Your old dentist has retired, you’ve moved to a new city, or you just aren’t happy with the care you are receiving in your current dentist’s office, so you decide to make the switch to someone new. You’ve asked your friends and co-workers, you’ve checked the websites and Google ratings, you’ve picked the dentist you would like to take charge of your dental health…why do you have to have a brand new examination and x-rays when you’ve been going to your old dentist every six months faithfully for years?

A dental xray shows things we can't see with our eyes during an examination. In this xray we can see calculus and early cavity formation in this 22 year old patient.

A dental xrays shows things we can’t see with our eyes during an examination. In this xray we can see calculus and early cavity formation in this 22 year old patient.

Each dentist has the responsibility of performing a complete examination of each and every patient in the office as that relationship begins. This includes an assessment of gum health and other oral tissue health, oral cancer screening, TMJ/bite screening, restorative screening (existing fillings and need for new ones), x-ray evaluation and assessment, overall health assessment. While a patient may have had exactly this set of screenings performed in another office, or may have “just had a dental check-up” each dental office is independent and each dentist is responsible, as per our governing body, for independent evaluation and diagnosis. The RCDSO (our licensing body) also requires a “recall examination” at least once per year in order to provide any comprehensive treatment (including dental hygiene, or “cleaning”); in some cases, more frequent examinations are needed as the unique situation for each patient is made clear. As well, we are also required to perform another complete examination every few years (the time frame depends on changes to oral health or overall health over time) and could be every 2-5 years.

An xray like this one can show the extent of tooth breakdown, depth of current fillings, some areas of cavity, bone loss, all of which help us give patients the best diagnosis and treatment plan for ental health.

An xray like this one can show the extent of tooth breakdown, depth of current fillings, some areas of cavity, bone loss, all of which help us give patients the best diagnosis and treatment plan for ental health.

In terms of x-rays, there is no specific time frame during which to take x-rays because every patient is different, and that need is assessed by each dentist given the health of each patient. If a new patient comes to us with “recent” x-rays which are of diagnostic quality, this can minimize the number of x-rays we take as part of our new patient examination. Patients with no history of cavities, gum disease, root canals, etc. don’t need x-rays as often as those who have these problems; however, a patient “feeling fine” is not an indicator for the recommendation for x-rays.

We take digital photographs of every new patient we see which become part of the permanent record. We also use them to teach patients how to achieve great oral health, and will frequently take additional photographs at future visits.

We take digital photographs of every new patient we see which become part of the permanent record. We also use them to teach patients how to achieve great oral health, and will frequently take additional photographs at future visits.

Dental photographs are taken in our office of every new patient as a part of our record; they capture exactly the condition of the teeth and mouth in a way words in a chart cannot. As well, these photographs are an excellent way to provide education to our patients about their dental health, either to give great kudos for a job well done, or to show areas of concern or places to improve daily home care. The patient in the photo below had never looked at the gumlines of her teeth in the mirror because she didn’t see them when she smiled. She was surprised to see her mouth in the same way we do. As the saying goes, a picture is worth a thousand words!

Do these teeth look healthy?

Photographs like this one of a new patient can show areas of our concern, and we also take new pictures after treatment is complete to show the difference and document the changes.

All of these guidelines are put in place to protect the patient. Dental disease is most often painless and can therefore progress undetected unless proper examination and diagnosis are able to be made on a routine basis. Refusing routine photographs, dentist examinations, measurements, and x-rays truly does handicap your dentist from giving you the best possible care. If you look hard enough, you may find a dental office here and there who will allow you to have treatment without a dentist’s full and proper examination, but I would caution you that if that office “bends the rules” for this, there may be other ways where proper attention isn’t paid that may not suit you or your oral health well as time goes on.

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at drandreastevens.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.