Oral Exams & Dental X-Rays

An oral exam, commonly referred to as a dental checkup, is the process used by dentists to carefully review your oral health.  Oral exams typically involve the entire mouth, as a component of a first-time visit or a regular 6-month check-up.  Oral exams can also be used to identify a specific issue in one particular area of the mouth, such as pain, swelling, broken teeth, or other dental problems.

What are the steps of an Oral Exam?

There are four main categories of oral exams:

• Comprehensive Oral Evaluation: A comprehensive oral exam is needed for patients who are seeing a new dentist for a checkup for the first time, or if it has been some time since the last visit.
• Regular (Periodic) Oral Evaluation: Regular exams are a part of the 6-month dental check-up process.  A periodic oral exam is a complete update of already existing information for established patients who regularly visit the office.  A periodic exam may or may not include X-rays, depending on when they were last taken, if the dentist observes an issue that may require an x-ray, or if the patient comes in for a checkup with pain or other symptoms.

During periodic or comprehensive oral evaluations, your dentist will review your radiographs (X-rays), conduct a visual exam, and look for inflammation, bleeding, periodontal pockets, and calculus (build-up) around and under the gum line. He or she will check the outside and inside of your mouth, tongue, and other soft tissue, and will let you know if they see anything that may be a potential warning sign of oral cancer or other condition.  In some cases, your dentist may refer you to your physician for certain issues.

Your dentist may use an explorer to check your teeth and gums, including any existing work you may have such as fillings, bridges, and crowns. If you have a full or partial denture, your dentist will ask you to remove them for the examination. At your checkup your dentist will ask if anything is bothering you. This is an excellent time to tell your dentist if you’ve noticed any symptoms or have any questions or concerns about your oral health or your smile in general.

• Limited Oral Evaluation: this type of exam is also known as “problem focused.”  It is used to  identify and diagnose symptoms such as dental pain, or swelling in a particular area of the mouth.  Limited exams may involve digital X-rays of the affected area and diagnostic reading by the dentist, as well as a visual evaluation.  Your dentist will ask questions relating to your symptoms.
• Follow-Up Evaluation: Your dentist may ask you to come back for a follow-up visit to check on the healing and progress for certain types of treatment provided, or if you are experiencing any pain or other symptoms beyond what is normally expected.

Pediatric Oral Exams for Children

At 1st Family Dental, we recommend that parents bring their children for oral exams beginning at 12 months, and every 6 months after that.  Bringing your child early and regularly is an important way to establish your child’s confidence and comfort during regular dental visits, and create a positive relationship with the dentist and staff.  To learn more about pediatric oral exams and dental check-up visits for kids, click here.

Dental X-rays are a critical part of the diagnostic process for oral health.  There are several types of X-rays that may be required for your visit.  Here are the main categories of X-rays:

• Full Mouth Series: Also known as a “full set” of X-rays, a full mouth series is typically associated with a comprehensive oral exam.  This series of X-rays captures the entire mouth and is used to establish an original or baseline oral health and history.  A full mouth set of X-rays is a combination of “bitewing” and “periapical,” or “PA” X-rays.
• Bitewing X-Rays: These X-rays show the upper and lower back teeth in a single view.  This allows the dentist to see how they touch each other and line up.  This type of x-ray also allows your dentist to see any decay, bone loss, gum disease, or possible infection.
• Periapical X-Rays: show the entire tooth, from the exposed crown to the end of the root and the bones that support the tooth. These X-rays are used to find dental problems below the gum line or in the jaw, such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases.
• checkup (Periodic) X-Rays: Also referred to as “recall” X-rays, these are a combination of bitewing and periapical X-rays.  These X-rays are typically updated as needed when combined with regular check-up visits.
• Limited or problem-focused X-rays: These are usually a combination of bitewing and periapical X-rays that are focused on a specific area to help diagnose a specific issue, or taken during a procedure if needed.
• Panoramic X-Ray: Also referred to as a “pano” or “panoramic,” this type of x-ray is typically used for specific types of treatment or diagnostics.  A panoramic x-ray shows the entire mouth including jaws, teeth, sinuses, nasal area, and temporomandibular (TMJ) joint, in one image.  Panoramic X-rays are often associated with diagnosing wisdom tooth issues, orthodontic consultations, implant and oral surgery consultations, or may be recommended by the dentist if there is an issue preventing a standard bitewing or periapical x-ray.

Our x-ray equipment is fully digital at all 1st Family Dental locations, which means that any radiation associated with these images is lower than with conventional (film) X-rays.  Humans are exposed to radiation of varying types and degrees during their lifetime – from airport and security screens, to sunshine, to home appliances.  Dental X-rays, when combined with our protective measures such as lead shielding, involve an extremely minimal exposure to radiation. We also follow best practice standards and only take dental X-rays when they are needed.  If you are concerned about dental X-rays, we encourage you to speak with your dentist for more information.

Women who are pregnant should continue their regular 6-month check-up routine.  Dental check-ups, diagnostic X-rays, and most forms of dental treatment do not pose risks for normal pregnancies.  In fact, hormone changes during pregnancy may make some women more susceptible to developing gum disease or other dental issues.  Regular check-ups and diagnostics can help detect and address these issues.  Periodontal disease is associated with low birth weight and pre-term deliveries.  If you are pregnant, it is important to let your dentist or hygienist know at the beginning of the visit, and discuss any potential questions or concerns.  Women who are pregnant should also be under the care of a midwife or obstetrician.

The cost of oral exams and X-rays vary and depend on multiple factors including frequency and type of x-ray needed.  Your dentist will review with you what type and frequency of X-rays and exams are needed to maintain your optimal oral health.

If you have dental insurance, your coverage often includes preventative care including regular exams and X-rays.  It is important to stay up to date with your insurance coverage.  Our staff are happy to review your coverage with you to ensure you are maximizing your insurance benefits while minimizing any out of pocket expenses.

Where can I get an Oral Exam or Dental X-Rays?

1st Family Dental offers full diagnostic services, including standard and panoramic X-rays, at all 1st Family Dental locations.  We also welcome walk-in or call-ahead emergency appointments during regular business hours.

Can I bring X-rays from another dental or specialty practice?  

Yes.  It is possible to transfer records from one dental practice to another.  You may be asked to provide permission to transfer your records, or you can bring them with you.  It is important to note that X-rays are a critical component of proper diagnostics, and even with electronic transfer of digital X-rays, there may be some loss of image quality.  Your dentist will review the records and let you know if additional X-rays may be needed for diagnostic purposes.

Can I refuse to have dental X-rays?

Yes. As a patient, you are fully in control over your oral health.  However, if you are concerned about the necessity or safety of any dental X-rays that are recommended, we strongly suggest reviewing your concerns with your dentist. X-rays are a critical component of the diagnostic process and oral evaluation.  In some cases, your dentist may not be able to proceed without X-rays, and will discuss this with you to review next steps.