Skip to 0 minutes and 10 secondsIn this session, we wanted to explore more about a regular dental checkup. And we thought the best way to do that would be to film a dental check up with the patient, the dental nurse, and the dentist, and then to play it back with the dentist being able to talk to us about what the thought processes, equipment, and paperwork they were doing while they were going through it and give us some more detail. I'm pleased to introduce Dr. Adrian Jowett who's our dentist. In the film behind me are Mr. White, our patient, and Sarah the dental nurse. So Hello, Adrian. Good morning. Can you take us through why you would do sort of regular dental checkups?
Skip to 0 minutes and 45 secondsIn a routine checkup like this, you're wanting to check the patient's general oral and dental health and check for any problems. OK. So let's play the tape and start the process. So you're introducing yourself to the patient. What are you covering here? It's very important to introduce yourself by name and also to check that you really have got the right patient, Mr. White, and to check his date of birth and things to try and ascertain that it is the patient you're used to seeing. OK. So we'll be watching this on the screen. You can see that we've got a variety of angles, including from your perspective.
Skip to 1 minute and 16 secondsWe've put ourselves in your boots with a head-cam, so we'll be able to see exactly what you see as we go through this video. So you're getting up now and you're going over and-- what are you going to be doing? Oh, you're putting on some magnification glasses? Yes. More and more dentists in England are wearing these now to magnify the teeth, the soft tissues. So you can see what's going on as cavities and fillings and things are becoming smaller over the years. Right. And these are called "loupes"? Yes. Jewellers used to use them as well, and that's where the term comes from. Ah, right. OK. All right.
Skip to 1 minute and 48 secondsAnd you've also put on a mask and some gloves by the looks of it. Yes. This is just the personal protective equipment for stopping cross infection between the patient and the operator. Right. OK. And you're also washing your hands. Here we are. Yes. So just using an alcohol disinfectant rub here. My hands were clean when I went into the surgery and it's quicker and less damaging to your skin to use these just between every patient. Right. OK. Now, we come back. We can see the partnership really with your dental nurse, Sarah, here because everything's sort of sliding into place because you are now ready for the procedure. And we get a good look at the surgery as well.
Skip to 2 minutes and 20 secondsSo everybody's getting into position. So the first thing that you're going to be doing is moving the dental chair. Shall we talk a little about that? Why does it need to move? The whole aim of the dental chair really is to try and get the patient in as good a position as possible for the ease of the operator, the dentist, so that you can see everything you need to and work comfortably, possibly for quite a long time. And also, it's comfortable for the patient so that they can sit comfortably and participate in treatment for up to several hours sometimes. OK.
Skip to 2 minutes and 47 secondsLet's pause it here because the other thing that you've also brought into shot is the dental light, a quite famous dental light everybody seems to know about. So it is that really just so you can see better? There's no other-- No. Just so can see nice and clearly, and make sure that everything's visible. Great. OK. So let's carry on and see what happens. So the first thing is, rather than going into the mouth, you're looking around the mouth with your hands? Yes. Here what we're looking for are the lymph nodes, which you're just trying to palpate for. These are-- well, sometimes people call them glands beneath the border of the mandible and also in the neck.
Skip to 3 minutes and 21 secondsAnd these can be an indicator of serious disease. They can swell with things like cancer and things. They can swell sometimes if you've got a cold as well. So it's always worth it to know what the patient's history is. Yeah. OK. So this is an indication that a dental checkup is much more than just counting some teeth and checking everything? Yes. Definitely. The patient's oral health in the broadest sense is the key remit. Right. OK. All right. Let's carry on and have a look at what you're doing. So you're checking as well that the jaw is in good shape and it can open and close comfortably and everything else? Yes.
Skip to 3 minutes and 48 secondsIn most patients, there's not a lot to see, but it can be an indicator of major arthritis or sometimes fractures of the jaw. Right. OK. All right. You've gone into your instrument kit and you've grab the mirror? Is that right? And I think we've got one here. Yes. There's the three parts in the key examination kit. We do have a dental mirror, which you can use for looking at surfaces which aren't directly visible and also importantly for pulling the soft tissues to one side to maximise what you can see. So the more you can see, the more you can see what's going on. OK. Excellent. So there we go.
Skip to 4 minutes and 24 secondsWe've got a good view from your view here exactly of what's going on. And now you've gone for another instrument. What's this one? Yes. This is a probe for undertaking the basic periodontal examination. This is really to get an overview of the health of the patient's gums. There's some stripes on here. Yes. The three bands are used really to give a gradation of how healthy the patient's gums are. This is a depth gauge, is it? It's a depth gauge. OK. Yes. It's very much that. If you can stay within the first silver band, you'd score a 0. And that would really show that the patient's gums were well-attached to the teeth, and there wasn't a lot going on. OK.
Skip to 4 minutes and 59 secondsYou can sometimes score a 1 if the gums bleed when you probe them. OK. I'll just pause it for a sec while you're talking. And there is an increasing score of 2, which would be a little bit of tartar or dental calculus. And 3 and 4 progressively say that the gums are separating from the teeth, and you do have a condition of disease. OK. So you've got different a scale of numbers, and Sarah on the patient's notes is making a record for around here. You've also gone and grabbed another thing while we've been talking. It seems to be a sort of squirty device. Yes. As you say, this is one of the famous things as well.
Skip to 5 minutes and 32 secondsThis is known as a "three-in-one syringe." The three things are air, water, and spray if you press both together. And the water and the spray can be used for cleaning the surface of the teeth and potentially the gums and things. And the air can be used for drying the teeth to make sure that you've got a nice, dry surface which isn't shining back at you. This means that you can look for very small defects, either in the teeth or in fillings really very clearly. Right. Excellent. I like that. OK. So let's carry on then and have a look. And we see Sarah now is following what you're calling out from what you've been telling us.
Skip to 6 minutes and 4 secondsShe's filling in the dental chart, and I think we've got one of the sheets that Sarah is using here. Here we go. So can you explain a little about the process, what you're calling out and how it's recorded onto this chart? Yes. Each of these squares represents one tooth in the patient's mouth. Really this is just a map of the patient's teeth. And you cross out the teeth which are absent, and then you can fill in the boxes on the chart for where there are fillings or areas of decay inside the teeth. OK. And Sarah appeared to be writing backwards. So she's going that way. Is there a particular way round that you do the charting?
Skip to 6 minutes and 37 secondsDifferent dentists work in different ways, but I always start in the upper left and work my way around in a circle. And different dentists and nurses get used to their patterns of working. And yes, a different dentist will work in a different sequence. I always start in the upper the left, and then work my way round. And you could call that out to the nurse. They know what you're doing. OK. So there's part of that teamwork approach with your nurse that you would be expecting or have agreed beforehand on what you were going to do? Yes. Indeed. OK. So you're just finishing the checkup now. So it doesn't seem to take very long. You're going through.
Skip to 7 minutes and 7 secondsAnd you have a good view of the teeth. You're drying them. You're viewing them. You're making the notations. So if everything about our Mr. White is quite orally healthy, this is quite a quick process? Yes. Indeed. The less there is to look at, in a way, the quicker the process goes. Mr. White's got good oral health and very few fillings and things. There's actually not an awful lot to write down. And here you are. You're finishing. So your dental nurse is moving everything out of the way for you. It's quite a slick operation. The chair comes up, and he's finished. But you're going to talk to him now.
Skip to 7 minutes and 39 secondsSo what will you be saying to the patient at the conclusion of the checkup? We really need to summarise what you've seen and what other treatment might be required. At the very least, you need to inform the patient that everything's looking healthy and that you've not found any problems that they need to deal with. You might need to explain you have found issues, will need other further treatment or maybe be booked in with a hygienist or possibly a longer course of treatment- which will require quite a lot of explanation. All right. Well, thank you very much. I think that was a very good insight into what happens during a dental checkup.
Skip to 8 minutes and 9 secondsAnd we'll be exploring some of the issues raised in this film in a little bit more detail throughout the course.
Insight: The dental checkup
Dental patient Dave White was due a dental check-up with Dr Adrian Jowett (Dentist) and Sarah Hayward (Dental Nurse), and we filmed it.
In this video Chris replays the event while talking to Adrian, who explains what is going on, shows the equipment he used, and offers insights on what a dentist is looking for when you go for a checkup.
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