The Initial Exam
The initial exam can be a valuable way to gain a great deal of information. Details about the bite, development, growth, and other potential problems present as well as information about recommended treatment options, and cost/insurance information will usually be discussed. Most orthodontists tend to provide an examination at no charge as a service to their patients. Since there may be some who do charge, it is a good idea to ask prior to the appointment.
An initial exam is usually quite easy for the patient. Most times, basic demographic information, insurance information, and basic medical information is requested prior to the examination. The information gathered is important to better understand the patient’s medical history, and also gives the orthodontist information on the chief concerns of the patient. This is important since there may be different treatment options available, but taking care of the main concern should be a top priority.
To prepare for the initial exam, try to have the following information readily available:
- Medical and Dental history
- Home address, home/work phone numbers
- Insurance information and insurance card
- Referral slip (if given)
- Chief concerns
- Pertinent x-rays, if available (not necessarily “bitewings”)
If the patient is a child, a parent or legal guardian needs to be present for the exam. This will allow for a proper medical history and permission to examine the patient, as well as provide communication with the parent regarding problems and recommended treatment.
If x-rays have recently been taken, they may be useful to the orthodontist during the exam. The “bitewing” x-rays taken by a general dentist will normally not be needed. If a panoramic or other x-ray has been taken recently, this may be useful. If there is a question about the need for an x-ray, call the orthodontist before the appointment to see if it is necessary to have it for the exam.
Once the paperwork has been finished, the orthodontist will usually perform an exam using a dental mirror. The exam is painless since the teeth are only being observed, and no treatment is generally performed at this appointment. During the exam, the orthodontist will be looking at the bite, teeth, and jaws for any abnormality.
Once the orthodontist has finished with the examination, the following information should be provided:
- The types of problems (preliminary diagnosis)
- Possible treatment options (preliminary treatment plan)
- The necessity and timing of treatment
- Length of proposed treatment
- Cost of treatment
- Possible alternatives
Remember that the orthodontist is working at a disadvantage, since a final diagnosis and treatment plan cannot be provided until a complete set of orthodontic records is available. The x-rays and models of the teeth are necessary to make final decisions. However, the clinical exam should provide enough basic information to provide at least a preliminary diagnosis and treatment plan.
