It is important to give your dentist a complete, accurate and up-to-date medical history. On the first visit you will be asked several questions about medicines you take or have taken within the last year, and any allergies you have to medicines. You will also be asked about medical conditions such as heart trouble, diabetes, hepatitis or cancer, either now or in the past, and about recent stays in the hospital.
These questions are not for idle curiosity. With this information on your record, the dentist can plan your safe and effective dental care. If there are changes in your history, the dentist should be told on your next visit so these can be recorded.
Your dental examination begins the moment you meet the dentist or a member of the dental team. It includes:
Observation of the Head: The shape of your head might be observed from both the sides and front, with special notice of obvious differences in the size or shape of your head, face or neck. Any unusual colour, textureor tone of your skin and lip muscles will also be noted.
Lymph Node Examination: (Fig. 1) Lymph nodes throughout the body drain and filter some body fluids. When infection or disease occurs, the nodes in that area become enlarged. These are commonly called swollen glands. Since there are many lymph nodes from the neck up, each responsible for an area of the head, dentists examine them on a routine basis.
Nodes around the chin called the submental lymph nodes, drain the central lower lip, the floor of the mouth and the tip of the tongue. Those at the angle of the lower jaw, called the submandibular, drain the corner of the eye, the cheek, the sides of the nose, the upper lip, the corners of the lower lip, the gums and the sides of the tongue.
The ones by the front of the ears are the pre-auricular nodes and drain the front of the ears and the skull in this area. Those behind the ears and the occipital nodes drain the skull in this area and the back of the scalp. Changes in the size, shape or consistency of any of these glands can give a dentist valuable clues about infection or disease which may be present.
Examination Inside the Mouth: In the mouth, the dentist will check the oropharynx (the back of the throat), tonsils, soft palate, hard palate, cheeks, ducts of the saliva glands, tongue and the floor of the mouth (Figures 2 and 3). The form or shape of these tissues will be checked as will their colour and texture. Next, the focus will be the gingival (gum) tissues and finally, the teeth.
No dental exam is complete without x-rays. These help a dentist check those areas which can't be seen or felt such as the inside of a tooth, or the tooth below the gum line. Next visit, ask your dentist to hold your x-rays up so you can see for yourself what the hidden parts look like.
Dental care is no longer just a trip to the dentist to have a tooth filled. Modern dentistry is concerned with preventive care to the teeth and to the gums and bones around the teeth.