Dental check-up and diagnosis: examination, panoramic X-ray and 3D scanner

1 What problems can a dental check-up identify?

A dental check-up can detect tooth decay, gum and periodontal problems, infections, fractures, tooth wear, malocclusions, and abnormalities of the oral tissues, even before noticeable symptoms appear. During the examination, the dentist also assesses existing fillings, dental restorations, prostheses, implants, and other previous treatments, checking for signs of leakage, wear, or deterioration.

The dentist also examines the oral mucosa, including the tongue, cheeks, palate, and floor of the mouth, to identify any lesions, spots, or abnormalities that require monitoring or further investigation. When a clinical examination alone is insufficient, the assessment may be supplemented with X-rays or digital diagnostic tools to examine structures and details that are not directly visible.

2 Dental examination: what does it assess and how long does it take?

A dental examination assesses the teeth, gums, oral mucosa, bite and existing restorations and usually takes approximately 20–30 minutes, unless additional examinations or more detailed diagnostic investigations are required. The dental consultation begins with a medical and dental history, during which the dentist collects information about current symptoms, previous medical conditions, allergies, medications and earlier dental treatments. During a first consultation, the patient’s functional and aesthetic needs are also evaluated.

This is followed by a clinical examination of the oral cavity. The dentist checks the teeth for decay, fractures and wear, assesses the gums for inflammation or bleeding and examines the oral mucosa for any abnormalities. The bite is also evaluated to identify chewing difficulties, tooth misalignment or problems affecting the relationship between the upper and lower dental arches.

When clinically necessary, the dental examination may include specific tests such as pulp vitality testing, assessment of tooth mobility, measurement of periodontal pocket depth and evaluation of jaw function. A routine follow-up appointment may be shorter, while the presence of symptoms or the need for diagnostic imaging may extend the duration of the visit. When a complete view of the teeth and jaw bones is required, the dentist may recommend a panoramic dental X-ray or other targeted radiographs to support a more accurate diagnosis.

3 Panoramic dental X-ray: what does it show and when is it needed?

A panoramic dental X-ray shows the teeth, dental arches and jaw bones in a single image and is recommended when the dental examination requires an overall assessment of structures that cannot be seen directly. Also known as an orthopantomogram or OPG, it may reveal impacted teeth, wisdom teeth, bone loss, root abnormalities and possible lesions affecting the jaws. A panoramic dental X-ray is commonly used during the initial assessment for orthodontic, implant or oral surgery treatment and whenever both dental arches need to be examined together. The procedure is quick and painless. The machine rotates around the patient’s head while the patient remains still. Before the image is taken, metal objects that could interfere with image quality must be removed.

A panoramic X-ray provides a general two-dimensional view, but it does not show every detail of an individual tooth or the three-dimensional thickness of the bone. When more specific information is needed, the dentist may request intraoral radiographs, CBCT imaging or another targeted examination. A 3D intraoral scanner is used instead when the aim is to record the shape and position of the visible dental surfaces digitally.

4 3D intraoral scanner: how does it work and what is it used for?

A 3D intraoral scanner captures optical images of the teeth and gums and creates a digital impression that can be used to design restorations, prostheses and orthodontic treatments. During the scan, the dentist moves a small handheld device inside the mouth. The software processes the images in real time and reconstructs a three-dimensional model of the dental arches, which can be reviewed immediately and sent digitally to the dental laboratory.

The intraoral scanner is used when planning veneers, crowns, bridges, dental prostheses, night guards and clear aligners. Compared with conventional impressions, it avoids the use of impression materials and may improve patient comfort, particularly in people with a pronounced gag reflex. The scan does not use X-rays and records only the visible surfaces of the teeth and gums. It therefore does not show the tooth roots, bone or internal anatomical structures and cannot replace radiographic examinations when these are clinically necessary. Panoramic radiographs, intraoral radiographs, CBCT scans and intraoral scanning provide different types of diagnostic information and are selected according to the specific problem that needs to be assessed.

5 How are the diagnosis and treatment plan defined?

A dental diagnosis is established through a structured process that combines a complete medical and dental history, a detailed clinical examination and targeted diagnostic investigations such as dental radiographs, panoramic X-rays or dental CT scans. The dentist considers the symptoms reported by the patient, evaluates the condition of the teeth, gums and oral tissues and identifies any conditions such as tooth decay, infection or periodontal disease. Based on this information, a personalized dental treatment plan is prepared. The plan defines the treatments required, the order of clinical priorities, the expected treatment schedule and the overall costs, allowing care to be organised according to the patient’s oral health needs.

The dental treatment plan includes the sequence of procedures, the expected number of appointments, possible treatment alternatives and the risks associated with each intervention. More urgent conditions, such as active infections or gum inflammation, are treated before restorative, rehabilitative or cosmetic procedures so that treatment begins from a stable clinical foundation. Although photographs and radiographs sent remotely may support an initial assessment, a definitive diagnosis always requires an in-person examination at the dental clinic. After treatment has been completed, the dentist establishes a schedule of follow-up appointments and professional oral hygiene sessions based on the patient’s individual level of risk, helping to maintain the results over time.

6 How often should you have a dental check-up?

A dental check-up is generally recommended every 6–12 months, although the appropriate frequency depends on the patient’s individual risk factors and the condition of the teeth and gums. More frequent examinations may be required for patients with recurring tooth decay, periodontal disease, dental implants, prostheses, orthodontic appliances, diabetes, smoking habits or inadequate oral hygiene.

The dental appointment should be brought forward if symptoms such as pain, swelling, persistent gum bleeding, tooth mobility, dental fractures or difficulty chewing occur. Dental radiographs are not automatically taken at every check-up. They are performed only when they are clinically necessary, according to the symptoms, previous findings and current oral health status.

The recommended frequency of dental appointments and the need for any diagnostic investigations may also influence the overall cost of monitoring and treatment.