Patients frequently ask me how often they should come in for a dental checkup. For several decades the stock answer has been, "every 6 months". Back in the 1950's, military exams were revealing teeth in very bad shape. Dental and health organizations felt the need to establish a standard despite the lack of research. Before long Crest was advertising their toothpaste and the recommendation for 6 month dental visits. Although twice a year visits have proved useful the truth is there is no one answer because each patient is unique. Therefore, in order to meet the specific needs of each one of my patients, I evaluate each of my patients to determine the most appropriate dental care schedule for them.

I see patients on several different intervals ranging from one month to one year. Consequently, there is variability in how often I examine patients, take x-rays and perform patient dental cleanings. Why such a variety of cleanings, x-rays and exam intervals? There are four factors that are important in determining the best intervals and they are: history of dental disease, age, medical history and does the patient want to have their teeth cleaned more frequently.

Probably the most important is the patient's history and susceptibility of dental disease. By history of dental disease I mean has the patient had a recent or past history of decay, periodontal (gum) disease, trauma, growths or tumors, erosion, wear, joint pain (TMJ) and/or a history of breaking teeth. By susceptibility, I mean that we check the patient's susceptibility to get cavities with a simple test. The history of dental disease and the susceptibility test are excellent indicators of a patient's future dental health.

The next criteria is the patient's medical history. Patients are at high risk for dental disease if they are a smoker or have diabetes. Persons with disabilities are at a distinct disadvantage when it comes to brushing and flossing. Patients with a history of trauma, tumors and growths should be seen more frequently for evaluation. The number and types of medications a patient takes may decrease their flow of saliva. Age is also an important factor. As we age our saliva flow decreases and we tend to be on more medications. Saliva is our body's protective mechanism for the mouth and when saliva decreases the oral environment changes allowing harmful bacteria to flourish. We also tend to become less effective brushers and flossers due to dexterity changes.

After a thorough evaluation of these factors I am able to make a recommendation on the most effective dental schedule of exams, cleanings and x-rays to maintain excellent oral health and detect early signs of disease as well as adjust the schedule according to the changes we all experience over our lifetime. Additionally, I like to ask the patient if they would prefer to come in more frequently. Some people really love the feeling of clean teeth and knowing someone is checking on how things are going.

Dr. Robert A. Gallegos is a Fellow in the Academy of General Dentistry, he is on the faculty of Spear Education, a member the American Academy of Cosmetic Dentistry, the American Academy of Dental Sleep Medicine and the American Dental Association. Dr. Gallegos practices dentistry in Middleburg, VA. www.MiddleburgSmiles.com.