First Visit to a Dentist: What to Expect
I would like to share my ideas on what a first visit to the dentist should be like for the patient. With my 30 plus years of experience as a private practice general dentist to shape my views. I am continually striving to improve my abilities and methods, but I feel I have a good grasp of this procedure.
Personally I don’t believe in scheduling a new patient examination with the hygienists and the Dr. appears for 5-10 minutes to do his evaluation. Rarely is this adequate time to perform a thorough evaluation of the patient’s oral health.
How Long is the First Visit to a Dentist?
I believe most new patients value the amount of time I allow for a new comprehensive patient evaluation, approximately 1 hour. We often receive compliments on how thorough the examination was. I enjoy getting to know the patients and hearing about their jobs, stresses, kids, hobbies, etc. I try to slowly build a relationship with my patients to get to know them and their priorities.
Part of the fun of being a healthcare provider is discovering we all have things in common. We are all just human. We often share happy stories and sad stories. Most of the time we can express something that will make us all laugh and maybe reduce the patient’s anxiety a little.
A First Class First Visit Examination
I think every new patient deserves a first class examination. The process begins with the initial phone call and relies on the skills of my front desk person to gather all the data necessary for my office to be prepared for a new patient visit. A variety of paperwork and forms must be filled out including insurance information, dental history information, medical history, and various consent forms.
Some things can be delegated to staff members, but my time commitment for the initial examination is usually about 1 hour for an adult. This is a different experience for many patients and must be explained to them prior to the appointment. The quick 5-10 minute exam just doesn’t fit my style.
More than Just a Visit to the Dentist
My initial meeting with the patient includes an introduction to the patient by my assistant. Before sitting a patient back in the dental chair I like to review their personal information, medical history, dental history and any areas of concern. I also like to know what their job entails, family details like parents, kids, grandkids and if they are native Coloradoans or have relocated from elsewhere.
I also like to ask what their special interests are, which is fascinating to hear. Many patients like to hear about my family, hobbies, and activities and I am happy to share info with them. Being a cancer survivor also lets them know I can empathize with them on many levels.
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Expect to have X-rays Taken
After this fairly brief conversation I like to focus on why they are here and begin my examination with a very brief look in their mouth before I request any radiographs(x-rays). The patient is still in the chair and upright. The x-rays are taken and thanks to the nearly instant digital x-rays I can then review the x-rays with the patient and point out good things and potential problem areas. Patients usually like to see the x-rays and ask a variety of questions. After questions are answered we can sit the patient back and begin the evaluation.
An Oral Health Screen
My oral examination consists of documenting many things present including:
- Orthodontic jaw relationships,
- Crowding
- Excessive spacing
- Excessive wearing of enamel or dentin
We will also take jaw movement measurements and palpate the temporomandibular joint (TMJ) and do a screening for temporomandibular dysfunction by checking for joint sounds, erratic movements, lack of mobility, and a muscle palpation. This evaluation also incorporates an extra oral cancer screening, checking for growths or lymph node involvement. It is surprising to me how many patients have not had this done before, or not had it explained.
First Dental Visit Examination Steps
I can now move to the mouth itself. I’ll continue the cancer screening intra orally including gum tissue, cheeks, lips, tongue, palate, tonsil area, and under the tongue.
I once detected enlarged submandibular lymph nodes on a patient and made her an appointment with a specialist. The diagnosis was lymphoma cancer. They had to move away, but her husband called several years later to thank me as the oncologist told him to. She had made a complete recovery- possibly my most rewarding day in dentistry ever!
Next I will examine the periodontal tissue- gum tissue. This generally requires probing the teeth to check for periodontal health. We also check gingival recession, mobility, amount of ginigva remaining, etc. Some patients require more time than others for this evaluation, but healthy gum tissue is the foundation point for a healthy mouth.
Now, I can finally move to checking the teeth. This process includes charting existing restorations, decayed areas, broken teeth, cracked teeth, potential root canal problems, missing teeth, etc. Depending on the extent of existing work or teeth needing treatment, this will take a few minutes.
The last part of the exam is using a small intra oral-extra oral camera to take as many pictures as necessary. These pictures help document conditions and be able to show and explain possible treatment options to the patient. The majority of patients like to see “their” teeth in pictures and usually have great questions when they are initiated by viewing their pictures. I am happy to answer their questions while viewing pictures.
A Final Assessment
At this point, I now have somewhat of an idea of my patient’s oral conditions. I will review the pictures-one-on one and then move on to treatment. If the patient needs a routine cleaning and a filling or two I will present that at this time. If there are more advanced issues, such as endodontic, periodontic, or restorative issues then I will have the patient reappoint for a consultation appointment as it may take me an hour or more to evaluate pictures, x-rays, and clinical notes to be able to formulate a treatment plan.
Overall, your first visit to a dentist should be about you! You are trusting them with your oral health and expecting them to make the best decision. You want a dentist that will take the time to understand your medical history. Someone that will put your needs first and want to build a long lasting relationship.
