A dental examination may include a variety of components. The order in which these are conducted may differ from office to office. Not all will be done at every visit. A comprehensive examination (one that includes more of the components, especially evaluation of areas outside the mouth) is likely to be done during an initial visit to a dentist, or upon changing dentists. The following may occur during a dental examination:

• Visual and physical inspection:
  
  
• Soft tissue inside the mouth (e.g., tongue, cheeks, inner and outer lips, floor and palate of the mouth). This is done by a visual inspection of the inside of the mouth to identify any sores, swelling, growths or other abnormalities that may indicate health problems, such as infection or oral cancer.
  
  
• Periodontal screening. This involves visually inspecting the gums for redness or swelling that may indicate gingivitis or gum disease (periodontal disease). A dentist may gently poke these areas to see how easily they bleed. A special probe with a blunt end may be used to measure the space between the tooth and gum. Healthy gums are firm tissues that follow the contours of the teeth and attach tightly to the tooth, allowing little space (usually less than 3 millimeters) between the tooth and gum. Diseased gums swell and detach from the tooth, creating a larger space. The extent of receding gums may also be noted during this part of the examination. A standardized screening system (Periodontal Screening and Recording) is used by some dentists. This method is usually less time-consuming than a comprehensive periodontal screening.
  
  
• Occlusion. Examination of a patient’s bite (how teeth of the upper and lower jaws fit together). This may involve placing special paper in the mouth prior to biting to obtain an impression of how the sets of teeth correspond. This may indicate a need for treatment for bruxism or malocclusion (e.g., braces).
  
  
• Hard tissue inside the mouth (e.g., bones, teeth). Visual inspection of all teeth for noticeable signs of tooth decay. A mirror may be used to see all sides of the teeth. Teeth may be poked with a dental explorer (handheld tool with a sharp end) to identify possible cavities. Some dental professionals have argued that this tool is overly harmful to weakened, soft enamel. However, it provides a dentist with tactile verification of cavities, which can be hard to identify by sight alone. Loose teeth may indicate gum disease or bite problems.
  
  
• Head and neck area. This may include visual examination of the face, neck and lips for swelling, bleeding or other abnormalities. Additional areas examined may include:
  
  
• Temporomandibular joint (TMJ). Where the lower jaw connects to the skull. A dentist may ask patients to open and close their mouths, or move their lower jaw from side to side. Pain or tenderness in the area may indicate a problem, such as TMJ disorder.
  
  
• Salivary glands. These glands, located below the tongue and around the jaw, may be observed and felt by hand for inflammation that may indicate infection or disease.
  
  
• Lymph nodes in the neck. This area may also be touched by the dentist to check for signs of infection or disease.
  
  
• X-rays. If there is suspicion of tooth decay or other oral problems, x-rays will be taken. This allows the dentist to see inside a tooth and under the gums. It is the only way to identify problems in these areas. Some studies suggest that dental x-rays may also help to detect certain general health conditions, such as osteoporosis or risks of stroke.
  
  
• Dental cleaning. Cleanings may be performed by the dentist or by a dental hygienist. This includes:
  
  
• Cleaning. Cleaning removes tartar from above and just below the gum line that can lead to tooth decay and gum disease. At-home dental care removes plaque, but only professional dental instruments can remove tartar build-up. Ultrasonic equipment may be used in cases of severe tartar build-up.
  
  
• Polishing. Polishing involves the application of a gritty substance to the teeth, which are then buffed with a rotating rubber brush. This removes plaque and surface stains. Patients are usually advised to rinse their mouths during cleaning and polishing.
  
  
• Fluoride treatment. A natural mineral that strengthens teeth and helps prevent tooth decay. This application usually takes several minutes, and patients may be advised not to eat or drink anything (including water) for at least 30 minutes after this treatment.