Re-Examine Your Exam

Have you noticed that when your physician looks in your mouth he or she looks right past your lips to the back of your throat? Even if he scans your mouth, chances are he can’t recognize the early signs of periodontal disease, caries disease, oral cancer, or occlusal disease. We, on the other hand, look in the mouth with trained eyes and see it all. But like the physician, as is human nature, we see only what we expect to see!

What if we could look in the mouth with super-powered eyes and immediately see an array of other signs—signs of early systemic diseases/disorders such as diabetes, sleep apnea, heart disease, acid reflux, food sensitivities, fungal infections, drug/alcohol dependency, multiple drug interactions/side effects, vitamin deficiencies, cancer-causing viruses, or depression? The good news is, we can! Oh what the mouth can tell us about the body, if we would just make the investment to retrain our brains.

By discovering early signs of systemic conditions we can predict negative outcomes and help our patients preempt major disease—at every age. Today the new patient exam begins under one year of age, because one third of three year olds already have active decay and many are well on their way toward a lifetime of obstructed breathing. The infant oral exam includes a significant dialog with the child’s caregivers, helping them understand our up-to-date concepts on raising healthy children. For example, most don’t know that caries are 100% preventable, if we can prevent saliva transmission. So is childhood obesity if we can gift caregivers with a few learnable food rules. Incidentally, offering infant oral health exams is a fantastic source of adult new patients!

Reviewing total health examsChild exams might now include a summary of growth and behavior change: home care skills/habits, posterior airway and lip closure analysis, addressing significant weight gain, diet/nutrition counsel, early signs of depression, and even a letter of information and/or advocacy to the child’s physician.
An adult new patient visit can begin with a significant dialogue, letting the patient tell their own story instead of relying on a written health history. During this interview, stay very curious and resist the urge to educate—striving to learn everything about their dental and medical histories, current frustrations, imagined solutions, and what level of systemic health/oral health/function/esthetics he or she is seeking. Remember, the more you know about your patient before you put your gloves on, the greater your ability to help them and the higher your rate of case acceptance.

When you finally examine, make sure you’re able to recognize all that the head/face/mouth are telling you. Don’t forget, we now have a plethora of advanced technologies to help—for example, salivary diagnostics. From a single drop of saliva, we can detect bacteria that travel to nest in blood vessels and vital organs, genetic biomarkers of periodontal disease and cardiovascular disease, underlying fungal infections, and HPV—the leading cause of oral cancer. We can also monitor pre-diabetes and diabetes from a single drop of blood in less than five minutes.

In the climate of America’s declining health, the preventive dental visit is taking on new importance and patients are expecting us to see their mouth as a window to what’s going on in the rest of the body. Here’s your call to action: the sooner your team goes back to school to learn how to conduct personalized total health exams, the faster you will stand out as the go-to place for health-seeking patients in your community.

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Originally published in Sidekick Magazine.

About the Author: Dr. Susan Maples leads a successful, insurance-independent dental practice. She has preventive and restorative dental expertise, a passion for mouth-body total health, a master’s degree in business/marketing, and 30 years of experience in private practice. Dr. Maples believes that helping people individually forge commitments to health can change the face of generations to come. She is the author of BlabberMouth! and is an internationally recognized health educator.