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IN THE TEETH OF ADULTHOOD, CHECKUPS ARE A MUST

You're not a kid anymore. You brush, you floss, and you never eat candy. So do you still need a dental checkup every six months?

The sad news is this: As you age, there are a lot more things that can go wrong in your mouth than just cavities. You need regular dental checkups now more than ever.

Why every six months?

That's the amount of time it takes for the plaque and tartar (hardened plaque) to accumulate to the point at which it can no longer be removed at home with a toothbrush and dental floss, says Dr. Diane Monti-Markowski, vice president and dental director of Delta Dental of Rhode Island.

By removing this plaque and tartar on a semi-annual basis, you disrupt the colonies of bacteria that begin to form and eat away at your gums.

People with dental insurance are those most likely to get checkups, but too many adults still avoid the dentist's office until they have a major problem, says Dr. Monti-Markowski, a dentist in private practice.

About half of American adults suffer from the early stages of gum disease, gingivitis, most of it undetected. The longer you avoid the dentist, the more time the bacteria have to proliferate and creep along the root of the tooth to where it meets the bone. This process leads to the harsher version of gum disease, periodontitis, which can involve bone loss. Periodontitis affects about one of four people age 60 and older.

So what happens during a dental checkup?

After the dental hygienist scales the tartar from your teeth, polishes the last bit of soft plaque away and makes an initial check for tooth decay, the dentist arrives to do a more thorough diagnosis. This part of the checkup involves a more thorough search for tooth decay as well as a probe for gum disease.

A special instrument poked into the gum measures the depth of the gum around the tooth. If the probe bounces back quickly, giving the dentist a shallow reading of two to three millimeters, the gums are in good health. If the probe sinks into the gum and the dentist gets a reading beyond four millimeters, that could signify the beginning of gum disease, says Dr. Monti-Markowski.

A reading of six or seven indicates more advanced disease.

There are other possible problems in addition to gum disease. About 400,000 new cases of oral cancer, the sixth most common cancer worldwide, are diagnosed in the nation each year. Most frequently affected are those 45 years and older, especially men.

Painless in its early stages, oral cancer can progress unnoticed.

Using a mirror, the dentist probes the mouth to check for red or discolored lesions, patches or lumps, on and under the tongue, in the cheeks and on the soft palate.

Most dentists also do a simple head-and-neck exam, feeling for swollen glands and any abnormal lumps or bumps that could indicate other kinds of cancer.

A semi-annual dental checkup can also reveal the first sign of a jaw misalignment called TMJ syndrome (temporomandibular joint syndrome), diabetes, immune deficiencies, nutritional deficiencies or eating disorders.

Does all this mean you'll drop dead if you miss your six-month dental checkup?

Probably not, but Dr. Monti-Markowski says that you could lose time by missing a valuable early diagnosis of problems that could continue to progress unnoticed.

And even in the disease-free mouth, she adds, there's always the pain factor.

The longer you wait between cleanings, the more inflamed your gums will be and the more they will hurt and bleed when you do get your teeth cleaned. Any tooth decay will advance. Small cavities hurt less when they are drilled than large ones.

And if you wait a really long time, the cavity goes into the pulp of the tooth and the worst could happen: You might need a root canal.

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