Dental Examination

Dental Examination

Also called: Dental Evaluation, Dental Exam, Oral Examination, Oral Evaluation

Reviewed By:
Andrew M. Sicklick, D.D.S.


Dental examinations are an important part of every person’s overall health care. Patients who perform proper dental hygiene at home still benefit from these examinations because a dentist can discover problems early, while they are easy to treat. Dental experts recommend that people visit their dentist for an examination and cleaning twice a year.

Prior to a dental examination, a patient should provide an updated medical and dental history to the dentist. This can identify certain medical conditions or lifestyle choices that may affect a patient’s oral health. Patients may also wish to speak to their dentist about any fear, anxiety or special concerns (e.g., a sensitive gag reflex). 

Dental examinations involve a number of components. These may include:

  • Visual inspection of the soft tissue inside the mouth, including a check for lesions and signs of oral cancer.
  • Periodontal screening, which may include a measurement of the space between the teeth and gums for signs of gum disease.
  • Examination of a patient’s bite, which may indicate a need for braces.
  • Visual inspection for signs of tooth decay. This may include the use of specialized tools that can help a dentist identify the presence of cavities.
  • Feeling the head and neck area, including the temporomandibular joints (TMJ), for signs of infection, disease or other problems.
  • Dental x-rays, to identify any hidden signs of decay or disease. The frequency of x-rays depends on a patient’s dental history and risk of tooth decay.
  • Dental cleanings, usually performed by a dental hygienist who cleans and polishes the teeth, and may apply a fluoride treatment.

After an examination, patients may be advised on the proper method of brushing and flossing their teeth. The use of fluoride may also be encouraged.

Certain treatments may be recommended, depending on the findings of the examination. Some treatments (e.g., fillings, crowns) may be performed by the dentist, while others (e.g., root canals, braces) may require a visit to a specialist (e.g., endodontist, orthodontist). In some cases, protective measures such as dental sealants may be recommended.

About dental examinations

A dental examination is a process in which a dentist examines the teeth and gums for signs of disease or irregularity. It may also include a dental cleaning, as well as evaluation of the patient’s head and neck area. Significant changes or findings are recorded in a patient’s dental records.  

The dental examination is typically performed by a general dentist who is either a doctor of dental medicine (DMD) or doctor of dental surgery (DDS). Both designations indicate similar education and training. Which title a dentist uses depends on the school attended.  Some schools use the DMD designation, while others use DDS.

A general dentist provides primary diagnosis, treatment and coordination of dental care for patients of all ages. If a dental examination indicates certain types of treatment are needed (e.g., a root canal), the patient may be referred to a specialist (e.g., an endodontist). Dental cleanings may be performed by a general dentist or a dental hygienist.  

Regular dental examinations are important even for patients with good at-home dental hygiene practices. A dentist may be able to identify tooth or gum problems at an early stage, when they are easier to treat. Problems such as tooth decay may not become apparent to the patient (e.g., cause pain) until they are significant.

Dental experts recommend that patients visit a dentist for an examination and cleaning twice a year. Some people may need to make more frequent visits to the dentist, depending on a person’s individual dental care needs. Patients should consult their dentist about the frequency of their visits.

Patients should mention any health concerns or conditions they may have to the dentist, even if they do not necessarily involve the teeth or gums. Some medical conditions, such as heart murmurs or artificial joints, may require patients to take antibiotics before a dental examination as a preventative against infection.

Many diseases and illnesses can affect a person’s dental health. For example, people with diabetes are at greater risk of developing gum disease (periodontal disease), which in turn may make the diabetes more difficult to control. People with immune system deficiencies (e.g., AIDS) may be more likely to develop infections in the mouth, and people with oral infections may have an increased risk of heart attack and stroke. In pregnant women, tooth or gum problems may increase the risk of having a baby with a low birth weight, or a premature birth. Additionally, using certain medications can increase the risk of dental problems.

Before the dental examination

If a patient has questions for the dentist, it may help to write them down and bring the list to the dental office. This helps patients remember everything they intended to ask, especially if they are nervous, distracted or the dental office is very busy.

It is important to discuss certain items with a dentist before a dental examination. This includes the patient’s complete medical and dental history, which involves informing the dentist about the following:

  • Current symptoms
  • Recent trauma to the teeth or mouth
  • Any history of tooth grinding (bruxism)
  • Current medications, including recent changes
  • Tobacco and alcohol use
  • Recent surgeries or illnesses
  • Current medical conditions (e.g., asthma, diabetes)
  • Family history of conditions or diseases
  • Allergies
  • Pregnancy, or the possibility of being pregnant

Patients with certain medical conditions may need to take medications such as antibiotics before and/or after a dental examination or cleaning. These conditions include heart murmurs and artificially implanted joints. Any bleeding that may occur during the examination may allow bacteria to enter the bloodstream, and people with these conditions are more susceptible to bacterial infections in the affected areas. Antibiotics can kill the bacteria before they cause damage.

Other items that may be discussed prior to a dental examination include:

  • Dental anxiety. Many patients fear visits to their dentist. These feelings may be alleviated by sharing them with the dentist. Fear of possible pain associated with dental care may be lessened by knowing exactly how the dentist can reduce or manage a patient’s pain. Fear of having a particular disease or illness may be alleviated by having the dentist specifically look for signs of that condition. Even the act of sharing the feelings may make patients feel better. Some patients may need anti-anxiety medications. Parents should be especially careful not to transmit anxiety they may feel to children they accompany to the dentist’s office.
  • Sensitive gag reflex. Patients with a sensitive gag reflex should inform their dentist. Certain accommodations (such as avoiding touching the sensitive area near the back of the throat) may be made that can make the dental examination more pleasant.

During the dental examination

A dental examination may include a variety of components. The order in which these are conducted may differ from office to office. Not all will be done at every visit. A comprehensive examination (one that includes more of the components, especially evaluation of areas outside the mouth) is likely to be done during an initial visit to a dentist, or upon changing dentists. The following may occur during a dental examination:

  • Visual and physical inspection:
    • Soft tissue inside the mouth (e.g., tongue, cheeks, inner and outer lips, floor and palate of the mouth). This is done by a visual inspection of the inside of the mouth to identify any sores, swelling, growths or other abnormalities that may indicate health problems, such as infection or oral cancer.
    • Periodontal screening. This involves visually inspecting the gums for redness or swelling that may indicate gingivitis or gum disease (periodontal disease). A dentist may gently poke these areas to see how easily they bleed. A special probe with a blunt end may be used to measure the space between the tooth and gum. Healthy gums are firm tissues that follow the contours of the teeth and attach tightly to the tooth, allowing little space (usually less than 3 millimeters) between the tooth and gum. Diseased gums swell and detach from the tooth, creating a larger space. The extent of receding gums may also be noted during this part of the examination. A standardized screening system (Periodontal Screening and Recording) is used by some dentists. This method is usually less time-consuming than a comprehensive periodontal screening.
    • Occlusion. Examination of a patient’s bite (how teeth of the upper and lower jaws fit together). This may involve placing special paper in the mouth prior to biting to obtain an impression of how the sets of teeth correspond. This may indicate a need for treatment for bruxism or malocclusion (e.g., braces).
    • Hard tissue inside the mouth (e.g., bones, teeth). Visual inspection of all teeth for noticeable signs of tooth decay. A mirror may be used to see all sides of the teeth. Teeth may be poked with a dental explorer (handheld tool with a sharp end) to identify possible cavities. Some dental professionals have argued that this tool is overly harmful to weakened, soft enamel. However, it provides a dentist with tactile verification of cavities, which can be hard to identify by sight alone. Loose teeth may indicate gum disease or bite problems.
    • Head and neck area. This may include visual examination of the face, neck and lips for swelling, bleeding or other abnormalities. Additional areas examined may include:
      • Temporomandibular joint (TMJ). Where the lower jaw connects to the skull. A dentist may ask patients to open and close their mouths, or move their lower jaw from side to side. Pain or tenderness in the area may indicate a problem, such as TMJ disorder.
      • Salivary glands. These glands, located below the tongue and around the jaw, may be observed and felt by hand for inflammation that may indicate infection or disease.
      • Lymph nodes in the neck. This area may also be touched by the dentist to check for signs of infection or disease.
  • X-rays. If there is suspicion of tooth decay or other oral problems, x-rays will be taken. This allows the dentist to see inside a tooth and under the gums. It is the only way to identify problems in these areas. Some studies suggest that dental x-rays may also help to detect certain general health conditions, such as osteoporosis or risks of stroke.
  • Dental cleaning. Cleanings may be performed by the dentist or by a dental hygienist. This includes:
    • Cleaning. Cleaning removes tartar from above and just below the gum line that can lead to tooth decay and gum disease. At-home dental care removes plaque, but only professional dental instruments can remove tartar build-up. Ultrasonic equipment may be used in cases of severe tartar build-up.
    • Polishing. Polishing involves the application of a gritty substance to the teeth, which are then buffed with a rotating rubber brush. This removes plaque and surface stains. Patients are usually advised to rinse their mouths during cleaning and polishing.
    • Fluoride treatment. A natural mineral that strengthens teeth and helps prevent tooth decay. This application usually takes several minutes, and patients may be advised not to eat or drink anything (including water) for at least 30 minutes after this treatment.

After the dental examination

After a dental examination, a dentist or dental hygienist may encourage a patient to use proper daily dental hygiene (brushing, flossing), which may include the use of fluoride (e.g., in toothpaste, mouth rinse, drinking water). This can help prevent tooth decay and gum disease (periodontal disease). A patient may also be instructed on the proper brushing or flossing techniques.

A dentist or hygienist may also advise patients to avoid tobacco products and limit their alcohol intake to improve dental health. In addition, most dental offices provide patients with a free toothbrush, dental floss or other appropriate dental care gift to take home.

Potential risks with dental examinations

A dental examination does not typically involve risks and is an important factor for a person’s overall health care. In addition, the amount of radiation a patient is exposed to when receiving dental x-rays is very low. However, the effects of radiation are cumulative and people are often exposed to minute levels of radiation in their daily lives. Although dental x-rays are considered safe, the U.S. Food and Drug Administration recommends avoiding unnecessary exposure.

At the dental office, precautions against unnecessary exposure include the use of a lead apron, which blocks radiation from entering the chest, abdominal and pelvic areas. In addition, radiation is directed at as small an area as possible, and fast film speed means a person is exposed to radiation for less than a second. In addition, if a person has had dental x-rays taken recently, a new dentist may be able to obtain those records rather than take more x-rays.

The frequency of dental x-rays depends on the results of a patient’s dental examination, as well as an individual’s dental history and risk of tooth decay. Some patients may require x-rays several times a year, whereas others may only require them once every year or two. A dentist can determine how often x-rays are needed in each case.

Patients who are pregnant should advise the dentist of their condition. X-ray radiation poses a small risk to an unborn child. However, this should be weighed against the need to treat an existing dental infection, which also poses a health risk to an unborn child.

Treatments that may follow a dental exam

Depending on the findings of a dental examination, certain treatments may be recommended. These include:

  • Dental restoration. A dentist may recommend and perform specific treatments, such as fillings or crowns when teeth are decayed and damaged.
  • Protective care. This may include dental sealants, a composite resin coating applied to the molars and premolars to help prevent cavities from developing in children.
  • Referral to specialists. This may include referrals to a periodontist (e.g., to treat gum disease), orthodontist (e.g., to install braces) or an endodontist (e.g., for a root canal).

Questions for your doctor

Preparing questions in advance can help patients have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor the following questions related to dental examination:

  1. How often should I have a dental examination and cleaning?
  2. Will I need x-rays at every visit? Is this harmful to me?
  3. Do I have any medical conditions that may be affecting my oral health?
  4. Do any of my medical conditions require me to take antibiotics before a cleaning?
  5. What is the proper way to brush and floss my teeth?
  6. Are there particular areas in my mouth I should pay attention to when I am brushing and flossing my teeth?
  7. What type of toothbrush do you recommend?
  8. Do you recommend electric toothbrushes or water irrigation devices? Should I use these instead of a regular toothbrush or dental floss?
  9. Should I use a fluoride rinse after brushing my teeth? What type do you recommend?
  10. Can you recommend a specialist if I need additional dental treatment?
  11. How can I reduce the anxiety I feel about my visits to the dentist?
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