Extreme Dental Makeover - Where to Begin...
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By Dr. David Leader
"Extreme Makeover" has shown many examples of what dentistry can do. Television shows what modern dental techniques can do to improve appearance. Improved appearance can help to increase self-esteem.The only problem is that it shows the change so quickly that it is difficult to appreciate how a dental makeover is done. Most dentists follow the same steps to guarantee their patients will be happy with their new look. Let's break it down into easy to understand parts.
The first appointment is very important. The dentist collects the information needed to plan your treatment. Most important is the medical history form. Dentists must know everything about your physical condition including what medications and food supplements you take, and what systemic illnesses affect you.
If you have a heart murmur, prosthetic valve, or a joint replacement you may even have to take medication before the dentist or hygienist can examine your teeth. (If you have a condition like this your medical doctor should inform you, but it is always a good idea to ask if you are not sure.) Other forms include personal information such as name and address, insurance information (bring your card and booklet if you have it), and you even sign a form saying that you are aware of the office's privacy practices.
Most dental offices take a set of radiographs (x-rays) next, unless you have come to the office with a more pressing problem like a toothache. A full set of radiographs may include up to 24 individual exposures or as few as 2 individual exposures and a single, large radiograph called a panoramic that shows all the teeth and the upper and lower jaws on one film.
Next, the dentist asks you what you would like to accomplish in the realm of dental health. You may have specific problems such as bad breath or stained teeth; you may want to say something general about living healthy; you might want to improve your appearance by straightening, lightening and rebuilding broken or missing teeth. When the dentist knows what is most important to you the dentist can examine you with that in mind.
The examination usually begins with an oral cancer screening. The dentist or hygienist will examine the soft tissue of your face and mouth for anything unusual. Areas of swelling, discoloration or ulceration will be noted in your chart. Many dentists will photograph anything that they want to remember.
If you have removable dentures, the dentist or hygienist checks their function, fit and stability. Before cleaning your dentures they are checked for cracks and broken pieces.
A periodontal screening is done to check for gum disease. You might hear the dentist or hygienist call out numbers to an assistant. These numbers directly relate to the health of your gums. The results of the periodontal screening may show that years of neglect have caused gum disease that requires further examination and treatment. However, if the results are nearly normal then you may only need the usual dental cleaning or prophylaxis.
To check your teeth the dentist or hygienist records the position and size of your teeth, crowns, dental implants, fillings, cavities and bridges (crowns and porcelain teeth that are cemented in place). You may hear a lot of dental jargon (words like mesial, composite, and onlay). When this procedure is finished, your chart will contain an accurate record of the condition of your teeth and mouth at the time of the exam.
Depending on the office's procedures and the extent of your need the staff or doctor may make models of your teeth and photograph them from different angles. The models and photos will aid in designing any needed porcelain veneers, crowns or caps and replacement teeth. Some dentists use computer imaging to show you what your smile will look like after your proposed treatment.
Sometimes you will be able to leave the office that day with a list of all of the recommended procedures. Many times, it will take the dentist time to design the best treatment for you. Often, you have choices to make such as replacing teeth with removable or fixed bridgework, or whether to use tooth colored or silver fillings. Usually, you receive a complete plan for your dental makeover not later than the third appointment.
Next time, the makeover begins.
Dr. David Leader is the Chairman of the Health Advisory Committee of the Lynnfield Schools, a member of the Professional Advisory Committee of Tri-CAP Head Start, and is a member of the Mass Dental Society Council on Dental Care and Benefits Programs.