first appointment

New patients can make an appointment with or without a referral from a general dentist. Usually the first appointment will take about 1.5 hours and (unless there is some urgent problem) start with the doctor obtaining a thorough understanding as to why the patient has sought their assistance, their expectations and their needs. Successful treatment requires a full understanding of the issues and causes of problems so the discussion includes the patient’s medical and dental history as well as life style issues. For example, many systemic diseases and medications have implications in the oral cavity and can complicate the delivery and extent of dental treatment. A thorough clinical examination then follows including extraoral and intraoral structures. Janis and Yvonne apply a systematic approach which has been developed over many years, so that a comprehensive picture can be gained. From this they can make a problem list (their provisional diagnoses) which forms the basis of subsequent treatment planning.

what is involved in a comprehensive oral examination?

A comprehensive oral examination is much more than looking only for cavities. It can assess:

  • The patient's concerns (their "complaints" history)
  • Medical, dental and lifestyle histories
  • Salivary glands, lymph glands and nodes of the head and neck
  • Chewing muscles, jaw joints and jaw mobility
  • Facial and dental aesthetics
  • Salivary flow and consistency
  • Oral soft tissue and cancer check
  • How teeth bite together (the "occlusion")
  • How well the gums are attached to the teeth ("6 point periodontal charting" )
  • Existing restorations, cavities and defects
  • Evaluation of any dentures, splints or other appliances
  • Special tests if required (eg pulp vitality testing)
  • Analysis of any accompanying radiographs
It should provide the basis for:
  • The making of the provisional diagnoses
  • Discussion with the patient in broad terms outlining the nature and extent of the diagnosed problems
  • If possible, a broad outline of the various treatment options and a cost range for each option.

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