Your dental check-up, done as a full examination.

The examination starts with a medical history, not as a formality, but because systemic conditions, medications, and allergies change how we diagnose and how we treat. After that comes the extraoral examination: the lymph nodes, the temporomandibular joints, the muscles of mastication, the facial symmetry, and the skin around the mouth. Then the intraoral soft-tissue screening: every surface of the oral mucosa is systematically inspected for changes in colour, texture, or morphology that may indicate early pathology. None of this involves a drill or a treatment plan; it is data collection. Then the radiographic survey: a full-mouth series of periapical and bitewing radiographs, or a panoramic radiograph supplemented by bitewings, chosen based on the patient's clinical presentation. The systematic-review evidence on radiographic caries detection confirms that bitewing radiographs remain a key tool for identifying proximal caries that visual examination alone misses ^[1], while a 2021 meta-analysis of early caries detection concluded that no single method is reliable enough on its own, so radiographs and other aids should support a careful clinical examination rather than replace it ^[3].

After the radiographs comes the periodontal charting: six probing measurements per tooth, recorded systematically, producing a full map of the attachment levels and pocket depths throughout the mouth. This is not an optional extra; it is what the current periodontal classification system, the staging and grading framework published by the 2017 World Workshop on Periodontal and Peri-Implant Diseases, requires for a diagnosis to be made at all ^[4]. Without this data, the clinician cannot distinguish between early gingivitis that needs only better home care and advanced periodontitis that needs active treatment immediately. We also take a full set of intraoral photographs (at minimum: retracted frontal, left and right lateral, upper and lower occlusal views), because photographs are the only record that captures colour, texture, and spatial relationships in a way that written notes and radiographs cannot. The whole process takes time, and that time is what lets every later decision rest on your own data. Conservative dentistry depends on it.

The examination also includes a systematic oral cancer screening, a visual and tactile assessment of every mucosal surface in the mouth, the floor of the mouth, the tongue, and the oropharynx. Oral squamous cell carcinoma has a significantly better prognosis when detected early: in a 2022 systematic review of 17 studies, the two that measured outcomes found fewer severe cases and deaths when people at risk were screened more than once ^[5]. This is a three-minute addition to the appointment, and we do not skip it. We do it at every recall, on every patient, regardless of risk profile, because the consequence of missing an early lesion is not a filling that could have been smaller but a cancer that could have been caught.

When all the data has been collected, the treatment plan writes itself, and it is often smaller than the patient expects. An early enamel lesion that is remineralising under fluoride and improved hygiene is a lesion we monitor, not a lesion we drill. A slightly deep pocket that responds to improved home care and one round of scaling is a pocket we watch, not a pocket that needs surgery. An old amalgam filling that is clinically intact, causes no symptoms and shows no leakage on the radiograph is a filling we leave alone, however long it has been in the mouth: a restoration is replaced when it fails, not when it reaches a certain age. Conservative dentistry means treating what needs to be treated and leaving alone what does not, and it is impossible to make that distinction without the examination. A plan built on complete data protects tooth structure over the years, because nothing is removed that did not need to be.

After the first examination, your routine check-ups build on it. At each one, Dr. Khalid checks your gums and where they bleed, looks for new decay, checks your existing fillings and crowns, screens the soft tissues of the mouth for early changes, including oral cancer, and looks at your bite and any signs of wear. X-rays are taken only when they are due for your level of risk, not at every visit. A check-up takes 30 minutes to an hour, and if you book a cleaning with it, Dr. Khalid carries that out himself.

At the end, he explains what has changed since your last visit, what needs attention and what can simply be watched, and sets your next check-up at 4 months, 6 months or a year, reviewing that interval each time you come ^[2]. Dr. Khalid sees children for check-ups too: for anyone under 18, the interval is never longer than 12 months ^[2]. More about children's care is on the children's dental care page.

A central output of a comprehensive examination is not a treatment plan but a risk profile. The caries risk assessment asks: how likely is this patient to develop new decay, given their diet, saliva, fluoride exposure, oral hygiene, medical history, and current caries activity? Structured tools such as Cariogram and CAMBRA help organise that question: in a systematic review of 32 studies, all 28 that looked separately at children or at adults found that the risk levels these tools assign were associated with patients' actual or future decay, although the authors judged the evidence too limited to call any model reliable on its own ^[6]. That is why we use them as a structure for clinical judgement, not a substitute for it. The periodontal risk profile asks the same kind of question: given the probing depths, the attachment loss, the bone levels, and the systemic risk factors, how likely is this patient's periodontal condition to progress, and how closely should it be monitored? Both profiles feed directly into the next decision: how often should this patient come back?

So how often should you come back? Regularly, at an interval set for you. National guidance in the UK asks dentists to choose each patient's interval from their own risk and to review it at every check-up: as short as three months when needed, and never longer than 12 months for under-18s or 24 months for adults ^[2]. Dr. Khalid sets yours at 4 months, 6 months or a year. Gum disease, implants, diabetes, smoking, braces or aligners, pregnancy or a recent run of new decay usually mean a shorter interval, and a mouth that has stayed healthy and stable can usually be seen once a year. In a four-year trial of adults who attended regularly, every group kept coming for check-ups, and their decay and gum results were similar whichever interval they were given ^[7][8], which is why your interval can be fitted to you rather than to the calendar.

Gum disease and tooth decay are the most common diseases people have and the main reason teeth are lost ^[9], and regular check-ups are how changes are found while they are small. People who keep a routine of check-ups do better over the years. In a New Zealand study that followed 932 people from their teens to age 32, those who attended routinely had less decay and fewer missing teeth, and the longer they kept it up, the stronger the effect ^[10]. In Sweden, people followed from 50 to 65 who kept attending were less likely to lose many teeth ^[11]. Studies like these follow people over time rather than test one routine against another, but they point the same way.

A review of recall care found some evidence that regular recall visits help keep the natural teeth healthy and working ^[12]. That is what your check-up is for: keeping what you have, with no more treatment than is needed, at an interval set for you and reviewed each time.