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Comprehensive Dental Checkup Overview

Before starting a regular schedule of dental check-ups, Dr. Flewelling believes its best to undertake a comprehensive dental exam. The benefit of having a comprehensive dental exam is that this type of exam is not limited to checking for tooth decay and or gum health, but extends to a complete examination the mouth, head and neck areas.  Comprehensive dental exams are undertaken by Dr. Flewelling for all new, first-time patients and repeated on a 3 year interval, which is consistent with current ADA guidelines. 


The comprehensive evaluation begins with examination of the head and neck for swelling or tenderness, as these types of conditions may be an indication of infection or disease of the lymph nodes, salivary glands or the Temporomandibular joint which connects the jawbone to the skull.  Next, Dr. Flewelling focuses on the soft tissues of the mouth which includes the throat, tonsils, tongue, inside of the lips and cheeks, as well as the floor and roof of the mouth areas. These areas need to be examined to see if any spots, lesions, cuts, swellings or growths might exist, as these can indicate one or more oral health problems.   In addition, the gum tissue and areas surrounding your teeth are closely examined for any signs of gum disease, also known as periodontal disease.  This condition is typically manifested by red, puffy gum tissue that bleeds easily.


Another area covered during the comprehensive dental exam includes examination of upper and lower teeth, and how they come together or how the teeth meet.  Also, during this portion of the examination, Dr. Flewelling searches for signs of tooth decay on the surface of every tooth using a dental instrument called an “Explorer”.  The Explorer works well because decayed enamel  can feel softer when probed, especially when compared to healthy dental enamel. The Explorer is also used to find any existing problems with fillings, braces, bridges, dentures, crowns or any prior dental restorations.


Once the comprehensive dental exam has been completed, Dr. Flewelling uses X-rays to look for any other signs of tooth decay, gum disease and other oral health problems.  At that point, Dr Flewelling has enough information to recommend the right type of cleaning procedure needed as well as any procedures that are required to restore dental health.


Dental Hygienist Exam and Cleaning


When scheduling dental check-ups, Dr. Flewelling assigns a Dental Hygienist to conduct subsequent oral exams of your gums. While Dental Hygienists are not allowed to diagnose tooth or gum problems, the Hygienist will document them before Dr. Flewelling continues. In addition, the Dental Hygienist will take care to document any changes in overall health, medicines used, how teeth are cleaned and polished, or to answer any questions you might have. Dr. Flewelling will also conduct a secondary oral exam of your gums and teeth, ask about changes in your overall health or medicine use, review the cleaning done by the Hygienist, and look for new indications of oral cancer and other diseases, as well as diagnosing any oral health problems, and making treatment recommendations.


While home-based tooth brushing and flossing help remove plaque, only a professional cleaning can thoroughly clean your teeth and remove deposits of hardened plaque that builds up on teeth. You’ll often hear Dr. Flewelling referring to such deposits as “calculus” or “tartar” when giving instructions with the Hygienist.


Once per year, your Hygienist will measure the depth of the pockets around your teeth.  These measurements are one of the findings used to help determine the health of the tissues surrounding your teeth.  After completion of these measurements, most hygienists use a series of metal hand instruments to conduct a professional grade cleaning of the teeth. Such cleaning may involve the use of ultrasonic scalers, which provide deep cleaning above and below the gum line. 


After your teeth have been professionally cleaned by the Hygienist, they are then carefully polished to remove excess plaque and staining found on the surface of a patient’s teeth. The polish contains a mild abrasive substance and fluoride, which is then applied using a small rotating rubber cup or brush attached to the dental hand piece.


Dr. Flewelling’s Hygienist may offer additional instructions for you to follow at home about brushing or flossing, or general care questions about your teeth and gums.  In some cases, the Hygienist may need to take x-rays to help evaluate any abnormality found in the teeth.  Dr. Flewelling uses this information to develop treatment recommendations.  This might include referral to a specialist, additional diagnostic testing, or guidance on appropriate restoration work such as fillings and crowns, or additional oral healthcare actions.


Periodic Dental Checkups


Once the comprehensive dental exam, dental hygienist exam and cleaning have been completed, you are then ready for scheduling regular periodic visits to maintain optimal oral hygiene.  Two dental visits a year are usually recommended for most patients, not including any other procedures that might be needed.


In a typical check-up, patients are seen by the hygienist and Dr. Flewelling. The hygienist cleans and polishes your teeth, talks to you about caring for your teeth and answers your questions. The dentist reviews the cleaning done by the hygienist, conducts an oral exam of your gums and teeth, diagnoses any oral health problems, orders X-rays (if appropriate) and make treatment recommendations. Check-ups are important not only for cleaning, but are also important in order to find early signs of decay.  The earlier a problem is found, the more manageable it is.


During each periodic visit, it’s important to update medical history and all current medicines being taken.  Dr. Flewelling will want to know if you have been diagnosed with any diseases, or any other health issues, even those that that may not relate to the mouth. Several diseases can have a direct impact on oral health. By example, diabetes can increase the risk of gum disease or the risk of getting cavities.  At that time, its best to let Dr. Flewelling know if you think you have a new cavity or areas of sensitive teeth, as well as any lumps or bumps in your mouth, or any other oral health concerns that will help with an early diagnosis.


In addition to the foregoing, it’s also important to bring a complete list of all medicines you are currently taking and their dosages. Some medicines can cause dry mouth, which can increase your risk of cavities. Other important reasons for your dentist to know your medicines are so that he or she doesn’t prescribe a medicine that could interact with one you are already taking and to change the type of anesthesia given, if necessary.


If you have any fears about going to the dentist or receiving dental care, be sure to tell Dr. Flewelling. Dental treatments have changed drastically from years ago and so have pain management options that will help ease your fears, minimize pain and make you feel more comfortable. 

Dr. Flewelling with Patient
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