Your routine dental check-up reveals more than just the condition of your teeth
and gums. It uncovers important clues about your overall health. Dentists and periodontists
are concerned about more than saving your teeth - they're looking at how oral health
fits into your overall well- being. Here are some of the most common conditions
dentists look out for that can affect your oral health.
Diabetes : People with type 1 and type 2 diabetes are more likely
to develop gum disease. That's because they may have a decreased ability to fight
bacterial infections, including those that occur in the mouth. In addition, serious
gum disease can make it more difficult for people with diabetes to control their
blood sugar. Signs of diabetes are frequent gum abscesses, swelling, a lot of bone
loss in a short amount of time and gum disease that doesn't respond to normal treatment.
Your dentist or periodontist may recommend that you schedule dental exams more frequently
-- for example, every three months -- if you have a history of diabetes and gum
Oral Cancer : The first sign of oral cancer is often a small red
or white spot or sore in the mouth. It can appear on your lips, gums, tongue, cheek
lining or in other parts of your mouth. Often, the patient does not notice it because
it starts as a small spot toward the back of the mouth or under the tongue and they
don't have any symptoms. Your dentist will typically screen for oral cancer as part
of a routine dental exam. By scheduling regular check-ups, you can increase the
chances that any potentially cancerous or precancerous lesions will be caught early
and successfully treated. Also, be sure to tell your dentist if you've noticed symptoms
like a sore in your mouth that doesn't heal, a lump, or pain or numbness anywhere
in your mouth or on your lips
Stress : If your teeth are worn down or chipped then you've been
unconsciously grinding or clenching them. This grinding -- also known as bruxism
-- can eventually cause bone loss that your dentist may detect on your X- rays.
Bruxism is usually caused by stress but can also occur because the top and bottom
teeth aren't aligned properly. You may or may not be aware that you've been grinding
your teeth, but your dentist can spot the signs. To prevent damage to your teeth
and keep them apart so your jaw muscles can relax, your dentist can fit you with
a custom mouth guard to wear while you sleep.
Premature and Low-Weight Births : Studies suggest that pregnant
women with serious gum disease -- called periodontitis -- are more likely to deliver
a premature baby of low birth weight. The bacteria in the mouth of a woman with
gum disease can trigger an increase in a chemical compound called prostaglandin
and other harmful inflammatory molecules. These chemicals can induce early labor
and impair fetal growth. Women who are pregnant or thinking about becoming pregnant
should get a dental exam and if necessary, treatment for gum disease as early as
Heart Disease : Since gum disease may increase the risk of heart
attacks and strokes, you should tell your dentist if you have cardiovascular disease
or have a family history of these conditions. Inflammation in the mouth increases
inflammation in other parts of the body, including the arteries. This inflammation
may play a role in heart attacks or strokes. By treating gum disease and reducing
the inflammation in your mouth, you may be able to lower your risk of stroke or
People with weakened immune systems are more likely to get fungal and viral infections
in the mouth.
The dentist on seeing your oral cavity realizes the presence of the following problems:
- Deterioration in the dental fillings, crowns and other restorations.
- Root cavities which is decay on roots of teeth exposed by receding gums.
- Pockets formed in your gums (periodontal pockets) due to gum diseases.
- New decay below the gum line
- Cavities under existing fillings.
- Hairline tooth fractures.
- Impacted wisdom tooth.
Some blood disorders and gastrointestinal disorders such as GERD (Gastro Esophageal
Medicine may cause dry mouth. This increases dental decay, oral yeast infections
and other oral infections.
Vitamin deficiencies can have serious effects on your mouth and teeth.
Tobacco use and poor dietary practices can affect mouth and face.
Signs of other problems that can affect your general health.
Hypertension : It is important to inform your dentist about any
health conditions you have, and the medications you are taking. Your dentist should
be aware of the special needs, and potential problems. People with hypertension
are generally advised to reduce salt intake, lose weight, and increase aerobic exercise.
If these measures are not sufficient, a number of drugs are needed to reduce the
blood pressure. As dentists, we are concerned with how well-controlled the hypertension
is. Patients with poorly controlled hypertension will often bleed more after routine
oral surgery. Patients who take hypertensive drugs may be more sensitive to the
small amounts of epinephrine in dental anesthetics as well as need a greater level
of assistance when being elevated in a dental chair from a supine (lying on the
back) position. Patients whose blood pressures are above target should be monitored
at least every 2 months. Follow- up at short intervals improves patient adherence
and is required to increase the intensity of treatment.
Dentists refer a high percentage of their difficult procedures to dental specialists,
electing to do only routine treatment. The main reason for this disparity has to
do with the training and experience of the general dentist. In most cases, dentists
who have had hospital or other residencies, and have taken many hours of continuing
education are more likely to perform procedures that are sometimes referred to specialists.
In fact, the recent trend is for the general dentist to do more of these advanced
procedures, providing most of their patient's dental needs "under one roof." Even
so, in some cases, the dental specialist is the best person to treat a difficult
dental problem. The various dental specialities are -
Selection of dentist depends upon the following:
- Oral Medicine Diagnosis and Radiology [OMDR]:
These specialists are qualified for a better diagnosis and understanding of oral
diseases and radiology [X- ray].
- Conservative Dentistry and Endodontics:
They specialize in the treatment of dental caries and its outcomes, root canal treatment,
aesthetic treatment eg. correcting tooth shape and colour using laminates veneers.
The Periodontist specializes in prevention, diagnosis, treatment and structural
diseases of the periodontal membrane or gums and related tissues that surround and
support the teeth.
The Pedodontist specializes in the overall health of children up to the age of 12
- Oral Surgery:
These dental surgeons are skilled in oral surgical procedures and treatment of oral
cancer, oral cysts, tumours etc.
The Orthodontist specializes in braces and deals with straightening crooked teeth
and teeth alignment.
The Prosthodontist specializes in preparing caps [crowns] and replacement of missing
teeth with artificial teeth.
- Community Dentistry:
There are several dentists that serve the community in providing dental health at
the social level.
- Oral Pathology:
Oral pathologists deal with microscopic details of oral tissues and its diseases.
Does the dental office offer you a convenient schedule?
Is the dentist located near your home, office or are you willing to travel to visit
the right dentist?
Is the office clean, neat and orderly?
Does the dentist follows sterilization protocol such as wearing gloves, masks and
Does the dentist explain how to control dental problems?
Information about fee to be charges should be told prior to the treatment?
Answering these questions can make your choice easier. Find out if the dentist is
a registered practitioner in order to safeguard yourself from quacks and mal- practices.
Question that you may ask your dentist
- Visiting a new dentist
The dentist will want to know more about your general health on the following issues.
- Medical history/current medicines:
Your dentist will want to know if you have been diagnosed with any diseases. Tell
the dentist all your health issues, not just those you think relate to your mouth.
- Current dental health :
Inform the dentist about you oral health problems as this helps to make a prompt
diagnosis. Consult the dentist about changes in colour, looseness or position of
teeth, teeth sensitivity (heat cold or sweet), changes in gums (colour, tenderness,
or bleeding) when you brush or floss, change in the oral skin, you clench or grind
teeth, smoke (smoking causes oral cancer), allergies, pregnancy, medicines you are
currently taking or disease (medical condition) you suffer from.
- Dental fears:
If you have any fears about going to the dentist or receiving dental care let your
dentist know in order to resolve the problem because today dental treatments have
changed and so have pain management options.
Clinical examination of teeth :
The dentist will check for signs of tooth decay using a metal probe and a small
mirror with an angled handle. Next, poke your teeth with a dental instrument, called
an explorer, to look for cavities. During the cleaning, the dentist will use a scaler
(a small metal instrument with a blade like end) to scrape off tartar above and
below the gum line. Then use an ultrasonic vibrating device to shake loose plaque
and tartar and next rinse it away with a stream of water. The now-smooth tooth surfaces
makes it difficult for plaque to accumulate.
The dentist will also check for gum swelling, redness and measure the depth of the
gingival pockets. Your dentist will test how your upper and lower teeth come together
and will look for evidence of tooth grinding or problems with the temporomandibular
joint (which connects the lower jaw to the skull). Examine the neck, lymph glands,
palate and the soft tissues of your mouth (cheeks, tongue, lips, and floor of the
mouth) for signs of infections or oral cancer, especially if you are 35 years or
older. Your dentist will also check for any problems with fillings, braces, bridges,
dentures, crowns, or other restorations.
In the course of dental work, your dentist may inadvertently touch the soft palate
at the back of your throat, evoking your gag reflex. This often happens when your
dentist positions X-ray films or takes tooth impressions. Fear often exacerbates
the gag mechanism. Needless to say, this causes problems for both the patient and
X-rays: The dentist will take X- rays to look for signs of tooth
decay, as well as for gum disease and other oral health problems.
Conditions that can be diagnosed by a dental X ray are:
- Cavities between the teeth below the gums and around old fillings.
- Bone loss caused by gum disease.
- Teeth that are trapped (or impacted) in the gums, such as wisdom tooth.
Infections of the root of the teeth with deep caries.
- Problems with the bone holding the tooth.
What toothbrush and floss are best for me?
Is my brushing and flossing adequate and effective if not, teach me the right way.
Where does plaque accumulate in my mouth?
Are there any areas in my mouth that I am missing during brushing or flossing?
How fast does plaque accumulate in my mouth?
For most people, two checkups per year are sufficient. But if you have special problems
or if you're at high risk for conditions such as periodontal disease, your dentist
may recommend that you come in as frequently as every three months.
To make your dental visit as comfortable as possible, your dentist may suggest aids
to reduce or eliminate any pain or anxiety that may be related to your dental treatment.
The type of anaesthesia required for any dental procedure depends on the needs or
preferences of the patient. The choice may be to give either local or general anaesthesia
when undertaking dental procedures. Analgesics are group of drugs that relieve pain
and are given post dental procedures.
Dental anaesthesia : These
are important tools to reduce even eliminate discomfort during dental treatment.
The choice may either local or general anaesthesia to help alleviate anxiety or
pain that may be associated with dental care.
Local anaesthesia : Are drugs that cause loss of sensibility of
peripheral nerves of a particular area. In simple words, they cause numbness of
the mouth by injecting anesthetic drug into your gum or inner cheek.
Are applied to mouth tissues with a swab to prevent
pain on the surface level. A topical anaesthetic numbs an area for administering
an injectable local anaesthetic. Topical anaesthetic also may be used to soothe
painful mouth sores.
Injectable local anaesthetics: Prevents pain in a specific area
of your mouth during treatment by blocking the nerves that sense or transmit pain
and numb mouth tissues. They cause the temporary numbness often referred to as a
"fat lip" feeling. Post treatment you may have difficulty in speaking clearly or
eating and drinking from a straw. Be careful not to bite your mouth or lip as the
area is still numb. Injectable anaesthetic is used in procedures like filling cavities,
crowning or treating periodontal (gum) disease and root canal treatment.
Sedation and general anaesthesia: Anti-anxiety agents, such as
nitrous oxide or sedatives may help you relax during dental visits and often may
be used along with local anaesthesia. Dentists also can use these agents to induce
"minimal or moderate sedation," in which the patient achieves a relaxed state during
treatment but responds to speech or touch. Sedatives can be administered before,
during or after dental procedures by mouth, inhalation or injection.
More complex treatments may require drugs that can induce "deep sedation," causing
a loss of feeling and reducing consciousness in order to relieve both pain and anxiety.
On occasion, patients undergo "general anaesthesia" in which drugs cause a temporary
loss of consciousness. Deep sedation and general anaesthesia may be recommended
in certain procedures for children or others who have severe anxiety or who have
difficulty in controlling their movements.
Analgesics are group of drugs that relieve pain, in simple words painkillers. They
are usually 2 types; non-narcotics or NSAID’s and narcotic analgesics. Non-narcotic
analgesics are the most commonly used drugs for relief of toothache or pain following
dental treatment. This category includes aspirin, acetaminophen and non-steroidal
anti- inflammatory drugs such as Ibuprofen. Narcotic analgesics, such as those containing
codeine, act on the central nervous system to relieve pain. They are used for more
Understanding the range of choices that are available relieve anxiety and discomfort
makes you a well informed dental consumer. If you have questions or concerns about
your oral health care, don't hesitate to talk to your dentist. If you still have
concerns, consider taking a second opinion. Working together, you and your dentist
can choose the appropriate steps to make your dental visit as safe and comfortable
With the huge data base of the Indian Dental Association, you can locate a dentist
in your locality to suit your needs.