The Right Dental Checkup Can Save Your Life
Alan A. Winter, DDS
Seven ways to tell whether your dentist is doing his job.
You may think that you see
your dentist just to have
your teeth cleaned, a cavity
filled or to get a crown. But
your dental visits should include
much more than that.
During your regular dental
checkups, your dentist should be
performing not only the standard
services that most people know
about, but he/she also should be
examining your mouth carefully
for signs of disease that could affect
other parts of your body, such
as cardiovascular disease and lung
To get the most from your dental
checkup, your dentist should…*
Check for periodontal disease.
People with gum (periodontal)
disease are nearly twice as likely to
have heart disease. Untreated gum
disease also has been linked to increased
risk for such conditions as
stroke and pneumonia.
Bleeding gums are not normal
and are a telltale sign of gum disease.
Surprisingly, however, some
dentists (and hygienists) don't use
a tool called a periodontal probe,
which is a millimeter ruler that
measures the separation between
gums and teeth to routinely check
for periodontal disease. The deeper
the pocket, the worse the problem.
If gum disease is diagnosed,
your dentist should devise a treatment
plan to reduce inflammation
and restore gum health—and perhaps
refer you to a periodontist, a
dentist who specializes in the treatment
of gum disease.
Screen for oral cancers.
A dentist should screen for oral cancers
at every checkup. This involves
looking for suspicious lesions on
or underneath the tongue, on the
palate and inside the cheeks. Oral
lesions sometimes go unnoticed
by the patient because they don't
ordinarily cause pain. Your dentist
also should palpate the floor of
the mouth and under the neck for
lumps that may indicate cancer.
Your dentist should
check for ill-fitting crowns and/
or fillings—sharp edges can cause
chronic tissue irritation that can
become precancerous. Caution: If
you have a sore in your mouth that
does not heal within two weeks, see
your dentist to have it evaluated.
Use digital X-rays.
dental X-rays expose you to 10
times more radiation than digital
dental X-rays. High-speed film is
better than conventional X-ray film
but still uses more radiation than
digital. Because the effects of radiation
are cumulative, it makes sense to limit your exposure whenever
possible. When you call to schedule
an appointment, ask if the dentist
uses digital X-rays.
Important: While every dentist
should use a protective apron to
cover the patient's torso, a thyroid
collar should also be used to protect
this sensitive gland, which is
located at the base of the neck and
can be unnecessarily exposed to
radiation from dental X-rays.
Follow infection-control procedures.
To prevent the spread of
germs, any equipment touched
by the dentist and/or dental assistants,
such as the overhead light,
telephone and intercom buttons,
should be covered with clear plastic
that is replaced after each patient.
Disposable products, from suction
tips to drinking cups, should be
used at all times.
Nondisposable instruments must
be sterilized between patients to kill
bacteria and viruses. For your safety,
dentists use an autoclave, which
resembles a small safe and sterilizes
under high heat and pressure.
Keep pace with technology.
dentists stay up to date on
new technologies in order to offer the
most current therapies, which may
provide better results than outdated
ones. For example, computer-aided
design and computer-aided manufacturing
which does not emit radiation, can
be used to make digital impressions
(for crowns, for example) that are
extremely precise. Cone beam scanners
take 3-D images of the jaws to
better plan for the insertion of dental
implants, remove wisdom teeth, etc.
Important: 3-D images reduce risk
and improve outcomes. However,
new technologies do not necessarily
translate to high-quality dentistry,
and dentists who don't use all forms
of new technology may offer outstanding
Present you with options.
dentist has a legal and ethical obligation
to present you with all
viable treatment options, even if he
doesn't perform them all himself.
Let's say you cracked a tooth on
an olive pit and the tooth can't be
saved. Many dentists will suggest a
replacement bridge but won't mention
a dental implant (even though
it might be a better option) because
they don't do implants. You don't
want a dentist who says, "This is
what we're doing" and proceeds
without discussing options.
Refer you to specialists for diagnoses
and advanced treatments.
Up to 80% of dentists are general
practitioners, but when you need
advanced care, you may want to
be treated by a professional with
advanced skills, such as a periodontist…
oral surgeon (to remove
impacted wisdom teeth, for example)...
endodontist (for root canals)
or orthodontist (for braces).
A responsible dentist will not be
offended if you inquire about specialists
and should be willing to
offer an appropriate referral.
If your dentist does not follow
the steps described in this article,
contact the American Dental Association
org) or a specialty organization such
as the American Academy of Periodontology
Perio.org) for a referral.
*Twice-yearly dental visits are recommended for
most people. For people with gum disease, four visits
per year are typically recommended.
Bottom Line/Health interviewed Alan A. Winter,
DDS, founder and president of Central
Park Periodontics, PC, www.CentralPark
Perio.com, in New York City. Dr. Winter
is a diplomate of the American Board of
Periodontology and an adviser to the
Journal of Implant and Advanced Clinical
Tags: 3D cone imaging, sinus grafts, periodontics, dental implants, laser gum surgery, dentist, dental practice, gum treatment. LANAP, bleeding gums, periodontal disease
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