Diseases of Dentistry: What Is Your Dentist Looking for at Exam Appointments?

You enter the dental office and it is time for your yearly exam. Have you ever wondered what is going on with the x-rays and what is going on inside your mouth? There is a method to all this madness, just like at your physical you are getting checked for various diseases.

Cavities

Cavities, or dental caries are caused by acid and bacteria. The bacteria themselves cause acid which dissolves the enamel of the tooth. When the bacteria feed on carbohydrates the produce this acid, which is why sugary snacks are a risk for tooth decay. Other sources of acid can also cause damage. Carbonation from soda, energy drinks, and even acid reflux and vomiting can weaken the enamel. The enamel softens gradually and decays,eventually the softened area becomes large enough that it needs to be filled.

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 may be used is a visual exam by the dentist. They may blow air on the teeth to see if the tooth has a chalky color that is common in early cavities or areas where there is obvious visual decay. They may also feel the teeth with an instrument to check for soft areas. Finally there is a method that uses laser fluorescence to detect decay. These instruments give a numerical value that equates to how severe the decay is, from healthy with no decay to severe decay. The DIAGNOdent and the Spectra Caries Detection Aid are the most common ones used. These instruments allow detection of early decay so it can be treated before it becomes more severe and costly.

Periodontal Disease

Periodontal Disease is extremely common. The most obvious result of periodontal disease is loss of bone and eventually teeth. If you have ever looked at someone’s smile and their teeth appear long you have seen someone with periodontal disease. The way level of periodontal disease is assessed at the dentist includes a full periodontal assessment. During this assessment your gums will be measured with an instrument that is like a little ruler. It measures the space between the tooth and the gum called the sulcus or pocket. Additionally any root surface showing above the gum-line will be measured. The teeth will be checked for mobility or looseness, bleeding and the degree of plaque and tartar on the teeth will be assessed. The combination of this data, along with your health history will help determine your treatment.

Your x-rays are another way that your bone level can be evaluated. There are additional screenings that can be done which will tell which particular bacteria are in your mouth but those are not used as frequently in initial screenings.

If there is no bone loss or bleeding your gums are healthy. That is great. If there is …