaboration: The dental relationship is now based on the value that you can derive from your dentistry team and what you want for your dental future rather than just on the techniques and procedures your dentist can do. Through dental continuing education, your dentist has the skills and knowledge to help you make decisions for your dental health in a positive and informed way.
• Predictability: New materials and advances in treatment provide you with opportunities to maintain your dental health throughout your life. With the innovative cosmetic and specialized dentistry approaches to reclaiming teeth that formally would be lost, your dentistry professional can help create and maintain teeth and gums. Predictable treatment, effective prevention methods, and the longevity of treatment are now part of any treatment plan.
• Thoroughness: Advances in assessment and diagnosis now enable dentists to make thorough evaluations of your overall dental and oral health. The outcome is a plan for your health that will give you peace of mind, knowing you can have a well-informed dentistry plan in place.
• Prevention: This characteristic of the new dentistry has received much publicity in recent years. It has been proven over and over again that there are several measures that you can take as a consumer of dental care to create and maintain your dental health in collaboration with your dental team. It bears repeating again — flossing and brushing combined with regular dental hygiene checks are your greatest allies in maintaining your teeth and a bright smile.
• Precision: The new dentistry utilizes instruments and technologies that are far advanced from what was available even 15 years ago. Both general dentists and specialists have access to technologies that provide precision in diagnosis and treatment. The value for you is higher quality care.

The dental profession has established a strong foundation for a pleasant smile and a healthy dental future for all of us. Dentistry improvements are continuously being made to this foundation. You can choose to avail yourself of these improvements by asking your dentist, "What can help me to maintain my dental health?" They have the knowledge and the desire to help you.

By Brian DesRoches, PhD