You may go to the answers below and find links to other Chapters.

Questions about Diagnosis

  1. How often should I get X-rays?
  2. Are those digital X-rays safer than the old type?
  3. Why is it so uncomfortable to get X-rays?
  4. When the dentist goes around and sticks his probe in my teeth, what is he looking for?
  5. I’ve had my gums measured but it was not really clear what they were looking for – what are they really measuring?
  6. Does the dentist look at anything other than the teeth?
  7. I only go to the dentist when I have pain – is there any reason I should go at other times?
  8. Can the dentist give me a good idea about how much my teeth determine how good I look?
  9. What does the dentist look for on the X-rays?
  10. What if I am really nervous at the time of a dental appointment – is there something the dentist can do to help me with that?

Answers about Diagnosis:

  1. How often should I get X-rays?  Traditionally there are guidelines that apply here – bitewings every 6 month to one year (those four pictures in the back of your mouth), and full mouth X-rays every 3 years.  These days these guidelines are revising for two reasons:  1.  With the newer digital sensors instead of film, the amount of X-ray exposure is quite a bit less; and 2.  People tend to be more concerned these days about any exposure.  The net result is that the guidelines for digital radiography are probably about the same as the traditional timing.  But, your dentist will help you determine what your NEEDS are.  He may be quite confident that he can see enough in most areas without the X-rays, especially when you are young.  Bottom line:  Non-routine X-rays are done on an as –needed basis, whereas routine X-rays are taken infrequently…………………BACK to questions
  2. Are those digital X-rays safer than the old type?  First,the X-rays are exactly the same.  It is only the sensor that varies, either a digital sensor or a piece of film.  Since the digital sensors require much less exposure TIME to the X-ray beam, it is safer in general.  Although, it is generally said that you get as much radiation exposure when flying in an airplane (you are exposed to more radiation from the universe that is not filtered by as much atmosphere), so the amount of anxiety that is appropriate should be very low…………………BACK to questions
  3. Why is it so uncomfortable to get X-rays?  In the “old days” when everyone used film, the edges of the film were pretty sharp and if the dentist didn’t fold over the edges a little for you, and your mouth is a little smaller than average, the film could feel like it was cutting into your tissues.  A careful dentist can minimize this, however.  The newer digital sensors, which many dentists have these days, are thicker, but the edges are not sharp.  It still can be a “mouthful” to get the sensor in the right place, however – and not really more comfortable if your mouth is on the small side.  But – whatever is used, film or digital sensor, it has to be placed so as to reveal the details even of the tips of the roots, far down in the bone and this may involve some pressure to get it there…………………BACK to questions
  4. When the dentist goes around and sticks his prove in my teeth, what is he looking for?  The sharp point of the probe, or explorer, will stick into any groove or area that is decayed.  When he pushes it into a groove on the biting surface and then removes it, if it sticks a little it comes out with a kind of “boing” feeling, and this is what YOU as a patient don’t want to experience.  It means you will need some kind of filling – whether it is a restoration that extends to the dentin of the tooth, or is a simpler sealant depends of the depth of penetration………………..BACK to questions
  5. I’ve had my gums measured but it was not really clear what they were looking for – what are they really measuring?  Around each tooth there is gum tissue, which seals to the tooth.  Keep in mind that the teeth are really an extension of the skeleton outside the “body” – and where it extends through must be well sealed against any kind of foreign body invasion.  As the gum tissue, or gingiva, attach to the tooth, it forms a little pocket where the tissue extends somewhat higher than the area of seal or attachment.  The depth of this pocket is an indication of how healthy the area is.  The dentist or hygienist measures the depth of these pockets at six different places on each tooth in the mouth.  If harmful bacteria have inhabited the periodontal pocket, the level of attachment may move along with the recession of the bony support of the tooth, and the gingival tissue can become swollen and puffy – both changes can increase the depth of the pocket.  Normal pocket depth is 2-3 mm.  Slight problems start around 4-5 mm pocketing.  6 – 7 mm pockets indicate moderate problems, and 8-10 mm pockets denote serious periodontal problems…………………BACK to questions
  6. Does the dentist look at anything other than the teeth?  They are responsible for anything in your mouth to the outer edge of your lips.  The periodontal attachment and gingival tissues are inspected and measured to track progression of any periodontal disease.  The soft tissue of your mouth, tongue, under tongue, cheeks, and palate are all inspected to identify anything that might indicate other pathologies.  Sometimes there are things noted that are clear indications of systemic disease.  Sometimes the first indication that a patient has AIDS is a dark lesion on the palate of the mouth.  Certain types of cancer show up in the mouth.  It is the responsibility of the dentist to identify these things, and others, and refer you to the appropriate dental specialist or medical doctor to more thoroughly investigate the potential problem.  Also, in the X-rays it is possible that things will show up in the bone that suggest further exploration, sometimes even surgically. Your dentist will even help you determine if anything can be done in your mouth that will help you look better!………………… BACK to questions
  7. I only go to the dentist when I have pain – is there any reason I should go at other times?  Of course!  Most often the source of the pain you feel could have been identified and dealt with earlier.  This not only could save you the experience of the pain, but a much simpler solution may have been found that would also save you a lot of money!  There is a reason why regular dental checkups are important – in dollars and cents terms it will save you money…………………BACK to questions
  8. Can the dentist give me a good idea about how much my teeth determine how good I look?  Yes – but HOW good you look is more practically determined by you and your friends.  The dentist is trained to evaluate your smile and tooth-supported facial features from a general esthetic sense – what looks more typical and “normal”.  Anything that the dentist can do to improve your appearance he will suggest, based on general social norms – but what you feel needs to be done is far more personal and should be done in collaboration with those close to you…………………BACK to questions
  9. What does the dentist look for on the X-rays?  The X-rays or radiographs reveal irregularities and abnormalities in the structure of the bone of the jaws, any signs of pathology in the bone surrounding the teeth, indications that bone has been lost around the teeth which indicates periodontal disease, and signs of decay in the teeth themselves, especially on the sides of the teeth where they touch the adjacent teeth…………………BACK to questions
  10. What if I am really nervous at the time of a dental appointment – is there something the dentist can do to help me with that?  Yes! Familiarizing you ahead of time about what exactly will be done can help.  If you know that he is good at anesthetizing your tissues so you will feel no pain can help.  His/her assuring voice can help.  Sometimes the dentist will suggest that you use nitrous oxide, laughing gas, which can calm your fears greatly for the procedure.  Even oral sedation and conscious sedation by injection can be suggested by the dentist for more serious concerns.  The dentist may also suggest you schedule an appointment with a therapist trained in the reduction of stress and anxiety, especially by helping you realize the source of this reaction by your nervous system…………………BACK to questions