We were recently emailed by a couple new to the Kanata, Ontario area, as they are looking for a new dentist. “We’ve been regularly going to the dentist every six months in…[previous home town], and are looking to continue that care with you here in Kanata.” After scheduling appointments, our receptionist informed the gentleman that our New Patient Examinations are scheduled for two hours. “Why such a long time? We don’t want to duplicate records we’ve already had from our previous dentist, can’t we just have that transferred and set up a cleaning appointment?”
When a patient transfers care to a new dentist, that dentist is responsible for completing an independent set of diagnoses. While x-rays and notes of past treatments completed can be forwarded along, these alone may not be enough to truly understand a patient’s current oral condition. For example, in Ontario, Canada, the licensing body (The Royal College of Dental Surgeons of Ontario: RCDSO) requires each dentist to perform a complete examination of every new patient to the office prior to prescribing what type of treatments should be done. An individual office may have its own protocols regarding what is included in this Comprehensive New Patient Examination, but there must be consistency for every patient treated in that office. Here is what we do in our office, and why we feel each step is important to provide excellent patient care.
- Review medical history: We need to be certain every patient we treat is healthy. Medically compromised patients (those with unstable medical conditions) often require consultations with the patient’s physician prior to starting certain types of treatment. We also take a baseline blood pressure and record that in the chart.
- Review past dental history: Hearing from the patient about their past experiences, past treatments, and any special needs they may have will help us provide the best care we can. We also have a form on our website called “Handle Me With Care” which describes specific needs a patient may have while in our care.
- Complete series of dental radiographs: Using digital x-rays, we take a series of 10-18 dental radiographs to enable us to evaluate conditions we may not be able to see with our eyes. Even for a patient with no history of treatment for cavities or gum disease, it is still our responsibility to be sure nothing is hidden from our view. If a patient has recent x-rays of diagnostic quality forwarded from a previous dental office, and these x-rays show us all areas of the mouth, we can skip this portion of the appointment. The best part about digital radiographs is that a full series of x-rays has about 70% less radiation than film-based dental radiographs.
- Intra-oral photographs: A picture is really worth a thousand words! Taken with a digital camera, this allows us to record the appearance of the mouth when we meet our new patients. We use these for documentation, for diagnosis (because we enlarge these photographs to fill our computer screen), and for patient education.
- Examination and recording of dental conditions: A variety of screenings are done at this point, including gum tissue health, restorative health, occlusal (biting/chewing) health, and esthetics. These screenings are made objectively, and risk for pathology/disease in each of these areas is also noted.
In our office, steps 1-5 are typically completed by our Dental Hygienist and can take up to 45 minutes to complete. Dr. Stevens performs the restorative evaluation with a visual examination while reviewing all x-rays and photographs, and then 30 minutes of time is reserved for her to discuss the findings with each patient. Dr. Stevens educates each patient about the health of the mouth, and what treatments, if any, are recommended. At this point, the Dental Hygienist takes over with Periodontal Therapy, and this can take between 30-45 minutes to complete, rounding out the two-hour appointment. Some patients will be rescheduled for a continuation of their Periodontal Therapy if the allotted time isn’t enough to complete that part of treatment.
What our new patients often say as they are leaving our office is “I’ve never had such a detailed examination before, and I understand my dental condition better than I ever have!” This sentence is our goal because we believe that the key to excellent dental health is knowledge and understanding. We can provide corrective and supportive treatments, but the patient must actively take great care of themselves at home. We are ALWAYS happy to accept new patients to our dental family who wish to be active participants in the best dental health possible!
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.