Checkup, X-ray and Cleaning
One of the most important dental procedures is to come into our office for your 6 month exam and cleaning. There is really no excuse for not making this an important habit. Most insurance companies pay for this 100% and, even if you don’t have insurance, it really is not expensive.
As a new patient it’s important for me to get to know you. I really want to do my very best for you. I need to know your dental history, so we ask you about previous problems you’ve had. As we start the exam we look throughout your mouth at your past dental work. My assistants help me record existing dental treatment and, then, we look at the health of your teeth and gums.
It is important that we have a clear, diagnostic set of full-mouth x-rays. If we don’t, I always tell my patient, “It’s like having your car mechanic work on your engine without lifting up the hood”. A full set of radiographs comprises 20 single films. This is the standard of care for all dentists licensed in California and which we are all taught to perform in dental school. If you don’t have this set of x-rays from a previous dentist within the last 3 years, we will take one at this first visit.
Some patients ask about radiation exposure. We want to minimize the amount of x-ray you receive and, fortunately, dental radiation dosage is very small. We also use a new technology called a Diagnodent. It measures laser fluorescence within tooth structure.We use it to find areas of decay on the chewing surfaces of teeth. Since it is hard to detect decay when it occurs through small openings in dense enamel (and x-rays only show it when it’s worse), it is extremely accurate in finding small cavities before they get big.
At your first visit we will also clean your teeth (prophylaxis). My staff and I do your cleaning using a team approach. I will use dental scaling and sonic instruments to remove plaque and calculus (tartar). Our assistants are Registered Dental Assistants (RDA) who are licensed to perform your coronal polishing.
Plaque actually is the cause of dental disease (tooth decay and gum inflammation). It’s really your job to remove plaque yourself. Plaque is a sticky, nearly invisible film that forms on the teeth. It is a growing colony of living bacteria, food particles and saliva. The bacteria produce toxins (poisons) that inflame the gums. This irritation is the beginning of periodontal disease.
Our job is to remove calculus which is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. It forms above and beneath the gum line and can only be eliminated with special dental instruments. Calculus really doesn’t cause the disease but it makes a rough surface for more plaque to stick. When the calculus is gone, then tooth polishing helps take away stains and plaque that are not otherwise eliminated.
The most important service I can provide is to educate you to take care of your own dental health. We have known since the late 1960′s what causes dental disease (the most common disease in mankind). Since there is no cure for dental disease, and plaque is its cause, you need to learn to remove it effectively for yourself.
If you could remove all your plaque yourself everyday (it forms once every 24 hours), you would be free of dental disease. In theory, you would never need to come to the dentist and have your teeth cleaned. Isn’t that an amazing thought!! The reality is that people don’t remove their plaque very well each day.
Unfortunately, the primary way that we are taught (from TV commercials) to clean our teeth is tooth brushing. I always tell my patients, “Toothbushing is like washing your car with a push broom”. Plaque primarily accumulates around the gumline exactly where the toothbrush doesn’t go.
Even though there are a million toothbrush designs (including automatic), they all fall short. Therefore, as part of your cleaning, we will introduce you to specific cleaning aids including interproximal brushes, dental tape and the perio aid (toothpik holder). These are very effective in removing all your plaque.
By the way, toothpaste and mouthwash do not help you control plaque. They don’t “kill germs by the million”. The alcohol in mouthwash dries your mouth (you need saliva to keep your mouth healthy) and most commercial toothpaste has sodium lauryl sulfate which causes gum irritation in many people.