More than 50 years ago there were no set standards for dental visits. In general, people had poor oral health. To improve dental health and establish prevention of dental disease, dental and health organizations developed some guidelines. Among those guidelines was the recommendation that people visit their dentist every six months for a check-up and thorough cleaning (hygiene). There was no research to support this guideline. In the last couple of decades, studies conducted on the frequency of dental visits and health care concluded visits should be customized to the patient. People at less risk need less frequent visits and those at higher risk need more frequent visits. I have a few patients that we see once a month and a few that we see every two years, however, most patients fall into a 6-month recare frequency because of the level of risk.

Identifying risk factors:

Gums that bleed when probed by the dentist or hygienist
History of, or new, gum disease
A new cavity in the last two years
Evidence of cracks or recently fractured teeth
Substantial previous dentistry (fillings, crowns, gum treatment, tooth loss)
Reduced ability to brush and floss (arthritis, physical or mental disability)
Medicines that cause dry mouth increase risk (e.g. high blood pressure, allergy, anti-anxiety, antidepressants)
Medical conditions that cause dry mouth increase risk (e.g. Sjögren's syndrome, diabetes, Alzheimer's, stroke)
As we age our saliva glands produce less saliva, increasing the risk

At the time of your checkup and cleaning, your dentist and hygienist may recommend additional dental care based on your history and findings that day. This dental care generally falls into two categories: essential and non-essential or elective. Essential services are those that address dental problems that are related to health and/or function, like decay (cavities), gum disease, airway problems, crowded teeth, replacement of missing teeth, cracked or fractured teeth, abscess, growths, and tumors. If your dentist and dental hygienist detect any of these issues they will recommend treatment in order to address the disease and restore proper function and optimal health. Your dentist can tell you how urgent each situation is, but essential services are not problems you want to delay because they just get worse, have more consequences and usually become more expensive.

Nonessential or elective services may or may not improve health and function but may be important to the patient. This includes treatment of discolored teeth, correcting minor tooth crowding, silencing snoring and improving smiles. Treatments may include whitening, veneers, tooth colored fillings, minor orthodontic movement, snore therapy and/or crowns. Dentistry that is still functional but not esthetic can be replaced with more esthetic dentistry. Examples of this are dark gray amalgam (silver-mercury) fillings, stained tooth-colored fillings that no longer match the teeth, veneers that have stained edges or no longer cover the full tooth due to some gum recession, old crowns or bridges that no longer match your teeth or show metal edges. Although these treatments are elective, they often give the patient satisfaction and self-esteem.

Twice a year visits to your dentist is still the general rule for those with some risk, but if you haven't had a discussion with your dentist about the recommended frequency of your hygiene visits do so, especially if you have any of the risk factors listed above. If your dentist detects issues that will negatively impact your health move forward with the recommendation. Our patients' good health and happiness are our ultimate goals.