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At the dentist: the general examination

Based on the findings obtained, it is possible to carry out an optimal treatment. In terms of diagnostic options, modern dentistry now has a large number of instruments at its disposal.

The dentist begins by inspecting the oral cavity using a mirror and probe. In addition, x-rays, images with the intraoral camera (camera in the mouth), vitality tests and the control of the clenching of the teeth can be carried out.

Other modern methods for determining the risk of caries are examinations of the germ spectrum from plaque samples and in the gingival pockets. These examinations are usually only used if a disease is suspected.

The history or anamnesis

The previous history (anamnesis) is extremely important for the dentist, because it provides him with important information for assessing the examination results obtained later and for planning therapy. The later therapy will also be adjusted due to any significant illnesses.

When visiting a practice for the first time, the patient receives a form on which, in addition to personal details and the status of the insured, is asked about existing or past illnesses and medication. This medical history form should be filled out carefully as it serves as the basis for the first discussion with the dentist.

It is also important to indicate possible infectious diseases, for example hepatitis C or HIV, in order to give the dentist and employees the opportunity to comply with the necessary protective measures.

What the dentist does

If you do not go to the consultation hour with acute pain, a thorough examination of the oral cavity and teeth will be carried out at regular intervals (oral examination).

This includes the inspection of the teeth, the tooth bed, the oral mucosa, the masticatory muscles and the temporomandibular joints and is primarily carried out using classic medical methods:

  • Inspection (looking) which, with the help of the mirror, allows conclusions to be drawn about diseases of the teeth, gums and oral mucous membranes with a rough diagnosis of tooth decay and periodontitis
  • Palpation (feeling, touching) with the hands to assess loosening of the teeth and swelling, as they often occur when the jaw spreads; Detection of subtle changes in the teeth, fillings and crowns with the probe
  • Auscultation (listening) with a stethoscope in diseases of the temporomandibular joint

A large number of diseases can be detected with these relatively simple examination methods. On a case-by-case basis, however, it is advisable to carry out further examinations or to consult a specialist for special clarification of an unclear clinical picture.

The vitality test: is the tooth still alive?

During an examination, it can often be important to check the vitality of the nerve (pulp) of a tooth.

With an intact nerve, for example, it is medically unlikely that there is inflammatory bone dissolution (granuloma) at the tooth root.

If the pain in a tooth is unclear, the dentist first carries out a vitality test (with an ice spray or electrical stimulation) in order to differentiate between hypersensitivity and nerve inflammation. If there is no vitality in the tooth, it is possible that the tooth no longer has a nerve or that it has already died.

The X-ray examination

X-rays are one of the most important dental examination methods. It allows, for example, a look into the spaces between the teeth or makes pathological changes at the root tip visible.

There are different admission procedures:

X-ray

In the case of small x-rays (dental films) showing one to four teeth, the x-ray film is located inside the mouth.

Panoramic shot

The panoramic image is taken extra-orally, i.e. outside the mouth, by the dentist or an employee. The teeth, the jaw and, in some cases, the adjacent areas of the jaw area, the maxillary sinus, appear as free from overlapping (orthoradial) as possible.

This is usually at the expense of the level of detail, which is only possible with intraoral recordings, i.e. inside the mouth, the so-called "dental films".

Newer digital devices work with computer support and thus have up to 70 percent less radiation exposure.

X-ray status

A special form is the so-called X-ray status, a representation of the upper and lower jaw on ten to 14 small X-ray films in the mouth. Compared to the panoramic image taken outside of the mouth, this is a relatively complex, but very detailed procedure. This type of recording is mainly used in a later session as preparation for a gum treatment or for caries diagnosis in the interdental spaces.