a visit to the dentist meaning

• Lesson 08: A visit to the Dentist

Back To The Course

Readings – level 2.

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• Reading – Level 2

A visit to the Dentist Eva has a terrible toothache today. She wants to see her dentist as soon as possible. She visited her dentist six months ago. She went there for a cleaning and check up. When she visited the dentist everything was all right. Eva is afraid of the dentist’s drill. She does not like the sound it makes. She gets nervous when she hears the drill going. She knows that visits to the dentist can be very expensive if you do not have dental coverage. Some employers offer dental coverage as part of the benefit package. Other employers offer to pay a big percentage of the coverage. Eva has a good job. She works for a financial company on Wall Street so she has a good dental coverage. The dentist is going to see if Eva has a new cavity. Cavities are little holes that bacteria make in your teeth when you don’t brush them. To avoid getting cavities people should brush their teeth three times a day. If the filling of the cavity is gone, the dentist will have to fill the cavity one more time. Eva is nervous. She does not like the idea of getting a new filling because her dentist will have to use the drill to clean the bad part of the tooth. If he has to do that, Eva will ask him to give her a shot of anesthesia so that she does not feel the pain. When Eva leaves the dentist’s office, she will not be able to eat anything for quite some time. document.createElement('audio'); http://easyworldofenglish.com/wp-content/uploads/2020/11/readings_level2_11b.mp3

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Dental Visits – The Dentist Visit And What To Expect

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Medically Reviewed By Colgate Global Scientific Communications

What Happens During a Dental Visit?

First, it is important to find a dentist with whom you feel comfortable. Once you've found a dentist you like, your next step is to schedule a check-up — before any problems arise.

On your first visit to a dentist, they will take a full health history. On subsequent visits, if your health status has changed, make sure to tell them.

Most dental visits are checkups. Regular checkups (ideally every six months) will help your teeth stay cleaner, last longer and can prevent painful problems from developing.

• A thorough cleaning Checkups almost always include a complete cleaning, either from your dentist or a dental hygienist. Using special instruments, a dental hygienist will scrape below the gumline, removing built-up plaque and tartar that can cause gum disease, cavities, bad breath and other problems. Your dentist or hygienist may also polish and floss your teeth.
• A full examination Your dentist will perform a thorough examination of your teeth, gums and mouth, looking for signs of disease or other problems. His or her goal is to help maintain your good oral health and to prevent problems from becoming serious, by identifying and treating them as soon as possible.
• X-rays Depending on your age, risks of disease and symptoms, your dentist may recommend X-rays. X-rays can diagnose problems otherwise unnoticed, such as damage to jawbones, impacted teeth, abscesses, cysts or tumors, and decay between the teeth. A modern dental office uses machines that emit virtually no radiation — no more than you would receive from a day in the sun or a weekend watching TV. As a precaution, you should always wear a lead apron when having an X-ray. And, if you are pregnant, inform your dentist, as X-rays should only be taken in emergency situations. Your dentist may ask for a Panoramic X-ray, or Panorex. This type of film provides a complete view of your upper and lower jaw in a single picture, and helps the dentist understand your bite and the relationship between the different teeth and your arch.

How Long Should I go Between Visits?

If your teeth and gums are in good shape, you probably won't need to return for three to six months. If further treatment is required — say to fill a cavity, remove a wisdom tooth, or repair a broken crown — you should make an appointment before leaving the office. And don't forget to ask your dentist any questions you may have —this is your chance to get the answers you need.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider. 

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First Visit to a Dentist: What to expect for your appointment

Dr. craig parlet.

• November 3, 2021

Home » First Visit to a Dentist: What to expect for your appointment

First Visit to a Dentist: What to Expect

I would like to share my ideas on what a first visit to the dentist should be like for the patient. With my 30 plus years of experience as a private practice general dentist to shape my views. I am continually striving to improve my abilities and methods, but I feel I have a good grasp of this procedure. 

Personally I don’t believe in scheduling a new patient examination with the hygienists and the Dr. appears for 5-10 minutes to do his evaluation. Rarely is this adequate time to perform a thorough evaluation of the patient’s oral health.

How Long is the First Visit to a Dentist?

I believe most new patients value the amount of time I allow for a new comprehensive patient evaluation, approximately 1 hour. We often receive compliments on how thorough the examination was. I enjoy getting to know the patients and hearing about their jobs, stresses, kids, hobbies, etc. I try to slowly build a relationship with my patients to get to know them and their priorities. 

Part of the fun of being a healthcare provider is discovering we all have things in common. We are all just human. We often share happy stories and sad stories. Most of the time we can express something that will make us all laugh and maybe reduce the patient’s anxiety a little. 

A First Class First Visit Examination

I think every new patient deserves a first class examination. The process begins with the initial phone call and relies on the skills of my front desk person to gather all the data necessary for my office to be prepared for a new patient visit. A variety of paperwork and forms must be filled out including insurance information, dental history information, medical history, and various consent forms. 

Some things can be delegated to staff members, but my time commitment for the initial examination is usually about 1 hour for an adult. This is a different experience for many patients and must be explained to them prior to the appointment. The quick 5-10 minute exam just doesn’t fit my style.

More than Just a Visit to the Dentist

My initial meeting with the patient includes an introduction to the patient by my assistant. Before sitting a patient back in the dental chair I like to review their personal information, medical history, dental history and any areas of concern. I also like to know what their job entails, family details like parents, kids, grandkids and if they are native Coloradoans or have relocated from elsewhere. 

I also like to ask what their special interests are, which is fascinating to hear. Many patients like to hear about my family, hobbies, and activities and I am happy to share info with them. Being a cancer survivor also lets them know I can empathize with them on many levels.

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Expect to have x-rays taken.

After this fairly brief conversation I like to focus on why they are here and begin my examination with a very brief look in their mouth before I request any radiographs(x-rays). The patient is still in the chair and upright. The x-rays are taken and thanks to the nearly instant digital x-rays I can then review the x-rays with the patient and point out good things and potential problem areas. Patients usually like to see the x-rays and ask a variety of questions. After questions are answered we can sit the patient back and begin the evaluation.

An Oral Health Screen

My oral examination consists of documenting many things present including:

• Orthodontic jaw relationships,
• Excessive spacing
• Excessive wearing of enamel or dentin

We will also take jaw movement measurements and palpate the temporomandibular joint (TMJ) and do a screening for temporomandibular dysfunction by checking for joint sounds, erratic movements, lack of mobility, and a muscle palpation. This evaluation also incorporates an extra oral cancer screening, checking for growths or lymph node involvement. It is surprising to me how many patients have not had this done before, or not had it explained.

First Dental Visit Examination Steps

I can now move to the mouth itself. I’ll continue the cancer screening intra orally including gum tissue, cheeks, lips, tongue, palate, tonsil area, and under the tongue. 

I once detected enlarged submandibular lymph nodes on a patient and made her an appointment with a specialist. The diagnosis was lymphoma cancer. They had to move away, but her husband called several years later to thank me as the oncologist told him to. She had made a complete recovery- possibly my most rewarding day in dentistry ever!

Next I will examine the periodontal tissue- gum tissue. This generally requires probing the teeth to check for periodontal health. We also check gingival recession, mobility, amount of ginigva remaining, etc. Some patients require more time than others for this evaluation, but healthy gum tissue is the foundation point for a healthy mouth.

Now, I can finally move to checking the teeth. This process includes charting existing restorations, decayed areas, broken teeth, cracked teeth, potential root canal problems, missing teeth, etc. Depending on the extent of existing work or teeth needing treatment, this will take a few minutes.

The last part of the exam is using a small intra oral-extra oral camera to take as many pictures as necessary. These pictures help document conditions and be able to show and explain possible treatment options to the patient. The majority of patients like to see “their” teeth in pictures and usually have great questions when they are initiated by viewing their pictures. I am happy to answer their questions while viewing pictures.

A Final Assessment

At this point, I now have somewhat of an idea of my patient’s oral conditions. I will review the pictures-one-on one and then move on to treatment. If the patient needs a routine cleaning and a filling or two I will present that at this time. If there are more advanced issues, such as endodontic, periodontic, or restorative issues then I will have the patient reappoint for a consultation appointment as it may take me an hour or more to evaluate pictures, x-rays, and clinical notes to be able to formulate a treatment plan.

Overall, your first visit to a dentist should be about you! You are trusting them with your oral health and expecting them to make the best decision. You want a dentist that will take the time to understand your medical history. Someone that will put your needs first and want to build a long lasting relationship.

Dr. Craig Parlet is a recently retired private practitioner after practicing dentistry for over 3 decades. He attended Creighton University in Omaha, Nebraska and received a Doctorate of Dental Surgery in 1983. Dr. Parlett was a member of two different study clubs, RAZA Study club and S.T.A.T study club. Both clubs dealt with overall accountability and critiquing dental work. 

Written by: Dr. Craig Parlet

General Dentist

Curator: The DentalScout Team

25+ years of dental experience

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How to Prepare for Your First Visit to the Dentist: A Comprehensive Guide

• May 18, 2023

Going to the dentist for the first time can be a scary and nerve-wracking experience for anyone. You may be wondering what to expect, what to do, and what to bring with you. However, with a little bit of preparation and knowledge, you can make your first visit to the dentist as stress-free and comfortable as possible.

So, how can you prepare for your first visit to the dentist? First, make sure to schedule your appointment well in advance, and let the receptionist know that you are a new patient. Next, gather any medical history or insurance information you may need to bring with you. Lastly, ask any questions you may have beforehand to ease any anxieties and prepare yourself for the visit.

Preparing for Your First Dental Visit: Why it’s Important

Going to the dentist may not be something you look forward to, but it is an essential aspect of maintaining good oral health. Dental check-ups allow for early detection and treatment of any problems and prevent them from becoming more significant issues down the road.

It is recommended that you visit the dentist once every six months for a regular check-up, and if you are experiencing any problems such as pain, swelling, or bleeding, you should schedule an appointment as soon as possible. Neglecting your oral health can lead to serious issues such as gum disease, tooth decay, or even tooth loss, so it is vital to take proper care of your teeth.

Finding the Right Dentist for You

Choosing the right dentist can make all the difference in your dental experience. With so many dentists out there, it can be challenging to find the one that best suits your needs. One key factor to consider is the dentist’s experience and qualifications. Look for a dentist who has several years of experience and is updated with the latest dental techniques and technology.

Another crucial factor to consider is the location of the dentist’s office. Choose a dentist who is located conveniently close to your home or workplace, so it will be easy for you to schedule appointments and keep up with your regular check-ups.

Finally, consider the services the dentist provides. Do they offer the specific treatments you may need, such as braces or oral surgery? Having a dentist who can perform all the necessary procedures in one place can save you time and hassle in the long run.

What to Expect During Your Dental Visit

Knowing what to expect during your dental visit can help relieve any anxiety or nervousness you may be feeling about your first appointment. Here is a brief overview of what will happen:

• You will first be greeted by the receptionist, who will ask you to fill out some paperwork, including medical history and insurance information.
• Next, a dental assistant will call you back to the exam room where they will take x-rays and perform a cleaning.
• The dentist will then perform an exam, checking for cavities, gum disease, and any other dental issues.
• If a problem is found, the dentist will discuss treatment options with you and schedule a follow-up appointment.
• Finally, you will be given instructions on how to maintain good oral health and schedule your next regular check-up.

Preparing for Your Dental Appointment

Now that you know what to expect during your visit, it’s important to prepare yourself beforehand to ensure a smooth and comfortable experience. Here are some tips:

What to Bring:

Make sure to bring your insurance card, ID, and a list of any medications you are currently taking. If you have any previous dental records, you may want to bring those as well.

What to Wear:

Wear comfortable clothing that allows easy movement, and avoid wearing jewelry or other accessories that may interfere with the exam. It’s also a good idea to wear short sleeves to make it easier for the dentist and assistant to access your mouth and take x-rays.

How to Prepare:

If you’re feeling anxious or nervous about your appointment, consider practicing relaxation techniques such as deep breathing or visualization. It may also be helpful to talk to your dentist about any concerns you have beforehand, so they can help put you at ease.

By following these tips and knowing what to expect during your visit, you can feel confident and prepared for your first dentist appointment.

Dental Insurance and Costs

Before visiting the dentist, it’s important to understand how your dental insurance policy works and what it covers. Check with your insurance provider to see what services are covered and any out-of-pocket costs you may incur. Some policies require a co-payment for certain procedures, while others have deductibles that must be met before coverage begins.

Additionally, it’s important to ask your dentist about payment options and what forms of payment are accepted. Some dental offices offer payment plans or financing options to help manage the cost of more extensive dental work. Be sure to inquire about these options beforehand so you can plan accordingly.

What Your Dentist Needs to Know About You

It’s crucial for your dentist to know about your medical history and any medications you are currently taking. Certain health conditions, such as diabetes or heart disease, can affect your dental health or the procedures your dentist may recommend. Additionally, some medications can impact your dental health or interact with medications given during dental treatments.

Be sure to inform your dentist of any surgeries, illnesses, or conditions you have been diagnosed with, as well as any current medications or allergies. This information will help your dentist develop a treatment plan tailored to your specific needs and ensure your safety during dental procedures.

If you’re unsure about what information to share with your dentist, consider bringing a list of your medications and medical history to your appointment. This can help ensure that you don’t overlook any important details and allow for a more thorough assessment of your dental health.

Common Dental Procedures and Treatments

Knowing what to expect during a dental visit can help ease any anxiety you may have about the unknown. Some of the most common dental procedures include teeth cleaning, X-rays, and cavity filling.

Teeth Cleaning

A teeth cleaning is a preventive measure taken to remove plaque and tartar build-up that can lead to tooth decay and gum disease. During a cleaning, the dental hygienist will use special tools to polish your teeth and remove any stains.

X-rays are commonly taken to help diagnose dental issues that may not be visible to the naked eye. These include cavities, impacted teeth, and bone loss. The amount of radiation exposure during a dental X-ray is very low, so there’s no need to worry about potential harm.

Cavity Filling

If your dentist finds a cavity during your visit, they will recommend a filling to prevent the cavity from getting worse. The procedure involves removing the decayed area and filling it with a material, such as silver amalgam or tooth-colored resin. The process is quick and usually doesn’t require any anesthesia.

Dealing with Dental Anxiety

Dental anxiety is a common issue that can make visiting the dentist a stressful experience. Here are a few tips to help you manage your anxiety:

Communicate with Your Dentist

Let your dentist know about your anxiety before your appointment. They can work with you to find ways to make the experience more comfortable and may be able to prescribe medication to help you relax.

Breathing Techniques

Deep breathing exercises can help reduce anxiety and promote relaxation. Try taking slow, deep breaths from your belly and exhaling slowly. This can help calm your nerves and decrease your heart rate.

Distraction Techniques

Bring headphones and listen to calming music or a podcast during the appointment. Some offices also offer TVs or tablets to help distract patients during the procedure.

With these tips in mind, you can be better prepared for your first visit to the dentist and feel confident in maintaining good oral health.

Caring for Your Teeth and Oral Health

One of the best ways to prepare for your first visit to the dentist is by adopting a regular daily routine for oral hygiene. This routine should include brushing your teeth twice a day with fluoride toothpaste, flossing once a day to remove plaque, and using mouthwash to kill bacteria. These habits will help prevent cavities, gum diseases, and bad breath. Don’t forget to replace your toothbrush every three to four months as worn or frayed bristles won’t clean your teeth effectively.

Along with a regular daily routine, your diet plays an essential role in maintaining good oral health. Eating a balanced diet rich in calcium and vitamins can help keep your teeth healthy and strong. Avoid sugary foods and beverages like candy, soda, and cakes as they can lead to tooth decay. Instead, opt for a healthier choice like fruits, vegetables, nuts, and dairy products. Drinking enough water also helps to clean your mouth and keep it hydrated.

In addition to good oral hygiene and a healthy diet, regular dental check-ups are crucial in keeping your teeth and gums healthy. Visiting the dentist every six months can help detect any dental problems early and save you from expensive treatments in the future. Your dentist will also clean your teeth and advise you on any necessary dental procedures or hygiene practices.

Frequently Asked Questions

What should i bring to my first dental appointment.

On your first visit, it’s essential to bring your dental insurance information, a list of your medications, and any medical conditions you have. It’s also important to inform your dentist of any allergies you may have or any concerns you might have about your teeth or oral health.

Are dental x-rays safe?

Yes, dental x-rays are safe. Dentists use a minimal amount of radiation that poses no risk to your health. The American Dental Association recommends bitewing x-rays every two years and a full-mouth x-ray every three to five years, depending on your dental health.

What happens during a routine dental check-up?

During a routine check-up, your dentist will examine your mouth, teeth, and gums for any signs of decay, gum disease, or oral cancer. They will also clean your teeth and remove any plaque or tartar build-up. If any dental procedures are necessary, your dentist will discuss them with you and make any necessary recommendations.

Importance of Follow-Up Visits

Now that you have successfully completed your first visit to the dentist, it is important to understand the significance of follow-up visits to maintain good oral health. Regular dental check-ups can prevent oral health problems from developing into serious issues. Your dentist can detect and diagnose any early signs of tooth decay, gum disease, oral cancer, and other potential problems that you may not be aware of. Regular dental check-ups can ensure that your teeth and gums are healthy and can help identify any problems that may require treatment before it becomes too late.

Dental check-ups are recommended every six months or as determined by your dentist’s assessment of your oral health. Children may need to visit the dentist more frequently, depending on their dental needs. During each follow-up visit, the dentist will carefully examine your mouth, teeth, and gums to look for any signs of decay, infection, inflammation, or other issues. They may also take X-rays to check for any issues that cannot be seen with the naked eye.

Your Next Steps

Tips on how to schedule your next appointment.

Once you have completed your first visit, it is time to start thinking about scheduling your next appointment. Make sure to schedule visits well in advance, so that you don’t have to rush or squeeze in an appointment at the last minute. If you prefer to schedule appointments online, check if your dentist’s office has an online portal. If not, you can call or email the office and schedule an appointment that way. Make sure to let them know if you are experiencing any discomfort or have any concerns regarding your oral health.

The importance of following the recommended treatment plan

During your follow-up visits, your dentist may recommend specific treatments or procedures that will help maintain good oral health. Make sure to follow your dentist’s recommendations and adhere to the treatment plan. If you have any questions or concerns, do not hesitate to ask your dentist for further information. Following the recommended treatment plan can help prevent oral health problems from developing into serious issues and can ensure that your teeth and gums are healthy for years to come.

By understanding the importance of follow-up visits and adhering to the recommended treatment plan, you can maintain good oral health and enjoy a healthy, beautiful smile.

What to Expect During Your First Dental Appointment

Now that you have prepared yourself to visit the dentist, let us give you an idea of what to expect during your first visit.

Dental History

The dentist will ask you about your medical history and your dental history during the first visit. It is important to be honest about your dental habits, including how often you brush and floss, as well as any past dental procedures you’ve had. This information will help the dentist provide you with the best possible care.

In addition, you will be asked about any current dental problems or concerns you may have. Do you have a toothache? Are you experiencing sensitivity? Do your gums bleed when you brush? Make sure to share any dental concerns or issues you have with your dentist.

Finally, the dentist may also ask you about your diet and lifestyle habits, such as whether you smoke or chew tobacco, which may affect your oral health.

Dental Examination

After discussing your dental history and any concerns you may have, the dentist will conduct a thorough examination of your mouth. During the examination, the dentist will look for any signs of decay, gum disease, or other oral health issues. You may also receive dental x-rays to check for problems that may not be visible to the naked eye.

Based on the examination, the dentist will provide you with a diagnosis and treatment plan, if necessary. This may include recommendations for dental work, such as fillings, root canals, or extractions, as well as advice on how to improve your oral hygiene habits.

Now, armed with this knowledge, you are ready to take the first step towards maintaining a healthy and happy smile. Don’t forget to schedule your regular dental check-ups and cleanings to keep your teeth and gums in tip-top shape!

Final Thoughts

Congratulations on taking the first step towards good dental health by scheduling your first visit to the dentist. It’s natural to feel a little nervous, but don’t worry! With these tips on how to prepare and what to expect, you’ll be well on your way to a successful appointment.

Remember to bring your insurance information, arrive early, and communicate any concerns or questions you may have with your dentist. Taking care of your oral health is an important part of overall wellness, so keep up with regular appointments and good dental habits at home. Best of luck on your journey to a healthy smile!

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LESSON PLAN FOR ENGLISH TEACHERS

Visiting the dentist.

Level: Intermediate (B1-B2)

Type of English: General English

Tags: health and wellbeing visiting the doctor/dentist/vet Situation based

Publication date: 29/11/2016

In this dialogue-aided lesson plan, students learn a variety of words and expressions for describing dental equipment and communicating with a dentist in English.

Visiting-the-dentist-Ex5

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In this dialogue-aided lesson plan, students learn a variety of words and expressions for describing dental equipment and talking with a dentist.

Visiting-the-dentist.mp3

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English vocabulary for going to the dentist

by Adriana Stein

Published on January 23, 2021 / Updated on November 10, 2022

Learning the most common words and phrases to get help when you’re sick is one of the most important benefits of learning a language. When it comes to the dentist, not knowing what to say once you’re there and not understanding your dentist’s advice is especially frustrating – and even potentially life-threatening! 

Don’t wait to develop a toothache to brush up on your English vocabulary for visiting the dentist. Most dentists recommend going for a routine dental check-up twice a year anyway, so you can practice using this dentis vocaulary and phrases while your teeth are healthy. 

Start your journey to reach fluency

Vocab words and phrases you’ll need for a visit to the dentist.

In case you need to visit a dentist, the following words and phrases help you describe your symptoms and understand the dentist’s instructions and recommendations.

Quick note: if you’re having trouble with other parts of your body and need to visit a doctor instead, take a look at this u seful vocabulary for doctor’s visits.

Parts of your mouth

Your mouth has many parts with different medical names. Most of time when you visit the dentist, you’ll only speak about your teeth. However, to help you understand from a visual perspective, we’ve added this graphic of the mouth. These words are helpful when describing your symptoms or when understanding your dentist’s recommendations, especially if they slip into medical dental jargon.

If you’re in doubt about the correct word to use, you can also just point to the area that hurts or feels uncomfortable and ask the dentist to look there (I actually do this anyways even in my home country, because it’s easier).

Dental symptoms

If you’re not just at the dentist for a teeth cleaning, you’ll need to describe the symptoms you’re experiencing in order for the dentist to diagnose the problem. You can use the phrases below to clarify the issue:

Common dental problems

Once your dentist has finished the examination, they will explain the issue and how it can be treated. Some of the most common dental problems are as follows:

Dental procedures and treatments

There are a wide variety of regular and specialised dental treatments. This table provides a dental word list your doctor might use when explaining such dental procedures:

Types of dentists and other related health practitioners 

After a general checkup, your dentist may recommend you to visit a specialist who can best help with your specific dental problem. Here is a list of words that describe a dentist more specifically and other related health practitioners that you may need to visit:

To mention something super important: the extent to which dental costs are covered by health insurance depends on the location and country at hand. If you’re traveling or living abroad and are new to the healthcare system, make sure you check with your insurance provider about how they handle visits to the dentists in order to avoid or reduce paying for everything on your own.

For more specific details on this, take a look at our country-specific health insurance guides for:

Adriana Stein

Adriana Stein is an Online Marketing Consultant based in Hamburg, Germany. Originally from a small town in Oregon, USA, she decided to move to Hamburg in early 2016 after falling in love with the city during a study abroad.

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How to Advocate for Yourself at the Dentist

To get the best care, experts recommend speaking up. Here are tips for what to ask and how to evaluate the treatments you are offered.

By Knvul Sheikh

Think about the last time you went to a dentist : Did you walk out feeling like your questions were answered, or did you wonder whether your provider was being straight with you?

Dental visits can be daunting — and not just because of the whirring drills. Dentists may seem to speak another language entirely, and everything they suggest can feel important. You must have a sealant painted on your tooth or risk bacteria creating holes in it. You must get an extraction because an oral infection has spread and is causing pain.

To get the best results and a more positive experience, experts recommend speaking up. Here are tips for what to ask and how to evaluate the treatments you are offered at the dentist.

Get a good look at the problems yourself.

The first step to effectively advocating for yourself is understanding what your problems are. Ask your dentist to show you exactly where the pockets of your gums are getting deeper and letting bacteria accumulate, or which fillings are getting worn down by night grinding .

“You don’t have to get technical about it,” said Ellie Phillips, a preventive dentist based in Austin. “But I would recommend noting if it’s something affecting your front teeth or the back of your mouth. Is it on the outside, which is the cheek side, or is it on the tongue side?” Visual aids like X-rays or images from an intraoral camera — or even just looking in a mirror — can also help demystify what’s going on in your mouth.

Don’t feel pressured to agree to anything — even cleanings.

Your dentist should be able to explain why particular problem areas need specific treatments, said Alyson Leffel, director of patient advocacy and social work at the NYU College of Dentistry. And it’s perfectly reasonable to ask them for time to research and reflect on your options.

Not every child or adult needs cleanings twice a year, for instance. Studies have found they don’t necessarily lead to better dental outcomes. Similarly, experts debate the benefits of extracting wisdom teeth . And old silver fillings don’t always have to be replaced with composite ones. If you feel uncomfortable pushing back in the moment, one way to give yourself more time is to schedule the recommended appointment for a future date, Dr. Phillips said. Then you can call to reschedule or cancel later.

Ask what’s urgent, and what the alternatives are.

Some issues, like an abscess, may need to be treated right away. But others, such as teeth that need to be replaced with implants, should ideally be dealt with over multiple appointments, Dr. Phillips said. It’s the dentist’s job to lay out a treatment plan that prioritizes the most urgent issues and avoids piling major treatments into a single visit . As the patient, you can — and should — request detailed explanations of the benefits and risks of each treatment, what the recovery time is like, whether you will need to take medication to manage pain and whether there are consequences of delaying care.

“The more questions you ask, the more educated you will be about your dental treatment, and the less likely you are to be anxious about it,” Ms. Leffel said.

Experts also recommended asking about alternative treatments, such as antibiotics for managing gum disease instead of scaling and root planing or surgery. There may also be alternative materials available for the same kind of fix, like porcelain, resin or gold crowns.

Get a second opinion.

If you have oral surgery or another big procedure coming up, or feel uncomfortable with your dentist’s recommendations for any reason, consider getting another expert’s perspective.

If you need your bite corrected, talk to an orthodontist. If you have pain or bleeding in your gums, seek out a periodontist. And if a dentist has recommended a root canal or a full mouth extraction, consult an endodontist or oral surgeon, said Craigg Voightmann, a dental malpractice lawyer in Scottsdale, Arizona.

“If there’s a specialty that does the procedure, you shouldn’t have a general dentist doing it for the most part,” Mr. Voightmann said.

Beware of other red flags.

When you first see a new dentist, be wary if they recommend far more treatment than your previous provider ever suggested. Not all procedures are strictly necessary. For example, some early-stage cavities can simply be monitored every couple months and don’t need to be filled right away.

Avoid practices that offer steep discounts just to get you in the door or say they can do complicated procedures like implants in one day, Mr. Voightmann suggested.

And rely on personal recommendations from friends, family or dental professionals themselves. Ask your hygienist or dentist where they would go if they needed the treatment you’re getting, Mr. Voightmann said.

The best scenario is when your dentist’s treatment philosophy aligns with your own.

“They could be the best dentist or specialist in the world, but if you don’t feel comfortable with them, that’s not going to be a successful relationship,” Ms. Leffel said. “So you need to, as a patient, decide what makes you feel the best.”

Knvul Sheikh is a Times reporter covering chronic and infectious diseases and other aspects of personal health. More about Knvul Sheikh

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'Go to the Dentist' or 'See a Dentist'

The expressions “go to the dentist”, “see a dentist”, and “visit a dentist” are often interchangeable and commonly used in everyday English.

The expressions “ go to the dentist ”, “ see a dentist ”, and “ visit a dentist ” are often interchangeable and commonly used in everyday English.

You should see a dentist on a more regular basis.

Note that we always use an article (a/the) or another determiner (this, that, my, your, etc.) before " dentist ".

I need to go to the dentist .

Children should visit a dentist for a checkup twice a year.

1. ‘Go to the Dentist’ vs. ‘See a Dentist’

2. ‘visit a dentist’.

When seeing a dental health professional, we commonly use the expression “ go to the dentist ” or “ see a dentist ”.

She went to the dentist after school.

I’ve got to see a dentist tomorrow.

When attending our usual dentist or having a dental appointment, we normally use the expression “ go to the dentist ”.

I go to the dentist every six months for a checkup.

This expression contains the article “the” even if the dentist has not been identified.

I hate going to the dentist .

The phrase “ see a dentist ” is usually more generic (less precise).

You should see a dentist to prevent oral health problems.

Seeing a dentist is not a pleasant experience.

But you can use other determiners, such as “my”, “your”, “her”, “the”, “that”, etc., to identify the dentist you are talking about.

I need to see my dentist to remove all plaque from my teeth.

In more formal situations, we can use the terms “dental practitioner”, “dental health practitioner”, or “dental health professional”.

If you need more specialized care, your dentist can refer you to another dental health practitioner .

"Go to the doctor" or "See a doctor"

We can also use the phrases “ visit a dentist ” and “ visit the dentist ”.

Visiting a dentist twice a year is a good rule of thumb for many people.

An ongoing toothache is considered an urgent sign that you should visit the dentist .

We can also say the noun phrase “ a visit to the dentist ”.

A visit to the dentist doesn't have to be something to dread.

Do you need an article in front of the name of a place?

PristineWord

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Explore plans

Health coverage, dental, vision and supplemental, member support, the health guide, additional resources, listen to your mouth: 6 signs you need to see the dentist.

Young children, a demanding job, a friend in need ― many things can cause preventive health care to fall by the wayside. Until a nagging symptom reminds you it’s been a while since your last checkup.

It’s tempting to put off seemingly minor dental issues until your schedule lightens up. But the warning signs below shouldn’t be taken lightly. This is especially true if you’re managing a chronic condition, like diabetes. Read more about the connection between oral health and overall health . By catching problems early on, you’ll save yourself precious time and money.

1. Bleeding after brushing or flossing

Blood on your toothbrush or in the sink isn’t normal. It could mean you’re developing gum disease ― also called periodontal disease ― an infection of the tissues that hold your teeth in place. When untreated, gum disease can lead to bone loss around the teeth and eventually tooth loss. Other signs include red, swollen or tender gums, and discharge between the teeth and gums.

2. Receding gums

Some gum recession can be a normal part of the aging process: 88% of people over 65 experience recession around at least one tooth. But recession can also be a sign of gum disease. Regardless of the cause, retreating gums can expose the delicate roots of teeth, increasing the risk of decay, infection, pain and tooth loss. When it’s caught early, treatment can stop or even reverse the process.

3. Dry mouth

A healthy mouth is well lubricated by saliva, which washes away food particles and neutralizes the acids produced by plaque. If your mouth feels unusually dry, it could be a sign of illness. Your dentist can determine what’s causing your dry mouth and suggest ways to restore moisture and protect your teeth.

4. Loose or shifting teeth

Adult teeth should last a lifetime. If you notice slight movement or widening gaps, take it seriously. It could be a sign of infection or bone loss. Also look out for changes in the way your teeth fit together when you bite, or changes in the fit of partial dentures.

5. Bumps and sores

Common canker sores will clear up on their own in one to two weeks. But other oral lesions need to be treated. A fungal infection called thrush, or candidiasis, can show up as white sores on the tongue, inner cheek, tonsils or roof of your mouth. People with diabetes are more prone to thrush, which thrives on high sugar levels in saliva. Medicine can treat thrush.

6. Toothache

Okay, this one’s obvious. But it bears repeating that toothaches shouldn’t be ignored. Pain and sensitivity can have many causes: a cavity, abscess, broken tooth, damaged filling or grinding your teeth. Only your dentist can determine what’s behind the pain, treat the underlying issue and help you avoid future problems.

Top 5 ways to keep your mouth healthy

Often there are no warning signs of early gum disease. So be sure to get regular checkups ― even when you’re experiencing no symptoms ― and take good care of your teeth at home:

• Brush at least twice a day for about two minutes each time.
• Use a toothbrush with soft bristles; firm bristles can damage gums.
• Floss once a day to clean away particles from between your teeth and below the gum line.
• Ask your dentist if you should use a fluoride rinse to help prevent decay.
• If you wear dentures, clean them every day. Remove stains and plaque buildup that can irritate your gums. Take dentures out when you sleep to help your gums stay healthy.

Related Content

5 fun ways to get your kids to brush their teeth

The mouth-body connection: What your dentist knows about your overall health

Also of interest:

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What to Expect During Dental Cleanings

In this article

Key Takeaways

• Routine dental cleaning or prophylaxis cleaning involves an exam, plaque and tartar removal, prophy polish, and fluoride treatment
• The procedure is quick and painless
• Dentists recommend a dental cleaning once every six months
• Routine dental cleanings can help control plaque and tartar
• It can also help prevent gum disease and maintain oral health

What is a Prophylaxis Teeth Cleaning?

A prophylaxis dental cleaning is the most common type of teeth cleaning a dental hygienist does. It usually takes 45 to 60 minutes.

Dentists recommend you get this procedure every six months for preventative care. Regular dental cleanings are essential to:

• Maintain good oral health
• Prevent gum disease
• Stop the progression of tooth decay
• Provide education on oral hygiene

Other Types of Teeth Cleanings

Prophylaxis cleaning is the most common type of teeth cleaning. If you properly care for your oral health, it may be the only cleaning you’ll ever need.

However, there are other types of dental cleanings for more severe issues, such as: 

• Scaling and root planing — Deep cleaning of the gums performed on patients with gum disease
• Periodontal maintenance — Tartar removal performed on patients with periodontal disease
• Gross debridement — Removal of extensive plaque and tartar that interfere with the oral exam

Why are Regular Teeth Cleanings Important?

Regular cleanings are essential for the overall health of your mouth and body. If you don’t visit the dentist every six months, there’s a strong chance you’ll develop cavities or gum disease.

Brush and floss regularly between cleanings, and follow any recommendations from your dentist or dental hygienist.

What To Expect From a Dental Cleaning

Routine teeth cleaning, or prophylaxis teeth cleaning, typically includes the following steps:

• Examination of your teeth, gums, and mouth
• Professional cleaning
• Fluoride treatment

A dental hygienist will perform each step of the cleaning. Your dentist may also examine your mouth when the hygienist finishes.

What Happens During a Prophylaxis Teeth Cleaning?

A dental hygienist will perform the prophylaxis teeth cleaning. Once done, your dentist may also assess your oral health.

Here’s what to expect when you go in for a prophylaxis dental cleaning:

Step 1: Oral Examination

First, your dental hygienist will examine your teeth and gums. They’ll use an instrument called an explorer to look for signs of:

• Tooth decay
• Gum disease
• Plaque and tartar buildup
• Problems at the tooth roots
• Orthodontic or bite issues
• Other potential oral health issues

The hygienist will also examine your head and neck for abnormalities like cancer. If they find anything unusual during the exam, they’ll recommend treatment or a consultation with the dentist. 

Step 2: Plaque and Tartar Removal

After the exam, the dental hygienist will remove plaque and tartar from your teeth and gums. Plaque is a sticky film that forms in your mouth from bacteria and food particles.

Without proper cleaning, plaque can harden into tartar. You can only get it removed at the dentist’s office.

Your dental hygienist will use a dental scraper or scaler to remove built-up tartar. They may also use an ultrasonic scaler, which uses water flow and vibrates at high speeds.

Step 3: Prophy Polishing

Next, your dental hygienist will polish and floss your teeth expertly. They will use a prophy cup and tooth polishing pastes.

The polishing paste may feel gritty because it’s supposed to scrub and polish your teeth. The prophy cup will remove lingering plaque and extrinsic stains.

After polishing your teeth with the prophy cup, your hygienist will use dental floss to perform an interdental cleaning and remove any residual prophy paste between your teeth.

Step 4: Rinsing

After polishing and flossing, your hygienist will thoroughly rinse your mouth to remove leftover particles. The rinse may include water or a liquid fluoride mixture.

Step 5: Fluoride Treatment

The final step in your prophylaxis dental cleaning is when the hygienist applies fluoride to your teeth. Fluoride is a naturally occurring mineral that strengthens enamel and protects teeth from decay. 

Not every cleaning will include fluoride. For example, if you’re an adult with healthy teeth who gets regular check-ups, you may not need fluoride treatment for cleaning.

Step 6: Dental Exam

When the hygienist finishes, they will call the dentist to examine you. Your dentist will check for problems and discuss ways to maintain optimal oral health. 

They may also:

• Recommend additional treatment
• Prescribe you a medicated mouthwash if you have gum disease
• Give you instructions for home care
• Discuss cosmetic procedures

Other Steps

Routine appointments take longer if your dentist finds any oral health issues during the exam. If you haven’t visited the dentist in a long time, they may also want to take updated mouth X-rays.

What to Expect After a Dental Cleaning

It’s normal for your mouth to feel strange after teeth cleaning. You may feel tender or sore. Your teeth should also feel glossy and smooth after a dental cleaning.

Follow the oral hygiene instructions given to you by your dental hygienist and dentist—brush and floss daily to prevent gum disease and tartar accumulation.

Commonly Asked Questions About Dental Cleaning

Is it normal to be afraid of dental work.

If you’re afraid of going to the dentist, you’re not alone. Dental work can be stressful for many people, even if it’s just a routine cleaning.

In 2019, 34% of adults hadn’t visited the dentist in the past year. 1 Knowing what to expect from a typical dental cleaning can decrease your anxiety.

Does insurance cover dental cleanings?

Most dental insurance plans cover the cost of preventative dental care. This includes annual or semiannual teeth cleanings.

Your insurance will also cover the expense for other services such as x-rays and sealants. Talk to your insurance provider about the full extent of your coverage.

How much do dental cleanings cost without insurance?

The cost of prophylaxis can vary depending on what you need, the area you live in, and your overall oral health. The price can range up to:

Dental cleaning – $100 to $150

Scaling and root planing – $300 Dental x-rays – $18 to $150 Dental exam – $100 to $150 Flourite treatments – $60

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Related pages.

General Dentistry: Common Treatments & Procedures

Medically Reviewed by Lara Coseo

Enameloplasty - Procedure, Side Effects, Pros, Cons & Costs

Medically Reviewed by Khushbu Gopalakrishnan

What Is Dental Prophylaxis?

How to Become a Dental Hygienist

Medically Reviewed by Erica Anand

Orthodontic Headgear: Types & When Treatment is Necessary

Root Canal Procedure

• “ Dental Visits .” National Center for Health Statistics, Centers for Disease Control and Prevention, 2022.
• “ Gingivitis and periodontitis: What are the advantages and disadvantages of professional teeth-cleaning? .” InformedHealth.org, National Library of Medicine, 2020.
• “ Adult Oral Health .” Centers for Disease Control & Prevention, U.S. Department of Health and Human Services, 2020.
• Edlund et al. “ Efficacy of power-driven interdental cleaning tools: A systematic review and meta-analysis. ” Clin Exp Dent Res, 2023.
• “ Dental Scaling and Root Planing for Periodontal Health: A Review of the Clinical Effectiveness, Cost-effectiveness, and Guidelines .” Canadian Agency for Drugs and Technologies in Health, National Library of Medicine, 2016.
• Lamont et al. “ Routine scale and polish for periodontal health in adults .” Cochrane Database System Review, National Library of Medicine, 2018.

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Going to the Dentist

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Q: What part of your body helps you to digest your favorite foods, say "cheese," and look great in pictures? A: Your teeth !

It's true. Your teeth are an important part of your smile, and they also help you chew foods like crunchy apples or yummy pizza.

Brushing and flossing are important, but you also need to visit your dentist regularly to keep your teeth strong and healthy. Let's learn more about what happens at the dentist's office.

What Does the Dentist Do?

The dentist is a doctor who is specially trained to care for teeth. When you visit for a checkup, your dentist will look at your teeth and gums to check for any problems. The dentist also wants to make sure your teeth are developing properly as you grow.

It's important to visit your dentist every 6 months to make sure you're taking good care of your teeth and that your teeth and gums are healthy.

What Happens at the Dentist's Office?

After your name is called in the waiting room, you'll go into an exam room and sit down in a big, comfortable chair that is like a huge recliner. The chair will have a place to rest your head and lots of room for you to stretch your legs. Next to the chair may be a little sink with a cup that you can use to rinse out your mouth as your teeth are being cleaned.

During the exam, your teeth will be cleaned, flossed, and checked for cavities .

How Are Teeth Cleaned and Checked?

One of the people you may meet at the dentist's office is the dental hygienist (say: hi-JEH-nist). A dental hygienist is a person who knows all about keeping teeth and gums clean and healthy. Either the dental hygienist or the dentist will check your teeth and give them a good cleaning.

The dentist or hygienist will look inside your mouth to make sure your teeth are growing properly and your gums are healthy. A bright, overhead light will shine down into your mouth like a giant flashlight so they can get a good look inside your mouth.

The dentist or hygienist will clean and polish your teeth, using tiny dental tools like a tooth scraper, mirror, and special toothbrush. The tooth scraper removes plaque (say: plak) from your teeth. Plaque is a thin, sticky layer that coats your teeth and contains bacteria (say: bak-TEER-ee-uh) that grow on your teeth over time. Plaque that isn't removed from your teeth can cause a cavity (say: KAH-vuh-tee). A cavity is a decayed, or rotted, part of a tooth.

Next comes brushing and flossing. The dentist or hygienist will brush your teeth with a special toothbrush and toothpaste. The toothbrush has a small, round tip that moves around and around to clean your teeth. The toothpaste might taste like your own toothpaste at home, but it will feel a little grittier — almost like sand.

Then they will floss your teeth and show you the proper way to brush and floss your teeth at home. Flossing involves using a piece of waxy string called dental floss to get in between your teeth and remove food particles that your brush can't reach.

How Does the Dentist Check for Cavities?

During your visit, the dentist carefully looks for cavities. You may also have X-rays, or pictures, taken of your teeth. X-rays are like superhuman vision. They can show cavities hiding between your teeth and problems beneath your gums. 

It does not hurt to get an X-ray and it takes only a few seconds. The dental hygienist will place a thick blanket over your chest (to protect your body from the high-energy waves) and put a piece of plastic (that holds the X-ray film) into your mouth. As you gently bite down on the plastic, you'll have to be very still for a few seconds while the dental hygienist snaps the picture.

The dentist will look at all of your teeth and check your gums to make sure they're strong and healthy. The dentist will also check the way your top and bottom teeth work together. This is called your bite . If there might be a problem with your bite, you may be referred to an orthodontist (say: or-tho-DON-tist). This is a doctor who specializes in correcting the shape or positions of all your teeth through orthodontia, or braces .

The dentist will study your X-rays (looking for cavities or other problems) and ask if you have any questions about your teeth. Your dentist may also prescribe fluoride drops or tablets for you to take every day at home.

What Are Fluoride Treatments?

Fluoride (say: FLOOR-ide) is a natural mineral that makes your teeth strong and helps prevent cavities. At the dentist's office, a fluoride gel or foam will be applied to your teeth. Most dental offices offer fluoride treatments with flavoring, like bubblegum or grape.

The fluoride treatment takes just a few minutes. The dental hygienist may tell you not to eat or drink anything (including water) for 30 minutes after the fluoride treatment.

What Happens if I Have a Cavity?

If you have a cavity, you'll probably come back to the dentist's office for another visit. At that time, the dentist will give you a tiny shot of an anesthetic (say: ah-nus-THEH-tik), a medicine that numbs the area around the tooth. Then, the dentist removes the decayed part from your tooth with special dental tools. That area gets filled with material to keep your tooth strong and healthy, like tooth-colored or silver fillings.

Your mouth may be numb for a little while after you leave the dentist's office, but the anesthetic will soon wear off and you'll be left with a beautiful smile!

What Are Some Dental Words to Know?

Some words used at the dentist's office might be new to you. Here are a few and what they mean:

• bacteria — tiny organisms that live on your teeth and are found in plaque
• cavity — the decayed, or rotten, part of a tooth
• dental hygienist — a person with special training on how to keep teeth and gums clean and healthy
• dental X-rays — pictures of your teeth and gums that will show a dentist if there are any cavities
• flossing — using a piece of waxy string called dental floss to get in between your teeth and remove food particles that your toothbrush can't reach
• fluoride treatment — a gel or foam applied to teeth that makes them strong and helps prevent cavities
• orthodontist — a doctor who specializes in correcting the shape or positions of teeth
• plaque — a thin, sticky layer containing bacteria that grow on your teeth

When your checkup is over, the dentist may have a present for you! Usually, this is a free toothbrush or dental floss to use at home or some sugar-free gum.

The Dentist — a short story for English reading

Michael hates going to the dentist.

And today is no different.

But he has some work to do on his teeth.

Today though, the dentist introduces a brand-new painkiller. It could be just the thing that Michael needs.

Check out my short story, The Dentist, which comes with a full and complete lesson plan that you can use in your English class today.

Take a look below… And tell me what you think.

Table of Contents

Introduction

Do you like to go to the dentist? Why/why not?

What do you dislike about going to the dentist?

What is a psychopath?

Could a dentist be a psychopath? What if he was?

The Dentist

Michael hated it.

He hated sitting in the chair and feeling helpless. The bright light above his head and the clean, hygienic walls that surrounded him.

It all made him feel incredibly uneasy.

“Michael, I can assure you, there is nothing to worry about,” said Mr Crane. He wore his dentist’s white coat and had perfect white teeth. He gazed back at Michael with a relaxed air. Like there was nothing to worry about.

It was all right for him. He wasn’t sitting in the chair. He was not about to have treatment for a new crown to be fitted.

Michael shifted his weight in the chair and grimaced.

“I’m sorry about last time,” he said. “It’s just a stupid fear I have.”

“Fear of going to the dentist?” asked Mr Crane. “Don’t worry about it. I get this all the time from patients.”

He leaned forward. “Some are a lot of trouble, I can assure you.”

He gave Michael an encouraging smile.

This did nothing for Michael’s nerves. He would rather be anywhere else than in this dentist’s chair. He could accept the pain in his tooth. That was much better than sitting here, while Mr Crane drilled into the offending tooth.

“Michael, I have something I want to show you,” said Mr Crane, going to a small tray to the side of the room. He turned and picked up a small glass vial. He raised it to show to Michael. It was filled with a clear liquid.

“This is a new anaesthetic on the market,” he went on. “It is brand new, and only my private students are allowed to have it. The company that makes it wants it to be very secret.”

Mr Crane sat on the stool next to Michael and looked down at him. “But this is an incredible formula. It is probably the best pain-killer on the market.”

The dentist continued to hold Michael’s gaze. “Would you like to try it?”

“I- I don’t want to be any trouble,” said Michael.

But his eyes were fixed on the small vial held between Mr Crane’s finger and thumb.

“It’s no trouble at all,” said Mr Crane. He leaned forward and lowered his voice. “Our little secret.”

The thought of being given something so powerful that he would not experience any pain at all sent a calm, soothing feeling through Michael’s nerves. He could feel himself relaxing as if he were already under the influence of the new painkiller.

“Are you sure?” asked Michael.

“No problem,” said Mr Crane.

Michael lay back in the chair while Mr Crane filled the syringe from the tiny bottle. He hummed a small tune as he did it and Michael recognised it as a popular song that was on the radio.

Through the window, he could make out normal life carrying on outside. He heard a bus drive by and the sound of a bell on a bicycle.

People’s voices and children laughing.

Everything was fine. There was nothing to worry about at all.

“Shall we?” said Mr Crane, and he raised the syringe in front of him.

Michael nodded. He would pass by all this pain and torture and not feel a thing. He was so happy. So relieved.

Mr Crane leaned forward. “You’ll just feel a little jab as the needle goes in. Then, nothing to worry about.”

Michael tensed as the needle entered his gum. Yes, very uncomfortable, and ice-cold, but in a few minutes nothing but deep relaxation.

“All done,” said Mr Crane. “I’ll be back in a few minutes and we can begin.”

Michael lay deeper into the chair and half-closed his eyes. The muscles of his arms, legs, his entire body felt relaxed. A warm soothing feeling washed over him and he felt as if all the worries and anxieties he had ever experienced left him for good.

His body was so relaxed that all he could do was breathe. He tried to lift the little finger of his right hand and it felt as if it moved a little but he couldn’t be sure. He forgot about it and allowed the dream-like quality of the anaesthetic to wash over him.

A little nagging thought tapped at his inner-most mind and he tried to move his little finger again.

It felt as if it moved but he could not feel it really move. It was like he imagined it moving only.

He went to move his head to the right to see his hand more clearly. He could not.

A small jab of tension cleared his mind a little, and he tried again. Nothing.

He could not move his head at all.

He took a deep breath of air into his lungs and automatically tried to lift both of his hands. But they stayed on the armrests of the chair like they were glued there.

No resistance. No feeling.

He simply could not move his arms or head at all.

He kicked out, and neither foot moved.

Michael sucked in a chest full of air and went to call out to Mr Crane. No sound came.

He could not move. And he had lost the power to make any sound.

He was paralysed. Stuck to the chair, but wide awake.

A shadow appeared beside him.

“We should be about ready by now,” said Mr Crane.

His voice sounded like an echo and far away.

And where was the nurse? The dental assistant?

There was usually a young woman helping. It was just him and Mr Crane. Why was he alone with him?

The dentist’s face loomed up in front of Michael.

“Shall we see if this new drug has taken effect yet?” he asked.

He had a bright, shiny scalpel in his hand.

Michael tried to scream but no sound came. He just lay in the chair unable to move.

Mr Crane opened Michael’s mouth and jabbed the scalpel against his tongue. A dagger of pain soared through Michael’s mouth and into his brain.

Inside his head, he let out a scream.

“ Let’s get to work then,” said Mr Crane, closing the blind of the window.

Reading Comprehension Questions

Where is Michael?

How does he feel being there?

What specific aspects of the dentist’s office make Michael uneasy?

Describe Mr Crane’s demeanour as a dentist.

What is Michael’s concern regarding his dental treatment?

What does Mr Crane think about Michael’s feelings? What expression does he use to try to calm him?

Is this Michael’s first visit to see Mr Crane?

Where does Michael want to be instead?

What does Mr Crane show Michael?

Does Mr Crane want Michael to try the new anaesthetic?

What kind of patients usually use this anaesthetic?

Why does Michael agree to try the new anaesthetic?

What can Michael hear outside the window?

How does Michael feel immediately after Mr Crane gives him the injection?

What effect does the anaesthetic have on Michael’s body and mind?

What part of his body does Michael try to move?

What does he try to move next?

Describe Michael’s initial reaction when he realizes he can’t move.

Why does Michael become increasingly panicked?

How does Michael attempt to communicate his distress?

What was Michael’s first clue that something might be wrong with Mr Crane’s intentions?

Is there a nurse to help the dentist?

What actions does Mr Crane take after Michael’s paralysis becomes apparent?

What realization dawns upon Michael about the situation?

What does Mr Crane have in his hand?

What does he do with this object?

What is Michael’s reaction?

How does Mr Crane react to Michael’s initial attempts to move and call out?

What does Mr Crane do next after realizing the drug has taken effect?

What does Mr Crane do next?

Why does Mr Crane close the blind of the window?

True or False

Go over all the sentences below and say if they are true or false.

The correct answers can be found at the end of the lesson plan.

Michael is at the dentist.

Michael loves going to the dentist.

Michael feels comfortable and at ease while sitting in the dentist’s chair.

Mr Crane wears a white coat and has perfect white teeth.

Michael’s fear of going to the dentist is uncommon and rarely experienced by other patients.

Mr Crane doesn’t know Michael.

Michael needs a new filling for his tooth.

Mr Crane shows Michael a little vial.

Mr Crane introduces a new tooth cleaner to Michael.

Michael doesn’t want to try this new medicine.

It is during the daytime at the dentist’s.

Mr Crane lets Michael use the syringe on himself.

Michael feels relaxed and relieved of all worries and anxieties.

Michael can move his head and little finger after the painkiller is administered.

Michael cannot speak.

The nurse helps Mr Crane.

Mr Crane taps Michael’s gum with his finger.

Mr Crane closes the blind of the window to let more light into the room.

Michael becomes increasingly panicked and tries to scream for help.

Mr Crane expresses concern and tries to assist Michael when he realizes something is wrong.

Michael is able to call out to Mr Crane for help when he is paralysed.

Essential Vocabulary

Write down all the words and phrases in your vocabulary notebook. Look in your dictionary and find the meaning of each word. Write the definition next to each word.

Then make up your own sentences using each word or phrase.

For example:

Relaxed air — a calm and easygoing atmosphere or demeanour, promoting comfort and informality.

Scream — a noun and verb that refers to a loud and high-pitched vocal expression of intense emotion, often conveying fear, excitement, or distress.

Then write a sentence of your own that uses the new word or phrase correctly.

I entered the room of the party and was glad to see that the place had a very relaxed air.

The woman let out a scream when the man outside banged on the door.

Do this with all the vocabulary and, over time, this will help improve all your English skills — reading, writing, speaking and listening.

Discussion Questions

Have you ever had a similar experience at the dentist, where you felt nervous or uneasy? Can you share your story?

What is Michael’s feeling about going to the dentist?

Why does he feel like this?

Put yourself in Michael’s shoes. How would you feel and react if you were in his situation?

Describe the dentist, Mr Crane, and his attitude towards Michael. Does he seem like a nice person?

Has Michael been to visit Mr Crane before? What happened last time, do you think?

Is Mr Crane used to people being afraid? How do you know?

Mr Crane shows Michael a new anaesthetic. What is really in this little vial, do you think?

What do you think is the significance of the new anaesthetic being described as a “secret formula”?

Why do you think Michael decides to try the new anaesthetic despite his fear?

Why is there no nurse to help the dentist today?

Is Mr Crane a psychopath?

Or is Michael imagining it all?

Discuss the idea of trust in the story. Why does Michael initially trust Mr Crane, and how does this trust change over time?

Imagine you are one of the characters in the story — either Michael or Mr Crane. How would you describe your thoughts and feelings during the crucial moments?

What emotions and thoughts might have gone through Michael’s mind when he realized he couldn’t move or make a sound?

Why do you think Mr Crane chose to close the blind of the window before proceeding with his actions?

What do you think about this story?

Do you think it is realistic? Why/why not?

Do psychopaths live within our normal society? What do they do? What kind of jobs do they have?

This is a role play exercise.

This role has two characters:

2. Mr Crane

Take all the existing dialogue and use this as a basis for your role play.

You can add your own lines of dialogue if you wish, and you can change all the dialogue if you really want to, but in the end, you should have a complete role play to show the class.

Take some time to prepare and when you are ready, perform your role play in front of the class.

This is a survey activity.

Look at the questions below and ask these questions in class.

Try to evaluate the responses and talk about the outcomes.

For example; most people feel comfortable going to the dentist. Or; some people hate seeing the dentist.

How frequently do you visit the dentist for regular check-ups and cleanings?

What is the main reason you typically schedule a dental appointment? (e.g., routine check-up, specific dental issue, cleaning)

How do you feel about visiting the dentist? (Very comfortable, somewhat comfortable, neutral, somewhat uncomfortable, very uncomfortable)

Have you ever experienced dental anxiety or fear before a dental appointment?

If yes, can you briefly describe what aspects of visiting the dentist make you anxious or fearful?

What strategies, if any, do you use to cope with dental anxiety or fear? (e.g., deep breathing, listening to music)

How important is the demeanour and communication style of the dentist and dental staff to make you feel comfortable during your visit?

Are there specific amenities or features in a dental office that help alleviate your anxiety or make you feel more comfortable? (e.g., soothing music, comfortable waiting area)

How well-informed do you feel about the procedures and treatments your dentist recommends?

Have you ever postponed or cancelled a dental appointment due to anxiety or fear?

If yes, what could have been done differently to encourage you to keep the appointment?

How likely are you to ask questions or voice your concerns to your dentist during a visit?

Have you ever sought professional help, such as therapy or counselling, to address dental anxiety or fear?

Do you find that the overall environment and decor of the dental office influence your comfort level?

How would you rate your overall dental experience in terms of comfort and anxiety level? (Very positive, somewhat positive, neutral, somewhat negative, very negative)

Are there specific dental procedures that cause you more anxiety than others? If so, please specify.

How important are online reviews and recommendations when choosing a new dentist?

Have you ever had a particularly positive or calming experience at the dentist? If yes, could you describe it briefly?

What suggestions do you have for dental offices to create a more comfortable and anxiety-free environment for their patients?

Overall, how satisfied are you with your current dentist and the care you receive?

Quiz — Are You a Psychopath?

This is just for fun! Or maybe not… Answer all the questions and find out if you or any of your classmates are psychopaths!

1. Do you never feel fear?

2. Do other people like you a lot?

3. Do you like to act spontaneously?

4. Do you lose interest in people and new interests quickly?

5. Do you think the idea of falling in love is silly?

6. Are you good at charming others?

7. Do you think money is the most important thing in the world?

8. Do you sometimes pretend to be nice to people, even though you don’t want to?

9. Do you think you are better than others?

10. Do you have the ability to be very polite when needed?

11. Do you find other people to be a little stupid sometimes?

12. Do you get bored easily?

13. Do you get jealous of other people sometimes?

14. Do you tell many lies?

15. Do you sometimes spend money on foolish things?

16. Have you ever cheated your family or friends?

17. Do you feel indifferent when people are sad?

18. If you get caught doing something wrong, do you feel no sense of shame or guilt?

19. Are you good at manipulating and/or exploiting others to get what you want?

20. Do you think you are an aggressive person?

21. Do you have few friends in your life?

22. Do you like to take risks?

23. Do you laugh at inappropriate moments?

24. If you answer ‘Yes’ to most of the questions, then you could be a psychopath!

Now discuss in the class.

Which people answered yes to most of the questions?

Do these people seem like psychopaths to you?

This is a creative writing exercise.

You are going to write a short story. It is a continuation of the story you read at the beginning of the lesson plan. The title of the story is:

The Dentist From Hell

Use the questions below to help you come up with some ideas.

• Does Mr Crane try to kill Michael?
• Is the pain all inside Michael’s head? If so, why?
• What does Mr Crane do when he finds that Michael cannot move or speak?
• Does someone come to help Michael?

Now write your story.

When you have finished writing, you can read it out loud in front of the class.

Or hand it to your teacher for review.

You can download the full lesson plan by clicking the link below!

You can also join my mailing list by clicking the link below. I will send you new guides, articles and lesson plans when I publish them.

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2 thoughts on “the dentist — a short story for english reading”.

I think this is a great story and an excellent topic for discussion. Going to a dentist is an inevitable experience we must all undergo and not too many people are thrilled about it! It is also en excellent opportunity to discuss fear and pain. I particularly liked the extension activities in this lesson as they opened new doorways and opportunities for additional related lessons.

Many thanks Leona, I am glad to hear your thoughts on this lesson. I am hoping to write more of these short story lesson plans in the future as I think they could be useful for students and make learning English fun.

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• Find-a-Dentist

Your Baby's First Dental Visit

Your baby is hitting new milestones every day, and his or her first dental visit is another one to include in the baby book!

Your child’s first dental visit should take place after that first tooth appears , but no later than the first birthday. Why so early? As soon as your baby has teeth , he or she can get cavities. Being proactive about your child’s dental health today can help keep his or her smile healthy for life. (Need a dentist? Use our Find-A-Dentist tool to find one in your area.)

How to Prepare

Moms and dads can prepare, too. When making the appointment, it can’t hurt to ask for any necessary patient forms ahead of time. It may be quicker and easier for you to fill them out at home instead of at the office on the day of your visit.

Make a list of questions, as well. If your child is teething , sucking his or her thumb  or using a pacifier  too much, your dentist can offer some advice.

What to Expect During the Visit

If your child cries a little or wiggles during the exam, don’t worry. It’s normal, and your dental team understands this is a new experience for your child!

Tips for a Great Visit

• Don’t schedule an appointment during naptime. Instead, pick a time your child is usually well-rested and cooperative.
• Make sure your child has had a light meal and brushes their teeth before their appointment so they won’t be hungry during their visit.
• Save snacks for after the visit so they aren’t on your child’s teeth during the exam.
• Think of the appointment as a happy and fun experience. If your child becomes upset during the visit, work with your dentist to calm your child. You’re on the same team!

• Vocabulary exercises help you to learn synonyms, collocations and idioms.
• Intermediate and Advanced level grammar practice with progress tests.
• Listening and pronunciation, exam preparation and more!

Explore topics

• Business basics

What Happens to Your Teeth If You Don't Visit the Dentist Every Six Months

Posted: May 1, 2023 | Last updated: June 30, 2023

Essential functions such as eating, drinking, breathing, and speaking all hinge on good oral health . And yet, many people don't realize that how you care for your teeth has even farther-reaching implications: Poor oral health has been linked to a wide range of health problems including cardiovascular disease , pregnancy complications, cognitive decline, and more.

Besides daily brushing and flossing, visiting your dentist every six months is another key way to ensure your oral health is in tip-top shape. Routine cleanings and exams can help you avoid serious—not to mention expensive—dental health issues, experts say. Read on to learn what happens to your teeth if you don't visit the dentist every six months, and to find out why skipping your appointment for too long could come with life-threatening consequences.

READ THIS NEXT: Never Do This After Brushing Your Teeth, Dentists Warn .

You may experience tooth decay.

READ THIS NEXT: This Common Bathroom Habit Is a "Disaster" for Your Teeth, Dentist Warns .

You may be more likely to experience tooth loss.

If you don't visit the dentist every six months, you may also be at higher risk of gum disease, or periodontitis, Silver warns. Known to damage the soft tissue around teeth, gum disease can ultimately erode the bones supporting the teeth "which can result in tooth loss and other health issues if left untreated," she says.

Think it can't happen to you? Tooth loss is a surprisingly prevalent problem across the U.S., according to the Centers for Disease Control and Prevention (CDC). Over one-quarter of adults over the age of 65 have eight or fewer teeth, while one-sixth of adults in that age range have lost all of their teeth.

You may develop bad breath.

When you go too long between dental visits, you run the risk of developing halitosis —the main symptom of which is bad breath. "Without correct and regular brushing and flossing, and routine dental exams, food remains in the mouth," explain experts from Johns Hopkins Medicine. "This is a breeding ground for bacteria. Food that collects on the teeth, gums, and tongue may rot. This causes an unpleasant odor and taste in the mouth."

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Your teeth may become more discolored.

When you skip dental appointments, you skip the deep cleanings that help prevent tooth discoloration. "Certain foods, beverages, and behaviors (such as smoking) can discolor teeth over time. Regular cleanings and examinations can aid in preventing or minimizing these blemishes," says Silver.

Establishing good dental health habits at home can also help prevent tooth discoloration. Brushing twice a day with a dentist-approved whitening toothpaste and flossing daily are a great place to start. Additionally, you should limit your intake of foods and beverages that are known to stain teeth, such as coffee, soda, tea, juice, and red wine. Quitting smoking can also help prevent tobacco stains on your teeth—not to mention reduce your risk of oral cancer.

You'll fall behind on screening for oral cancer.

One of the most important things your dentist does during a checkup is something you may not even notice: screening for signs of oral cancer. "Most people aren't aware of this, but a standard part of your dental exam is an oral cancer screening," explains Pinto, who says that the process involves carefully examining the gums and soft tissue of the mouth to identify any suspicious spots or lesions.

"I've had several patients come in that presented discoloration and abnormalities that concerned me and prescribed a biopsy in order to rule out cancer," she says, adding that early detection is key, and that skipping your appointment could have a "significantly negative impact on your health."

To this point, if you notice any symptoms of oral cancer between appointments, don't wait until your next checkup to have them examined, experts warn. Some symptoms of oral cancer include "a lip or mouth sore that doesn't heal, a white or reddish patch on the inside of your mouth, loose teeth, a growth or lump inside your mouth, mouth pain, ear pain, and difficulty or pain while swallowing, opening your mouth or chewing," explains the Mayo Clinic. Speak with your doctor or dentist to learn more about screening for oral cancer. Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.

Read the original article on Best Life .

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• Open access
• Published: 15 April 2024

Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren’s syndromes patients - a cross-sectional study

• Indre Stankeviciene 1 ,
• Lina Stangvaltaite-Mouhat 2 ,
• Jolanta Aleksejuniene 3 ,
• Diana Mieliauskaite 4 ,
• Ieva Talijuniene 4 ,
• Irena Butrimiene 5 ,
• Ruta Bendinskaite 1 &
• Alina Puriene 1  

BMC Oral Health volume  24 , Article number:  454 ( 2024 ) Cite this article

Metrics details

Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness.

Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren’s syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization’s Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests.

The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren’s syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren’s syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren’s syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1–2.9), OR 5.6 (95%CI 1.7–18.3) and OR 6.9 (95%CI 2.2–21.3), respectively. Participants with Sjögren’s syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1–0.8).

Conclusions

Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Peer Review reports

Introduction

As societies age worldwide, dry mouth conditions become a point of interest in research [ 1 , 2 , 3 ]. Besides older age, dry mouth was also associated with systemic diseases, use of medications, radiotherapy in the neck or head region, and unhealthy lifestyle, including smoking and high stress, therefore, dry mouth patients are considered a vulnerable population for oral diseases [ 2 , 4 , 5 , 6 , 7 ]. Although the term ‘dry mouth‘ is often used to refer to all dry mouth-related conditions, a distinction needs to be made between specific dry mouth types. Xerostomia is diagnosed in individuals who self-report symptoms of dry mouth [ 7 ]. Sicca and Sjögren’s syndromes are diagnostic terms often used interchangeably, although these conditions are different [ 2 ]. Sicca syndrome is diagnosed when objective signs of oral and ocular dryness are present [ 2 ]. According to our previous study, 25% of individuals with Sicca syndrome also had Sjögren’s syndrome [ 8 ]. Sjögren’s syndrome is an autoimmune disease that impacts the exocrine glands, with 95% of patients experiencing mouth dryness and/or dry eyes [ 2 , 5 ].

Higher dental caries rates and lower numbers of retained teeth are frequently observed in dry mouth patients [ 9 , 10 , 11 ]. Also, there are some indications that those with impaired salivation have a greater risk for dental erosion [ 10 , 12 ]. The relationship between mouth dryness and periodontal disease still remains unclear, as some studies reported a positive relationship, while others did not find such an association [ 13 , 14 , 15 , 16 ]. Furthermore, individuals may be more at risk of developing various systemic diseases due to their physical, psychological, and social environments, such as poor living conditions and taking health risk behaviours [ 17 ]. The development of oral diseases follows a similar pattern. Establishing good oral health-related behaviours is of importance in preventing oral diseases [ 18 ]; yet only a few studies have investigated behavioural patterns in patients with dry mouth conditions. A study focused on patients with Sjögren’s syndrome reported that despite oral health behaviours, individuals with Sjögren’s syndrome had poorer oral health than control subjects. However, this study included only 20 patients and 20 control participants [ 19 ].

Moreover, stress has been identified as a common risk factor for oral and general diseases. Stress may impact health through a direct pathway which relates to unhealthy behaviours usually practiced to cope with stress, such as having unhealthy diet, smoking, and abusing alcohol. Such risk behaviours dysregulate the body’s homeostasis, for example, causing hyposalivation and xerostomia [ 20 , 21 ]. In addition, stressful life events may be a risk factor for developing Sjögren’s syndrome [ 22 ]. It is still unknown whether dry-mouth conditions have an impact on the most common oral diseases, whether individuals with dry mouth engage in appropriate oral health-related behaviours, and perceive adequate stress levels. The current study examined oral health, related behaviours, and perceived stress in individuals with xerostomia, Sicca syndrome, and Sjögren’s syndrome and compared them to sex and age-matched subjects without mouth dryness. We hypothesized that participants with dry-mouth conditions have higher stress levels, poorer oral health and its related behaviours.

Study participants

Data were extracted from two cross-sectional datasets; 2017–2019 Lithuanian National Oral Health Survey (LNOHS) and 2020–2022 dry mouth study. The dry mouth study selected adult subjects from five capital hospitals: a specialised dental care hospital, a rheumatological centre, and three hospitals providing long-term care for patients with chronic, non-acute medical conditions. The study inclusion criteria were self-reporting mouth dryness assessed by a question: How often do you have dry mouth? (responses: ‘often’ or ‘always’), and consenting to participate in the study.

Considering the mean differences in caries experience between dry mouth groups, the minimum sample size calculation employed the G-power calculator considering 95% power and α = 5%. This calculation showed that we needed to recruit a minimum of 126 participants. In the dry mouth study, we managed to recruit 127 cases, and additional 55 cases were selected from the Lithuanian National Oral Health Survey (LNOHS), which employed a stratified random sampling from five biggest Lithuanian cities and ten randomly selected periurban/rural areas, one in each of the Lithuanian counties (details published elsewhere) [ 8 , 23 ].

In the LNOHS, subjects with mouth dryness were identified in the same way as in the dry mouth study. To support analyses, three dry mouth groups were created. The xerostomia group comprised individuals who experienced dry mouth ‘often’ or ‘always’ and did not have Sicca or Sjögren’s syndromes. The Sicca syndrome group included participants with hyposalivation indicated by ≤ 0.1 ml/min of saliva production over 15-minute period following the unstimulated whole sialometry test and Schirmer’s test over 5-minute period showing ≤ 5 mm in at least one eye, and excluding participants with a Sjögren’s syndrome diagnosis. The Sjögren’s syndrome group consisted of subjects with a confirmed diagnosis according to the 2016 ACR/EULAR criteria [ 24 ]. We found that a portion of participants with Sjögren’s syndrome also experienced Sicca symptoms, and decided to include these patients in the Sjögren’s syndrome group; otherwise, some patients with Sjögren’s syndrome would have needed to be excluded, compromising internal validity. The detailed procedures of unstimulated whole sialometry, Schirmer’s test, and diagnosing Sjögren’s syndrome were presented elsewhere [ 8 ]. The comparison groups included controls which were age and sex-matched, and the control subjects for each of the dry mouth groups were selected from the LNOHS dataset [ 8 ]. In both studies, all data were collected by one trained and calibrated examiner (IS). The intra-examiner reliability was assessed using the intra-class correlation coefficient (ICC) calculated by comparing duplicate recordings of 10 randomly selected patients, which were not included in the main study, with 2 weeks between repeated clinical examinations. The ICC values indicating intra-examiner agreement were as follows: for the total numbers of decayed surfaces (ICC = 1.00,) missing surfaces (ICC = 0.99,) filled surfaces (ICC = 1.00,) teeth with 4 + mm periodontal pockets (ICC = 0.95 and for the teeth with signs of erosive tooth wear (ICC = 0.95) [ 23 , 25 ].

Self-reported data

The World Health Organization’s Oral Health Questionnaire for Adults [ 26 ] was used to inquire about participants’ sociodemographic characteristics (sex, age, education in years) and several oral health-related behaviours. These behaviours were measured as follows: frequency of tooth brushing (once a day or less ‘0’, twice a day or more ‘1’); use of interdental floss or toothbrush (no ‘0’, yes ‘1’); use of the fluoride toothpaste (no ‘0’, yes ‘1’); last dental visit within last year (no ‘0’, yes ‘1’); frequency of sweet consumption (a few times a day ‘5’ and every day ‘4’ were referred to as the ‘high’ consumption of sweets in univariate analysis, those who ate sweets several times a week ‘3’ or once a week ‘2’ comprised the ‘moderate’ category, and those consuming several times a month ‘1’ or rarely/never ‘0’ were defined as a ‘low’ sweet consumption. In the binary logistic regression, the original coding was used.

The stress levels were measured by the Perceived Stress Scale (PSS-10), which underwent forward-backward translation from English to Lithuanian languages [ 27 ] and subsequent validation. The construct validity of the Lithuanian version of the Perceived Stress Scale was evaluated employing the Exploratory Factor Analysis (EFA) and setting the Eigen value > 1.0 as the threshold for the factor (dimension) extraction. According to the Lee 2012 review of the psychometric adequacy of the perceived stress scale, we expected either one or, alternatively, a 2-factor solution [ 28 ]. In addition, to get a better insight into the scale’s dimensions, we employed the Varimax rotation and acquired dimension-based item loadings. Our EFA produced a two-factor solution, each representing clear dimensions (here factors). The ‘Helplessness’ dimension included six items, and the ‘Self-efficacy’ dimension included four items, where the first dimension explained 38.1% and the second dimension explained 20.5% of the scale’s variance. The ‘Helplessness’ dimension included the following items (loadings): item 1 (loading = 0.744), item 2 (loading = 0.816), item 3 (loading = 0.783), item 6 (loading = 0.681), item 9 (loading = 0.681) and item 10 (loading = 0.828.) The ‘Self-efficacy’s dimension items (loadings) were as follows: item 4 (loading = 0.779), item 5 (loading = 0.752), item 7 (loading = 0.727) and item 8 (loading = 0.606.) Our scale’s validation-related findings were in accordance with several earlier studies performed in different countries and diverse samples, which most commonly reported a two-factor PSS-10 structure. Our two-factor/dimension solution explained 59% of the total variance in stress levels and this finding is also in accordance with previous studies. To sum up, our validation-related testing indicates that the Lithuanian PSS-10 scale version is a valid measure.

Clinical oral examinations

For the clinical assessment of oral conditions, a plane mouth mirror and a CPITN periodontal probe were used as advised by WHO. Dental status was evaluated at a surface level as total numbers of decayed (DS), missing (MS) and filled surfaces (FS). Subsequently, the total DMFS summed all components reflecting one’s overall caries experience [ 26 ]. In addition, the number of teeth with signs and levels of erosive tooth wear were also recorded following the WHO methodology [ 26 ]. The percentage of teeth with periodontal pockets of 4 + mm indicated the extent of periodontal pocketing.

Statistical analyses

Analyses were performed using IBM SPSS version 28.0 software (IBM, NY, US), while age- and sex-matched control participants for comparison groups were selected using R 4.1.0 (R Core Team, 2021) package. The mean and standard deviation (SD), as well as the median and inter-quartile ranges (IQR) were calculated for continuous variables. The Chi-square test was used for categorical, and independent sample t-test or Mann Whitney U test were used for continuous outcome variables. The patient groups and their controls were compared in regard to sociodemographic characteristics, oral health-related behaviours and self-perceived stress. The Mann-Whitney U test compared oral health status between patients with dry mouth-related conditions and their controls selected independently for each dry mouth condition. For each dry mouth condition, multivariable binary logistic regression models tested oral health-related behaviours as independent predictors while adjusting their effects for the socio-demographic characteristics. For the multivariable binary logistic regression models, we selected the oral health-related potential predictors based on the literature, and all behavioural predictors in spite of their bivariate significance were included in the multivariable models. The adjusted effects of predictors are presented as Odds Ratios (OR) with their 95% confidence intervals (CI).

The final dataset included 182 cases and 302 age- and sex-matched participants in the comparison groups. Of all dry-mouth cases, 24% ( n  = 114) were allocated to the xerostomia group, 5% ( n  = 24) to the Sicca syndrome group, and 6% ( n  = 31) to the Sjögren’s syndrome group. A total of 18 (58%) of participants in the Sjögren’s syndrome group also had Sicca syndrome.

Table  1 summarises results of socio-demographic characteristics, oral health-related behaviours, and perceived stress among dry mouth groups and their matched controls. Half of the participants with xerostomia, 67% with Sicca syndrome, and 39% with Sjögren’s syndrome brushed their teeth twice a day; 55%, 42%, and 42%, respectively used interdental care measures. A higher proportion of participants with xerostomia than controls (56% vs. 42%), Sicca syndrome (73% vs. 35%), and Sjögren’s syndrome (80% vs. 44%) used fluoridated toothpaste. In addition, a higher proportion of participants from the Sjögren’s syndrome group than in the comparison group reported that their last dental visit was more than 12 months ago (52% vs. 24%).

Table  2 compares oral health-related conditions between dry mouth groups and their matched controls. In comparison to controls, a higher mean DMFS was in participants with xerostomia, Sicca syndrome, and Sjögren’s syndrome, the latter had higher mean DS and MS, but lower FS mean values. In addition, individuals with Sicca syndrome and Sjögren’s syndrome had a lower mean number of remaining teeth than their matched controls. The mean extent of periodontal pocketing of participants with Sicca syndrome and Sjögren’s syndrome were lower than the corresponding means of their controls.

Table  3 presents findings from binary logistic regression analyses examining associations between several oral health-related behaviours and dry mouth conditions when adjusted for socio-demographic characteristics. Participants with xerostomia had almost two times higher odds, and participants with Sicca syndrome had almost eight times higher odds of using fluoridated toothpaste than their controls. In addition, participants with Sicca syndrome were seven times more likely to brush their teeth twice a day or more frequently. The participants with Sjögren’s syndrome had seven times higher odds of using fluoridated toothpaste, but 80% lower odds of a last dental visit within the last 12 months than control participants.

The current cross-sectional study examined oral health status, oral health-related behaviours, and self-perceived stress in participants with xerostomia, Sicca syndrome, and Sjögren’s syndrome and compared dry-mouth patient groups with age- and sex-matched controls. We observed that participants having any of the three dry mouth-related conditions had poorer oral health as indicated by their higher caries experience and more missing teeth. In contrast, those with Sicca and Sjögren’s syndromes had better periodontal health than their matched controls. Of importance, oral health-related behaviours were not optimal in the majority of dry mouth patients. Although Sjögren’s syndrome patients were more likely to use fluoridated toothpaste, they tended having less regular dental visits. Our findings only partially support our hypotheses as oral health status in dry-mouth participants was worse than in controls in regards to three out of the four oral conditions and two out of five oral health-related behaviours. However, no significant differences were found among patient and control groups regarding perceived stress levels.

Some of our study’s limitations were potential selection bias due to a cross-sectional study design and potential information bias due to self-reporting. In addition, the cross-sectional study design did not allow us to make any causal inferences. As commonly chosen in cross-sectional studies, we calculated ORs, given these are probability ratios, the true risks of our dry mouth patients might be overestimated. Another limitation might be related to our xerostomia group by including into it individuals who complained of having dry mouth ‘often’ and ‘always’ (common recommendation). However, if we had chosen a different cut-off point for inclusion, for example, also including into this group less severe cases, our findings might have been different.

In addition, we did not have accurate information (potential information bias) about the duration our participants experienced symptoms of mouth dryness, as many participants could not remember this with any accuracy. Similarly, another potential information bias might relate to the cases of Sjögren’s syndrome, because these patients also could not determine the onset of their disease. Furthermore, some of our participants with Sicca symptoms also had the Sjögren’s syndrome. This occurrence is not surprising, as hyposalivation and ocular dryness are common symptoms in Sjögren’s syndrome patients. Another limitation is that we included information from two datasets where slightly different sampling methods were used: the LNOHS study used stratified random sampling, while the dry mouth study recruited a convenience sample from five preselected hospitals. On the positive side, the same questionnaire and the same clinical type of examinations were used in both studies and all clinical examinations were performed by the same standardized examiner.

Higher caries experience rates were observed in participants with dry mouth conditions than in control participants. Our findings are in line to a Danish study which reported a median DMFS value of 83 for those with Sjögren’s syndrome and 43 for the control group [ 19 ], and in the Xin et al. Chinese study, mean DMFS values for Sjögren’s and non-Sjögren’s groups were 47 and 33, respectively [ 29 ]. In our study, the median DMFS values were higher; in participants with Sjögren’s syndrome, it was 96, while in the comparison group it was 74. In comparison to the two above-mentioned studies, our participants were older, which can partially explain our higher median DMFS value. In our study, those with Sjögren’s syndrome and their controls had mean ages of 69 vs. 65 years, while in a Danish study, the means were 60 and 56, and in the Chinese study, corresponding mean values were 51 and 50 years. One of the possible reasons why caries experience is higher in dry mouth participants than in controls may be changes in the microbiota due to dry mouth conditions. A 2023 study suggested that such changes are specific for patients with Sjögren’s syndrome, while another study mentioned that dysbiosis is seen in all dry mouth patients despite the etiology of their conditions [ 30 , 31 ].

Currently, oral health-related information about Sicca syndrome patients is scarce. This may be due to the earlier mentioned fact that Sicca syndrome is often considered synonymous to Sjögren’s syndrome, also it is possible that the latter condition is prioritized in research due to its relationship with autoimmunity. A study examining dental caries in diabetes mellitus patients found that xerostomia was significantly associated with higher caries experience [ 32 ]. However, there is a lack of studies directly comparing caries between xerostomia and non-xerostomia individuals. It is important to mention that many earlier studies examined xerostomia’s potential impact on dental status where mouth dryness was measured objectively (hyposalivation) instead of using patients’ self-reports (self-perceived dryness).

Our patients with Sicca and Sjögren’s syndromes had significantly lower numbers of present teeth than their matches, and this finding is in accordance with a Dutch study reporting significantly more of edentulous patients with Sjögren’s syndrome than in the control group. Also, the mean number of extracted teeth during a 13-year period was higher in the Sjögren’s syndrome group than in the control group [ 33 ]. The authors concluded that this was due to reduced salivary flow, consequently leading to the development of dental caries and eventually to a tooth loss. In our study, Sjögren’s syndrome was associated with lower odds of timely dental visit, consequently lack of regular dental professional care might have led to higher extraction rates.

In our study, we found significantly lower odds for extensive periodontal pocketing in the Sicca and Sjögren’s syndrome groups versus the participants from the comparison groups. A systemic review with meta-analysis revealed that although those with Sjögren’s syndrome had higher plaque rates and gingivitis, no significant mean differences in periodontal pocketing and clinical attachment loss were found between Sjögren’s syndrome patients and their controls [ 34 ]. One possible explanation might be the co-occurrence of periodontal diseases and dental caries at the same teeth which consequently might lead to extraction [ 35 ]. In our study, such potential co-occurrence could have resulted in higher overall caries experience including lower number of remaining teeth and lower rates of periodontal diseases, as the latter measure related to the numbers of remaining teeth.

The need to assess the quality of oral hygiene in patients with mouth dryness was emphasized by other studies [ 34 ]. Even though dry-mouth patients have increased risk of some oral health diseases, in general, their oral health-related behaviours were not optimal. Only 39–67% of the participants with dry mouth brushed their teeth twice a day, 42–55% of them used interdental measures, and 48–67% did not have a dental visit within the last year. We also found that those with dry mouth were two to eight times more likely to use fluoridated toothpaste than participants from the comparison groups; most likely dentists encouraged their high-risk dry mouth patients to practice regular use of fluoridated toothpaste twice daily, however the compliance with such recommendation we observed only in Sicca syndrome patients. We found that participants with Sjögren’s syndrome had lower odds of visiting a dentist on a regular basis. In contrast, a 2001 study comparing oral health-related behaviours between Sjögren’s syndrome patients and controls found that patients had more frequent dental visits, and a higher proportion of them brushed teeth more than twice a day [ 36 ]. However, this study was performed in a Scandinavian country where compliance with oral health-related behaviours might be superior. Important to consider that for those with dry mouth to practice good oral health behaviours might be more challenging, as in addition to having mouth dryness, some of them may experience chronic fatigue and pain [ 37 ]. These challenges might lead to decreased motivation to perform physically demanding regular oral self-care. In spite of being in a high-risk patients group, as indicated by having higher rates of dental caries and a lower number of teeth, our subjects with dry mouth conditions tended to have inadequate oral health-related behaviours.

Our findings suggest a further need to examine in more detail other potential determinants of high dental caries and tooth loss in dry mouth patients. We believe that clinicians should emphasize to their dry mouth patients the importance of prevention of oral diseases. Furthermore, national population-based oral health prevention programs should be established with a focus on including high-risk dry mouth patients.

Dry-mouth patients had higher overall caries experience, fewer remaining teeth, and a lower extent of periodontal pocketing than participants from comparison groups. Despite a higher usage of fluoridated toothpaste among patients with dry mouth than in the comparison groups, their oral health-related behaviors were suboptimal, indicating a need for improvement.

Data availability

The data supporting this study’s findings are available upon reasonable request to the corresponding author (IS, [email protected]).

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Acknowledgements

We thank our participants for their voluntary involvement in the study and Dr. Angela Tether for proofreading and editing the final manuscript.

The dry mouth study was supported by Vilnius University and the Lithuanian National Oral Health Survey by The Borrow Foundation.

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Indre Stankeviciene, Ruta Bendinskaite & Alina Puriene

Oral Health Centre of Expertise in Eastern Norway, Oslo, Norway

Lina Stangvaltaite-Mouhat

Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada

Jolanta Aleksejuniene

Department of Personalised Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania

Diana Mieliauskaite & Ieva Talijuniene

Clinic of Rheumatology, Orthopaedics Traumatology and Reconstructive Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania

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I.S., L.S.-M., J.A., D.M. and A.P. made substantial contributions to the conception of the current work. I.S., L.S.-M., J.A., D.M. and A.P. contributed to the design of the study. R.B., I.B., and I.T. contributed to the recruitment of the participants, I.S. collected the data. I.S. and L.S.-M. performed statistical analyses and together with J.A. and A.P. interpreted them. I.S. together with L.S.-M. drafted the manuscript, and all co-authors substantially revised the manuscript. All authors approved the final version of the manuscript and agreed to be personally accountable for their contribution and to ensure that questions related to the accuracy or integrity of any part of the work, even parts in which the authors were not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Correspondence to Indre Stankeviciene .

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This study was performed in compliance with Good Clinical Practice and the Declaration of Helsinki. Approval was obtained from the Lithuanian Bioethical Committee (reference number 2020/9-1263-746). Participation was based on a signed informed consent form. Informed consent was obtained from all the study participants.

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Stankeviciene, I., Stangvaltaite-Mouhat, L., Aleksejuniene, J. et al. Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren’s syndromes patients - a cross-sectional study. BMC Oral Health 24 , 454 (2024). https://doi.org/10.1186/s12903-024-04224-7

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Received : 27 September 2023

Accepted : 03 April 2024

Published : 15 April 2024

DOI : https://doi.org/10.1186/s12903-024-04224-7

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