Preventive Dentistry #2: Dental Checkup

Doctor's Insight.

Do you brush your teeth every day?

It is said that even people who brush their teeth often, have 100 to 200 billion bacteria living in their mouths.

While not all of these bacteria are bad, some, such as dental caries and bacteria that cause gum disease,

have negative impacts on our teeth and gums.

Dental caries and bacteria that cause gum disease are completely different types of bacteria.

Please take a look.

In dental checkups and preventive dentistry, it is standard to check the levels of these bacteria and to look for any signs of diseases.

The latest technology can determine the composition of saliva and the number of bacteria.

This is a saliva testing device, called Salivary Multi Test, or SMT.

We can tell whether or not a patient is developing tooth decay or gum disease by checking their saliva.

Today, we'll learn about the latest technology used in dental checkups and find out why routine checkups are essential.

Today's expert is assistant professor Adachi Naoko from Tokyo Medical and Dental University.

Professor Adachi is a dental hygienist and also conducts research on preventive dental care.

Dr. Adachi, welcome back to our show!

I'm happy to be back.

Let's start off with why it's essential to get a dental checkup.

Currently in Japan, you can get excellent dental care.

However, when you don't get routine checkups, it can not only become costly to treat your teeth,

but your the size of the filing may become too large after repeated treatments of caries, and you can eventually lose your teeth.

Also, when you have gum disease that worsens, it not only affects your teeth, but affects your entire body in various ways.

That's why it's important to get routine dental checkups and maintenance to prevent gum disease and tooth decay.

I see. So prevention is really important.

Now, how do you check for gum disease?

Please take a look at this.

The first step in checking for gum disease is performing the most basic exam, the periodontal exam.

A probe is inserted along the border between your tooth and gums to measure the periodontal pocket depth.

They also determine if there is any inflammation by checking whether there is bleeding.

Another point is to check for any wobbles.

Dr. Adachi, what's happening here?

We use safe natural dye that temporarily stains any plaque left on your teeth to check for its presence.

The more plaque you have, the greater the risk of gum disease and tooth decay.

Hmmm, that's a great way to check.

Now, they're taking pictures, but what does that have to do with gum disease?

Intraoral photos are used as records of overall alignment of a person's teeth, the condition of the gums and "dental bites."

Healthy gums are firm and pink in color, whereas people with gum disease have red, soft and swollen gums.

The photos are shared with the patients and are also used to track the changes when undergoing treatment.

So, different kinds of methods are being used to assess the condition of gum disease.

That's right.

We also perform imaging tests using X-rays.

X-rays can reveal the condition of your periodontium, which consists of; your teeth, the bone that supports your teeth, periodontal ligament which acts as a cushion, and gums.

With X-rays, we can also tell if there is tartar buildup, check the condition of dental caries, and find any diseases hidden at the tip of the root.

Now, a dental imaging test is underway in Japan that is the world's first.

The test was approved by Japan's Pharmaceutical Affairs in 2020 and is now being put to use.

It's called Optical Coherence Tomography or OCT.

The greatest advantage is that there is no risk of radiation exposure, so the test can be performed safely on children, pregnant women, nursing mothers, and the elderly.

Take a look at this.

The red arrow is pointing at a hidden cavitated decay.

In this condition, the damage could heal without cutting the tooth structure too much.

The green arrow shown here is pointing at a crack in a tooth.

OCT can capture such conditions with high resolution, which had been difficult to detect with X-rays.

OCT can accurately diagnose whether a tooth needs to be shaved, or, if it can be remineralized without shaving.

We can choose the treatment based on accurate imaging diagnosis, so OCT is a useful device.

This kind of research being carried out in Japan may become mainstream around the world.

Dental care is ever-evolving.

New information and technologies will continue to emerge all over the world, and we should combine them to help accelerate progress for preventative dentistry.

The most important thing is to "not get gum disease or cavities in the first place," is this right?

Yes, that's right.

The key is to take action to prevent gum disease and tooth decay.

To do so, people need to understand their own risk of gum disease and tooth decay.

How can I find out if I am at risk for gum disease or tooth decay?

One method is to check the saliva.

Our saliva? What exactly do you look at?

For example, there is a testing device called the oral bacteria counter.

It can determine your susceptibility to tooth decay and gum disease by examining the number of bacteria in your saliva.

How do you use it?

The number of caries bacteria and bacteria that cause gum disease is measured by calculating the concentration of bacteria in 1mL of specimen.

It is divided into 7 levels according to the number of bacteria.

The higher the level, the more bacteria you have living in your mouth.

It only takes 1 to 2 minutes.

Now, another type of saliva testing device is also available.

Another test that uses saliva is the Salivary Multi Test, or SMT.

The test can assess 6 different items at a time to determine your risk of tooth decay and gum disease.

It takes 5 minutes and the result is displayed on a chart.

The condition of a person's mouth can be measured without much time or effort.

Let's take a look at a patient's test results.

The risk of tooth decay can be determined by examining three things including dental caries and the acidity of saliva.

The risk of gum disease can be determined by looking at the white blood cell count which increases as a defense reaction against bacteria,

the protein count which increases due to the effects of plaque, and the ammonia count that cause bad breath.

In this graph, the closer the results are to a regular hexagon, the lower the risk of gum disease and tooth decay.

That's amazing! There is so much information we can find out from saliva.

Yes, it's important to know the condition of your mouth through these various tests and to get good advice on preventive measures that are right for you.

It makes me want to go see my dentist real soon or even right now!

When you go in for a checkup, you should also receive routine oral maintenance.

What do you mean by "maintenance?"

During a dental checkup, it's also important to have a thorough cleaning and to get advice on how to brush your teeth and improving lifestyle habits.

I see. How often should we visit our dentist?

That depends on the person's susceptibility to gum disease, tooth decay, and complications such as diabetes.

Some people should go in once a month, while others only need to see their dentist once a year.

Generally, people visit once every 3 to 6 months.

One visit normally takes 30 minutes to an hour.

Please consult with your dentist about how often you should visit.

I like to put reminders in my calendar!

Dr. Adachi, do you have anything else you want to share before we wrap up?

It's important to visit your dentist or dental hygienist even if you don't think you have any oral health issues.

Hmmm, "prevention is key."

Dr. Adachi, thank you so much for being on our show.

It was a pleasure. Thank you for having me.