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Complete Exam vs Specific Exam

What kind of patient are you? 

There are many ways to look at this question, but probably the most relevant way is to answer the question, “Do you see the dentist regularly even though nothing hurts, or do you see the dentist only when something is wrong?”  These, really, are the two broad categories of patients.  They are termed Regular Care Patients and Episodic Care Patients.  

The Ontario Dental Association has as one of its aims to encourage patients to gain the best dental health that they can have.  There have been great strides toward this aim in the last six decades or so.  Dental pain is no longer the most common cause of missing work like it was in the aircraft assembly industry during World War 2 in the USA.  One of the things that has accounted for this general increase in dental health in the population has been the wide acceptance of regular dental checkups.  This means going to the dentist at least every year (or every 6 months depending on your condition) even though there is no pain.  Dental problems are usually painless in the beginning and remain painless until major damage has been done.  Once pain starts, it is usually time consuming and expensive to restore the mouth back to full function—or for a lot less time and money, a tooth is lost.  Both of these options are less than ideal.  This is where regular checkups come in.  Catch a problem when it is still small and it is much less time consuming and much less expensive to restore the tooth to full function.

What the dental association has done to try to push along the idea that regular well checkups are needed has several facets.  There has been a fair amount of media coverage in the form of advertisements on TV and in the newspapers over the years encouraging people to get regular checkups.  In the last couple of years, the dental association has encouraged the dentists to along with encouraging regular checkups, discourage the patient from seeing the dentist only when something hurts.  The dental association makes a list of suggestions for fees for the procedures done by dentists on their patients (ODA Fee Guide).  Dentists are not bound to charge the fees suggested by the dental association, however many do.  What the dental association has done is to increase the fee for the exam when a person is only seeing the dentist when something hurts rather than seeking regular care.  This kind of patient is termed an episodic care patient—meaning the patient only seeks care when there is an “episode” causing him to seek care.  Using the current Ontario Dental Association fee guide, it is more expensive to have one of these episodic care exams done (called a specific exam or an emergency exam) than it is to have a complete exam done, and several times the cost of having a recall (regular well patient) exam done.  This is a recent happening and is aimed at getting people to seek regular care rather than wait until something hurts.

Costs are lower for the patient, there is a lot less time spent, and the mouth remains much healthier when problems are not allowed to become large before they are restored (fixed).  Here again, prevention is easier for everyone than cure.  Sometimes problems come up that are time-consuming and difficult to fix on people seeking regular care, but they come up much less frequently than they do on people who only see us when there is pain.

Ask your dentist what recall exam schedule is right for your case and ask why that interval was chosen by the dentist.  By doing this, you will learn a lot about your particular oral condition and what you can do at home and with the dentist to improve it. 

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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