Published 30 Jul 2021
Why do I need to go to the dentist for a check-up? Everything feels fine to me.
This is something dental professionals often hear. The simple answer is that many conditions that impact the mouth produce little or no symptoms in the early stages and, as with so many things in life, early detection can often result in simpler, easier and cheaper treatment. By the time you notice something unusual or experience pain, the issue has usually been there for some time and may have progressed. By ensuring you regularly attend the dentist for an examination, any issues which may be developing in the background can be detected and managed, or even completely prevented.
How often should I attend?
While the recommended frequency for dental examinations is every six months, some adults with well-maintained mouths may be advised by their dentist to extend this to yearly. Patients with complex medical histories, high decay rate or gum disease may be advised to attend more frequently.
When dentists carry out examinations, they are not only undertaking a check of your teeth. Firstly, they will check the surrounding soft tissues both inside and outside of the mouth such as the lips, cheeks and tongue. They will look for any lumps, bumps or ulcerations that should not be there. Some general health conditions that impact your body can also produce changes in your mouth for example leukaemia, diabetes, anaemia and other vitamin and mineral deficiencies and even reflux. Your dentist will also take a look at your jaw joints and the muscles involved in making them move for actions such as eating and speaking.
Secondly your dentist will look at your teeth. They will look closely at each tooth in order to make sure nothing is missed. Decay is generally symptom free until it gets quite close to the pulp of the tooth (which is the part of your tooth that contains its nerve and blood supply). By this time, it is usually quite advanced and may have destroyed a significant amount of the tooth structure. To treat decay at this stage is not only more involved it is invariably more expensive. However, when decay is detected early it can often be prevented from progressing further or damage may even be reversed with simple procedures such as applying fluoride or other remineralising agents, fissure sealants and specific advice regarding diet and cleaning techniques.
During your appointment, dentists will also assess the teeth for worn fillings that are no longer providing adequate protection, cracks in both the fillings and tooth structure which if detected before they break, can often be managed more easily. They will look for excess wear, which can be a sign of clenching and grinding, over-vigourous tooth brushing or excess acid either from your diet or reflux. Again, early detection and management of these issues can slow or prevent progression.
Your dentist may recommend they take X-rays of your teeth. These will help the dentist to see what is going on ‘under the surface’ and spot any hidden decay between the teeth, check the supporting bone, check the roots of the teeth and any potential problems with unerupted teeth such as wisdom teeth.
Finally, your dentist will check your gums and your cleaning technique. They can see areas you may be missing with your cleaning and give you tips on how to reach those areas more effectively, improving your oral hygiene techniques. They can also show you where you may be overbrushing and thus traumatising the gum causing it, and eventually the supporting bone, to be pushed back or recede. Recession – the most common cause of which is trauma from over-vigourous tooth brushing – exposes the root of the tooth. The root is made from dentine which is not only more sensitive, but it is softer so more easily worn away and is more vulnerable to decay.
It is important to note that healthy gums should not bleed when you are cleaning them. This is a sign of inflammation and most often caused by a build-up of plaque along the gum line. Superficial inflammation of the gums, or gingivitis, is relatively simple to manage. It develops when plaque is not effectively removed during cleaning of your teeth. If necessary, the dentist (or hygienist) will clean your teeth and remove any plaque and hardened plaque or tartar which is not easily removed with normal home cleaning methods. In fact, the longer it is left, the thicker it becomes. In some cases, the accumulation of plaque along the gum line not only causes superficial inflammation, it also causes the gum to pull away from the teeth and can affect the bone that supports the teeth. This condition is called periodontitis. Again, this condition often causes few initial symptoms and if left untreated can cause teeth to become loose. By this time, the disease has become significantly advanced and its management more complex and may even result in the loss of otherwise healthy teeth. However, by having regular dental checkups, conditions like this can be detected and managed more easily. Poor gum health has now been linked to systemic conditions such as lung disease, heart disease and diabetes so the importance of oral health has become increasingly more recognised.
The last and most important reason to visit your dentist on a regular basis, in addition to support prevention, is so that your dentist can get to know both you and your mouth. This is particularly true for children. If they present regularly for check-ups, the practice, the people and the simple routine procedures become familiar, building their confidence so that should treatment become necessary, not only is the process more likely to be straightforward for them, they are less likely to become anxious. When checking your child’s mouth regularly, dentists will monitor the growth of your child’s mouth and look out for missing teeth, crowding or impacted teeth. The earlier such problems are detected the easier they are to manage. Good habits are best started young!