WAY TO WATCH...do you hear what I see? exam notes

 

Way to Watch....Do you hear what I see?

During a recent exam, a patient commented, “ wow, I have a lot of things going on. You are watching a lot!” Dr. Martin explained to the patient, that at the initial exam he diagnoses many conditions are going on in your mouth. He evaluates each of those at checkup appointments to see if they have improved, remain unchanged or need to be treated.

One can become pretty anxious as they are awaiting the ,”looks good.” Patients are awaiting to hear they have no cavities, but there are many things that Dr. Martin examines during the visit. He leaves to “calculus” unturned.

He was telling a patient today that enamel is the hardest substance in the body, but at time that wears away. You may hear “watching” the erosion at the CE or gumline of #20.

As we age, our gums recede where the enamel meets the cementum (or part of the tooth under the gum). Sometimes, this is caused from simply brushing too aggressively, and tissue is also brushed away. Here are some other things you may hear during your visit.

Fracture at the distal of 30 -- This is simply a crack on a lower right molar. While cracked teeth are very common, every crack doesn’t require further treatment. If a crack becomes sensitive to temperature or biting pressure, treatment may be needed. Every cracked tooth doesn’t need a crown.

Crown--A porcelain fused to high noble gold “cast” is fabricated to replicate a protect the tooth that has a symptomatic crack or broken cusp. The tooth is shaped, then covered with a crown to prevent the crack from causing the tooth to split, or shift on the plane by holding it position. 

Occlusion-- This is how your upper and lower teeth come together when your mouth is closed. You might hear him describe it as Class 1, crossbite, overjet, etc. 

Wear --over time grinding and clenching can wear away your tooth’s enamel. An occlusal guard can protect them from this stress.

Anterior and Posterior Triangles--These are the lymph nodes in the neck area that are palpated to check for inflammation. While lymph nodes are often enlarged when you are fighting an infection, they can also indicate more serious conditions.

Palatal Torus-- a common bony growth that is in the roof of the mouth. It is mostly thought to be a genetic hereditary condition.

Bilateral Mandibular Tori--Wow, this is a lot to hear. It is simply the same bony growth that can be found in the palate, but is under the tongue or sometimes on the sides of the lower teeth. Again, these growths are harmless. If Dr. Martin mentions bilateral, this means that the growths are on both sides.

As he reviews your radiographs, he may, “watch the mesial of 14”. He may be concerned that the enamel is wearing away at the front part of the upper left 1st molar. If the decay is through the enamel, he will schedule treatment for a filling for the cavity.

Decay--also known as a cavity. Bacteria from sugary foods or starches produce acid that break down the enamel of a tooth. When the decay erodes through the enamel the damage is permanent. The decay will be removed, so the cavity can be filled. 

Pockets--this is a measurable space between the gumline and where the gum tissue attached to the tooth. The hygienists are very mindful to take measurements during a patients visit to make sure gum disease is found and treated at an early stage. 

Fissured-- a description of the tongue that comes two ways, with lines or without. A geographic or lined tongue is simply a patterned tongue. Dr. Martin encourages each patient to brush their tongue to help remove bacteria and prevent the saliva from bathing the teeth with bacteria trapped in the grooves.

 

All these terms are processed from a patients perspective as frightening, but in order to provide the highest level of care many of these terms may be used. The only scary part is not asking if you have questions during your visit. Dr. Martin and his hygiene team are educators, as well as care providers. We encourage you to ask questions regarding your oral health. We are going to “watch” and see if you do. Listen up at your next visit, see what you hear and what Dr. Martin sees. The hygiene team often takes intra-oral pictures to help give patients a better understanding. The hygienists are happy to help provide each patient with a better understanding as they are passionate about your dental health.

 

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