The Complete Dental Exam: Every Step Your Dentist Should Cover for Total Oral Health

Toothaches get all the attention, but most oral health problems do their damage quietly. We sit down with Dr. Stephen Blank, a long-time Port St. Lucie dentist, to walk through what a complete dental exam should look like when it’s done thoroughly and with prevention in mind. If you have ever wondered whether your checkup is truly “comprehensive,” this conversation gives you a clear checklist and the why behind every step.

We talk about the process from the very first contact, including why learning your dental history and concerns before the visit can change everything about the appointment. Dr. Blank explains the essential building blocks of a comprehensive dental exam: a complete set of dental x-rays to evaluate roots and jawbone health, bitewing x-rays to spot cavities between teeth, and a careful review of existing fillings and crowns to see what’s holding up and what’s starting to fail. We also get into full-mouth periodontal charting, bite and chewing function, and how these details connect to comfort, stability, and even headaches.

One of the most useful parts is the intraoral camera “video tour,” where patients can actually see cracks, wear, and problem areas up close. That visual clarity tends to spark better questions and better decisions. We also cover oral cancer screening and why checking the soft tissue, tongue, and throat area matters even though findings are rare, because early detection can dramatically reduce the treatment burden. Finally, we lay out how often to repeat a full exam and full x-rays versus the shorter, ongoing checks that help you stay ahead of change.

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To learn more about Dr. Stephen Blank visit:
https://www.PSLdentist.com
Dr. Stephen Blank, DDS
184 NW Central Park Plaza 
Port St. Lucie, FL, 34986
772-878-7348  

Transcript

Welcome And Why Exams Matter

SPEAKER_00 0:03

Welcome to the PSL Dentist Podcast, where healthy smiles meet real talk. Hosted by Fort St. Lucie's very own Dr. Stephen Blank, the one dentist who's been making the treasure coast smile for decades. From one-visted crowns to clear aligners, Botox, and even lifting threads, yep, your dentist does that too. So sit back, open wide, not literally clean. And get ready to sink your teeth into today's episode.

SPEAKER_01 0:35

A healthy smile starts long before a cleaning or a filling. Today we're breaking down the exam that sets the foundation for long-term oral health and why every step matters more than most people realize. Welcome back, everyone. Frederick, co-host and producer, back in the studio with Dr. Stephen Blank, your Port St. Lucie dentist. Dr. Blank, great to have you here. Ready for another deep dive?

SPEAKER_02 0:59

Great to be with you, and it really helps my patients. I've been getting good feedback that they learn a lot from these podcasts. So thank you.

SPEAKER_01 1:06

Awesome. Yo, I learned so much. I'm so grateful to be here with you. So, with that in mind, shall we dive into today's topic? And

What “Complete Exam” Should Mean

SPEAKER_01 1:15

today's topic is what is a complete dental exam and what steps should be covered by the dentist? Dr. Blank, can you help us understand what a thorough, high-quality exam really includes?

SPEAKER_02 1:27

Yes. In my office, this is a critical step because I really like to have all my patients enter the practice through a complete examination process where we discover everything that's going on before patients have disasters, emergencies, toothaches, problems that if we looked ahead of time, we might have been able to prevent or care for when they were really small. So when we have a new patient come in, we start off right away with, first of all, just a good contact on the phone to find out why they're calling, what issues they have, if there's a specific uh dental concern, and then we address that by scheduling the examination visit if there's nothing more pressing. Once we separate them into that category where they're a new patient that needs an examination. I take off on that. My my receptionist gives me a uh a patient note sheet that includes that phone call information. And I like to reach out to my patients before the first visit and give them a phone call the night before. And it lets me touch base with them and I call you up and I say, hey Frederick, what's going on? And talk to me a little bit about your past history, any problems. And then I'm able to find out more about you and your dental situation. For many people, it's a two-second phone call done. But for some people, they have a lot to talk about. And that gives them a chance to talk a long time if they need to, but they're not in my office. There's no hurry. We don't have a schedule. And I find out quite a bit about issues that they've had in the past, things that have gone wrong, or fears that have kept them from seeking the care that they need. And that gets us started on the right foot.

SPEAKER_01 3:13

Yeah, sounds like it does. Like uh sounds like a really good discovery call where you get to learn a lot about them, they learn about you. And that being said, I'm pretty interested. Like, what do you do differently from other dental offices when you're doing a comprehensive dental exam?

X-Rays, Gum Measures, Bite Checks

SPEAKER_02 3:30

Very good. So at all dental offices, basic things should be done. A complete set of x-ray pictures where we see uh the roots of all the teeth from up above and down below. And then we also do the cavity checking ones that shoot straight through. Uh people call those bite wings. Uh so we get a complete picture of the health of the roots. If there's been any root canals or deep fillings, we can see are the roots healthy? Are there any teeth or any problems in the jaw bones? All sorts of things that could crop up. And hopefully they're not there, but you know, we need to know. Uh, a lot of people like to put the blinders on. If we don't look, we don't have a problem. And it's like, well, it doesn't really work that way. So a full set of x-rays, we do an uh an intraoral uh cancer screening. We check head and neck for any lumps, bumps, or growths or changes in the skin in the mouth to make sure everything is healthy and typical, or if it's not that we document and make a decision if we need to follow that up with a referral for biopsy or uh or follow up uh in a couple weeks to see if things heal. Sometimes it's food trauma or they bit their cheek or little things. Um then we examine the teeth. So the basic part patients think of is just the teeth. But we check all the teeth for cavities, we check all the teeth that have any fillings or any crowns present for the integrity of the dental restorations. Is everything doing okay? Or does it need updating? Um, you know, anytime it's like a new car. From the day you buy it, it starts breaking down. Hopefully, not the first year or two, but eventually things are in a state of, well, they might need to be updated. Um, just like the tires on the car, I can probably go another month. Can I go another year? So that's the kind of things we look at with the teeth. Are they doing good enough to make it to next year's visit? Um, or do we need to start looking at plans? We look at crowding, we look at alignment of teeth, we look at the bite and the chewing function, which is an important one for patients. Uh often bite function uh relates to headaches. So it's important to know how they are doing with headaches, how is their bite functioning, are their teeth in harmony with their mouth? So that's all part of the notes that I take on that day. Um in my office, we do full mouth periodontal measurements. That's where we check every tooth, not just some of the teeth, or a little random measure, and we document that and save it in the computer. We give a printout to the patients. Um, we want to know how you're starting. That's your baseline. This is where you came into my office. Do we need to make that better? Or do we just have a goal of keeping you the same way? Um for some people that are at one end of the spectrum, and others are at the other end where maybe we need to talk about a denture, losing every tooth in your head. So we want to know where people are so we can make a plan that's appropriate for that patient. Um, one other thing that I do, and I find this enjoyable for me and my patients, they all think it's kind of silly, but we afterwards they say that was really good.

Intraoral Camera Video Tour

SPEAKER_02 6:34

Um, we do a video tour. And what a video tour is, is we go through with a little camera, then when I hop it in the mouth, your picture shows up on the screen, and there's your tooth, life size, or bigger than life size. And I like to record a couple pictures in each corner, and as I'm going, I'm describing to the patient and my dental assistant what I'm seeing, and I capture those images. So we capture a bunch of still pictures, and I can print those out and share them with my patients as well. So that lets me see things that maybe we might not see without the bright light of the camera. Um, sometimes that light reflects and we see cracks or lines in teeth that might go hidden. And then patients start asking questions. When that happens, I feel real good because now they take ownership of their dental situation. They'll ask me, should that filling be replaced, or is that tooth okay? Um, do I need to do something here? Um lots of good questions come from that. So I like that video tour portion.

SPEAKER_01 7:38

Yeah, that video tour really sounds interesting. I kind of want to see a video tour of the inside of my mouth as well, but we'll chat about that after. So open bit. Yeah. Yeah. So um that you did mention um oral cancer screening.

Oral Cancer Screening Explained

SPEAKER_01 7:52

And I'm I'm curious how important is the oral cancer screening portion of the exam?

SPEAKER_02 7:58

Well, the good news is we rarely find things. The bad news is when we do, it's important. So it's we we feel the the saliva glands on the side, we look at the soft tissue throughout the whole mouth. Underneath the tongue, we want to look at the floor of the mouth where the saliva glands are hiding there. And then in the pharynx, the back of the mouth where the air and the food go down, uh, we want to see that there's nothing back near the tonsil area uh or or any other uh the back of the the wall, the pharynx, where you know the food goes past that all the time. Um I've had a couple patients in my practice that have had oral cancers. Um, one or two that I've discovered, some that they found lumps and went to the ear, nose and throat doctor in between. Um it's really good to find it early. Um if it's found early, sometimes a little snip and we're done. In bigger situations, it can be a bigger snip, losing a piece of the jawbone uh or head and neck uh radiation. There's all sorts of things that uh the sooner we find it, the less you have to go through. Um and if the diagnosis is just nasty, it's really good that we find it when it's small because then it's more treatable. Um that said, most people don't get those problems, but they do exist.

SPEAKER_01 9:20

Well, thankfully you mentioned that a lot of times you don't find something when you're doing the oral cancer screening. So then my question is, what are the what do you find? What are the most common issues that you do catch early during these comprehensive visits?

Silent Problems Found Early

SPEAKER_02 9:33

Well, even just on basic x-rays, I get patients that come in with zero symptoms. Everything's fine, Doc. Five minute checkup, right? And when I look at the x-rays, I'll find a tooth that maybe they got a big filling or a couple crowns placed uh 10, 20 years ago, and we see an area at the top of the root. And it's indicative of a of a pulp that has died long ago and but maybe not infected yet. It just there's no living tissue inside. And once a bacteria goes in there and finds a place to grow with no circulation, it gets nasty. So when we see those on X-ray, we schedule care or refer for root canal care um before they get symptomatic. And those are the really good saves. And we can do something before somebody feels something. Then the other type of thing is if a patient has a root canal treatment finished on a tooth, they can't feel a new cavity. They might smell something between their teeth, but they won't feel it because the nerve has been removed and replaced with a filling material inside the roots. So they won't be cold sensitive, they won't be hot sensitive. Um, and that's why it's more important on those teeth than the other teeth that I look really carefully because the patient can't help me on that one. So that's why it's important for me to do my job.

SPEAKER_01 10:52

Yes, sir, yes, sir. So speaking of uh coming in to, you know, get ahead of the problems early so that hopefully they don't get to the point where it's a bigger snip, all that stuff.

How Often To Repeat Full Exams

SPEAKER_01 11:04

Um, how often should patients schedule a complete exam so that they can stay ahead of such problems, any problem, really?

SPEAKER_02 11:11

That's a great topic. So in my office, we start everybody with a complete set of x-ray pictures, a thorough examination, and then I like to repeat that about every four or five years. If their mouth is in good condition with no need for much dentistry, uh five years is fine. If they had a whole bunch of fillings done this week, next week, the whole this whole year is a big dental project, uh, maybe three or four years is a good time to check again. And I'm checking on me. I need to know that what I did is good. I need to know that when you went home, you took care of your teeth and my fillings are holding up, or my crowns, whatever it might be. Um, until we reach a sense of stability, uh, we want to be looking. Each year when you come in for your hygiene, you come in maybe two times, sometimes three or four times a year, depending on your gum health and your abilities to clean for yourself. Um, if I see you uh a couple times a year, once in that year, I'll take the cavity checking pictures we call bite wings, just two on each side, and that lets us see a little bit of each tooth. We don't see the roots at the top and the bottom. We just see right in between to make sure nothing new is starting in those areas. Um, so that's usually 12 months. On my good patients, maybe 18 months. Um, on patients that have unfinished dentistry or that were not so healthy at the beginning, it's 12 months because things can change that fast. So it depends on how you present and what we see.

Wrap Up And How To Book

SPEAKER_01 12:40

Thank you, Dr. Blank, for sharing all your wisdom and expertise. Really good information. Uh, gives patients a clear picture of what a complete exam looks like and what we all should be doing, uh, you know, to get ahead of the problem and why it's so essential to stay ahead of the problem. So thanks again for sharing your expertise. Thank you, everyone, for tuning in, and we'll see you all again next time.

SPEAKER_02 13:01

Thank you, Frederick.

SPEAKER_00 13:06

That's a wrap for the PSL Dentist Podcast, where smiles are brighter and laughter always cavity-free. To keep your smile in shape, call 772-878-7348 or visit psldentist.com to schedule your appointment with Dr. Stephen Blank, the one stop doc for smiles, beauty, and everything in between. Until next time, keep flopping, keep smiling, and keep listening.