The Diagnostic Records

The world of modern dentistry offers so much to patients who choose to have healthy mouths.  In past weeks I’ve discussed different parts of the comprehensive examination that assist the dentist in helping patients achieve their oral health goals.  This week I would like to explain some of the records and tools that are available to assist in our diagnosis. 

Along with the process of examining a patient’s mouth, the dentist will suggest appropriate radiographs (x-rays).  These may include films of the teeth, entire jaw system and if necessary, specific films of a patient’s jaw joints.  Conventional radiographs work very well, but the advent of computer assisted digital radiography has increased our ability to not only see decay and pathology, but also utilize approximately 10-15% of the radiation needed for a conventional film.

Diagnostic impressions of a patient’s upper and lower teeth may be made with an elastic material.  These impressions are a “negative” of the mouth into which plaster or dental stone is placed to make an accurate copy of the mouth.  The resultant duplicates of the mouth (casts) will often be mounted on an artificial jaw (articulator), which simulates the movement of the lower jaw relative to the upper teeth.  In essence, we can duplicate the patient’s teeth and chewing motions outside of their mouth.  This is invaluable in evaluating and diagnosing concerns in a patient’s mouth.  It also gives the dentist an opportunity to design treatment prior to actually “drilling” in a patient’s mouth.  It’s like the blueprint a contractor would use to build a new home. 

A final step often taken in gathering data during the comprehensive examination is a complete set of close-up photographs of your teeth and face.  This is especially helpful in the design of a new smile.  It is important to make sure a new smile “fits the face” of the person wearing it.  Your smile is much more than just the teeth.  Facial contours, lip positioning, symmetry of the face are just a few things that come into play when designing a beautiful smile.

During the entire process, the patient and the dentist will be discussing each portion of the examination and what they are discovering.  It is a time for the dentist to actively listen for a patient’s questions, concerns and opinions.  The patient is an important collaborative member of the oral health team and is vital to the overall success of the provided care.

Before advising a patient of treatment, the dentist will often take time to study all of the gathered information and form a thoughtful plan that addresses the patient’s concerns and any health problems uncovered during the evaluation.  In many cases, the dentist may invest substantial time in the diagnosis and treatment planning phase of the process.  Often, if advanced treatment is involved, a patient will be invited to schedule a subsequent appointment to discuss the findings and treatment alternatives that would best meet the patient’s goals and objectives. 

It is important to emphasize that the essence of this entire examination experience is for the dentist to understand the patient’s unique aspirations and expectations and learn how best to work with them and for them. 

I hope these last few weeks have brought to light the importance of a comprehensive examination and the difference between it and the typical cursory “check up” that is given with an oral hygiene appointment.  Patients deserve optimal health and the dentist who takes the time to utilize their care, knowledge and advanced technical training will strive to help them have it for a lifetime.