Dental Exams and Teeth Cleaning in Miami

A new patient visit at Vizcaya Dental Arts is a comprehensive examination by Dr. Kottar, a full set of digital X-rays unless you bring recent ones, and in most cases a cleaning the same day. Returning patients come every six months for an examination and a cleaning, or every three or four months if their gums need it. We recommend treatment only for what needs it, and what to treat and when is your decision.

Your first visit

Dr. Kottar sees every new patient himself. We take a full set of X-rays, or use a recent set from another office. He checks the soft tissues of the mouth for oral cancer, examines each tooth, and measures the gums.

Then we talk about treatment, if any is needed. If your gums are healthy or mildly inflamed, the cleaning is done at the same visit. Patients who need deeper gum treatment usually have an initial cleaning first and then schedule the rest.

Routine visits

At a periodic exam we check the soft tissues for oral cancer again, examine the teeth, and measure the gums to see what has changed. Then you have a routine cleaning, or periodontal maintenance if you have been treated for gum disease.

Most patients return every six months. Patients who find home care difficult, or who are on periodontal maintenance, come every three or four months, because their gums stay stable at that interval.

Three kinds of cleaning

Three different procedures are called a cleaning. Which one you need depends on your gums.

• A routine cleaning (prophylaxis) is for healthy gums, or gums with gingivitis, the early inflammation that bleeds a little and has not reached the bone.
• Periodontal treatment, usually scaling and root planing, is for active gum disease, where the gums are inflamed and bone is being lost. It is deeper, done in stages, and described on our gum disease treatment page.
• Periodontal maintenance is the follow-up care once treated gums are stable. Lost bone does not grow back, but a maintenance cleaning every few months keeps the teeth stable.

We decide which from your history, the X-rays, the gum measurements, bleeding and inflammation, and how home care is going.

The oral cancer screening

Every examination includes a screening for oral cancer. Dr. Kottar looks at and feels the lips, the inside of the cheeks, the tongue including its underside and sides, the floor of the mouth, the palate and the back of the throat, for any patch, lump, ulcer or color change. It takes about a minute. Most findings are harmless and are noted and rechecked. Anything that persists is followed up or referred.

If it has been years

Many patients come back after a long time away. The visit works the same way: a full examination, a clear account of what we found, and a plan with anything urgent first and the rest sorted into what matters next and what can wait. If there is a lot to do, it is done one step at a time, at the pace you choose. If the visit itself is the hard part, our anxiety and comfort options page explains what we can do.

X-rays

Every new patient needs starting records, usually a full set of X-rays or an update of the set you bring. After that the frequency depends on your risk:

• A patient who develops cavities easily may need check-up X-rays every six months.
• A patient at very low risk may go eighteen months.
• For most people about once a year is right.

We use digital sensors, which give sharp images at a low dose.

Treating or watching

Not every finding needs treatment. We recommend treatment when something clearly needs it, or when a finding is likely to become a problem soon. A small area that can be monitored safely is rechecked at your next visit. It is your mouth and your decision. Our job is to explain the options and the risks and let you choose.

Second opinions are a regular part of our week. Patients come to us after another office recommended treatment that felt like a lot, and we often recommend fewer restorations. A careful examination also sometimes finds what a previous one missed. We recommend what we would recommend to our own family.

What happens at the visit

1. 1
   Step 1 of 5 Records

   A full set of digital X-rays for new patients, or an update of the ones you bring. Returning patients have check-up X-rays only as often as their risk calls for.

2. 2
   Step 2 of 5 Conversation

   Your health history, what has been bothering you, and what you want from your dental care.

3. 3
   Step 3 of 5 Examination

   Oral cancer screening, every tooth checked, gums measured, and a look at your bite and jaw muscles. Dr. Kottar explains what he sees as he goes.

4. 4
   Step 4 of 5 Findings and plan

   What needs treatment, what can be watched, and what we would recommend for our own family, in writing, with an estimate.

5. 5
   Step 5 of 5 Cleaning

   In most cases the same day, followed by home care advice for your mouth.

Home care

A professional cleaning happens a few times a year. What you do every day matters more.

• Flossing is essential, and we show you a technique that works for your hands and your teeth.
• Fluoride toothpaste helps prevent decay; children should not swallow large amounts.
• For children, sealants on the chewing surfaces of molars are a sensible option in many cases, though not every child needs them.

Comfort

If dental visits make you anxious, tell us. Nitrous oxide and oral sedation are available for treatment visits. Most patients find that once they get used to the way we work they do not need either, but the option is there. Our anxiety and comfort options page explains more.

Frequently asked questions

How often should I have a cleaning and exam?

Most patients come every six months. Patients who find home care difficult, or who have had gum disease and are on periodontal maintenance, usually come every three or four months. The interval depends on your gums.

Can I have a cleaning at my first visit?

Usually, yes. Once the examination is done, most patients with healthy gums or mild gingivitis have their cleaning the same day. If your gums need deeper treatment, we will often still do an initial cleaning and then schedule the rest.

Does a cleaning hurt?

A routine cleaning should not. Some tenderness is possible where the gums are inflamed, and that improves as the gums get healthier. If you are sensitive, tell us; we can go gently or numb an area.

How often do I need X-rays?

It depends on your risk. Someone who gets cavities easily may need check-up X-rays every six months; someone with a very low risk may go eighteen months. For most people it is about once a year. A full set is taken when you join the practice unless you bring recent ones, and we use digital sensors that keep the dose low.

What is an oral cancer screening?

A careful look at the lips, tongue, cheeks, palate, throat and floor of the mouth for anything that does not look right, done at every examination. It takes a minute and is one of the most important parts of the visit.

Do I need fluoride and sealants?

Fluoride toothpaste helps prevent decay and we recommend it; children should not swallow large amounts. Sealants are a sensible option for many children, though not every child needs them. We suggest them case by case.

Sources

Professional guidelines and peer-reviewed reviews this page draws on.

1. Weyant RJ, Tracy SL, Anselmo TT, et al. Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review. Journal of the American Dental Association. 2013;144(11):1279-1291. PubMed
2. Wright JT, Crall JJ, Fontana M, et al. Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: a report of the American Dental Association and the American Academy of Pediatric Dentistry. Journal of the American Dental Association. 2016;147(8):672-682. DOI
3. Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009-2014. Journal of the American Dental Association. 2018;149(7):576-588. DOI