During the Comprehensive Oral Examination (COE), the dentist will examine the overall condition of your whole mouth, not just teeth. Our dentists look at all the tissues, muscles, tongue and jaw.
This is a thorough check for any indicators of gum disease and bacteria that can often go undetected. If there is any degree of gingivitis or periodontal disease, we help to halt or treat it. The dentist will use intra-oral cameras to show you the various conditions inside your mouth.
The dentist begins the examination by listening to your needs. Information from filled out new patient forms allow for a review of your medical and dental history and to address your main concerns.
Medical history is very important as it determines if dental treatment should be modified to fit the patient needs. Any habits or risks that can affect oral health are discussed. Nearly 50% of patients have some form of past or present medical history data that will influence treatment.
If forms are completed ahead of time, we review the medical history on the phone before the appointment to determine if the new patient is high risk and may need medical clearance. A medically-compromised patient's resistance to disease is different than that of a healthy patient — for example, we all have pathogenic bacteria in our mouths but not all of us will develop periodontal disease.
X-rays, including panoramic x-rays, are taken with patient and parent/guardian consent. If the patient is unable because they are too young and cannot maintain the sensor in their mouth, they will be attempted at the next appointment. Our patient care specialist will take a full mouth series of intra-oral photos from all angles — closed bite, open bite, and a natural smile photo.
If radiographs have been taken recently at a different office, a request is made to have them transferred to our office.
Risk factors and habits that can affect oral health are discussed. You are encouraged to ask questions throughout the process.
The following areas are examined:
An extra-oral exam examines all areas of the head and neck to detect any swellings or nodules that may be abnormal. Both visual inspection and palpation are used to assess the following:
We examine for oral cancer by observing and feeling around in your mouth — inspecting the inside of your cheeks, lips, roof and floor of the mouth, gum and tongue areas. The goal is to identify any signs early.
We start by inspecting the face and checking for any asymmetries, swellings, discolorations, or ulcerations.
The lips are evaluated both opened and closed. We check the frenums, any asymmetries, the contour, colour and texture, and note any ulcerations, traumas or abnormalities.
When inspecting the buccal mucosa, the labial commissures to anterior tonsillar pillar are examined. Pinching the cheek helps feel for hidden nodules. The parotid gland/Stenson's duct is checked for any abnormalities, discolourations, ulcers or signs of trauma.
One of the most common areas for oral cancers. We palpate underneath the tongue, feeling the submandibular glands, sublingual glands and lingual frenum, checking for any discolourations, lumps and nodules.
We visually examine all surfaces of the tongue for any anomalies, ulcerations or discolouration. Using gauze, we lightly grasp the tongue and move it from side to side and top to bottom to get a clear view of the lateral surfaces.
With your head tilted upward, a dental mirror is used to visually check and palpate the area for any lesions, discolorations or nodules. Maxillary torus is commonly found in this area and is a normal variance.
We ask you to stick out your tongue and say "AHHHH" to get a clear view of your tonsils and check for swellings or discolorations. Specifically, we are looking for:
The hygienist evaluates the periodontal condition. Factors assessed include:
The hygienist determines overall periodontal health status by measuring:
Gingiva — the following characteristics are assessed: