Captain Obvious Report: An ACTUAL Dental Exam is Necessary for Diagnosis

I was exchanging comments with Eva Grayzel earlier this week on the topic of dentists remotely examining patients. There’s apparently some new thing in England where physicians may start examining patients over Skype. I also came across a camera a few weeks ago designed for patients to take home, photograph teeth they’re concerned about, and send those pictures to their dentist. Can you believe that?

If this is the future, the future is ridiculous. Dangerous, too.

Dental patients frequently call the office with a diagnosis and a treatment plan already in mind and call just for a price about what they think they need. Sometimes patients are right, but other times they are completely wrong! You never know. I’ve seen dental patients that swore pain was coming from a tooth on the lower jaw and it was actually coming from the upper jaw. I’ve had patients that called thinking they needed a tooth extracted and all they needed was a filling. I’ve also had patients that thought they needed a denture adjustment and had oral cancer that needed immediate surgery.

Patients aren’t great at diagnosing themselves. My front office team is not trained or qualified to diagnose over the phone. I am not trained to diagnose over the phone, and even with my experience and knowledge I wouldn’t trust myself to get something right over the phone, even if I knew the patient.

You have to come into the office for a dental exam.

Evaluating and diagnosing a dental patient is a multi-sensory task for the trained professional. I have to see a patient’s teeth with my eyes, under magnification and bright light. I have to see digital radiographic images, often times more than one. I have to touch a tooth with an instrument to see how individual teeth respond to biting, percussion, and side to side movement. I have to touch lesions to see how they respond to pressure. Do they scrape off easily? Are they painful? Do they change color? I have to listen to what a patient tells me, look in their eyes, and listen to the sounds their jaw makes when they open and close. I have to pay attention to nonverbal communication to understand a little bit about a patient and what they are going through. I have to compare what I’m seeing to a memory bank of all of my other experiences, training, and studies. Believe it or not, smell comes in to play as well. Severe acid reflux and periodontal disease can often be detected within a few seconds of speaking to a new patient.

Thankfully, I never have to taste anything. Except cookies. If a patient brings us cookies, we will eat them.

In summary, an IN PERSON consultation with a dentist is an essential element for proper diagnosis. A dental exam could save your tooth and it could save your life.

Save your Skype calls for family time and your tooth pictures for Instagram!

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