You walk into the dental office and it’s time for your annual exam. Have you ever wondered what’s going on with the x-rays and what’s going on inside your mouth? There is a method to all this madness, just like in your physical, you are being checked for various diseases.
Cavities
Cavities, or tooth decay, are caused by acid and bacteria. The bacteria themselves produce acid that dissolves tooth enamel. When bacteria feed on carbohydrates, they produce this acid, which is why sugary snacks are a risk for cavities. Other sources of acid can also cause damage. Carbonation from sodas, energy drinks, and even acid reflux and vomiting can weaken enamel. The enamel gradually softens and breaks down, eventually the softened area becomes large enough to need filling.
At your dental visit, there are a few ways that cavities are detected. One way is x-rays. Your dentist will look for areas on the x-ray that look like shadows, these areas are where the enamel is less dense and cavities have formed. Another method that can be used is a visual examination by the dentist. They may blow air over the teeth to see if the tooth has a chalky color that is common with early cavities or areas where there is obvious visual impairment. They may also feel the teeth with an instrument to look for soft areas. Finally, there is a method that uses laser fluorescence to detect decay. These instruments give a numerical value that equates to the severity of the caries, from healthy with no caries to severe caries. The DIAGNOdent and the Spectra caries detection aid are the most widely used. These instruments allow early detection of cavities so they can be treated before they become more severe and costly.
Periodontal disease
Periodontal disease is extremely common. The most obvious result of periodontal disease is the loss of bone and eventually teeth. If you’ve ever seen someone smile and their teeth look long, you’ve seen someone with periodontal disease. The dentist’s way of evaluating the level of periodontal disease includes a complete periodontal evaluation. During this evaluation, your gums will be measured with an instrument that is like a small ruler. It measures the space between the tooth and the gum called the sulcus or pocket. In addition, any root surface visible above the gum line will be measured. Mobility or loosening of the teeth will be checked, bleeding and the degree of plaque and tartar on the teeth will be evaluated. The combination of these data, along with your medical history, will help determine your treatment.
Your x-rays are another way to assess your bone level. Additional tests that will tell you what particular bacteria are in your mouth may be done, but they are not used as often in the initial tests.
If there is no bone loss or bleeding, your gums are healthy. that’s great. If there is bleeding but no bone loss, you have gingivitis, which is the earliest stage of periodontal disease. Fortunately, this is reversible with proper treatment. Finally, if you have lost bone and there is bleeding, you will be diagnosed with active periodontal disease, which will need treatment to prevent further loss of bone and eventually teeth.
Cancer
The third disease examined in the dental office is cancer. During a manual oral cancer screening test, you will be asked to stick out your tongue and areas of your mouth will be seen and touched. Your dentist may pull on your tongue to get a better look. Dental professionals are trained to find suspicious injuries. In addition to this manual oral cancer screening exam, many offices perform additional exams with the help of special lights. You can go to an office that does Vizilite, Velscope, or Identifi tests. These additional screening methods are used to detect cancer earlier than manual detection. It’s a great addition to your checkup because early detection saves lives.
Why is all this necessary?
A thorough evaluation should be done at regular intervals to make sure you are healthy and to avoid painful, costly and lengthy procedures. Mouth problems do not tend to get better on their own. Without proper treatment, these problems progress. A cavity will get larger and may eventually need a root canal or extraction. Untreated periodontal disease is an infection that can interfere with your health in other parts of your body. Bone loss will not improve, but may progress without treatment. Undiagnosed cancer will not go away and may spread to other areas of the body. Knowledge is power. Understanding what’s going on in your own body is important to taking control of your health and your life.
Just like doctors and nurses, dentists and dental hygienists care about your health and aim to provide you with the best possible care. Unfortunately, there are many people who don’t consistently get these checkups. Often denture patients think they don’t need to go to the dentist because they don’t have natural teeth to worry about. They may not realize that oral cancer screening tests are so important. Another barrier to treatment is lack of insurance. Even patients with insurance often decline recommended treatment due to cost. Unfortunately, many patients believe that if they really needed something, insurance would cover it. This is unfortunate because it can lead to more serious illness in the long run, when illnesses are not diagnosed early.
The next time you go for a checkup at the dentist, pay attention to the exams you receive. If you feel you haven’t been screened for any of these conditions, ask for it. It is important that you take control of your own health. If I had a suspicious lump, I’d fight to get it checked out by a doctor, but more importantly, I’d hope they caught it before it turned into something dangerous. Be your own advocate. Ask to be screened for all three, cavities, gum disease, and cancer.