Dental examination

A dental examination is what a check-up is when it is done properly: a systematic look at every tooth, the gums, and every soft tissue in the mouth, plus imaging where the eye cannot see. It is the basis for everything else — no treatment is planned without one.

This page is about the diagnostic appointment itself: what is looked at, what gets recorded, and how findings become a plan. For the routine preventive visit and its fees, see check-up and clean.

When you need one

• As part of a routine check-up and clean
• Before any planned treatment — cosmetic, restorative or surgical
• If you have sensitivity, pain, bleeding gums, a broken tooth, or anything in the mouth that looks or feels different
• An ulcer, lump, or red or white patch that has lasted more than two weeks — do not wait for your next routine visit
• If it has been more than a year, or you cannot remember
• Before you commit money to cosmetic work anywhere — including treatment quoted overseas or online

New patient or periodic

A comprehensive examination is the longer first appointment. Every tooth is charted, pocket depths are recorded around each tooth, your history is taken in full, and baseline photographs and radiographs are usually made. It is the reference point everything later is compared against.

A periodic examination at subsequent visits is shorter, because it is looking for change against that baseline rather than building it from nothing. That is why a practice that has seen you for years can often spot something quickly that a new practitioner would need more time to find.

If you are transferring from another practice, ask them to send your records. Old radiographs are genuinely valuable, because change over time is more informative than a single image. See transfer of records.

What is examined

Teeth. Each surface of each tooth is checked for decay, cracks, wear, erosion and the condition of existing fillings and crowns. Decay between teeth and under old fillings is not visible to the eye.

Gums and bone. The depth of the pocket between gum and tooth is measured at several points around every tooth and recorded. Shallow readings with no bleeding indicate health. Deeper pockets, bleeding on probing, recession and loose teeth are the signs of gum disease, which is painless until late. Recording the numbers matters because the comparison next visit is what shows whether it is stable or progressing.

Soft tissues. Tongue, floor of mouth, cheeks, palate, lips, throat, and the lymph nodes in the neck. This is an oral cancer screening. Oral cancer is uncommon but often painless early, when it is most treatable, and this is the check most likely to find it.

Jaw joints and bite. Clicking, restricted opening, tenderness in the joint or the chewing muscles, and wear patterns that suggest grinding. See jaw pain and TMD.

Existing work. Crowns, bridges, implants and dentures are checked for fit, wear and the health of the tissue around them. Implants in particular need the gum around them assessed every visit.

Photographs are often taken so you can see what we see, and so there is a record to compare against next time. An intra-oral camera image of a cracked filling is considerably more persuasive than a description of one.

What gets written down, and why it matters

The record is not paperwork. It is the instrument that makes the next examination meaningful, and you are entitled to a copy of it.

Making sense of what you are told

A few terms come up constantly and are rarely explained.

• "We'll watch it" — a finding that is real but not yet worth treating. It should be written down, and it should be looked at again at a stated interval. "Watch" without a review date is just a word
• "Incipient" or early decay — demineralisation that has not yet formed a cavity. It can often be remineralised rather than filled
• Pocket depths in millimetres — shallow with no bleeding is health. What matters is the direction of travel
• "Deep" filling — close to the nerve. Higher chance the tooth stays sensitive, and a small chance it later needs root canal treatment
• "Guarded" prognosis — the tooth is being kept, but with realistic doubt about how long. Worth asking what the plan is if it fails
• Tooth numbers — Australian practices generally use the FDI system, where each tooth has a two-digit number. Ask which tooth is which; it is your mouth

What an examination cannot tell you

Worth being straight about, because no examination is a guarantee.

• Early cracks can be invisible on both examination and radiographs, and are sometimes only confirmed when a tooth is opened up
• Radiographs are two-dimensional, so decay can be further advanced than it appears
• Whether a nerve will survive a deep filling is a probability, not a prediction
• How long a crown, filling or implant will last depends heavily on grinding, home care and diet — which is why nobody can honestly promise a lifespan
• A clear soft tissue check today does not remove the need to report anything new that lasts more than two weeks

Radiographs

X-rays are taken when clinically indicated, not routinely.

• Bitewings show decay between the back teeth and the bone level. The most common radiograph taken at check-ups
• Periapical shows one tooth in full including the root tip, used when a specific tooth is symptomatic
• OPG, which we take on site, shows both jaws, all the teeth, the sinuses and the jaw joints in one image. Used for wisdom teeth, implant planning and a general overview

Digital radiographs use a low dose. Your dentist will tell you before any are taken and why. Intervals are matched to risk rather than the calendar: someone with frequent decay may need bitewings every year, someone with a stable mouth considerably less often.

If you have recent radiographs from another practice, we can request them with your permission rather than repeat them — call reception on (03) 9088 5808 and we will arrange the transfer. Tell us if you are or might be pregnant. See dental X-rays and OPG.

Your history

We ask about your general health and medications because both affect your mouth.

• Diabetes and gum disease worsen each other in both directions
• Many medications reduce saliva, which sharply raises decay risk. Antidepressants, blood pressure medication, antihistamines and others
• Blood thinners change how bleeding is managed during any procedure
• Bone medications such as bisphosphonates and denosumab affect how we plan extractions and implants
• Reflux, eating disorders and frequent vomiting cause a distinctive pattern of acid erosion
• Smoking masks gum disease by reducing bleeding, so gums can look healthier than they are
• Cancer treatment, planned or past, changes both timing and priorities — tell us before it starts where you can

Tell us everything you take, including supplements. None of it is judged and all of it changes what good care looks like.

What happens next

You are told what has been found — with the photographs and radiographs in front of you — and what it means. Where treatment is recommended, you receive a written plan with the options and their costs before anything begins. You take it home; nothing is decided in the chair.

A good plan says what happens if you do nothing, what the alternatives are, and what is urgent against what can wait. If any of those are missing, ask.

What a written plan should contain

1. What was found, tooth by tooth, in terms you can follow
2. What is recommended, and the item numbers, so it can be checked against your health fund
3. The alternatives, including the cheaper and the do-nothing option
4. What happens if it is left — which is sometimes "very little for now", and that is a legitimate answer
5. The cost of each option, and how it is staged if the work is extensive
6. How long it will take, and how many visits
7. The known risks, including the chance a tooth needs more treatment later

How urgency is described

Where treatment is extensive it is usually staged, both clinically and financially, with the urgent work first.

We always recommend a second opinion from another appropriately qualified practitioner if it would help you decide. Taking a written plan elsewhere is normal and nobody sensible is offended by it.

Children's examinations

Same structure, different emphasis. In children we are also watching eruption sequence, the space available for permanent teeth, habits such as thumb sucking and mouth breathing, enamel defects on the first permanent molars, and whether an orthodontic opinion is worth seeking and when. Early visits are deliberately short and unthreatening. See family and children's dentistry.

Anxiety

If you are nervous, say so when you book, not on the day. The first appointment can be an examination and a conversation and nothing more. See dental anxiety.

What to bring

• Your health fund card for on-the-spot claiming
• A list of your medications
• Any recent radiographs, or the name of your previous practice so we can request them
• Your Medicare card if a child may be eligible under the Child Dental Benefits Schedule
• A note of anything you have noticed, which is easy to forget once you are in the chair

Time, cost and claiming

Allow 30 to 60 minutes. The examination is included in the check-up and clean fee; radiographs are additional and quoted before they are taken. HICAPS on-the-spot claiming; Afterpay and Zip accepted. See payment options.

To have a clean at the same visit, select it when booking online or mention it when you call.

Questions we are asked

Will I be told off? No. We see people who have avoided dentists for years, and the useful conversation is about what happens next.

Can I just have the problem tooth looked at? Yes, and we will still recommend a full examination before planning anything substantial, because a single tooth rarely tells the whole story.

Are X-rays safe? Digital dental radiographs are low dose and are taken only where clinically indicated. Tell us if you are or might be pregnant.

Do I have to have everything on the plan? No. It is a set of recommendations with costs, and you decide what and when. We will tell you what is urgent.

Why measure my gums every time? Because the change between visits is the diagnosis, not the single reading.

Another dentist found things this one did not — who is right? Often both are looking at the same finding and disagreeing about whether it needs treating yet. Ask each of them to show you the image and explain what happens if it waits.

Can I get a copy of my records? Yes. Ask reception; see transfer of records.

Is an emergency visit the same thing? No. An emergency appointment deals with the problem in front of us. A full examination is a separate, longer appointment, and we will usually suggest one once you are comfortable. See emergency dentist.

Victorian Dental Group is a general dental practice in Malvern East and holds no specialist registration. Where an opinion or treatment belongs with a registered specialist, we will say so and refer you.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · book online

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.