A thorough dental examination is essential before undergoing any treatment plan. Without an examination, it is impossible to make an accurate diagnosis and this will influence the form of treatment that should be prescribed to the patient.
At Tzaneen Dental Studio, we advise all our patients to inform us about their specific complaint and whether or not they would like us to conduct a full oral exam. If so, our reception staff will book a 60-minute appointment on your behalf. If have an emergency we will book a 30-minute appointment for you as soon as possible.
The first appointment for a new patient is always booked for 60 minutes. This gives us sufficient time to introduce you to our practice and our facilities, do a thorough dental examination, and carry out any immediate treatment necessary. Patients with existing treatment plans must inform us, so that we can allocate the correct time and duration for your specific treatment.
Undergoing a Dental Examination
During a dental examination, we want to gather as much information as possible about a patient. We believe that we are not only treating teeth, but we are treating the patient as well. The process starts by completing an application form for each new patient, making sure that all details are correct, especially when it comes to medical aid details. We always request as much information and contact details as possible, as this allows us to get in touch with you at all times. You will also be required to fill in a medical history form, after which our reception staff will open a new file for you.
The dentist will collect you from our waiting room and escort you to his rooms and you are now ready for your dental examination.
Step 1: Your Main Complaint
We want to establish what the main reason for your visit is. We need to evaluate your main complaint, since our main focus is to address this problem. Please provide us with as much information as possible; the better you describe the problem, the more accurately we can make a diagnosis. Please discuss all additional problems you would like us to address during your dental examination.
Step 2: Extra-Oral Examination
The next part of the dental examination involves all the facial features outside the mouth. We examine the temporo-mandibular joint for any signs of dislocation or spasm. We examine all muscles of mastication for signs of spasm. These give us an indication as to whether or not a patient suffers from Bruxism.
We also look for any swellings or enlarged lymph nodes and any other abnormal facial features. The extra-oral examination becomes very important in aesthetic treatments and the examinations for these treatments will be discussed in more detail with you.
Step 3: Intra-Oral Examination
We start our intra-oral examination by looking at the hard tissues (teeth). Each tooth is individually examined for any signs of pathology. We pay special attention to the tooth that is causing the main complaint; we look for signs of decay or caries, attrition, abrasion, erosion and secondary decay around existing restorations.
We also check for fractured teeth and restorations, as well as plaque and calculus accumulation around the teeth. Everything is noted in your patient file, so that we can devise a custom treatment plan for you. If a tooth shows signs of pulpal or nerve damage, further clinical tests will be carried out. These include hot, cold and electrical testing to determine the health status of the tooth’s nerve canal system. A clinical diagnosis is very important and is only confirmed with a radiographic examination.
Next, we look at all the soft tissues in the oral cavity and the Periodontium. The Periodontium consists of the gingiva and bone surrounding a tooth. We look for any signs of oral pathology on the soft tissues and under the tongue that may need treatment by a specialist. Evaluating the Periodontium will give us an indication of any gum disease, such as gingivitis and periodontitis that may need urgent treatment. A thorough periodontal examination will be explained in the dental implants section.
It is important to note that caries (decay) and gum disease can spread, and if left untreated, it will affect the other teeth and gingiva in the mouth. We pay attention to the main complaint first, but devise a treatment plan to treat the other problems as well. Our aim is to prevent any future dental problems, and thus we take extra-oral and intra-oral photos, which will help explain the problems to our patients. These will aid us in educating you to better understand your dental problems.
Finally, we do a radiographic examination to confirm all our clinical findings. A panoramic x-ray will be taken of all new patients, as well as patients that have not been to our practice in the past 12 months. These x-rays give us a picture of the whole mouth. We can evaluate all the bone structures and the teeth on such an x-ray. It is an incredible diagnostic tool. It is used to detect any malignancy in the jaws. If a specific tooth is a problem, we will take a peri-apical x-ray of that specific tooth. It will highlight the areas around that tooth and aid us in making a correct diagnosis of the problem.
Step 4: Treatment Plan and Discussion
Once we have gathered all the data, we can make an accurate diagnosis and devise a treatment plan for our patient. The dentist will explain all problems and the treatment plan to correct these problems. We urge all patients to ask us if they feel unsure of anything. Our aim is not only treatment, but education as well. We will explain all risks and possible complications with treatment, as well as complications if the problem is left untreated. We will also provide you with an accurate quotation and explain the financial policy of our practice.
Once the patient is ready, we can start with the treatment and we ask that all patients sign our financial policy form. Certain treatments require informed consent forms to be signed, but these will be explained under each treatment section.
Your Medical History
Some of the information we will require you to complete, relates to where you are from, what you do for a living and how you’ve learned about our practice. Your medical history is just as important, as previous medical issues may interfere with your dental treatment. Here are a few common medical problems and how they may affect your dental treatment.
High Blood Pressure
If you suffer from high blood pressure it is very important to inform us, as the stress related to dental examinations and procedures, as well as the adrenalin in certain local anaesthetics, can cause a patient’s blood pressure to rise to dangerous levels. If your blood pressure is under control and you have taken your medication, we can continue with treatment. We will however use an alternative local anaesthetic that does not contain any adrenalin to reduce the risk of high blood pressure.
Pregnancy
If a patient is pregnant, we have to avoid using x-rays during dental examinations or procedures, as this can cause permanent damage to the baby. We prefer to only treat pregnant women from their second trimester onward, but in an emergency we will have to apply treatment, regardless of the stage of their pregnancy. We do take your health very seriously and we will never do anything that may be harmful to your baby.
During pregnancy, oral hygiene is very important as the hormonal changes in your body can lead to pregnancy gingivitis. We urge all pregnant ladies to book an appointment for a thorough cleaning once every three months while pregnant.
Myocardial Infarction
In a case where a patient has suffered a Myocardial Infarction in the last six months, we will not apply treatment as this may lead to another attack. We will contact your cardiologist and get his written consent before we start any dental examination or treatment.
Stroke
If you have had a stroke, there is a good chance that you are on medication such as Warfarin, which can interfere with our treatment. Please inform us so that we can contact your specialist and conduct the correct treatment plan, and to inform you about the correct usage of your medication during your dental treatment.
Valve, Knee or Hip Prosthesis
In case you have had any prosthetic replacement surgery, it is imperative that you inform us. You will need prophylactic antibiotics to prevent infection of the prosthesis after your dental treatment. Some dental treatments cause bleeding; oral bacteria can enter the bloodstream and cause an infection around the prosthesis. This can lead to failure of the prosthesis, or in the case of valve replacement, infection of the heart muscle and valves.We will discuss the situation with your specialist before we start with treatment. We also need to make sure that you are not on any specific medication that may interfere with your dental examination or treatment.
Rheumatic Fever
Rheumatic fever causes damage to the heart valves. The valves become covered with fibrous tissue, which is not as smooth as normal heart valve tissue. Again, bleeding in the mouth can cause harmful bacteria to enter the bloodstream (bacteraemia) and colonise around the damaged heart valves. This can lead to an Infective Myocarditis. These patients will require prophylactic antibiotics before we can start treatment.
Active Malignancy
Patients with cancer can experience complications with dental treatment, as chemotherapy causes damage to the red blood cells, white blood cells and platelets in the blood. A decrease in red blood cells causes a decrease in oxygen carried to the tissues of the body. With insufficient oxygen, wound healing is compromised. White blood cells are the body’s natural defence system, and a decrease in white blood cells can lead to a higher risk of infection.
A decrease in platelet count will also influence blood clotting. Thus, during surgical procedures, these patients tend to bleed a lot. Please inform us if you are on any cancer treatment, so that we can talk to your specialist.
Drug Abuse
Please inform us if you are receiving rehabilitation treatment for drug abuse. Some of the medications we administer and prescribe contain addictive substances, which may interfere with your rehabilitation.
Psychiatric Illnesses
Some medications prescribed for the treatment of psychiatric illnesses may interfere with the medication we administer and prescribe. Please inform us if you are taking any medicines so that we can provide the appropriate treatment option.
Epilepsy
If you are an epileptic, you need to inform us about the type of epilepsy you suffer from, the date of your last attack, and whether you have taken your medication. Stress during a dental examination or procedure may induce an acute epileptic attack. The overhead light may lead to an attack if you have photosensitive epilepsy.
Asthma
With asthmatic patients, we need to know the type of medication you receive and when your last attack was. Patients with mild asthma, controlled with an inhaler, need to keep their inhaler with them during dental treatments. If you are on cortisone treatments you need to inform us as well. The increased stress from a dental examination or procedure can cause complications in conjunction with cortisone. We will confer with your specialist and adjust your treatment.
Osteoporosis and Bone Cancer
If you receive treatment for osteoporosis or bone cancer, we need to know what type of medication you receive. Intravenous Bisphosphonates and oral osteoporosis medication can lead to bone necrosis in areas where surgical procedures are carried out. These patients are first sent for CTX tests to determine the risk level for treatment.
Smoking
Smoking is not a contra-indication for any dental examination or procedure, but may cause complications. Smoking decreases the blood flow to the mouth, leading to less oxygen supply in the wound area. This leads to poor wound healing. Smoking can also cause discolouration of teeth and various gum diseases, as well as oral cancer.
Smoking after an extraction may lead to a septic socket, which needs further cleaning. This can be very painful. We do not guarantee any dental implants on smokers, since smoking will disrupt the integration of the dental implant to the bone.
Diabetes
Every patient needs to inform us whether they are a type 1 or a type 2 diabetic. Diabetic patients are more prone to oral health problems, due to decreased immunity and poor wound healing. We urge all diabetic patients to come for regular check-ups and oral hygiene procedures, so we can help them maintain good oral health.
Before your dental examination, please make sure you take your insulin injections and medication the day before, and the day of the treatment. Consume a high carbohydrate meal before treatment. Diabetic patients need post-operative antibiotics after surgical treatment to prevent infection.
Allergies
Please inform your dentist if you suffer from any allergies to medication, or any other form of allergy. Some of the medications we administer and prescribe may cause an allergic attack if you are allergic to that specific form of medication.
Heart Problems
Prior to starting your dental examination, please discuss any heart problems with us before we start treatment, as you may be on certain medications that may interfere with treatment. We will confer with your cardiologist and start with treatment as soon as we have received a written letter from your cardiologist.
Any Medication or Other Medical Problems
Please inform us if you are using any medication or suffer from any medical problems that were not mentioned. Your health is our main priority and we do not want to compromise your health with dental examinations and treatments.
For more information about our dental examinations, please get in touch.