How often should you visit the dentist for a check-up?

Amber Aplin, Principal Dentist shares her latest thinking on how often you need to get a check-up at the Gentle Touch. Amber’s approach, and that of the entire team, is based on the practice ethos: to provide evidence-based holistic dentistry in a gentle and caring way. Constantly reviewing the latest medical research is part of this. In this blog, Amber draws on a paper published in February 2021 in the British Dental Journal. The paper studyied how often patients should have a routine check-up – known as the “dental recall”. The results might surprise you – read on to find out more!

When we think about how often we need to get a check-up at the dentist, we need to remind ourselves what it’s for. While I always love a chat and catch-up with my patients (!), the principal function of a check-up is the prevention and early detection of oral disease. Most of us have spent our lives heading to the dentist every six months for a check-up. This is based on the thinking on the best “dental recall” (check-up) interval dating back to the time of inception of NHS dentistry – 1948! Ever since, the habit has stuck – but is it one which is supported by evidence in 2021? The answer is a clear no – the latest research confirms that, for low-risk patients, a 6-monthly check-up is not necessary.

Latest research on dental recall (check-ups)

As I mentioned, six-monthly dental recall (check-ups) have been common practice since 1948. In 2004, however, the National Institute for Health and Care Excellence (NICE) updated the dental recall guidance to take account of the varying risk factors for individual patients. This guidance suggested recall intervals ranging from three months for higher risk patients to twenty-four-monthly recall for low-risk patients. Here at the Gentle Touch, we feel a twenty-four-month recall is too long, but we very much agree that a patient’s risk profile is what matters.

The most recent medical research was published in the British Dental Jounal in February 2021. The paper is entitled ‘Examining the effectiveness of different dental recall strategies on maintaining optimum oral health: the INTERVAL dental recalls randomised control trial.’ It’s the first national, pragmatic, randomised control trial in a primary care setting to evaluate the clinical, patient-centred, varying recall intervals. The research is extensive and it was conducted over a four-year period.

The key implications of the research are:

1. The traditional practice of scheduling six-monthly recall appointments for patients, regardless of the risk of developing dental disease, does not improve oral health. A variable risk-based recall interval is appropriate, is not detrimental to oral health, and is acceptable to patients and dentists.
2. Considering the impact of the Covid-19 pandemic limiting access to dental care, this study provides reassurance. For appropriate patients (low risk), the interval can be extended, based on an individual’s risk, without detriment to oral health.

Summary Results

• Four-year period
• (Of the 1,724 individuals), there was no difference in oral health for participants allocated to a six-month or risk-based recall.
• (Of the 648 (low risk) individuals), there was no difference between a 24-month, six-month, or risk-based recall.

What does this mean for how often our patients should visit the dentist?

Fortunately, due to preventive dentistry and a minimally invasive approach, most patients at The Gentle Touch are ‘low risk’ of any dental disease. Research from recent years, including 2021, shows that six-monthly check-ups are not required for many patients from a clinic perspective. Indeed, many of our patients have safely made the switch to attending just one check-up with their dentist each year. We also offer extensive hygiene treatments with our “Annual Plan” to ensure excellent patient dental health is maintained.

A reminder: what we ‘do’ at each check-up

Every time we see you for a routine check-up (after a catch-up, of course), we clinically assess the following:

• Your lymph glands for any swellings
• The skin for any abnormalities
• Your ‘soft tissues’ (everything which is not teeth) for any abnormalities.
• Radiographs (x-rays) – if these are over two years old, we will consider recommending new radiographs; we look for any decay developing under fillings or in-between your teeth. We can also see bone levels between teeth to look for signs of gum disease. 
• Your teeth to check for any decay, cracks, and wear.
• The restorations (if present) to check for failures, breakages, or cracks. If we see anything that may be of higher risk of problems, we will then diagnose the reasons for this. Then, we will recommend a preventive treatment.
• Your gums for signs of gum ‘periodontal’ disease.

Once we have gathered all this information, we assess the risk of mouth cancer, tooth wear, tooth decay, and gum disease. Then we can recommend the most appropriate dental plan to suit your individual clinical need.

Amber Aplin

Principal Dentist, The Gentle Touch